Bipolar 2 From Inside and Out

Posts tagged ‘anxiety’

The 5 Stages of Depression

One of my depression triggers has been well and truly tripped and I am experiencing the long plunge downward. It’s been quite a while since this has happened, but oh, how well I remember it.cracked egg conceptual image for birth

In the classical Five Stages of Grieving, depression is the fourth, right before acceptance. For me, in the Five (or however many) stages of depression, the first stage is (duh) depression. I guess the next four would be immobility, numbness, despair, and Total Meltdown.

Right now I would have to say that I am somewhere between depression and immobility. I got out of bed for a few hours today, and I am writing this. I managed to get a big project done before this bout of depression hit, which was a Good Thing. I also now have a good supply of meds on hand, which is, I think, an Even Better Thing.

The Best Thing is that I have Dan, my husband. He just made sure I got a hot meal and is now giving me space and alone time, which is what I need more than attempts at engagement. And a cat just licked my face, which would be comforting if he hadn’t just been licking his butt.

As Jenny Lawson says, depression lies. Right now it’s telling me I’m useless, helpless, guilty, and ashamed. I hope that at least some of these are lies, though at the moment they’re what my brain is telling me is true. Then add in a large helping of catastrophizing, which at the moment is more likely to happen than not. I can’t see a way out.

Since I’ve been through this process before, I know the things that will help (at least a little) and those that won’t. I’ll try to keep my brain engaged enough to continue writing, and I’ll try to intersperse the doom and gloom with some ideas I made notes on before all this hit. I feel a responsibility to this blog and its readers to keep the thing going as best I can.

Based on my estimate, this episode is likely to last a minimum of two months. Maybe this time I can stop the slide before Total Meltdown. Wish me luck.

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Self-Care and Sleep: Fact or Fiction?

Every article you see about self-care for bipolar disorder will tell you, Get enough rest or Get enough sleep.

Sleep is that golden chain that ties health and our bodies together.  – Thomas Dekker

But what did Thomas Dekker know? For many of us, proper, beneficial sleeping is easier said than done.

Neon light owlEven with my prescribed Ambien and Ativan, I’ve done the wide-awake-at-3:00-don’t-get-to-sleep-till-5:30 thing. And the unsettled-from-nightmares-afraid-to-go-to-sleep thing. (Also the just-one-more-chapter thing, but that’s my own fault.)

Then the next day I have to take a mega-nap (http://wp.me/p4e9wS-iO), which leads to guess what? More insomnia.

But this coin has another side as well. There are days when all I do is sleep. A full night plus (at least 10 hours), then a mega-nap, then right back to bed after dinner.

I don’t think I was awake for much of my childhood. I did a lot of napping. This might have been a defensive measure against encroaching depression. – Michael Ian Black

I know that part of my problem is my husband’s work schedule – third shift – and wanting to be awake at least at some of the same times that he is.

Another part of the problem is my medication. If I wake at 8:30 (yeah, I work at home) and take my meds, I’m down for the count again until at least 10:30. Or 11:00. Or even noon. I hope my clients think that I run errands in the morning or work on my projects with chat, IM, and phone turned off so as not to be disturbed.

And then there is my meal schedule, which is just as erratic as my sleep schedule. Most days I try to eat at least one good, full, hearty meal (another self-care recommendation, though they usually advise more than one meal). But after I eat – especially a hefty meal – I get postprandial torpor, the technical term for why you fall asleep on Thanksgiving after eating all that turkey. (And you thought it was the tryptophan.) And there comes another nap.

The repose of sleep refreshes only the body. It rarely sets the soul at rest. The repose of the night does not belong to us. It is not the possession of our being. Sleep opens within us an inn for phantoms. In the morning we must sweep out the shadows.  – Gaston Bachelard

But recently, it’s been the not-able-to-sleep thing. There’s a Tarot card that symbolizes the feeling – the 9 of Swords. In the Rider-Waite deck, the image is of a person sitting up in bed, hiding her face, with nine parallel swords floating in the background. I always refer to it as The Dark Night of the Soul. (The 6 of Cups usually means something like Childhood Memories, but for me it means “See Your Therapist.”)

(Note: I had a rather irregular introduction to the Tarot deck, and for me it acts sort of like a Thematic Apperception Test. I apologize to those of you I have just offended in one way or another.)

Sleep is when all the unsorted stuff comes flying out as from a dustbin upset in a high wind. – William Golding

Anyway, a recent event caused me a fair amount of trauma that I had to suppress at the time, and it came out immediately as bloody horrible nightmares the next time I slept. I haven’t had any more of those since, but I suspect they’re still lurking at the back of my brain.

That we are not much sicker and much madder than we are is due exclusively to that most blessed and blessing of all natural graces, sleep. – Aldous Huxley

I guess what I mean by all this is that sleep as self-care is wonderful, if it cooperates. But there are so many things that can go wrong and screw it all up – grief, guilt, depression, sorrow, anxiety, fear, loneliness, restlessness, obsessive thoughts, worries. It doesn’t feel like something that I have much control over.

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A Crowd-Hater at a Conference

“I’m gonna kick butt at this writers’ conference!”

I was a wee bit manicky.

“I am a writer and I know it! I’ve had articles published in lots of magazines! I have two blogs and I write in them every week! I can do this!”

It was a conference for humor writers.

“I know I can do this! I’ve written funny things about ratatouille (http://wp.me/p4e9wS-2z) and possums (http://wp.me/p4e9wS-46) and being burgled by Frenchmen (http://wp.me/p4e9wS-1B).”

So, comes the conference…at a time when I’m not the least bit manicky.

Forget what I said about having developed a few social skills (http://wp.me/p4e9Hv-2M). I was there alone, and confronted with a large group, not small groups or individuals.

And I had paid a lot of money to attend.

Yellow ladybird is marginalizedIt was noisy. It was people-y. It had multiple panels scheduled all day. Every day lunch was an Event with big round tables. Every dinner was an Event with big round tables and important speakers. Everyone there blogged daily or had three blogs, an agent, and/or a book contract.

What to do?

Give myself permission to do what I could do. And skip the other stuff. Ignore the money. Build in breaks. Find quiet spaces. Admit when I’m exhausted and go home. (I lived in the area. If I had stayed in the hotel, that would have been “take naps” and the quiet spaces would have been easier to find. If I had better social skills, I might have made a friend and asked to borrow her hotel room.)

This is how I got through it all. Or most of it, anyway.

Do what I could. I combed the program book for Sessions I Must Attend, Sessions I Would Like to Attend, and Sessions I Can Skip. Then I looked for sessions that were offered more than once and decided which offering fit my schedule better. I tried to avoid more than two back-to-back sessions.

Ignore the money. Yeah, I paid quite a chunk of change for this. But it would have been ridiculous for me to calculate how much money each session was worth and try to make back my investment. I had to tell myself that I spent a lump sum and that whatever I got from the conference was worth it.

Build in breaks. The conference had what they called breaks – 15 minutes between sessions when everyone rushed the snack tables, compared schedules, and chattered up a storm. My idea of a break was to sit in the lobby in a comfy chair, stare at the program book so no one interrupted me, and carry snacks with me (boxes of raisins are good).

Find quiet spaces. When I needed something quieter than a hotel or conference center lobby, I searched for unused classrooms. In a hotel, the bar is usually pretty empty during a conference and is a good place to sit and relax with a nice glass of iced tea and maybe even complementary peanuts. Sometimes I was lucky enough to find that if I went to the room I wanted for the next session, it would be empty or contain only a few people. When all else fails, there are always the restroom stalls. (Unless there’s a line.)

Leave when exhausted. On the last full day of the conference I found myself slumped in a chair in the lobby, totally wrung out. There were events scheduled that evening that sounded fun and that I had signed up for while manicky (see above). But I just couldn’t. The events were mostly entertainment rather than educational anyway, and I was not in a headspace where I could absorb entertainment. The fact that there was a flu going around made my disappearance more understandable (even though I wasn’t physically sick).

So did I learn anything at the conference? Did I make new friends? Did I come back revitalized?

Sort of. I learned that the one-on-one “speed dating” with experts was perhaps the most valuable thing I did. I learned that showing up early for a session allowed me the opportunity to meet one of my idols (the speaker) and spend a little time with her and a small group before the session started. I learned that if I sat near the door it was easier to slip out when panic struck.

I even learned a thing or two about writing – how to write a better query letter, how to improve my blogs, when to consider self-publishing, and so forth. I learned that, despite my manicky expectations, I was no better or worse than the other attendees. We all had skills and valuable experiences and we all had things to learn.

Did I make a lot of new writing friends? No. At least not then. The conference had a Facebook page for attendees and I got involved afterward, online, where I am more comfortable than in crowds. I recognized names I had seen on nametags and had conversations with them. I posted some material from my blogs and read what others posted. I commented and read comments. I “followed” some of the instructors. I read books that attendees had recommended.

To tell the truth, I think I got more from the conference after it was over than when it was going on.

Am I glad I went? Yes. The experience was good for me in more ways than one. Paying attention to my own limits and not trying to live up to artificial expectations made for a good – and survivable – learning experience.

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Work Hacks

Yay me! I just finished a big project (or at least the first phase of it) for which I will be paid actual money!

I am very fortunate/grateful that I am able to do freelance work at home, on my own schedule (mostly), using my education and skills, in my pajamas. Telecommuting is so way cool!

I can’t work an eight-hour day in an office any more (and likely won’t again). I can only concentrate for a max of three hours at a time, and some days not even that. Occasionally, if there’s a tight deadline, I can manage two sessions, or one and a half.Just Get Through It message on a dry erase board encouraging you to stick with your project or challenge during a stressful time in your work or life

Of course motivation is a factor. Deadlines and money are two really good ones. But sometimes I have to force myself – or trick myself – into doing actual work. This was true even when I did work in an office.

Anyway, here are some of my techniques – work hacks, as I guess they’re now called.

Taking breaks. Now of course, I can take breaks whenever I want, from a quick game of Candy Crush to an actual nap. My brain and body let me know when it’s time. They just crap out.

When I worked at the office, I tried taking crossword puzzle breaks at my desk. But apparently smoking was the only permissible break activity. Hiding in the bathroom didn’t work. People were known to track me down and ask questions anyway. (“Do you mind if I wipe and flush first?” Sarcasm seemed called for.)

When I got twitchy, I walked around the third floor or even more than one floor until I calmed down. The trick is to carry a clipboard or a few manila folders and walk sort of briskly so it looks like you’re going somewhere and doing something. It works best if the office has more than one room.

Pretending to work. I developed this technique at the office, but it can also be used at home. I would say to myself, “I don’t know how to get started. I’ll just write one sentence, so if someone walks by my cube, it looks like I’m working.” It was surprising to find that once the first sentence was on the screen, I knew what the second one should be – or that the first one was horrible and I could revise it, which also looked like work. Once I built some momentum this way, I was rolling. I don’t have anyone looking over my shoulder now, but the idea is the same – one sentence is the minimum, then see what happens.

Bribery and rewards. These are actually more or less the same. If I do X amount of work, I can check my email or eat a cookie or call a friend. I get to feel virtuous for working and satisfied by the little treat.

Forcing myself. If I’ve got a really tight deadline, I have to apply some internal pressure, especially if it’s one of those I-don’t-think-I-can-get-out-of-bed-days. Everyone in this house likes to eat. (The cats insist on it.) My pay will cover the mortgage, so we won’t be living under the Third St. bridge next month. This is dangerous, because I am a great catastrophizer, but sometimes it’s the only thing that works.

Artificial goals and lying to myself. If I can just do five more pages I can quit for the day. I know I can make it to the end of this section (that would be the lying part).

Stupid work. There are a lot of fairly pointless tasks that must be done anyway, but can be done by rote – adding headers and footers and page numbers, alphabetizing, running spell-check (or typing-check, as I prefer to think of it), that sort of thing. To me, that counts as actual work, and some days it’s all I can manage.

Unfortunately, none of these are effective for housework. No one pays me for that.

 

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I Got Away Successfully!

Last week I mentioned that my husband and I were planning a day trip to Cuyahoga National Park to see Brandywine Falls. This was based on a sudden, nearly inexplicable urge to get out of the house, get some fresh air, and see nature, despite my aversion to exercise. Maybe I was a little manicky. Who knows?mesign

I’m happy to report that the trip was a success, as you can see from these pictures. The drive up was long and hot (so was the drive back), but that gave us plenty of time for conversation. We got lost a couple of times in the park area (it’s a big, oddly shaped park), but with a little help we found the right parking lot and even grabbed a space near the trailhead. As advertised, there was a boardwalk that led right to the falls, or at least to an overlook with a great view.

stairsThere were also 69 steps leading down to the falls, or, more to the point, 69 steps leading back up to the boardwalk and the overlook. I declined to attempt the stairs, but my husband did, and got some pretty good pictures. janfalls

Since it was Father’s Day, there were a number of families there, but not so many that the trail seemed like a line for the rides at DisneyWorld. The weather was ungodly hot – in the 90s as we were driving home – but the boardwalk was shady and there was a bit of a breeze.falls3

So, what did I learn from this little adventure? First, that travel, at least on a small scale, is possible for me. I liked it so well that I am looking forward to taking another such trip, though most likely when the weather is cooler.

I drove the whole way up and back and was not bothered by my fears of drivers in the other lanes or railings and concrete dividers being too close to our car. (This is a thing that used to happen, even when I was a passenger. Driving was out of the question back then.)

Second, that I could make this trip with only minimal panic. I did have a moment on the way home. We stopped to eat, and as I rummaged in my bag for my regular glasses, I couldn’t find them. I thought they were pretty likely to be in the car, though I had visions of the case lying on one of the benches along the boardwalk. I was even trying to figure out whom to call or write that might be in charge of lost and found.

However, I managed to suppress the feelings, read the menu with my sunglasses on (that actually may have been the hardest part), resist the urge to ask Dan to go out to the car and check, and get through the meal.

The glasses case proved to be in the car and I managed to avoid either panic or mini-meltdown. I call that success. I finished driving home, we fed the animals, and then collapsed. It was exhausting and exhilarating and adventurous and restorative, and most of all, proof that I could travel again, at least for a medium-short jaunt. Travel was one of my greatest joys and one of the things I’ve missed most since the bipolar stole so many parts of my life. I am delighted to be able to say that I am beginning to reclaim it.

All photos by Dan Reily

 

 

 

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Forced to Face My Fear

A little while ago, I posted about my severe dental phobia (http://wp.me/p4e9Hv-cG). So of course fate pushed me to the wall and left me no choice but to confront it.

tooth fairy illustrationHere’s the backstory. My teeth are awful, and my dental phobia has a lot to do with it. Realizing this, we borrowed some money and put it aside for my dental work. The reason that we had to borrow that much money was not just because we’re broke (we are) or that our dental insurance is so crappy as to be nonexistent (it is), but the fact that the last time I got any dental work done (years ago), I was so terrified that I had to have a traveling anesthesiologist brought in to put me completely under. And that approximately doubles the cost of already-pricey, though necessary, procedures.

Then another disaster ate the money we had put aside. There was no choice in the matter. The dental money had to be sacrificed.

Then fate stepped in. Last Saturday I got a toothache. Of epic proportions. Not realizing that the dentist had a 24/7 emergency number, I toughed it out till Monday, when my face was hideously swollen and the combined powers of Anbesol and Tylenol were insufficient to let me sleep. I got in to see the dentist on Tuesday.

That one tooth was definitely going to have to come out and the abscess drained (did I mention there was an abscess?). And there were a few other highly recommended procedures that needed doing as well. None of which the crappy insurance would pay for.

But that wasn’t the real problem, or at least not the only problem. The traveling anesthesiologist was out. The dental slush fund no longer existed. Normally (that is, for normal patients) the dentist offers “oral sedation,” which turns out to be triazolam (Halcion). But since I already take lorazepam (Ativan), that wasn’t considered safe.Apparently the two don’t work and play nicely together.

“You’re going to do this without anesthesia AND without oral sedation?” the dentist said.

“I have no choice,” I replied. He had given me Vicodin for the pain (as well as an antibiotic for the abscess), but I couldn’t really take that long-term. And so I was cornered. I had to have the procedure, no matter what. (My husband offered to get a rubber mallet and knock me out, or knock the tooth out, or something. I politely declined.)

The plan we worked out was this: On Thursday, when they were to do the procedure, I would take two Vicodin and increase my lorazepam from .5 mg to 1.0 mg. (with my pcp’s permission). Then I would have nitrous oxide, which had never worked for me before, but hey, worth another try, right?

And I would have my husband there in the procedure room, as my comfort animal. He had to stay out of the way, but was able to reach over and pat me on the ankle. Which was comforting, actually.

Double Vicodin (I was permitted two but had been taking only one) and double Ativan (plus one prophylactic Immodium) left me suitably stoned. I was totally confused when the hygienist asked me, “Bubble gum or orange creamsicle?” I was stoned, but that made no sense. Turns out nowadays they have scented nose cones for the nitrous. (I chose mint.) I could barely feel the numbing shots, and the extraction went smoothly. I didn’t hear/feel the terrifying, sickening crunch that went from my jaw directly through my brain when I had my wisdom teeth out. My husband said I didn’t even flinch. He patted my ankle anyway.

Then we paid about the same as we recently had for two vet visits for our ancient cat, but nowhere near what we had borrowed, put aside, then spent.

I didn’t even disgrace myself, though I had spare underwear in my purse, just in case.

All in all, it went way better than I expected. Have I conquered my fear? I don’t honestly know, and probably won’t until the next time. (And there will be a next time.)

But at least I’ve proved that I can do it. I can have a dental procedure done without anesthesia and without oral sedation, if it’s really, really necessary. Pain is surely a great motivator. I am no longer a huge wuss, I guess – just a regular wuss. I do hope, however, that when the clot heals and the infection clears up, and the swelling has gone away, that I do not have to go through this again for a very, very long time.

(At least this time I did better than when I faced my apiphobia (http://wp.me/p4e9wS-7H).)

 

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How I Learned a Few Social Skills

I thought my social skills were bad until I encountered a woman who asked me, “Do you have mental problems?” (She recognized me from our mutual psychiatrist’s waiting room, but still….)

expression

With practice, however, I have been able to improve my casual conversation skills, at least enough to get by in some situations, as long as they don’t last more than an hour. Here are my secrets. They do take practice. I have been fortunate to have had people to practice with – friends, coworkers, and of course my husband.

Introductions. Actually, I taught this one to my husband. Often when we met someone that he knew, he would fail to introduce me, leaving me standing there like the proverbial bump on a log. He claimed that the problem was that usually he couldn’t remember the person’s name. “Just point to me and say, ‘This is my wife, Janet.'” Then I will stick out my hand to shake and say, “And you are?” That way we both learn the person’s name. It works like a charm, every time.

Very Brief Conversations. Conversation with strangers – just a sentence or two – is also relatively easy to learn. The trick is the innocuous comment and there are two ways to go about it. The first is to make the comment yourself – “Those are great shoes! They make your feet look really small.” “What a lovely handbag. My mother had one that was similar.” Make an observation and then a related remark, usually complimentary. They don’t even have to be true technically. If you can’t think of anything else to say, a comment on the color of an outfit is usually good. There’s hardly any way someone can take offense at “That’s a great shade of blue on you.”

The other side of the equation is to get someone else to make a comment to you. This requires a prop most of the time. I used to carry a purse shaped like an armadillo, and that proved a great conversation starter. I memorized several responses that I could use when the other person said, “Oh, what an unusual purse!” I could say, “My mother gave it to me for Christmas one year” or “A friend found it in some catalog.” The purse went over  big, especially if there were children present.

Longer Conversations. These require more practice. Luckily at one of the jobs I had, there were a couple of people that I could invite out to lunch and practice conversation with. (I suspect that they knew what I was doing, but they never mentioned it. In effect, they played along.) Mary, for example, had two adopted children, and questions about them we’re always good for a few minutes of interesting listening. They also had a cat and a snake. Pets and children make good topics.

Sometimes it’s best to steer clear of work-related subjects, but if the person is really understanding, you may be able to vent. You should also be able to listen to the other person too. The secret to that is not to try to fix the problem. Simply listen and validate the person’s feelings. “That sounds awful! Does she do that all the time?”

Formal Settings. Mary also provided me with the opportunity to learn about a sometimes-necessary but difficult situation – funerals. Mary and a few other people invited me to go with them to the viewing of a person that I knew only slightly in a work context, so the stakes were low. From watching Mary and her friends, I learned that the proper procedure is to stand briefly at the coffin looking solemn, then go to the bereaved, shake hands or hug (depending on whether they proffer a hand or two arms), and say, “I’m sorry for your loss” or “My deepest sympathy” and at least one remark about the departed. It can be as simple as “He was a pleasure to work with” or “Everyone at work is going to miss her.”

Not Melting Down. Another important social skill is not having a major meltdown in front of other people. When I first visited my husband’s family, I became very uncomfortable quite often because everyone seemed to be yelling at each other. Loud, angry voices tend to upset me, especially if they continue for any length of time. The technique I developed was to go into the other room and make a cup of tea. Making tea is socially acceptable. (If you’re in the kitchen, go to the bathroom or step outside for fresh air.)

Much later I learned that my husband didn’t realize that his family reacted to even minor questions with argumentative responses in loud voices. To him, and to them, this was simply the normal style of conversation. It wasn’t what was normal in my family, and it triggered my aversion to confrontation. I guess whatever you grow with grow up with seems normal to you.

One other piece of advice: Don’t attempt flirting unless you have a coach. It’s really tricky and possibly dangerous. Not for the novice (especially not the kind of novice who wears a habit).

 

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A Bipolar Child

I suppose I was a bipolar child. I don’t really know, but I assume I was, because now I’m a bipolar adult.

I think I was more of a depressed child, which actually makes sense, since I have bipolar 2, with depressive episodes far outnumbering hypomanic ones. There were some times, though, when I would laugh loudly and inappropriately in class, triggered by a word that reminded me of something funny I’d read. There were times I’d walk around with a village-idiot grin because of some minor accomplishment like winning a live goldfish at a school fair.

Depressed child with toyBut mostly I remember misery. Tears. Loneliness. Hysterics. Confusion. Isolation. Hurt. Despair.

I’m fairly sure my depression wasn’t reactive, mostly, although parts of it surely were. The bullying, betrayals by friends, not understanding social conventions – all these were things that could easily make a person depressed, regardless of brain biochemistry.

But by and large my life was what would be considered pretty damned idyllic. I had stable, loving parents, a comfortable home in the suburbs with good schools, all the food I wanted, and as many toys as I could play with. I had a sister and a neighborhood full of children my age, but I remember being perpetually lonely. I had a good education, but looking back I realize that my illness prevented me from getting the most from it. There was no sexual or physical abuse or neglect. No one close to me died or suffered major trauma, at least until I was in high school and my parents suffered illnesses. Even then, they did a good job of keeping life as normal as possible. At the time we never felt it was a tragedy. It was just something we got through together.

That just leaves endogenous depression. Or at least the depression half of bipolar disorder. I remember one day walking home from elementary school and thinking, “All these houses look so pretty, but the people in them aren’t all happy.” It was somewhat of a revelation to me.  I had several major meltdowns, which I’ve written about before, and hundreds of smaller depressive episodes (http://wp.me/p4e9Hv-6J). I had nervous twitches and tics, and was prescribed Valium for them.

During my high school years, it was suggested that perhaps I ought to go to the school district’s psychologist. (This was probably during the episodes of inappropriate laughter in class.) My parents, who were not really familiar with mental illness and psychiatry, asked me if I wanted to go. I didn’t. I probably should have, although back then – the seventies – it’s fairly unlikely that I would have been diagnosed with bipolar disorder, of any type. I might have gotten some help for the depression, though. They might have taken me off the Valium.

Like most lonely and misunderstood kids, and perhaps most depressive children, I found my salvation in books. They were friends, distractions, instruction manuals on how to survive, food for my emptiness, a place to lose myself when the world was too much with me. By and large it worked, at least as well as anything could – a self-prescribed and self-regulated form of instinctual bibliotherapy.

These were not books on how to make friends, or ones that promised to teach a child how to cope with emotions. They were for the most part pure escapism. Fantasy and science fiction, mysteries and adventures, literature and bestsellers – a complete mishmash of classics and trash. Those were my doctors, my therapists, my Prozac, my mood stabilizers.

I look back now on myself as a child – mentally disordered, undiagnosed, untreated – and wonder how I survived  as much as I did.

If I were a child these days, would I get the help that I needed then? Would my parents recognize that I was not just odd and unhappy, but mentally ill? Would I have been diagnosed properly? Medicated properly? Counseled properly?

With all that needs to go right and all that can go wrong during the process, it feels like getting help for a bipolar child certainly was – and perhaps still is –pretty much of a crapshoot. I made it through, but I hope it’s easier for a kid like me these days.

 

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The Pluses and Minuses of Highs and Lows

Low polygonal shape mountain background with clouds.

Bipolar disorder comes with highs and lows – mania and depression, for those who still call it manic-depressive illness. Bipolar 2 comes with plenty of depression (trust me on this), but mania that doesn’t reach the heights of regular mania. Hence the term “hypomania” – low mania. Like “hypoglycemia” – low blood sugar. (Actually, low blood sugar can affect the bipolar person’s – or anyone’s – moods, but that’s a story for another time.)

So. Mania. Mania comes with pluses – exuberance, euphoria, ambition, confidence, and other good feelings. It also comes with minuses – risk-taking behaviors that can ruin relationships, careers, finances, lives.

Hypomania, however, is usually not so extreme. Sometimes you don’t even realize that you have hypomania at all, because it comes out sideways, as anxiety. This is what happened to me, and is the reason it took me so long to get the proper diagnosis of bipolar type 2.

Recently I have been exploring the realm of hypomania, and I’m here to report that, similar to regular mania, hypomania has its attractions and its drawbacks. And they are intertwined.

On the plus side, I have more energy – more spoons to spend. I can go longer between naps. I have now gotten out of bed, dressed, and out of the house for three days in a row. I can concentrate longer on the books I’m reading and spend more time with my husband and do some actual paying work.

On the minus side, I pay for that energy. It’s like borrowing spoons – you can’t keep doing it. Sooner or later the spoons have to be replaced. Right before my most recent spurt of energy, I had a need for a nap that turned into a mega-nap – almost six hours. I woke up just in time to get ready for bed. Then I slept at least ten hours more – maybe 12. It’s impossible to schedule these things, but I have left tomorrow open just in case my body and brain decide that’s payback day for the three days of activity.

Another plus is that my creative juices are flowing. I’m working ahead on blog posts because I know at the end of the month I have a huge commitment that will keep me from writing something for that Sunday. I’ve also taken steps to spiff up my posts with visuals. And I’ve been thinking that I ought to write some fiction.

However, there’s a however. The last time I had a creative spurt I almost talked myself into starting two new blogs, for a total of four. I have plenty on my plate already, what with these blogs and paying work and trying to find an agent for my book and getting ready for a writer’s conference. This is no time to start a big new project that could easily devour my time and my ability to do the things I already need and want to do. But I do now have a computer file set aside for notes and ideas that flit through my busy brain. Call that file “Later.”

And let’s not forget anxiety. It’s hard to find the pluses there, except that anxiety, if properly harnessed, helps me prepare. I suppose it sounds better if I call it anticipation instead of anxiety. Anticipating my upcoming dental work spurred me into putting together the financing for it. Anticipating the writers’ workshop allows me to prep for all the details – wardrobe, business cards, directions, strategies to cope with exhaustion – that would make my nerves fray even more at the last minute.

I assume I needn’t discuss the minuses of anxiety. Let’s just say that for me, they include regrettable and appalling physical symptoms that no one wants to hear about.

Any way you look at it, the dental procedures are going to be a low and the workshop a high. I can already predict some of the difficulties that will accompany the workshop boost. It’s harder to think of pluses related to the dental work. Except that I really need it done, and with luck it will (eventually) improve my looks, my breath, my health, my pain level, and my self-esteem. At least that’s what I’m telling myself now.

Bipolar disorder is often compared to a seesaw (or teeter-totter, if you prefer) or a swing set or a roller coaster – for some reason, usually as a form of amusement that involves ups and downs. The amusement is debatable and fleeting. But the ups and downs are with us always. Better to learn to ride this beast rather than let it ride us.

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mental health

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Is Bipolar Disorder an “Invisible Illness”?

Empty Chairs Laid Out For Meeting

Yes and no.

First, a little on the concept of invisible illnesses. These are the sorts of afflictions that are not apparent on first looking at a person – conditions such as fibromyalgia, chronic fatigue syndrome, celiac and Crohn’s diseases, diabetes, epilepsy, lupus, Lyme disease, and many others.

Disabled-world.com says, “Many people living with a hidden physical disability or mental challenge are still able to be active in their hobbies, work and be active in sports. On the other hand, some struggle just to get through their day at work and some cannot work at all.”

Most mental disorders are invisible illnesses by that definition. There isn’t a sign around our necks that proclaims “Bipolar,” “Social Anxiety Disorder,” “PTSD,” “Depression,” or even “Schizophrenia.”  The word “Crazy” isn’t tattooed on our foreheads. Our mere appearance doesn’t give away our “secret.”

We have a lot of the same problems that people with other invisible illnesses have. Spoon theory, for example. For bipolar people, simply taking a shower requires so many spoons that we seldom go out. (I count myself among that number.) People who don’t know or understand Spoon Theory often don’t understand why we don’t accept their invitations or cancel at the last minute, or simply don’t show up. You lose a fair number of friends that way.

On the other hand, a mental disorder is not always invisible. People can see us burst into tears for no apparent reason, or go into the bathroom at a party and never come out. They can see our shaking hands, confused looks, and depressed expressions. They can hear our awkward attempts to socialize “appropriately.” They may not know what is wrong, but they can often tell something is.

When we realize this is happening, there are various strategies we try. We can leave the situation – entirely or partially (my go-to is to leave the room on the pretext of needing to make a cup of tea). We can try to brush it off or laugh it off (“Sorry. My nerves are bad today” or “I don’t know why I said that. Must be a brain-fart”). We can try the half-truth/half-joke (“Oops. Guess my meds just haven’t kicked in yet”). We can ignore whatever is happening and hope everyone else does too.

Or we can own it. “I have social anxiety disorder and need to be in a less crowded space than the mall.” “I won’t be able to go to the carnival with you because my PTSD is triggered by loud noises.” “I may come to your party if my bipolar disorder will let me.”

We can also address the subject when there isn’t a situation looming. During a phone conversation or an IM chat, we can let the other person know that we have a mental disorder – an invisible illness. It doesn’t have to be dramatic and dire. Casually may be the best way to handle it. “I know you’re wondering why I didn’t go to the movies with you last week.” “When I saw my doctor yesterday we talked about my physical health and my mental health too.” “You know that character on that show that has PTSD? I have that too, but it’s not exactly like on the show.”

If that sounds risky, you’re right. It can be. There will be people who still don’t get it. People who “don’t believe in” mental illness. People who try to brush it off. People who offer the latest vitamins or super foods or Eastern philosophy as the cure-all.

But you’ll also find people who say, “Oh, my brother-in-law has that too” or “Okay. But I’m still your friend” or “What can I do to help?”

So those are the choices, basically.

Take a chance. Or stay invisible.

Neither choice is right or wrong for everyone. Mental illness is very personal.

You decide.

 

 

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mental health

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