Bipolar 2 From Inside and Out

Posts tagged ‘anxiety’

The Spike

It was The Year of Living With Rex, and for me that meant dangerously. I was undiagnosed and unmedicated, except for wine. I had already been through an episode of cutting. I was clueless and stubborn, isolated and emotionally abused. Tired to my soul and trying to claw my way through my last year of college and a relationship that has affected me to this day.

Then the pain started. Without warning, I would feel a railroad spike being driven through my right temple. It was blinding, all-consuming, and lasted for as much as 30 minutes straight, sometimes. If I was lucky, it was only a few seconds, but I was seldom lucky.

I didn’t know anything that would make it better. All I could do was lie down and weep until it went away.

As this continued, the fear grew in me that I had something dire, like a brain tumor. In addition to my major depressive episode, I was living with massive anxiety.

I don’t know how I made it through my senior year. I don’t know how I made it through the train wreck I was living.

But here’s how I made it through the railroad spike.

Actually, it was kind of amusing, if you weren’t me and it wasn’t happening to you. I went to a doctor, a neurologist, who took one look at me and said,”I can give you any test you want, but I’ll tell you what it is right now. Your jaw is crooked.”

It was Temporomandibular Joint (TMJ) syndrome. And this was before it got trendy and over-diagnosed, the way way gluten sensitivity is now.

My jaw was indeed as crooked as could be. When the doctor put his fingertips on my jaw and asked me to open my mouth, we could both feel it slipping sideways. I’ve been told it feels like my jaw is going to fall off in the doctor’s hands. It made clicking and cracking noises that I had somehow never noticed, and occasionally seemed to get stuck briefly.

How did this explain the railroad spike? When I was anxious, my jaw muscles would clench – and since my jaw was crooked, they would tighten up unevenly. Causing much pain.

“What can you do for it?” I asked.

“We could break your jaw and put it back together, but there’s no guarantee that would work,” he said. (This was in the ’70s. I believe treatments have improved since then.)

While I contemplated whether I really wanted to have a surgically broken jaw (I did not), he gave me a prescription to calm my anxiety so the muscles wouldn’t tighten up and trigger the pain spasms.

Good ol’ Valium.

Now I was officially medicated with benzos and self-medicated with wine. It did take down the anxiety, but plunged me even further into the depression. And I was still living with academic pressure, isolation, no psychiatric diagnosis. And Rex.

I finished up the year, grabbed my diploma, and lit out for my home state as fast as I possibly could. Rex threatened to send the police after me if I took my things while he wasn’t home to supervise and prevent theft of any of his goods. Fine, I thought. Just let him try. I was across two state lines before he got home from work. No, geographic cures don’t work, but sometimes retreating to a safer place can help.

So, all in all, a truly rotten experience. But did I have a psychiatric problem? After all, a crooked jaw is a decidedly, visibly, diagnosably physical ailment.

Of course I did. The crooked jaw was just one component of my condition. The anxiety was another –  a big, huge, whopping one. After all, I’d had a crooked jaw my entire life, and it never sent me railroad spikes until that year. And the depression made it all harder to see and to get away from.

If you ever needed proof the mind and the body are so intertwined that you can hardly tell one from the other, there it is. Physical problem + psychological problem = pain, of both sorts. Good luck trying to sort the two out. And medicating one without making the other worse.

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Mental Health

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Things That Work – Sometimes

Right now I am in the middle of a fairly deep depression. It has gone on for days, which is unusual now that I am more or less stabilized on medication. But there is no let-up in sight.

This time is one of those I-have-nothing-to-look-forward-to moments; plus the holidays; plus the need-to-see-my-therapist thing; plus the have-an-appointment-with-new psychiatrist-but-it’s-not-till-March thing; plus the whole no-spoons-to-get-out-but-really-need to-get-out-of-the-house feeling; plus the various catastrophizing-about-finances-and-the-IRS problem; plus the there’s-something-I-really-want-to-happen-but-if-it does-it-won’t-be-soon-and-may-not-happen-at-all.

Let’s see. Is there anything else?

Oh, probably, but that will do for starters. Of course to a lot of people, those would be everyday annoyances and I would be having your standard pity party. But for a bipolar person, with my brain chemistry, it’s an invitation to a deep, dark pit.

So what are the things that help pull me through, or out, or up? And what are the things I can do while I just ride it out?

Well, there’s music. I’ve written about that before (http://wp.me/p4e9Hv-42). There are two long-form musical bits that have been known to lure me out: The Mikado and The Pirates of Penzance. Occasionally when I haven’t gotten out of bed in a while, my husband will put on a DVD of one or the other and wait for me to appear in the door of his study. There is usually beer or snacks, and I can sing along (badly but loudly) to my heart’s content. Heart’s content – now there’s a good thing. Going to see live productions of Gilbert & Sullivan was an activity my sorority used to do, and one of my best memories of otherwise-difficult sorority life. (I mean, really, can you picture me in a sorority?)

Then there are distractions. These don’t actually improve my mood, but they can help me avoid dwelling on the above list of what’s-wrongs. If I have the concentration needed to read, that’s my go-to choice. (I’ve also written about “comfort reading”: http://wp.me/p4e9wS-3n.) I usually try to keep one fiction and one nonfiction going, so I can switch back and forth.

Sometimes, though, I don’t have the concentration to make it through a chapter. Then it’s time to try TV. Something familiar, non-challenging, not too fast-paced. Cooking shows work, or something like Pawn Stars. True crime or true medicine. Shows where I already know the characters and the back-stories: Castle, Bones.

When I don’t even have enough concentration for that, I go for stupid clicky games. One round of Candy Crush Soda Saga is about as mindless as you can get and still be breathing. Even playing out all five lives takes about 15 minutes. Or I can turn off my brain entirely, play obsessively, and get lost for hours of not-worrying about anything more important than making six-letter words in AlphaBetty.

Occasionally I can do light-as-popcorn forms of social interaction. Phone calls with a depressed friend or one who always has a silly joke ready or one who reads the same sorts of things that I do. Instant messaging. Facebook.

Sometimes, though not often in this state, I can force myself to work a little. Or work on my blogs. It’s difficult and not really satisfying and sometimes even painful, but if I can do it, it’s probably the best thing for me. Accomplishing something – anything – helps build a step out of the pit.

As for the usual advice – rest, exercise, nutrition, meditation – I usually can’t manage those. Except for sleeping. I’m a world-class napper. Also a world-class insomniac. Don’t ask me how I manage that. It’s a gift. I have a new exercise regimen that involves walking up and down the stairs more times than I really have to. My husband makes sure I eat at least one good meal a day. For meditation I pet a cat.

Then I wait.

I know that this will not last for weeks or months or years the way it used to. I’m just going to be miserable until I’m not anymore.

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Mental Health

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Stress Plus

Mental stress plus physical stress = Stress Plus.

The mind and the body are part of the same system. What affects the one affects the other as well. When the body is stressed, the mind suffers. When the mind is stressed, the body suffers.

When both are stressed, you get Stress Plus.

Here’s how it works for people with mental disorders. You feel depressed or immobilized and you don’t get up and move around. Your body responds by becoming lethargic and flabby. Your mind responds to that by becoming discouraged and self-blaming. What you have there is a feedback loop.

My body and brain have been going different directions of late. My mood disorder has lessened and my brain doesn’t seem to be trying to kill me at the moment. This is good.

However, my body is experiencing all kinds of unpleasant disorders and sensations. Some – the thinning hair, the jowls, the weakened eyesight – are simply functions of aging. This does not make them any easier to deal with. They are wrapped up in my self-confidence, my sexuality, my identity, how others perceive me, and how congruent my self-image is with reality.

Stress symptoms have affected me at least since junior high. I developed a tic in which my chin would jerk up and to the left, making it hard for me (or anyone sitting behind me) to study. My doctor put me on Valium, which stopped the tic, but did no good, I’m sure, for my then-undiagnosed bipolar disorder.

Other physical ailments and disorders are the result of specific events or diseases. I have a bad back, which required two operations, the second because I irrationally thought it would be a good idea to ride an Arabian horse bareback. The experience has left me with nerve damage in my left toes – idiopathic radiculopathy, they call it – and an unsteady gait that sometimes necessitates the use of a cane for balance. It does not make me look or feel any younger.

Also, my hands shake. My neurologist called this an “essential tremor,” which means it’s caused by nothing in particular. He noticed that I often sit with my hands folded in my lap to call less attention to it. Between this and my balance issues, sometimes I stagger and shake like an old street rummy. A friend, God bless him, once told me I had a long way to go before looking like a street rummy. It was nice to hear, no matter what my brain tells me.

When my brain was acting up the worst, it also gave me the worst physical symptoms. My reflexes were hypersensitive and that included the reflex that empties my bowels. Just imagine the literal shitstorm I created in the bathroom of a bookstore one day. Then imagine how much of my self-esteem got flushed along with the rolls of toilet paper I used to try to clean it up. Imagine the humiliation of telling a store clerk, “Someone’s been very sick in the bathroom and you probably need to send a janitor.” I’m sure she knew it was me, because of how embarrassed and sickly I must have looked, but we both pretended that I was simply informing them that an accident had occurred.

Needless to say, all these conditions make me not want to go out amongst people, which adds to the isolation that my bipolar disorder already exacerbates. And when I don’t get out, my body doesn’t get moving, and I become even more immobilized – both physically and mentally.

Like I said, Stress Plus – a vicious circle.

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Mental Health

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Social But Spoonless

In the past week I have been out of the house more and seen more people than I have in years. It’s almost like having a social life.

In the past week I have also slept more than I usually do in my sloth-like, torpid existence.

I think the two are not unrelated.

If you follow Spoon Theory (http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/) you know that each spoon represents an amount of coping that you can do.

Every day you get a certain number of spoons – not the same number every day.  You use them to perform everyday tasks that most people think nothing of – things like getting out of bed (some days you don’t even have that spoon), taking a shower (1/2 spoon for Janet’s patented “super-fast smelly-bits sink wash-up”), getting dressed, finding something to eat, fixing that something (keep a box of Cheerios by the bed in case you run out of spoons at this point), and all that is without even leaving the house. Some days that’s all the spoons you have and when you’ve used up your spoons, that’s it.

Other days you can manage to do all that and leave the house, go to work, run errands, and assorted other normal activities. But for those of us who have mental disorders, such days are few and far between.

You hear depressed people talk of not being able to get out of bed, and for the most part that’s caused by lack of spoons. I am usually notoriously low on spoons. My husband now understands Spoon Theory and we use it as common shorthand for “I’m too tired” or “That’s all I can handle right now.”

Dan, however, is an over-scheduler and I often have to rein him in by pointing out that his proposed slate of activities will not be possible because I, for one, will run out of spoons, and he may too.

The dry run for my recent spurt of socializing began last week. After I went for my final session with Dr R., I managed a trip to the bank, a trip to the place where I could pay my power bill, and since it was right next door, a stop at Kmart to buy underwear. It was a good thing that was a hypomanic day, but it floored me for the rest of that day and the next. And it started a cycle of bipolar up-and-down oscillations that were clearly related to spoon usage.

My spate of social endeavors started with a double-header. On Saturday I had lunch with a friend at a favorite restaurant I almost never get to go to. We talked about politics, social issues, and book proposals. Then I went home and had a little nap.

That evening Dan and I went to Monkey Bones for Zombie Dogz. I know that takes a little explaining. Monkey Bones is the tattoo studio where I got my semicolon tattoo (http://wp.me/p4e9Hv-9G). Zombie Dogz is a local food truck. (Also, it’s fun to say “We went to Monkey Bones for Zombie Dogz.”)

Notice that in a single day I had to get up, out of bed, and get dressed twice. That’s a lot of spoons. Sunday I was not able to get out of bed at all.

Monday did not involve socializing, but it was another hellacious spoon-eater. Dan and I spent the day scrounging for documents and information that the IRS wanted. It was taxing. (See what I did there?)

Tuesday was an extra-special social event, though it did not involve getting dressed and going out, or even interacting with other people. It was Jenny Lawson’s online book launch party. Better known as the Bloggess, Jenny has severe social anxiety. At this stage in my life, I certainly would not be able to dress up, mingle, and make polite conversation with both friends and complete strangers. The online party was a genius idea.

I sat at home in my pajamas with some red wine while the Bloggess read chapters from her new book, Furiously Happy. (You should get it, by the way. It’s about mental illness, but funny.) As low-key a social situation as that was, it still used up spoons because it was something I had never done before. Making sure I had the right URL, converting Central Time to Eastern, not being able to ask questions because I don’t Tweet, worrying that Dan was getting bored – not a lot a lot of spoons, but still some.

The effects were getting cumulative. Again I was unable to get out of bed the next day. In fact, Dan and I both slept away most of the daylight hours. For him it’s understandable because he works third shift, but I have no such excuse. Except that if you borrow from the next day’s spoons, or try to keep going without them, you will pay.

Thursday, I was determined, with or without spoons, I was going to meet a friend for coffee. I’ve seen her only once, briefly, in several years. In a way, it was a test of my ability to maintain anything approaching a real social life.

I put forth the extra effort because a mutual friend cut her ties with me because I canceled so often on social engagements. I suppose I really have nothing to prove to anyone but myself but it seems important that I do so. It’s not like coffee with a friend is an ordeal or anything. It’s just that I know I’ll be using a spoon for more than stirring my coffee.

And I hope I have enough spoons left over to work on my other blog.

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Mental Health

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When Anxiety Attacks

I was grocery shopping and when I came to the cereal aisle, I found myself light-headed and breathing raggedly.

My husband dropped a knife in the kitchen; I jumped and all my muscles tightened up.

We were driving down the highway, when suddenly I flung my arms out to the side and gasped loudly.

In none of these cases was anything actually wrong. (Although the incident in the car nearly caused an accident when my husband turned and yelled, “What? What?”)

My depression has always been accompanied by anxiety. That’s one of the reasons I was later given a diagnosis of bipolar disorder, type 2. It seems that, where other people get hypomania, I get anxiety. (There is a thorough explanation of bipolar disorder and anxiety (or “mixed states) at http://psycheducation.org/diagnosis/mixed-states/anxiety-and-bipolar-disorder/.)

I have had generalized anxiety, where I have no idea whether anything specific is actually wrong or doom is impending. I have had phobic-type anxiety, where I imagine that any bee in the neighborhood is going to choose to sting me and I freeze up. I have had anxiety reactions to loud noises or sudden movements, where I feel like I’m jumping out of my skin and actually do physically jump. And I’ve had irrational moments of anxiety, as when I can’t sleep because I don’t know where I put my passport. (Naturally, I have to get up and look for it.)

Now that I am relatively well controlled on medication, the various anxieties don’t plague me nearly as much. And I’ve developed coping mechanisms for a number of them. For example, when I get anxious in the car on the highway I no longer fling out my arms and gasp. My husband notices my tension and asks if anything would make me feel better. “Drive in the other lane,” I say, “and not next to the concrete divider.” I take an extra Ativan (which my doctor allows) before social events I can’t avoid. My husband warns me if he is going to hammer a nail in another room, or reassures me that the cat just knocked over a glass.

I still don’t know what was going on in the cereal aisle. I thought it might be the imposing wall of large, brightly colored boxes, visual noise that seemed to overwhelm me. My therapist at the time said that it was likely that I was just having a random anxiety attack and happened to be in the cereal aisle when it happened. After that I associated the two.

Now I’m not sure. I may have been right about the visual noise. Auditory noises certainly provoke anxiety in me, and I know that some people on the autism spectrum can be overwhelmed by visual stimuli. (I’ve never been diagnosed on the autism spectrum, but I do share certain traits with Aspies.)

I think the anxiety will always be with me, to some extent, just like the depression. My meds make them bearable and my ways of handling them improve. But I don’t think I’ll ever get used to the fact that there are bees, wasps, and ticks in the world, all of them with a thirst for my blood.

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Mental Health

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More “News” About Mental Health

Next in my ongoing series (see: https://bipolarjan.wordpress.com/2015/07/05/new-hope-for-mental-illness/) of posts about news stories that bear on mental health, and what they may or may not mean:

Depression Damages Parts of the Brain, Research Concludes, July 2, 2015, by Sasha Petrova (http://www.iflscience.com/health-and-medicine/depression-damages-parts-brain-research-concludes_

“Brain damage is caused by persistent depression rather than being a predisposing factor for it, researchers have finally concluded after decades of unconfirmed hypothesising,” the article begins.

“A study published in Molecular Psychiatry … has proved once and for all that recurrent depression shrinks the hippocampus – an area of the brain responsible for forming new memories – leading to a loss of emotional and behavioural function.”

The article also claims that “the effects of depression on the brain are reversible with the right treatment for the individual,” though what those treatments might be is not explained.

The take-away: Depression damages the brain, not the other way around. What this means for patients is not yet known.

Link Found Between Gut Bacteria and Depression, July 28, 2015, by Caroline Reid (http://www.iflscience.com/plants-and-animals/link-found-between-gut-bacteria-and-depression)

Well, if it’s not the hippocampus, it might be your guts. According to this article, “Scientists have shown for the first time that there is a way to model how the gut bacteria in a mouse can have an active role in causing anxiety and depressive-like behaviors….

“[T]he lead author of the study… concluded that stress shortly after birth in mice, alongside the microbiome associated with stress, can lead to depression later in life.”

The take-away: More help for depressed mice. As the study author says, “It would be interesting to see if this relationship also effects humans. ….We need to obtain some human data to be able to say with confidence that bacteria are really inducing anxiety or depression…. However, so far, the data is missing.” In other words, more theory, more mice, no help for patients.

Mad Cow Disease Protein May Play a Role in Depression, by Justine Alford

(http://www.iflscience.com/brain/mad-cow-disease-protein-may-play-role-depression)

“In all likelihood, there is no single cause, but one of the leading ideas is that it results from an imbalance of chemicals in the brain, namely the ‘happy’ hormone serotonin and the ‘pleasure’ hormone dopamine.” Hard to argue with that. But here’s the meat of the article: “[S]cientists may have just discovered another contributing factor – abnormal bundles of proteins called prions.” Prions are also the culprit in mad cow disease. After some theorizing and mouse research, “the researchers propose a possible mechanism for the involvement of prion proteins in depression.”

The take-away: Interesting to scientists, but no help yet for depression sufferers. Plus, the article is a bit too technical for the lay audience – and all theory, except perhaps for the mice.

Picky Eaters May Be More Likely to Develop Anxiety and Depression, by Hannah Keyser (http://mentalfloss.com/article/67034/picky-eaters-may-be-more-likely-develop-anxiety-and-depression)

This sums it up nicely: “The study... found that picky eaters are more likely to develop anxiety, depression, and ADHD in later years….While moderate cases were associated with symptoms of separation anxiety and ADHD, severe picky eaters were more likely to have an actual diagnosis of depression or social anxiety in later years. But the scientists stressed that this is a case of correlation, not causation.”
The take-away: So, no news here. Correlation does not equal causation means this may be a coincidence, or anxiety and depression may cause picky eating, or some other factor may cause them both. Note the “May Be” in the article title – it often signals a result of little or no value.

A Urine Test Could Distinguish Between Bipolar Disorder and Depression, August 8, 2015, by Stephen Luntz (http://www.iflscience.com/brain/urine-test-distinguish-forms-depression)

“An easy and reliable method of distinguishing bipolar disorder from major depressive disorder could save tens of thousands of lives, and transform millions more. Now researchers at Chongqing Medical University, China, claim to have found just that in a study based on biomarkers in urine.” According to the study, the presence of six metabolites in urine was 90 percent reliable in diagnosing the two conditions, which are notoriously difficult to tell apart. “Studies have found that as many as 39% of patients diagnosed with MDD have unrecognized bipolar.”

The take-away: More research needed, but this could be big. Pee on a stick and find out whether you’re bipolar, instead of relying on the DSM. (Full disclosure: I was diagnosed with major depression for decades before my bipolar 2 diagnosis.)

The Startup That Wants to Cure Social Anxiety, by Robinson Meyer (http://www.theatlantic.com/health/archive/2015/05/the-startup-that-wants-to-end-social-anxiety/392900/?utm_campaignFacebook_lookalike2%25_8%2F3_Atlantic_desktop)

This is, if not new, at least a little different: Cognitive Behavioral Therapy (CBT) delivered on the web. The article claims that “[R]esearch conducted over the past half-decade shows that CBT delivered via a website can be just as effective as CBT delivered through an in-person therapist.” The service, called “Joyable,” can be accessed for $99 per month or $239 for three months, which includes a coach. The company says that the online treatment “reduces the stigma around seeking out therapy.”

The take-away: Yeah. We’ll see. And lose the name “Joyable,” for heaven’s sake. (Full disclosure: I’ve never been a fan of CBT.)

 The Healing Power of the Cat Purr (http://mentalfloss.com/article/63725/healing-power-cat-purr)
An infographic with references and everything.
The take-away: The infographic talks about physical ailments, but many of us can testify that a purring cat on one’s lap, or even by one’s side, can calm the distressed mind as well. Completely scientific, if you count anecdotal evidence.
Cats and Mental Health, Mental Health Foundation
(http://www.mentalhealth.org.uk/help-information/mental-health-a-z/c/cats-mental-health/)

Seriously, though, survey says, “Half of those people [more than 600 individuals surveyed in 2011] described themselves as having a mental health problem. The results highlighted some of the benefits of feline ownership:

  • 87% of cat owners feel that the animals have a positive impact on their wellbeing
  • 76% find that coping with everyday life is easier thanks to the animals
  • Stroking a cat is a calming and helpful activity.”

The article also refutes the myth about “crazy cat ladies” and self-harm.

My take-away: Pet therapy is a recognized technique that provides benefits to shut-ins, geriatric and psychiatric patients, those with ADD and autism, and even prisoners. My four cats increase the effects of Zoloft, Ativan, Lamictal, and Abilify. Be sure to have your pet spayed or neutered.

 

 

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Mental Health

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Mini-Meltdowns and Many Meltdowns

When my brain broke back in 2001 or so, I thought it was the first time that had happened. Later, on reflection, it turned out that wasn’t so.

The 21st-century breakdown was certainly the most dramatic. Although I had just quit working in an office to start a freelance career, I found myself unable to work after a few months.

I had become unable to work in the office because of mounting difficulties that I now realize were warning signs of the impending breakdown: inability to concentrate, increased anxiety (the feeling that an angry badger was about to claw its way out of my stomach), lessened ability to interact with coworkers, sudden flares of temper, turning people away with unintendedly cutting remarks and sarcasm, isolating, inappropriate affect, catastrophizing – you name it, I had it.

What was causing all these symptoms? My bipolar disorder, obviously. But I’ve had that for years. What was pushing me over the edge this time? I had trouble at work. My boss left and, when I “came out” to my new boss as depressed (which is what I was diagnosed with at the time), she reacted with wariness and incomprehension. She gave me the first bad review I ever had at that job.

My mother’s health was deteriorating seriously, too, about then. I lost time at work taking her to various appointments and I had to have “the talk” with her about how much longer she could live alone. Eventually I took over her finances – and by then I was scarcely handling my own.

I experienced a lift when I quit my job and began freelancing. Hypomania? You bet! My new flexibility allowed me to take better care of my mother, and the assignments kept coming in.

Then everything came crashing down. I screwed up my finances and my mother’s. She began having worse falls and injuries, hospital stays and drug reactions, even hallucinations which scared the hell out of me. I emotionally judo-ed my sister to come up and help, then fought with and resented her, and had to take care of parts of her life as well.

Those and other difficulties on top of my mental disorder added up to a non-functioning me. I dumped all the chores and coping onto my husband, which was a rotten thing to do, fought with him, sobbed for no discernible reason, became unable to work, or care, or do much of anything except think up at least three different ways (and reasons) to kill myself. Fortunately, I was too immobilized to try any of them.

I’ve written before about the things that helped me get back to some kind of functioning – a proper diagnosis, the right meds, time without work (as we gutted our retirement savings), lots of psychotherapy, and my wonderful, patient, ever-helpful, devoted husband.

But now, looking back, I can see that it had happened before, though not so dramatically and completely. In childhood, in my teens, in college – at every stage of my life I had at least one breakdown, often triggered by the circumstances of my life, but fueled and stoked by my mental illness. In every one, my ability to function deteriorated a little more.

The first one that I remember clearly was when I was around 12. My best friend and I were in charge of a birthday party for her younger sister and some friends. This was the old-fashioned kind of party that everyone in the neighborhood had then: cake and ice cream, party games, presents, and not much else. It happened during pin-the-tail-on-the-donkey. I was blindfolded – literally – and my friend kicked me in the ass – again, literally. In front of all those younger children.

I ran home sobbing. And I curled up into a fetal ball and didn’t quit for at least three days. Non-functioning, non-responsive, non-everything. What finally brought me out of it was seeing my mother’s pain at this inexplicable (to her) meltdown.

I had a mini-meltdown in my freshman year of college, which involved sitting in my nightgown in the hallway, staring for hours at a richly detailed poster of a fantasy realm. (I managed to frighten an intruder by arising, ghost-like, in my pale yellow shroud as he entered the suite.)

This one was triggered by my realization that I had probably chosen the wrong major and that there were no job prospects ahead for me. (It turns out I was wrong about that. Maybe I should have stuck with it, but my next choice turned out pretty well.) I took a year off college and took a job as a cashier in a restaurant, where I spent a lot of time crying into the roller towel and being told I should smile more. This convinced me that going back to college, with a new major (and even fewer job prospects), was the right thing to do.

The next meltdown was major. I had finished college, endured a year-long train wreck of a relationship, and lost a job as an assistant restaurant manager (I hadn’t fully learned that lesson yet). I got unemployment, which meant I lay around the apartment for most of the week (except for making half-hearted attempts at job hunting).

One notable symptom of this breakdown was my near-complete immobility. One errand in a day – say, going to the post office for stamps – made it a productive one for me. I had maybe three of those a month, with one being the obligatory visit to the unemployment office – a supremely depressing place to be depressed.

I had some truly irrational thinking that time, too. I thought I could cheer myself up by watching light, fluffy sitcoms on TV. But as I lay there on the couch, I found myself crying with every upbeat, cheery theme song that came with them. Laverne and Shirley making their dreams come true. One Day at a Time, which advised me to get up on my feet because somewhere there was music playing. And, oh, Mary Tyler Moore. Love is all around, my ass.

After that, it was a long, slow slide to my major breakdown. It wasn’t unrelieved misery. I got married. I got a master’s degree and a job in publishing. We acquired a house and cats. We traveled. But the Big One was waiting for me.

Nowadays, I still have mini-meltdowns, but they usually last a maximum of three days, rather than weeks, months, or even years. They still tend to be triggered by stressful life events, especially financial ones. But when I get one, I know I’ll be coming out of it soon. And that’s a wonderful feeling buried in all the misery.

 

 

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Mental Health

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Sense of Self

The air is still and blankets all my sense.
I’m muffled, muzzled in the sheltering dark
But dare not hope for fire, with bright, intense,
loud flames that rend the silence with a spark.

I breathe or not. It’s sometimes hard to tell
When swathed in dimness. Stifling, musty scent
Fills up my nostrils and my brain as well –
Which cannot will the veil be shredded, rent

to save from suffocation. How shall I
Withstand this cycle till the day appears
And breezes blow the dust away from my
Stopped ears and eyes and lungs, plugged full with fears?

Pull off the cover and let free the soul.
Take broken breath and heal it into whole.

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Mental Health

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Crazy Pills

Once upon a time in the land of Jublia lived a kind and powerful queen named Lunesta. One day the dragon Cialis and the evil sorceress Humira attacked the castle, but Jublia was saved by Lunesta and her faithful dog Boniva.

And the peasants rejoiced.

Honestly! The names that pharmaceutical companies give their drugs these days! It’s bad enough that the drugs have a list of side effects longer than the symptoms they’re supposed to cure. Not to mention the drugs where the side effects are the same symptoms they are supposed to cure, or the ones where the side effects are considerably worse than the condition they’re being prescribed for.

My favorite has always been, may cause death (excuse me, “increases risk of death”). That has to be the ultimate side effect. You’ll be dead, but your toenails will look great for the funeral. Leave instructions that include sandals.

I made a list of all the drugs that I’ve been prescribed in my pursuit of something resembling sanity. It’s quite long. I’ve tried almost every class of drugs there is – tricyclics, atypical, SSRIs, anti-anxiety drugs, and hypnotics – in various combinations and assorted doses, and even for off-label uses. (TIL that Abilify can be classed as an “atypical atypical,” which makes me feel a certain kinship with it.)

The only ones I know I haven’t taken are lithium and the MAOI inhibitors. which is a good thing, because I do so like red wine and cheese.

Here’s the list, as nearly as I can remember:
Abilify
buproprion
Desyrel
Effexor
Inderal
Lamictal
Lexapro
desipramine
Prozac
Sinequan
Tofranil
Topamax
Wellbutrin
Zoloft
Ativan
BuSpar
Ambien
Valium

I may have missed a few, what with the brand names and generics, the decades over which all this occurred, the memory deficits, and the ones I took for only a month or two before the side effects became too heinous.

The side effects I’ve encountered along the way include:
dry mouth
memory loss
nightmares
agitation
lethargy
weight gain

Not all at the same time, of course, thank heavens. Right now I seem to have dry mouth, residual memory loss, and weight gain. Given the alternatives, I can live with these. More or less. (That is to say, I have to.) The memories, I understand, are not coming back. I just hope I don’t lose any more, especially ones of the hot-n-juicy variety.

The side effects I haven’t suffered include:
death (obviously)
fatal skin rash (Stevens-Johnson Syndrome, which I wrote bout a while back: https://bipolarjan.wordpress.com/2014/03/07/saving-face-or…-die-from-that/)
tardive dyskinesia

I hope the drug regimen has settled down for a while. I must admit that I don’t follow the instructions to the letter. They’re simply too overwhelming: Take this one on a full stomach, this on an empty stomach, another with milk or never with grapefruit juice; something else at bedtime or half an hour before bedtime, or with the noon meal. And don’t forget the non-psychotropics (cholesterol, blood pressure, etc.), or the vitamin, fiber, and calcium pills my GP prescribes or recommends. Well, and the OTC Benadryl, Tylenol, and Immodium, as needed.

(Yes, I did once look up all my meds in a drug interaction database. Every one interacts with every other one. Maybe that’s one reason mixing an effective cocktail has been such a crapshoot.)

I knew a woman who took so many different drugs for her variety of illnesses and conditions that she had a kitchen timer that she continually set and reset every time she had to take a dose of something. Her meds were more precise than mine, though. If she screwed it up, the consequences would be dire. Her side effects did include death.

The regimen I’ve settled on is this: one set of pills when I wake up (whenever that is) and one set at 11:00 p.m. I eat whenever I’m hungry, and I don’t like grapefruit juice anyway. Anything more complicated than that I can’t be sure of remembering. It’s still complex, what with the only-in-the-morning pills, the only-at-night pills, and the take-twice-a-day things.

I have little tricks to help me remember the routine – daytime-only pills in a plastic bag, nighttime-only on the lamp base, twice a day on the tea cart. Turn the vitamin bottle upside down after taking morning pills. I suppose I should get one of those daily pill caddy things, but they never seem to have enough, or big enough, compartments.

Is this routine crazy? You should see me without the pills.

Well, no, you shouldn’t.

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Mental Health

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The Hypomanic Blogger

When I thought I had unipolar depression, I used to wish I were bipolar, on the theory that I could get a lot more done. (I later found that not to be true, as I’m sure many of you can attest.)

I had a lot more experience with depression than with mania. My bipolar disorder is Type 2, which means I get hypomania instead of full-blown mania. And most of the time the hypomania comes out sideways as anxiety and/or irritability.

(Don’t ask me why I get the full-monty-style depression and only a smidge of hypomania. I don’t know. If my shrink does, he hasn’t told me.)

Looking back, I can remember only one hypomanic episode before my new diagnosis made me more aware of the possibility. I was working at writing and editing – the same things I do now, only then I could do it in an office full-time instead of at home and freelance. A woman came to me, asking about how she could become a writer for magazines.

I positively burbled and babbled. I gave her all sorts of advice on query letters and Writer’s Market and niche publications and getting bylines and clips. I told her about how I started, writing for I Love Cats magazine and editing my martial arts club’s journal, and working my way up. (Incidentally, I am, as far as I know, the only person ever to have articles published in both Black Belt and Catechist magazines.)

The woman went away inspired, she said, though I never heard how she made out.

Now I can more easily recognize hypomania when it hits. I still get the anxious and irritable sort, but now I get more of the buzzy kind. And even though it makes me twitchy, I can make use of it.

It was in a bout of hypomania that I decided to start this blog (and my other, general-purpose one – janetcobur.wordpress.com).
It’s hypomania that has kept me going for over a year so far. Though I can now, thanks to medication, force myself to work while in the dysthymic stage or the “meh” stage, if I hit a spell of hypomania, I can use it to write and edit. Right now I’m using a hypomanic swing to stockpile ideas and first drafts against the inevitable downswing.

Of course, the ramblings that go with hypomania are not worth posting (or submitting to a client) the way they hit the screen. When I’m less jazzed, but not in the Pit of Despair, I can re-read, edit, and improve. It’s a fine balance, a tightrope I’m learning to walk. And it takes both therapy and medication to maintain.

In essence, the not-properly-treated bipolar 2 made my work go downhill (even as I did), until I was unable to work at all. Now that my diagnosis and my meds are more on track, so am I. I may not be well, but I certainly am better. I can live with what I’ve got, and even re-learn how to use some of the abilities I lost in my most recent, largest, most devastating crash.

I wouldn’t recommend mania or even hypomania to anyone, but as long as I’ve got it, I might as well make it be good for something.

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Mental Health

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