Bipolar 2 From Inside and Out

Posts tagged ‘anxiety’

The Un-Merry-Go-Round

I submitted this for a mental health anthology and swore that if it wasn’t selected, I would post it here. It wasn’t. so here it is.

 

Back when I was diagnosed with depression (unipolar) and anxiety, I secretly envied the manic-depressives (as we called them then). At least if I had a manic phase, I thought, I could get something done.

 

Then I met Kate, who was bipolar – and not well controlled on medication, to say the least. My envy lasted through her ambitious plans to make identical green velvet Christmas dresses for her three daughters. And vanished when I saw her tear them apart, recut them, start over, change her mind multiple times. You can write the ending to this one. There were no dresses, not by Christmas and not ever.

 

Kate was riding the roller coaster – perhaps the most common metaphor for bipolar disorder – the peaks and troughs, swooping crashes, anticipatory climbs, stomach-clenching vertigo, and, for some, an abrupt stop at the end.

 

Type 2 bipolar is not like that. Type 2 is what my new psychiatrist diagnosed. Except I seldom got the hypomanic mini-jags of ambition and purpose. Instead, it came out sideways, as anxiety.

 

The challenge for both my doctor and me was finding the right mix of drugs to get me functional and keep me functional, at least at some sort of reasonable level.

 

While supposedly unipolar, I had been through most of the different sorts of antidepressants and anti-anxiety meds, including, of course, Prozac. When the increasing side effects of each outweighed the diminishing relief, I went through a lengthening list of tricyclics, SSRIs, and so forth. I learned not to ask, “How do they work?” I couldn’t get an answer. The more basic question was, “Do they work?”

 

I can’t remember all the combinations now. My memory has become Swiss cheese after the spectrum of chemicals I tried. (Actual conversation: “Doctor, I’ve been having some rather embarrassing memory lapses. I asked a friend how her father was doing, when he had been dead for three months.” “Yes, that medication will do that. Stop taking it.”) But in addition to (instead of?) the Prozac, I remember buspirone, Wellbutrin, imipramine. Desyrel, Lexapro? I think so. Effexor, Sinequan? Maybe. No MAOIs or lithium, though.

 

What I do remember all too well is when my brain broke. I don’t know what else to call it: nervous breakdown, decompensating, mental and emotional collapse. It wasn’t the first time this had happened, I later realized, but it was by far the most severe. That’s when I climbed on the merry-go-round.

 

It wasn’t a carousel. No painted ponies or dolphins or elephants or zebras with fantastical, bright bridles of flowers and whimsical saddles, steadily but gently leaping to the calliope music like the calming rhythm of waves.

 

This was a merry-go-round of the type that is no longer allowed on playgrounds because of the danger. A wooden platform, painted a color no longer identifiable, a metal pole speared through the center. Bent metal pipes dividing the surface into rough pie-wedges. No power to make it twirl but the force of children pushing and then jumping on, not to thrilling acceleration, but only to inevitable slowing. No lilting music; only creaks and rattles. No scents of popcorn and cotton candy; only playground dust and much-used sneakers.

 

The metaphoric merry-go-round would start rotating with each new pill or combo that promised (or at least proffered) “Better Living Through Chemistry.” I couldn’t handle the side effects of some – hideously vivid nightmares or the feeling of wanting to jump out of my skin. Others had side effects that I could live with, but little or no therapeutic effect. “There’s another drug I’d like to try” was the constant refrain.

 

The merry-go-round creaked on for years. Literally. With each new med, I had six weeks or so of slowly sliding back into the numbness and misery as my body sloughed off that chemical. Then six or so more weeks, waiting for the new one to work or not, prove tolerable or not, be any better than the last drug or not. Each new drug cycle amounted to a minimum of three months of hell. More, sometimes, as the doctor slowly, cautiously ramped up the dosage to gauge the effects, both intended and incidental. Lather, rinse, repeat.

 

Those years are mostly a blur to me now. I remember sleeping a lot. I remember sitting on the sofa watching “reality” shows so I could see people whose lives were train wrecks worse than mine. I recall not having the wherewithal to add water and nuke a cup of macaroni and cheese. Not bathing. Not feeding the pets. Not paying bills. Not reading. Not caring.

 

I know now how lucky I was to have a husband who lived the vow about “in sickness and in health” and took up the enormous quantity of slack required. He put up with a distant, unresponsive wife; frequent and apparently unprovoked bouts of sobbing; irrational panics; and all the other symptoms he knew by then he couldn’t fix. He didn’t know about the suicidal thoughts, or if he suspected, he never mentioned it. He often asked how he could help, but really, there was nothing else he could do.

 

Then came the day that my psychiatrist said we were just about out of options. He was thinking of recommending electroshock (or ECT, electroconvulsive therapy, its current version). As he talked about how it wasn’t like the bad old days and really showed quite good results in some people, his voice seemed to fade and I heard my inner voice screaming, “Fuck, NO! Keep away from my brain, you Nazi sadist!”

 

I had heard how in the 1950s electroshock was used as a way to punish or control unruly, uncooperative, nonconforming women. And of course everyone knew about the Cuckoo’s Nest. The Snake Pit. As far as I was concerned, electroshock was right up (or down) there with icepick lobotomy, the frighteningly efficient epitome of former psychiatric treatments.

 

Reeling, I made it to my car and immediately called a friend, a scientist, one of the most rational people I know, to talk me down. Her extremely sensible advice was to do some research. Research was something I knew about and remembered how to do.

 

I started digging. The Internet was little help. The opinions and experiences of people who had undergone electroshock ranged from “It was hideous” to “It was a miracle.” I kept looking and questioning and slogging through the research as well as the dense fog around me. I lost one friend, my long-time go-to guy for comparing our conditions and our meds, who said, “Do it immediately or I will kick your ass.” (Hint: Advice phrased as a threat of violence doesn’t help, or have the desired effect.)

 

So there I was, on a merry-go-round that had jolted to a sudden, sickening stop by the notion of electrical jolts surging through my brain. My precious brain, which had both sustained me and betrayed me throughout my life. The only part of my body I ever really loved.

 

What was I doing, considering altering that unique organ with electricity? But the brain in question kept pondering.

 

Electroshock caused memory lapses. I was already having those.

 

I would be allowing doctors to tinker with and alter the functioning – perhaps even the structure – of my brain. But really, hadn’t I been doing those very things with chemicals for years?

 

I went back to my psychiatrist, ready to tell him I was at least willing to talk to the doctor who did the shocking.

 

Then I got a surprise (at least as much as anything repeated for years can be a surprise). “There’s one more drug I’d like to try,” he said. “Lamictal. It’s an anti-seizure drug.”

 

“I don’t have seizures. How does it work?”

 

“We don’t really know.”

 

Oh, why the hell not try it? One more spin around the playground.

 

More misery. More weeks of weaning off and ramping up. More weeks of no change. The same-old same-old.

 

And then one day, something did change. It was such a clear sensation, physical as well as mental. I felt a sudden click in my head – an actual click, like someone throwing a switch located about two inches inside the back of my skull. I could hear my brain saying, “Oh, yeah. I remember this. This is how thinking and feeling are supposed to work.”

 

The click wasn’t a flick from a magic wand. I still had a long way to go, rebuilding the parts of me that I still could and still wanted to. Setbacks. More fiddling with the dosages. The creation of a crazy cocktail of drugs to keep the crazy at bay. But I was on my way back to functioning, with the help of anti-depressant, anti-anxiety, and anti-seizure drugs, plus a sleeping aid. And lots and lots of psychotherapy.

 

So what did I learn from this process? Not “There’s always hope.” I gave up hope lots of times, every time another med didn’t work. Not “Desperate times call for desperate measures.” I am infinitely glad I did not have electroshock. “It’s always darkest before the dawn”? Please. No truly depressed person believes that crap.

 

The lesson I took was “Stubbornness is a virtue.”  It saved our marriage countless times. It saved my father’s life for five times longer than the doctors gave him. And it saved my sanity.

 

“Stubbornness is a virtue” is different from “There’s always hope.” Even when you do give up hope, when you know it’s hopeless, when you realize the merry-go-round is grinding to its inevitable halt, you keep pushing it. Hopelessly, if you must, but stubbornly. As long as it takes.

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mental health

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From Panicky to Manicky

I’ve been having one of my rare, slightly manicky  upswings for the last few days.

Why? And about what?

Well, I survived the business meeting/lunch on Wednesday. I prepared for it with a lot less anxiety than the last time (hair, outfit, jewelry, car, arrival time – all came together with astonishing speed). I even made it through lunch without my hand tremors causing me to dibble all over myself. Yay me!

And although the subject matter could have felt like an attack directed at me, it didn’t. I didn’t get defensive (well, maybe a little) and I help uncover some problems that indirectly supported my point of view.

Maybe I am getting better at this stuff, or remembering how I used to do it.

Also, I was not completely spoon-depleted that evening or the next day, as I had told my husband to expect.

I’ve donated small amounts of money ($25 and under) to a few charities and causes. I don’t know if this is cause or effect of the upswing, but who cares? I was motivated, and I did it. A small enough accomplishment for many people, but summoning the will to care and to act constitute progress.

I have supported a friend in his first solo freelance venture, predicted its astoundingly rapid success, and reveled in it with him. It’s a good feeling to share, even if my own freelance efforts have been less spectacular (though significant to me).

I won’t deny that this upswing makes me wary that a crash may be on the way. You know how feeling happy always seems like tempting fate? With bipolar disorder, I know that there will always be another downswing waiting around the corner for me.

But at least, for now, I can enjoy the good. And that’s a major improvement.

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mental health

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Ack! Ack!

Oh noes! Another business meeting/training session/lunch!

On Wednesday – not much time to get ready.

Panic? Check.

Hair appointment? Check.

Therapist appointment? Check.

Everything else? Not check.

Will I ever be able to do this again without freaking out? Guess that’s a question for my therapist.

Bonus Material (Actual Conversation)

Me (distraught): I have to find something to wear!

Husband (helpful): What about that white thing you wore last time?

Me (gently): It’s June, and that was a turtleneck with long sleeves.

Husband (no particular tone of voice): Oh.

(I didn’t bother explaining that it was actually off-white and I couldn’t wear the same thing to two of these events in a row. The seasonal thing was a big enough information bite.)

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mental health

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For Sharing

http://www.upworthy.com/these-9-college-students-want-to-tell-you-about-their-mental-illnesses?c=ufb1

Don’t give in to stigma. If you dig this video, share it so more people with mental illness can leave shame behind.

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mental health

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Surviving High School (and Reunions)

I’ve only ever gone to one of my high school reunions – the 25th. Now the 40th is nearly here.

I was terrified then. This time is not as bad. I don’t have the energy or the attention span to get all worked up about it. Will I go? Probably not. It’s like the Tower of Terror at DisneyWorld – I did it once and I’m glad I did, but I have no desire to do it again.

My difficulties with the reunion even made the local paper. I went to a high school friend, Mary, for advice. She was quite helpful. She also, with my permission, wrote about my panic in her newspaper column.

Here’s what I told her: “Over the last quarter century I’ve confronted and dealt with a number of pieces of my past and tried to make my peace with them. High school, however, is not one of those things. I’m afraid I’ll have flashbacks.”

Mary did note that “Janet had more reason than most to be apprehensive. While I had been actively ignored, she had been, at times, actively picked on – one of those kids too brainy, too head-in-the-clouds, to comprehend how to navigate the social firmament.”

Pretty close. Except that I wouldn’t have called it “actively picked on.” High school was merely another part of the continuum of bullying and harassment that I experienced from childhood on. In high school no one threw literal rocks at me, but by then they didn’t have to. I was conditioned to cringe.

The head-in-the-clouds part was also not entirely accurate. As I walked through the halls between classes, my head was down and my nose was in a book. I was trying to perfect my “invisible” act and practice that advice that the bullied always get – “just ignore them.”

And I wouldn’t call the social milieu in high school “the firmament.” Just sayin’.

I did go to the reunion, though. I got my hair done for the event and told my stylist to make me look “successful and sane.” She replied, “Oh, no, here comes the wish list.” “At least I didn’t ask for young and thin,” I pointed out.

I went, taking along my husband and telling him not to leave my side. I’m sure the husband came as a surprise to most people there, proof that I had at least managed to navigate that particular social firmament. And if my hairstyle did proclaim some degree of sanity, that was likely a surprise as well.

I survived. My big insight: “Not everyone hated me.” I should have known that already, since I had friends like Mary and a few others I’m still in touch with. But old fears die hard.

Mary was much more philosophical: “In adolescence our images are refracted through so many distorted lights – the way we see ourselves, the way everyone else sees us, the way we fancy everyone else sees us. What mattered was that we could all talk face to face, as adults, as equals, as friends.”

She may have been right, though “Not everyone hated me” was, in its way, a major alteration in my outlook and pretty much as far as I’d gotten by then in my continuing struggle to come to grips with my life.

Things have changed a lot since then and so have I. Now I realize I have nothing to prove, and no need to try.

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mental health

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My Brain, My Books

It used to be that I could never be found without a book within arm’s reach. I had a purse book, a nightstand book, a bathroom book, and a car book at the very least. (I kept them straight by having a different genre in each location.)

Now that I have a Nook e-reader, I have hundreds of books with me everywhere I go. But I’m doing a lot less reading.

I think it’s a function of my lack of concentration, but whether that’s the disorder or the meds, I couldn’t say.

I do know that when I was in the depths of my most recent breakdown, I barely read at all. I watched moronic reality shows like Trading Spouses, on the theory that these people’s lives were bigger train-wrecks than mine. And I watched cooking shows, because they were calming. (This was before cooking game shows really got going.)

During an earlier meltdown, I tried to watch sitcoms, but the relentlessly upbeat theme songs made me weep.

Now I have to hoard my concentration like I hoard my spoons. I am fortunate enough to be able to work freelance from home. But it’s the kind of work that sometimes has deadlines. On days when I can force myself to work, I can concentrate for about 2-1/2 to three hours at a spell. Some days I have to do two sessions like that with a nap in between, if a deadline is approaching too rapidly.

But when it comes to non-work activities, I can usually only concentrate for an hour at the most. Sometimes I try really hard so that I can watch a movie, but mostly I stick to half-hour or hour-long shows.

But reading takes concentration too, especially if the book has a plot (which I recommend) or is information-rich nonfiction. I do a lot of my reading in bed at night. (Yes, I know you’re not supposed to do that because it keeps you from falling asleep. But it’s a life-long habit.)

My mind flitters, the hamsters and sometimes the badgers stir, and I find myself several pages along with no idea what happened. At that point my need for distraction and my attention span collide and I have to find something moderately absorbing but short-term to do. It’s a good thing I have some games on my reader so I can play a hand of rummy or work a sudoku puzzle.

Reading has been one of the great joys of my life, since I was four, and it bothers me that I no longer have the ability to immerse myself in it the way I used to.

But, like so many other things, it’s something I’m having to learn to live with.

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mental health

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Posting Weakly

Today I don’t feel like writing at all. It’s been a tough week.

Although I usually try to say something about mental health in general, bipolar disorder specifically, something relevant that caught my eye in the news, or a piece of my past that might be interesting or informative, today I can’t.

I’m very depressed. Or feeling sorry for myself. Sometimes I can’t tell the difference.

There’s a convention in July that I would really, REALLY like to go to. I could see many friends, including one I haven’t seen in literally years and have been fearing I may not have the chance to again (maybe irrational thinking, maybe not). I would have intellectual stimulation, friend, parties, laughs, all sorts of fun available to me.

And I can’t go.

Some of the reasons are practical. We can’t afford it. My husband has to work. Driving that far and carrying luggage would trigger back pain and the walking required would rapidly exhaust me. If I went, I might well spend much of my time flat on my back in a hotel room, wiped out or communing with Vicodin.

The other reasons I can’t go have to do with my mental disorders. I barely leave the house as it is, except for doctor and therapist appointments. A day with a few simple errands uses up every spoon I have and sometimes the next day’s as well.

But mostly, it’s my over-sensitivity to the crowds and the noise. I can’t tolerate either one for more than a few minutes without a panic attack or a meltdown. Neither of which is pretty and neither of which would add to my enjoyment of the convention, or anyone else’s, for that matter.

I’m now thinking about all the things I can no longer do for physical or mental reasons. My therapist would tell me to look at how far I’ve come – all the things I can do now that I couldn’t do a few years ago, like write a blog and maintain a goal of posting weekly.

She’s right, of course, but for now I just need to go back to bed, and try again to accomplish something after a nap.

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mental health

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A Little Bit of This, A Little Bit of That

I’ve noticed that a lot of my friends who have psychiatric diagnoses display at least minor symptoms of other conditions as well. Depression with a side of Tourette’s. Bipolar with a soupçon of OCD. OCD with a smidge of anxiety disorder. PTSD with all of the above.

The symptoms of the secondary problem are usually not severe enough to warrant a second diagnosis and a separate treatment regimen. Most likely the add-ons are noticeable only to the person who has them, or possibly to very close friends (largely those who know about the main condition).

I don’t exclude myself. I have little rituals that help get me through the day, a certain order I do things in. I have a couple of words or phrases I mutter under my breath to keep me centered when I am stressed. (“Kittens” for mild stress and “jumping” for more than that. I suppose that if I ever get into kinky sex, I could use those as my “safe words.”)

Do these mini-disorders ever grow into major ones? I don’t know. They could be coping mechanisms or side effects of medication or fairly routine habits or personality traits.

Mostly I think one should ignore them – until or unless they start causing problems with one’s life. My husband, formerly a certified addiction counselor, says that’s how to tell when drinking or drugs have become a problem – when they start causing problems (in finances, work, relationships, legal matters, etc.)

For now, they’re  just little quirks – reminders that my brain has an alternative wiring scheme.

(See the disclaimer. These are my opinions only, not professional medical or psychiatric advice. YMMV.)

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mental health

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Saving Face, or You Can Die From That?

Once when my psychiatrist was changing my medication (again), he warned me about the possible side effects. I know that doctors don’t often do this, because they are afraid that the patient will imagine that all the side effects have indeed appeared. So when he wanted to talk about side effects, I perked up my little ears and listened.

“If you notice a rash starting, stop the drug immediately,” Dr. R. said. “It could be fatal.”

I had never heard of a fatal skin rash before. I had no idea that a skin rash could be fatal.

“Don’t look at pictures on the Internet,” he said. “It’s really gross.”

Terrific. I might be getting a really gross, possibly fatal skin rash. I probably should have asked for an increased dosage on the anxiety meds.

Of course I looked it up as soon as I got home. (I did try to avoid pictures, though, even though they might help me tell the difference between heat rash and the deadly one.)

The condition is called Stevens-Johnson Syndrome and apparently the rash is just the beginning. It’s possible for your skin to fall off, starting with your face. That’s probably the fatal part, as I imagine you’d be prone to infections, plus your insides would now be your outsides. And yes, that would be really gross.

I enlisted my husband’s help. “If you notice my skin starting to shred, or see a big piece of it lying on the floor, do let me know,” I requested. “Maybe pick it up and save it.” Then we debated the merits of duct tape vs. Gorilla Glue for reattaching it.

That was a few years ago. I am still taking the medication and I still have an adequate supply of skin. Now there are commercials on TV for various drugs, and they list the side effects. (I’m sure you’ve noticed that they are often worse than the condition they’re prescribed for.) I always get a little nostalgic when they list “fatal skin rash” among the possibilities. And just a teensy bit smug because I know what they mean.

The commercials could be fatal too, though. I might die laughing if the next ad was one for Gorilla Glue.

P.S. I apologize sincerely to anyone reading this who has, or knows someone who has, Stevens-Johnson Syndrome and does not appreciate my attitude.

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mental health

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Risky Business

It’s always a risk when you admit publicly to having a mental disorder. But I am thinking of doing just that.

I have not had uniform success when I have revealed to others that I have bipolar disorder (or chronic depression, either). There have been a lot of “me too’s” and “so’s my brother/sister/mother/friend/etc.” and then we compare diagnoses and symptoms and meds and war stories and have a jolly time.

Other times, well… My mother hoped my problems would go away after I got a “good, steady job.” My father said he didn’t mind if I went to a therapist “as long as he didn’t have to go too.” My mother-in-law “doesn’t believe in mental illness.” My rotten-ex-boyfriend “jokingly” suggested that if we went to couples counseling, he and the therapist could agree that I was a danger to self and others and have me put away. (I knew that wasn’t true and told him so. We went. It didn’t help.)

Recently I have started two blogs, this one for mental health issues and a more general one called Et Cetera, etc. (which you’re welcome to visit if you like). I have linked Et Cetera to my Facebook account, but so far I haven’t linked this one.

Starting these blogs feels like a risk to me, especially since I’ve set WordPress to remind me to post at least once a week. Making a commitment that I will pull myself together four times a month (eight if you count the other blog) and write is something I’m not completely sure I can do. I have good days and bad days, and sometimes those bad days pile up in a bunch.

But I have also taken a bigger risk. Creative Nonfiction magazine requested submissions to be considered for its Mental Health Anthology. So I submitted one. If it gets chosen, I will be “coming out” as bipolar and a mental patient. When (if) that happens, I will likely do the “big reveal” on Facebook. A fair number of my close friends already know, but they constitute only a small segment of my FB friends.

(Creative Nonfiction accepts only manuscripts that have not been published elsewhere. If they don’t accept mine, you can bet it’s going up on this blog the next day.)

So, having thoroughly terrified myself, I will anxiously await the results. And in the meantime, I’ll try to keep up the regular blogging.

Wish me luck.

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