Bipolar 2 From Inside and Out

Posts tagged ‘being overwhelmed’

Staying Home

This is our house, and it’s pretty great. When I first saw it, I thought it looked like it had just grown up out of the earth. The main bedroom is large, and there are two smaller bedrooms that have become studies, one each for my husband and me. A great room. A deck. Over and under double ovens. Over and under space-saving washer and dryer. All electric. Over an acre of land, mostly woods, with lots of flowers in the front yard. Quiet cul-de-sac. A modern, new hospital practically within walking distance. A mall and other stores nearby. Close to my husband’s work, my doctor and PT, restaurants, and assorted other amenities.

I almost never leave my wonderful house.

Oh, I go out to doctor’s and PT appointments. My husband can occasionally get me to go out to have a meal. And I get out for other reasons from time to time.

But not often.

We have only one working car, and Dan needs it for work. He works in a big grocery/home goods store and does what shopping I can’t do online. I work from home, doing ghostwriting and editing, and take care of our financial matters online, too. I keep track of all our appointments and subscriptions. Anything that can be done on the phone or computer, I do. I’m not completely useless.

However, I stay home most of the time, living in pajamas or sweats. I know there are people with agoraphobia, movement disabilities, depression, and other conditions that keep them from going outside.

That’s not me. There’s no mental or physical reason I can’t leave the house, though there are limitations on how long I can stand and how far I can walk. These are (I hope) temporary. I do have an anxiety disorder, which may contribute to staying home, but back in the day, I used to travel domestically and abroad, sometimes with my mother or husband, or by myself.

There are excuses I use for not going out. Too much walking. Bad weather—heat, rain, snow, or cold. Fear of falling. My husband’s hours at work. Not having a car I can use when he’s at work. Errands that require only one person to do, such as getting the car’s oil changed.

Back in the day, Dan had a cat that was so chill he could ride in a car without causing a ruckus. When I didn’t want to run errands with him, Dan would scoop up the cat and say, “C’mon, Matches. You’re coming with me.” And off they’d go. I wasn’t properly treated for bipolar back then and had many profound depressive episodes. I knew this maneuver was directed at me, but I didn’t care.

If I do have to go out, we try to make it an occasion—having a meal out before or after PT, for example, if we have the money. I’ve been to a couple of special movies shown on the big screen, with dinner before or after. Visiting a friend in the nursing home and bringing her a gift or treat. But if I don’t have to go out, I simply don’t. And if I do go out, it had better be within five miles of our house.

So, the choices for why I stay home: I still have depressive spells that immobilize me; I still have anxiety that makes braving the world outside seem treacherous; I’m content to let Dan do everything that needs to be done elsewhere; or I simply prefer not to leave the cozy place where I have everything I need.

I would like to travel again, though. But that won’t happen until my purely physical problems are resolved. Until then, I’ll do the best I can inside four walls of safety.

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Mental Health

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I’m Not Fragile

TW: Suicidal Ideation

When my husband and I were looking for a new house, we checked out various options. I found a house I liked, but it was too far from the businesses and services we used. Besides, it had a water tower in the backyard (which I was hoping Dan wouldn’t notice).

Then Dan found a beyond-fixer-upper that was crumbling into pieces. He looked at it as a challenge. I told him that if I had to live in it for more than a month, I would be compelled to commit suicide. To this day, I’m not sure whether I was serious.

At last, we found just the right house. Three bedrooms, two of which would be turned into studies. Over an acre of ground with many trees. It was a little more than we could afford, but we decided that this was our dream home.

It also had a small creek running through the property—more like a run-off, really. Dan’s mom tried to talk us out of buying the house. She had been through a flood many years earlier and feared that the tiny creek could possibly get out of control and destroy our house as hers had been.

“Besides,” she said, “Think of Janet. She’s fragile.”

By “fragile,” it was clear she meant my mental health was sometimes shaky, or beyond shaky.

I had made no secret of my bipolar disorder. At first, Mom Reily didn’t “believe” in mental illness, but eventually she admitted that there was something wrong with my brain. But it pissed me off that she used my mental condition to try to influence our choice of houses. However fragile I might be, there was no way that a tiny creek could break me.

I was not that fragile.

Nor was I fragile when our dream home was taken out by a tornado. I survived it, though I was on the upper story when the roof came off. I dealt with the insurance company, the motels, the rental property, our finances, and many of the other details.

I wasn’t fragile then.

Of course, there were times when my mental condition was fragile. There was the time when I was overwhelmed by three full years of a depressive episode, unable to do anything, from self-care to reading. And there was the times when suicide crossed my mind. Sometimes, it was idly wondering the plane I was on might crash (passive suicidal ideation) or if a fall from the balcony I was on would kill me.

Then there was the time I had active suicidal ideation. I had made a plan and everything. But I dithered so long over how, when, and where that the feeling passed, and I didn’t follow through. I didn’t tell anyone for decades, but then I told Dan.

So, have I been fragile? Yes.

But those were all times when there was something wrong inside my head. Flooding and tornados didn’t break me. The times I was fragile were all things that happened because of SMI, not purely physical circumstances.

Now—I’m not broken. I’m not even fragile. Years of therapy, years of meds, years of not experiencing floods and tornados, and years of supportive love from Dan have made me not fragile, but strong at the broken places.

I don’t fear the future. I’m not fragile anymore.

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Mental Health

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Anxiety Lies, Too

There are a number of mantras in the mental healthcare field: Mental Health Matters, My Story Isn’t Over, It’s Okay to Not Be Okay, Men’s Mental Health: Let’s Talk About It, You Are Stronger Than You Think.

The most common expression, perhaps, is: Depression Lies. Lots of people say it to themselves and others. Jenny Lawson says it frequently in her blog posts and books. It means that when you’re depressed, your mind tells you things that aren’t true—that you’re hopeless, useless, bad, unlovable, unloved, incompetent, incapable of ever feeling any better. And because you’re depressed, you believe them. You have an inner critic that repeats the false messages. They’re with you all the time, whatever you do. They keep you mired in your hopeless condition. It takes a long time to turn off those inner voices and their negative messages. It takes work.

But another truism that doesn’t get as much attention is this: Anxiety lies, too.

Anxiety tells you that you’ll fail, that only bad things await you, that you shouldn’t even try to achieve your goals, that something will thwart you, that you have only bad luck and you can’t change it, that every fear you have will come true, no matter what you do.

Anxiety can keep you from doing the things you want to do, whether that’s getting on an airplane, applying for a job, or starting a conversation. The inner critic from depression has its anxiety equivalent: your inner defeatist.

And when you have something to do that by all objective standards would make anyone anxious, like having an operation, taking a final exam, or getting married, your inner defeatist won’t let you accomplish it, or at least not without immobilizing fear. When I say immobilizing, I mean that literally. You can become so anxious that you can’t move—can’t get out of bed or out of your house, stop your hands or knees from shaking, force yourself to enter a room, or even speak.

So, what can you do when anxiety lies to you? How can you defeat your inner defeatist?

I have help on this one. My husband serves as my outer realist. When my anxiety soars and I’m catastrophizing, he helps me stay grounded. He tells me when my fears are unrealistic. He goes with me to difficult occasions like visits to the dentist. He reminds me of times when I’ve gotten through similar situations in the past. I can—and do—lean on him. He reminds me that anxiety lies.

But what can you do if you don’t have an outer realist like Dan? One thing you could try is to seek your inner Mr. Spock. Ask yourself if it’s logical to fear this event. Is it logical to think you’ll get a zero on the test you’ve studied all week for? No. You may not get 100, but getting a zero isn’t likely or logical. However, this strategy doesn’t usually work. Anxiety whispers: “You’ve been studying the wrong things. You’ll freeze up.” But it lies.

Another way to try defeating anxiety is to make a list of what you’re anxious about and assign a probability to each one. How likely is it that your plane will crash? Find statistics to reach a reasonable answer. (The answer is seven fatal accidents in over 40.6 million flights.) But, practical as this sounds, it doesn’t work well either. Anxiety whispers in your brain: “You’ll be on the one that crashes.” But it lies.

Another technique is to look at your track record. Of all the times you’ve been introduced to a stranger, how many times have you been unable to even say hello? Never? Anxiety whispers: “This time you won’t be able to.” Anxiety lies.

You could also find a sympathetic support person who can walk you through your anxiety. It doesn’t have to be someone who’s around all the time, like my husband is. You may have a friend that you can call for a reality check and a pep talk, or someone who will go with you to that doctor’s appointment. An outer supporter is more powerful than an inner defeatist. Someone who has been through it themselves can tell you from lived experience: Anxiety lies.

Perhaps the most effective way to defeat your inner defeatist is to talk back to it. Say, “I know you’re lying. My anxiety is real, but I know I can do the thing, or at least part of it. You don’t exist. I don’t have to listen to you.”

And of course, your therapist and your meds can help you during times when anxiety lies to you, when you are inclined to believe what it whispers to you anyway.

Let this become your mantra: Anxiety lies. Say it whenever anxiety whispers its dire warnings.

Anxiety lies.

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Mental Health

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Politics, Mood, and Self-Care

It’s difficult for me to maintain a positive mental attitude when I’m troubled by bipolar disorder, especially the depression part. It’s even more difficult in today’s political landscape.

I don’t care what your political persuasion is or who you voted for. I don’t care if you’re for or against DEI or ICE. What I care about these days is what’s happening to mental healthcare in our country. But let’s leave government policies and programs for another day. Right now, I want to discuss politics and mood disorders.

We seem to be overwhelmed by politics, but also by our reactions to politics. Friendships have broken. Families have been torn apart. Lots of people suffer from cognitive dissonance when their brains try to balance their love for friends and family and distress at their views.

None of us knows what to expect next. The difficulty isn’t limited to one side or the other. People who want smaller government are learning that the cuts will include public services such as extreme weather forecasting and disaster recovery. Others with differing views are afraid to travel abroad because they fear that, even with passports, they may be detained when they try to return.

The situation is especially hard on people with mood disorders. People who have phobias or anxiety disorders can find their feelings increasingly out of control. Those who suffer from depression have exaggerated fears. Most debilitating of all is the not-knowing. Am I overreacting? Are these fears reasonable or exaggerated? Will the things I fear never happen? Should I watch the news? Should I avoid watching the news?

I’m suffering from news-dependent symptoms myself. I hesitate to discuss politics with friends unless I already know their opinions are similar to mine. And with new acquaintances on Facebook, I share memes and chat about books.

But when it comes to not getting overwhelmed, I have a few suggestions. Most of them you may already know—they’re versions of basic self-care.

Remove yourself from the trigger. Get out of the room or the house when the talk turns to politics. Offer to go on a beer run. Leave the room and make yourself a cup of tea. Tell your friends or relatives you need to get some air. The outdoors is largely a politics-free zone, aside from bumper stickers and billboards. If you walk with a friend, stay on non-threatening topics like your pets. And prepare a neutral topic to suggest: Do you think the Dodgers have a chance this year? What do you think of Beyoncé’s country album? Should I go on a Disney cruise this year or a trek to the Grand Canyon?

Self-soothing. Music is another way to distract yourself from the present chaos when you take that walk or any other time. Personally, I prefer music with lyrics, as instrumental music gives me too much time and space to contemplate difficult topics. If you wear earbuds (even without music), people are less likely to engage you in conversation.

Use distractions. If you read, stay away from news magazines, the internet, and newspapers. Instead, you may want to revisit books from your childhood. There’s nothing wrong with reading children’s books. They may take you back to a more pleasant time, or you may discover aspects of a book that you never noticed when you were young. Or try a new genre, such as a romance or mystery that isn’t likely to contain much politics. Old classics like Dickens or Austen are good choices, too.

Limit your exposure. Allow yourself 20 minutes for listening to or reading the news. You can do this more than once a day, but leave a couple of hours in between. Clean the bathroom or watch a reality show. Organize your closet. Plant flowers or herbs.

Do things that lift you up. Pray. Sing. Bake bread. Work on a journal or a painting. Do life-affirming activities that will improve your outlook and your spirit.

Oh, yeah. And remember to take your meds, especially if you have an anti-anxiety pill. You’ll need them.

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What Was I Feeling?

It wasn’t supposed to be journaling. I thought I was writing a blog post to be called “On Happiness.” It was about the fact that, even though my bipolar disorder is well controlled, something was sucking the joy out of what should have been joyful times—our dream trip to Ireland, for example, or the fact that I just got a work assignment after a long drought. Not even a mid-winter trip to Florida lifted my spirits.

It didn’t feel like depression, though. That’s a creature I know well, and this wasn’t it. Oh, the lack of joy was the same, but there were no unexplained fits of crying or immobility. In fact, I was experiencing a flurry of activity getting ready for the Florida trip. Putting money away from every paycheck. Making sure we had enough meds for the week. Arranging boarding for the cat. Downloading directions to Google Maps. Checking the flight reservations at least twice a week. Planning what goes in the carry-ons. Juicing up my e-readers and my laptop so I could work on my new assignment and my blogs while we were away.

No, this wasn’t depression.

What it was, was anxiety. Where was this coming from?

Suddenly, I remembered. I had gotten a copy of my file when Dr. Ramirez had to prepare it for my disability application (which failed, of course). On it I read, bipolar disorder, type II, which was expected. But it also said anxiety disorder. And I forgot about that.

All these years, I’ve been concentrating on the bipolar diagnosis—keeping my moods level through a combination of meds and therapy, readjusting levels and times as needed.

But I had been ignoring my anxiety. I was taking one small dose of an anti-anxiety med, with permission to take an extra one as needed. Mostly, I just took the one at night to help me sleep. Unless I was under severe, immediate stress, I ignored the ability to take a second one. That only happened in Ireland, when we were driving on the unfamiliar side of unfamiliar roads with the first roundabouts I had ever encountered. After that, it was back to one a day at bedtime.

But then, as I was trying to write my blog post about how bad I was feeling, it occurred to me (duh) that what I was feeling was not depression, but massive anxiety. All my planning for the trip, all my worrying about our budgets and my work, were clear signs of it, even if I had somehow missed them.

By now, everything for the trip is planned, a few days early even, and my blogs are prepared to post while I’m away. I could relax. But you know I won’t, and I know it, too.

What I will do, though, is to start taking that extra anti-anxiety pill as part of my morning regimen. Unloading some of the remaining tasks like packing on my husband. And trying to distract myself by losing myself in a book.

And, of course, remembering all this for when we return and I have another appointment with my psychiatrist. Who knows? Maybe the twice-a-day pill regimen will have made a difference by then. And if it hasn’t, we can discuss it and see what else might help. (I know, I know. Breathing. Meditation. Mindfulness. Exercise. All of which are difficult for me to practice regularly. I haven’t been able to turn them into consistent habits.)

My husband helps me with my moods. I check with him when I start feeling manicky. He gives me loving attention when I start sliding into depression. He has proven that he can recognize extreme anxiety in certain unusual situations and recommend that I take that second anti-anxiety pill. What I plan to do, at least until my next med check, is not wait for that extreme anxiety to hit and work the second pill into my routine to see if it helps. And ask Dan for help in remembering to do that.

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Being There

Sometimes there’s just nothing you can do. A friend or family member is in distress—depressed, angry, disappointed, anxious, frustrated, or whatever. They may have experienced major trauma or be in the throes of some emotional upheaval. There’s no way you can solve the problem, and sometimes it’s simply better not to try. Not every problem can be fixed, and not everyone wants you to fix their problem. Sometimes it’s simply futile because there is no solution. Sometimes it’s insulting to even suggest that you might be able to fix it.

What do you do then? You sit with the person as they experience their feelings and say nothing. They don’t need advice. They don’t need conversation. They simply need the presence of another person. They just need you to be there.

Therapists sometimes recommend that when you have a strong feeling, you sit with it for a while. You don’t jump up and try to do something that will make it go away. You don’t ignore it. You don’t try to ignore it. You simply sit with the feeling and feel it. Later, there will be time to talk about it. First, you simply identify the feeling, if you can, and then be there with it.

Being there for another person is a great gift to them. In the face of strong emotion, they may not have the ability to talk about it. Having someone who will simply lend their presence in a time of turmoil gives comfort when it’s needed, unobtrusively.

You don’t have to simply sit when you’re being there for another person. You can touch them, place a hand on their shoulder. You can make them a cup of tea. You don’t ask if they want one. You just do it. The tea will be there if they need a soothing beverage. You will be there if they need a soothing presence.

Our society is so action-oriented these days. When we can’t solve a problem, we feel helpless. And that may be true. We’re helpless to change the situation, helpless to cheer up our friend, helpless to take pain away.

But being there may be the only action that is needed. The power of being there is the promise that, if your friend does need something concrete, something that you can offer, you will be there to provide it. In the meantime, there is nothing that either of you needs to do. Being there is the offering.

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Overthinking Night and Day

Like many people with SMI, my superpower is overthinking. In fact, even as I write this, it’s 2:30 a.m. I can’t sleep because I have hamster brain, a phenomenon I’m sure will be familiar to most of you.

I’ve got plenty to overthink about. I’m starting a new writing assignment and am confronted with a big, messy outline that I didn’t write and have to make into a coherent book. We don’t have the money to get a plumber, only the downstairs toilet works, and there’s only a trickle in the showers. Between the two of us, over the next six weeks, we have a total of six assorted doctor appointments coming up, for everything from nail fungus to heart meds to psych meds to test results to steroid shots. There’s the trip we have booked in January to see Dan’s 96-year-old mother. There’s our senior cat whose health is holding for now, but who knows? Pick any one. Or two. Or more.

If only overthinking were productive. Wouldn’t it be great if all that thinking led to creative problem-solving? But no. The problems remain and continue rolling over and over.

Overthinking is tied to anxiety, at least in my case. I do have an anxiety disorder, so my overthinking is something prodigious. And, as exemplified by the hamster brain analogy, it’s cyclical. Anxiety causes overthinking causes anxiety and so on and on. The more out-of-control your problems are, the more out-of-control your thoughts become.

Overthinking is also a symptom of other mental disorders, such as PTSD, OCD, and depression. Another perhaps related phenomenon is intrusive thoughts, the ones that seem to appear spontaneously in your mind for no apparent reason. Perfectionism can be involved, too, if you obsess about doing everything just right. Catastrophizing and all-or-nothing thinking can also contribute to overthinking.

But those are facts. And overthinking has little to do with facts. Take that upcoming trip, for example. The flights are booked, the accommodations are arranged, the rental car is reserved. All three are already paid for. All this was taken care of months ago. But I still overthink. I check the airline reservations to make sure they haven’t changed (they did at least once, with a layover in a different city). I hope we can get an accessible condo. I worry about paying for gas and food. I feel panicky about getting to the next gate during layovers. I have done everything I can think of to make sure the trip runs smoothly, but still…

It’s exhausting, so it’s ironic that I can’t sleep.

How to stop overthinking? Mindfulness and meditation are often recommended, but those don’t work for me. I just can’t shut off the over-thoughts long enough to accomplish them. Distractions are another recommendation, and I try that, but they only provide temporary relief. Reframing negative thoughts is yet another suggestion, but I don’t know how to reframe having to go downstairs to pee in the middle of the night. Self-acceptance or self-compassion, forgiveness, and gratitude—nothing seems to work.

I do take antianxiety meds, and I do have permission to take an extra one if I have more than usual anxiety. I have a prescription for a sleeping aid, but I don’t like to take it very often. More often I just say the hell with it and get up, read or write or watch TV. My sleep-wake schedule is off for days, along with my meals, but if I can just stop the thoughts for a while, I’ll take it.

For me, overthinking happens mostly at night, but it doesn’t have to. There’s plenty of fodder for overthinking during my waking hours. Perhaps I just don’t notice it as much because during the daytime I’m usually doing something that distracts me from my thoughts. Today I was overthinking how to get an accessible room at the condo where we’re staying in January. I made phone calls and stayed on hold, but I got put off until four weeks before the trip. That started me overthinking about what to do if we can’t get an accessible room. I’d have to get one of those shower substitute wipes they use for people who are bedridden. Then I started looking those up online. Maybe I should order some, just in case. Or, I thought, I could wash up in the sink every day. Or some combination of the above. It’s ridiculous how long I spent contemplating the possibilities. All I really have to do is request an accessible unit when I show up, and they’ll tell me whether one is available that day. But do you think I’ll be able to wait until we show up? No, I’ll keep overthinking it. And get the wipes just in case.

Because that’s just what I do.

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Mental Health

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Where Does the Money Go?

Though it embarrasses me to write this, it’s true that when I’m hypomanic, I overspend. That’s one of the ways I can tell that I’m actually hypomanic, when I go on spending sprees. Online shopping is my downfall.

I buy things for myself. I’m still in search of the perfect bra, and I like to have a good supply of underwear. I buy exotic jewelry—amber, picture jasper, zoisite—this despite the fact that I almost never leave the house. I end up wearing the jewelry to my doctor’s appointments. And I know it doesn’t really go with my t-shirt collection.

I buy books. Lots of books. I have an e-reader with almost 2,000 books on it. I know I’ll never read all of them, but I can’t resist something really interesting or by a favorite author.

I buy presents. I see things online that I think my husband might like, buy them, and squirrel them away until his birthday or our anniversary or Christmas. Half the time I don’t even know what he’ll do with them. My latest purchase for him was an articulated copper trilobite. I figure he has a curio cabinet and, if he can’t figure out anything else to do with it, he could put it there.

I buy presents for friends, too. Recently I bought carved stone guitar picks, for no reason, for two of my dear friends who play the guitar. And I sent a friend one of his favorite treats for his birthday.

Has this gotten me into financial trouble? I’d have to say yes. We’ve had some financial reverses recently, but truthfully, we could have absorbed them better if we still had the money I spent. There’s no room left on our credit cards. At the end of the month, things get tight and we have to watch every penny until our Social Security comes in.

Of course, my husband has his own fits of reckless spending. He buys presents, too, mostly for me or his mother. And he buys lots of garden supplies, everything from individual plants to truckloads of mulch. He also indulges in fossilized wood, spheres of polished stone, antiques, and the like. He can’t resist the discount shelves at the grocery store and brings home expensive (but bargain!) delicacies like canned banana leaves and pumpkin pasta sauce. We both like to eat out.

So, how do I try to keep these hypomanic spending jags down? I do try.

First of all, I take my meds faithfully. They include a mood leveler, which I hope will cut down on the hypomania.

Second, I listen to my husband. He often notices when I’m teetering on the edge of hypomania and tells me so.

Third, I try to spend the least amount possible when I do spend money. I buy books when they are discounted to $3 or less. (When we ran out of money at the end of last month, I didn’t even look at the ads for bargain books, just deleted them.) I buy underwear only when it is on a closeout sale. I use gift cards when I have them.

I also try to set limits. I try not to buy things that cost more than $25. (Sometimes I don’t make it.) I watch for sales, free shipping, and 2-for-1 offers. When I consider a larger expense, I talk it over with my husband. (Sometimes he enables me, however.)

Then too, I’m the one who pays the bills and monitors the credit cards and bank account. Sometimes I miscalculate, but I almost always know how much is in the bank and what bills are due and when. There are times when I tell my husband how much we can spend on groceries for the week (not that he always sticks to what I tell him).

Of course, the consequences of my hypomanic spending increase my anxiety, to the point where I’m almost immobilized. (That’s where I am right now.) I’m not sleeping well, or some nights at all. But I am trying to find ways to bring in more money to supplement our Social Security and my husband’s job. But my work is unpredictable and so are my earnings. There are steady months, but right now my assignments are in a slump.

Oh, well. I guess overspending is better than hypersexuality.

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The Varieties of Grief

Loss and grief affect us all. If you’re lucky enough that they haven’t yet, they’re coming. You won’t know when or why or how, but they’re unavoidable. There’s no way to prepare for them, either. Loss and grief rock your emotional balance and your mental health.

You’ve no doubt heard of Elizabeth Kubler-Ross’s Five Stages of Death and Dying—denial, anger, bargaining, depression, and acceptance. (Some people say there are seven stages, including the usual five plus shock and guilt.) The stages apply to other kinds of grief besides death and dying.

The thing is, not everyone experiences grief in the same way. You may not experience all five (or seven) of the stages or not in the order they’re usually presented. You might skip anger, for example, or begin with depression. It depends on the type of loss you’re experiencing and your psychological makeup. If you suffer from clinical depression, for example, it’s easy to get stuck in that stage of grieving a loss. If you have anger management issues, you might experience that before you get to denial, or you might skip over bargaining.

Nor is there a time limit on grief. The experts say that six months to a year is a “normal” time for grief to last. Obviously, this is not hard and fast. If it takes you two years or more to return to full functioning, that’s how long it takes. No one should push you to “get over it” in what they consider to be an acceptable length of time (but they probably will).

That said, there is a condition called Prolonged Grief Disorder. When grief lasts for years and interferes with your daily life and functioning, you may be suffering from it. If this is the case, you should consider getting professional help.

Grief enters your life in any number of ways, and not always ones you expect. Here are some of the common and less common ones.

Death

Death is what you usually think of when you consider grief and loss. This is usually the death of a loved one, but it can even be caused by the death of a public figure such as John F. Kennedy or someone you look up to and admire even if they’re not a family member or close friend. Even the death of a beloved pet can lead to very real grief that often is not understood by others.

Loss

There are kinds of loss other than death. If you work at your dream job and the company suddenly goes under or you are let go, you can feel grief and go through the same stages of grief as someone who experiences a death. You might be in denial, for example, or experience a period of bargaining or anger. Losing your home to financial reversals or a natural disaster is another example.

Health

If your health deteriorates severely, you can experience grief or a sense of loss over the things you used to be able to do. If you lose a limb, for example, or are paralyzed by disease or accident, you can feel grief over your new situation and again, denial, anger, bargaining, and depression. Even normal aging and the loss of abilities that often accompany it can cause you grief.

Relationships

The death of a relationship can also cause grief. Whether it’s by divorce, estrangement, or abandonment, you suffer because of the loss. You could obsess over the good times you spent together or be troubled by memories of the relationship when you least expect them, such as when you encounter a reminder of the person.

Ambiguous Grief

Ambiguous grief occurs when the outcome of a situation is unknown. A missing child is an obvious example. You don’t know whether they’re still alive or whether they’ve been abducted and killed. You bounce between hope and despair. You may be angry at God for allowing the situation or at the police for not solving the case quickly. If you have a loved one who is homeless and experiencing a serious brain illness, you may not know where they are or if they’re safe. You imagine the worst. You could blame yourself, even if it’s not logical. Bargaining is one typical response, a case of the “if only’s.”

There are support groups for many kinds of grief, such as for the bereaved, crime victims, or those with a family member in hospice. (This could be called anticipatory grief.) Other kinds of grief, such as grief over the loss of a job, home, or friend, usually don’t have any kind of support group. Friends and family members may try to offer support, but that’s not the same as a group with a mental health professional as a facilitator. Being with other people who have also experienced a particular variety of loss or grief can be a profound relief or lead to healing and acceptance. At the least, it’s a safe, nonjudgmental space where you can process your feelings.

Grief is deeply personal. Although there are commonalities to the experience, there is no one blueprint for grief. What you experience is in some ways unique to your situation. Length and depth of grieving can’t be quantified or predicted.

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Sleeping or Not

Sleep is one of the most problematic aspects of bipolar and many other brain illnesses. With bipolar disorder, you tend to sleep too much when you’re depressed and not enough when you’re manic. For adults, the recommended amount of deep, restorative sleep is 7–9 hours. That allows someone to have the proper proportion of REM sleep, which is when you dream and when your brain consolidates memories and experiences.

To this, many of us say, “Hah!”

Right now, I’m torn between the two extremes. I’ve been having mixed episodes, so there are days when I want to stay in bed all day. On other days, I can’t get that restful, uninterrupted sleep. I wake up at around 2:00 a.m. and can’t get back to sleep until at least 6:00. I take a nap in the afternoon, and then can’t get to sleep until around 2:00. Or I’m so exhausted that I go to bed by 8:00 and again wake up at 2:00. Once in a great while I go to bed around 9:00 and wake up in time to see my husband off to work at 5:30. Those are the good days.

It’s true that I’ve had a lot of stress lately. Financial, legal, health, and emotional problems have been piling up for both me and my husband. I read at night after taking my bedtime meds, and I feel sleepy in about half an hour. But when I put down my book and try to sleep, I get racing thoughts about every impending disaster—and there are plenty to choose from. The anti-anxiety med I take does nothing, even if I take a second one (which my doctor allows).

If and when I finally do get to sleep, it’s not restful and restorative. I know that I do enter REM sleep, because I dream. One night recently, every single impending disaster combined into a vision of ultimate dread. It wasn’t just that everything that could go wrong did. They all were over the top, all my fears taken to the extreme with vivid color and sound. Worst of all, I couldn’t talk to my husband about my disturbing dream as I usually do. He was dealing with the same fears and facing the same disasters. It seemed unfair to dump my terrors on him. Although he was involved in the dream, I didn’t want him to think I was blaming him.

Along with the terror dream, I’ve had the normal variety of unpleasant dreams that express frustration or inadequacy—missing a plane, losing a competition—the kind that I can generally shrug off. Now, however, they seem to linger in the back of my brain all day.

There is one thing that helps, but I know I shouldn’t do it. That’s taking a sleeping pill. I don’t currently have a prescription for it, though I did in the past. I stopped taking it when I learned that I slept okay without it. But I still had half a dozen pills and didn’t get rid of them. I thought I might use them if I needed to sleep on a long flight. Instead, I remembered I had them during the current series of crises. And they work. But I have to dole them out carefully. I don’t see my psychiatrist until next month, and he doesn’t prescribe over the phone. I tried to make an appointment to see him earlier, but I don’t have transportation on the days he sees clients.

My best bet at this point is to hope that some of the crises resolve before my appointment and I don’t need the sleeping pill anymore. There’s a chance that some of them will, but then again, they may not resolve in our favor. It looks like more hamster brain for me.

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