Bipolar 2 From Inside and Out

Posts tagged ‘being overwhelmed’

Remote Work and Mental Health

Nowadays, many workplaces have a toxic culture or at least a dysfunctional one. They demand – not just expect – more from their employees than any human being should have to, or be willing to, give. Sixty-hour weeks. Twelve-hour days. Giving up weekends and holidays. They treat employees as fungible things that can be easily replaced and regularly are, especially if they don’t live up to the brutal “standards” that are supposedly required by the free market.

Toxic workplaces are also full of toxic people. Bullying of employees and coworkers is common. Gaslighting even happens, more regularly than we’d like to admit. Required conformity and enforced corporate “team-building” parties and picnics suck the meaning out of workplace enjoyment. Exhortations that the workplace is a “family” and then behaving in ways that belie this are rampant – false, harmful, and destructive.

Corporate practices aren’t human-friendly, much less family-friendly. Flexible working hours, job-sharing, onsite childcare, remote work, part-time work, and extended sick and other types of leave are largely reserved for only the highest echelons or never even considered for any workers. Health and disability insurance are nonexistent or ultra-expensive for workers because of the monetary costs to the company. Discussions about the stress caused by work end in suggestions to try yoga. Employee Assistance Programs (EAPs), if they exist, provide some therapy, but only with a provider of the company’s choosing and usually only for six weeks or so.

Then along comes the COVID pandemic. Suddenly, corporations and other, smaller businesses were faced with the difficulties of staffing during lockdowns and quarantines. All of a sudden, workers weren’t so available or so desperate. Owners had to scramble to hire enough workers to keep the wheels turning. Some businesses were forced to raise wages. Others had to rethink corporate travel to cut costs.

And some turned to remote work. Not all could, of course. Some jobs simply can’t be done from home. Construction workers, wait staff, airline attendants, and countless others were simply let go or put on furlough, many of them without even partial pay. But many jobs, particularly office jobs, were the sorts that could be done from home, on the phone or via computer. And that proved beneficial both for the affected companies and for the mental health of their workers. Bosses suddenly realized that work-from-home even improved the bottom line, reducing overhead. It soon became clear that home-workers were able to be as or even more productive when not being constantly interrupted by mandatory meetings and other useless exercises.

How did telecommuting affect workers’ mental health? First, remote workers were spared from many aspects of toxic workplaces. Micromanaging became largely unfeasible.

This certainly helped improve their working conditions and stress. So did getting respectably dressed only from the waist up, especially for those of us with limited spoons. Being able to step away from the computer for a half-hour or more to do something about chores or even hobbies provided a welcome break. Lunches could now be taken whenever you were hungry and last more than 30 minutes. Even spending more time with pets reduced stress and provided emotional support that’s next to impossible in most workplaces.

Many of the stresses that so exacerbate mental health conditions were at least lessened. People were more comfortable in their own homes, with comfort objects and self-care items more readily available. Those with a greater need for alone time suddenly had more of it. If they found that they could work better or more productively part-time at home, it was a benefit for the companies as well.

Of course, not all bosses took to this new way of working. Once they figured out that employees could be more productive when working at home, some of them upped output requirements. They could insist that employees remain logged in during standard working hours, making flex-time less doable. Or they started requiring more output from those telecommuting, or scheduling Skype meetings that cut into employees’ time.

I work at home, remotely, and have for a number of years. I do so because I have been fortunate enough to find jobs that pay (though not a lot), jobs that match my skill set, jobs that aren’t 9-5, and jobs that are conducive to working around my days of depression and hypomania. I’ve considered going back to work in an office from time to time when funds were low, but not enough to actively pursue it. Truth to tell, I don’t think I’ll ever be able to do that again, and not just because I like working in my pajamas. (For those who are curious, I’m doing transcription and ghostwriting at the moment. They provide a supplement to Social Security and allow me time to work on my blogs.)

Did toxic work environments cause mental illness? Probably not, though they have pushed some people closer to the edge and others past the breaking point. It’s hard to work in corporate culture with any kind of mental disorder (except possibly narcissism). For these people, remote working is a blessing. COVID has been devastating, but one of its side effects has been to improve working conditions for millions of people – and especially those living with mental illnesses.

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Anxious in Ireland

So not us.

Over the last couple of months, I’ve written about the anxiety I’ve been having regarding our vacation in Ireland. There’s been the overplanning, overscheduling, overspending, and the trying to make sure that everything went perfectly (like that was going to happen). I had anxiety about whether I would pack too much or too little, whether I could sleep on the plane, whether I could find things to eat comfortably (after recovering from dental surgery). Anxiety about whether I could find help with my mobility challenges in the airports and at my destinations. Anxiety about driving on the left. Et endless cetera.

As my therapist noted when I spoke to her after my return, it was good I took my anti-anxiety meds with me. (I made sure to pack them, even though I haven’t been taking them every day since consulting with my prescribing psychiatrist. I packed all my other psychotropics too, of course. I also carried my sleeping aid, which I’ve also stopped taking regularly, for the plane flights, but didn’t need it.)

Many of the anxieties I encountered in Ireland did indeed have to do with driving. I tried driving the rental car once, but I was too nervous to continue that. My husband ended up doing all the driving and I navigated. After some bad experiences with the GPS unit that the car rental company provided, we switched to using Google Maps on my phone, both of which fortunately worked in Ireland. I was in charge of transmitting the directions to Dan and trying to translate kilometers into miles for him.

One of the first difficulties we had before we defaulted to Google Maps was when we were heading to our first bed-and-breakfast reservation (the accommodations were arranged in advance by the travel company, so I didn’t have to have anxiety about where we were going to sleep each night). The GPS took us on a series of narrow, stony roads that ended up with us running off the one lane and into a ditch. After the initial shock and the realization that we couldn’t simply rock the car out of it, though, I wasn’t really all that anxious, perhaps because it was late at night and I was emotionally as well as physically exhausted.

I had a flashlight in my purse (something I almost always carry). My husband took it and set off on foot to find help, while I waited with the car. In about half an hour he returned with a local couple of lovely, helpful people, who drove us and our luggage to the b-n-b (which was actually quite nearby). They also came back in the morning to pull the car out of the ditch and pulled out a minor dent for us, and they accepted a modest amount of Euros for all their help. All things considered, it could have been much worse. I fell into bed that night and slept soundly.

During the whole trip, I never got really used to the driving situation. Dan noticed that I was making humming noises as we drove and bracing my hand on the dashboard (or the roof) at times. He called this “vibrating” and gently reminded me that I had the anti-anxiety meds with me. Eventually, I got used to taking them every morning before we began our day’s wanderings. My vibration was particularly noticeable when we passed another car or when I thought we were swerving too close to the edges of the road (the ditch situation made this seem all too plausible). Parking in cities – and indeed simply trying to navigate in them – also triggered my anxiety.

Then there were the godawful problems with our flights and our finances. Back in December, the airline had changed our flight out but never notified us about it, so we showed up at the airport four hours after our flight left. I spent several hours on the phone with the airline, our bank, and our credit card company trying to make arrangements for the first flight out the next day and the money to pay for it (since we were considered no-shows). Fortunately, I went into task-oriented mode (which I am sometimes capable of) and shuffled money and flights around before I collapsed. We did miss our scheduled first day in Ireland, though.

Getting a flight back was even worse. There was a problem with our COVID certification (we needed an antigen test, not just a triple-vax card) and later flights were booked solid. In the end, we had to spend two days in a Dublin airport hotel while trying to make arrangements with a dying phone and no charging cable. Dan came through there too when I was at the end of my proverbial rope (or in this case cable) and managed somehow to get a replacement. But by then we were out of money and I had to ask friends and family to PayPal us money for the extra nights in the hotel. It was all quite nerve-fraying and close to panic-inducing.

We’re back home now and I have settled down quite a bit, though I’m still dealing with financial repercussions, which have always been one of my major anxiety triggers. But I’m not taking the anti-anxiety pills daily anymore. And, as always, Dan is helping me.

The good news is that, throughout and despite all this, we managed to have a great time in Ireland. Sure, I had anxiety – and quite a bit of it – but I was still able to enjoy the country, the scenery, the food, the activities, and the wonderful people. We’re already talking about saving to go back.

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How I Learned I’m Not “Pathetic”

When I first went to my therapist, I often described my life and myself as “pathetic.” Slowly, as I made progress, I stopped doing that. It was a revelation that took some time to sink in. Here are some of the things my therapist said and did to help me overcome this harmful description of myself and my bipolar disorder.

Refusing to accept my description. This may seem like an obvious thing, but it had real meaning for me. I had been majorly depressed for approximately three years and bipolar as long as I could remember. I couldn’t do anything – get out of bed, shower, feed myself or the cats, or perform the tasks of daily living. (My husband picked up the slack. Thank God for him.) My therapist never said in so many words, “You’re not pathetic” or “Your thinking is wrong.” She just patiently spent the time with me and gave me tools I could use to get better.

You’d think I would take this as denying my perception of reality, which I ordinarily hate when anyone tries it. But this time, I welcomed it. It was nice at that point to have someone denying my perception because Dr. B.’s perception was so much more appealing than mine. It gave me something to shoot for – a time when I would no longer feel that “pathetic” was an apt description. She also let me cry it out, which I often did when I was feeling particularly pathetic.

Baby steps. (Also known as “Eat the elephant one bite at a time.”) My healing was slow, thousands of baby steps of accomplishing more and more. Because my therapist never gave up, neither did I. Baby steps take you only so far at a time – after all, they’re tiny. But over time, they add up to a measurable distance. As I slowly moved away from my “pathetic” label, I also moved away from feeling pathetic. Eventually, I was able to eat, if not the whole elephant, at least a larger portion of it through slow but steady progress.

Not that I didn’t sometimes backslide. Whenever I hit another depressive episode, my feeling of pathetic-ness came roaring back. It was only as I learned that some other feeling was possible that I was able to catch a glimpse of a time when pathetic might no longer describe me.

Saying, “Look how far you’ve come.” This is something that my therapist kept reminding me. Dr. B. noted that I was becoming able to get out of bed to come to her office. She would bring up the tools that I had acquired or developed to help myself leave the bad old days largely in the past. She would also point out that I not only remembered those tools, I was using them.

Sticking with me. Dr. B. was also there when I backslid. A couple of times I had made so much progress that I thought I was able to go it alone. But, sooner or later, I would need a “booster shot” of work with her to remind me of the things that I really already knew. When I was feeling too low to make it into the office, we would have phone sessions. When COVID hit and in-person visits became even more difficult or impossible to arrange, we began having videoconference sessions. Slowly, I worked up from every week to once every two weeks to once every three weeks – and am now meeting with her only once a month.

And, let me tell you, it feels great not to feel pathetic anymore.


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No, I’m Not Taking Bipolar Passively

It may look like I’m taking my disorder passively. I stay in bed a lot. I seldom leave my house. It’s true I don’t exercise or go out with friends or hike in the woods or volunteer at a charity or arrange spa days for myself or sleep under a weighted blanket. Those may be good, proactive things that people can do in terms of elevating mood and practicing self-care. But I don’t do any of those.

I do all the “required” things, like visiting my psychiatrist regularly and taking all my meds faithfully. But when it comes to more active practices, I fall far short of the “ideal.”

It may look like I’m passive, but in reality, fighting bipolar disorder is a constant struggle for me. It just mostly happens inside my head.

First, there’s tracking my moods. This takes an active awareness of my behaviors and what they may be telling me about my moods. If I find myself spending more money than usual, I may realize I’m drifting into hypomania. If I can’t laugh at jokes anymore, I may be headed towards depression. If I receive an unexpected bill and start to feel overwhelmed, I may be in line for an anxiety attack.

Even activities that seem ultimately passive or ordinary may require positive activity for me. Answering a phone call may take a lot of effort, even if I know it’s a friend calling. Going to the grocery, as mundane an activity as possible, can take a lot of effort on my part – getting out of bed, getting showered and dressed, going out of the house, choosing from the many options at the grocery, carrying my purchases indoors. These are actions that may not seem related to my mental health, but are. And I must struggle internally with doing them. It takes up psychic energy, not just physical.

And what about seeing my psychiatrist and taking my meds? These, though they may seem minimal, are not passive actions either. As with grocery shopping, I must convince myself – even force myself – to keep track of my appointments and show up at them bathed and clothed. I must monitor how much of my meds I have left and pick up refills. (Or order home delivery for meds and groceries, if possible.)

When even the smallest efforts seem to take too much, well, effort, trying to accomplish them is at heart a mental battle – to think of what needs doing, convince myself I need to do it, plan for it, prepare myself to do it, attempt to do it, and, if I fail, try again later.

Lying in bed may seem the ultimate in passivity, but there can be a constant, very real struggle going on. On one hand, there’s trying to get to sleep and stay asleep. On the other hand is the struggle to get out of bed and do something – anything. Even if my struggles aren’t successful, that doesn’t mean that I am passive. They can be exhausting (though not enough to sleep). They can require tremendous mental effort, which is sometimes more difficult than the active kind for a person with a mental disorder.

So, no, I am not taking bipolar passively. I am fighting to get through it, to conquer it, to keep it at bay, to not let it win. Giving up would be the ultimate passivity, and I’m not going to allow myself to do that. I will continue struggling with my disorder as best I can, determined to do all I can to meet it actively, with intention, and with repeated efforts if necessary. And not beating myself up when I find myself being reactive rather than proactive. It’s important for me to remember that I’m doing the best I can with what I have. And that I dare not be truly passive when it comes to my mental disorder, lest it take over again.

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Coming Down From a Manic Jag

I have been manicky lately, and it has expressed itself, as it does for so many people, with spending money we don’t have. Or at least spending money we’re supposed to be getting but don’t have yet on things which we can’t afford until we get it.

The thing is, we have a nice lump sum of money coming, but we don’t know when it will arrive. And instead of sensibly waiting for it to arrive, I have already begun spending it. A new-old truck for Dan; passport applications for us both; tattoos for us both; concert tickets; clothes and maps and guidebooks and airline tickets for a trip we plan to take next year; a short getaway vacation last week; gardening and home improvement supplies. Just to name a few.

All this leaves us very little for necessities like mortgage, electricity, internet (essential for my work), and even food. We can probably live on our credit card for a while, but I know that’s only a temporary solution, and a bad solution at that, even though the credit company increased my credit limit so we could pay for the airline tickets.

Of course, I am mostly responsible for all this spending. Some of the expenditures wouldn’t wait – the airline tickets, which we had to buy immediately to lock in the current price, and the passports, which I understand can take months to arrive and we shouldn’t wait till the last minute to apply for.

But for other purchases, Dan has been enabling me – “You know you want to go hear Emmylou Harris,” for example. “She’s one of your heroes.” “Might as well get the ticket for Rodney Crowell, too. How likely is it that he’ll be playing in this area again, at least anytime soon?”

Now the proverbial chickens are coming home to roost. Last week I had to deal with a guy at the door who was there to shut off our electricity unless I gave him a check for the past-due balance on the spot. The credit card company may come to regret the limit increase. I’m sure they gave it to me because I regularly paid them more than the amount due, and I can’t do that anymore.

I realize this is relatively minor compared to some spending jags that people in the manic phase of bipolar have gone on – gambling debts, for example, and even ones that end in homelessness. But the spending adds up, and we are strained past our limit until that windfall finally arrives.

Naturally, because that’s the way things go, now that I have come to and realized the reckless spending, it has triggered my anxiety. Financial troubles have always been one of my triggers, but it’s appalling to realize that I have dug this hole myself.

And naturally, because that’s the way things go, that anxiety triggers my depression – maybe not a full-blown depressive episode, but enough to affect my life and actions. I isolate. I grow surly with my husband. I have trouble sleeping or sleep too much.

In truth, I am angry with myself and with this damned disorder. When I get manicky, I generally am able to limit my spending to amounts of $25 or less, if sometimes for several such items (or meals). But this time I have overwhelmed myself, and my husband as well. I know we’re not supposed to use bipolar disorder as an excuse for bad behavior, but I can’t help thinking that hypomania is involved at some level. The idea of live music and foreign travel were just so irresistible. I couldn’t make myself wait until a better time.

We’ll get through this, I know. Someday the expected check will come and I can start straightening out some of the mess I’ve created. But until then, anxiety and depression will be my companions. I hope the mania stays fully tamped down until then. At least, I’ll take my meds and hope so. And not skip my therapist appointment in a week and a half. We haven’t had much to discuss lately, but now I’m sure we do.

Good News, Anxiety (and a Little Hypomania)

My husband and I have been waiting for various pieces of good news for several weeks. If they come, and the money associated with them, we could accomplish a few things, both necessary and frivolous, that have been on our minds.

Naturally, the waiting that triggers my anxiety isn’t over yet. One of the good things that we’re hoping to indulge in is a trip abroad, in the early part of next year. Since I learned of this, I’ve been preparing for it like it was the Normandy Invasion.

I got a travel agent (my husband’s nephew) and spent a lot of time with him, going over what we wanted to see (scenic things, not big cities), what we wanted in the way of accommodations (guesthouses and bed-and-breakfasts), airline details, passport details, COVID details, birth certificate details, and more.

Though the trip is over six months away (which should be about right for getting passports), I’ve fallen into a morass of hypomania/anxiety. I’ve been checking what the weather will be like, how much local money we’ll need, any language difficulties, etc. I’ve started ordering things we’ll need, like rain slickers, a road map, power converters (I found ones with USB ports), extra underwear (I have a fear of running out), and so on. I’ve been poring over suggestions that our travel agent sent detailing interesting sights along the route he roughly mapped out for us, given that we’re going on a fly-drive plan. I suppose I’ll settle down at some point and just wait for everything to come together, but then again, maybe not.

Another anxiety-producing (or really, dread-producing) thing that may happen in the near future is getting my teeth fixed. I have a major phobia regarding dentists and have avoided them for far too long. I now have an appointment for a consultation. Even for that, I’ll probably need Ativan. If I make it through the anxiety and phobia, I perhaps will have done something that will bolster my sometimes-quite-low self-esteem. I’ve had problems with my teeth for years, but I am determined (well, sort of determined) that this will be the time that I will conquer them.

Our other new addition is a work truck for my husband, who needs to haul gardening equipment (including dirt and rocks) and timber and large tools around. This is also a piece of good news for me. Because of his work schedule and our one car, I have been unable to go out during the day. Not that I usually need to go out during the day, as I work from home, but it’s nice to have the choice.

Plus, I’ll be able to schedule appointments not just on Mondays, when my husband has off work, but during the rest of the week as well. With only one car, if I have a medical appointment, I’m limited in my choices of appointments and times. I have to drop my husband off at work at 6:00 a.m. to have the car for most of the day. Now I can have much more freedom and don’t have to feel trapped in the house. If I want or need to go somewhere, I can.

If we were sensible people (we aren’t), we would settle for using the infusion of money to fix my teeth and buy the work truck, then put the rest away for a nest egg. But, damn it, after all we’ve been through in the past few years, frankly, we need a break. I know that many people with bipolar disorder are not able to travel, even outside the town where they live. I know that I am lucky to be able to. I imagine I will still have some anxiety when we get there, such as when trying to adjust to driving on the wrong side of the road. But we’ve built rest and self-care into the plan.

Another time when we traveled, I gave myself permission to be depressed if I felt it coming on. It was a revelation. I didn’t have to force myself to participate in all the activities. I could sleep late if I needed to. I didn’t have to resort to “smiling depression” to seem “normal.”

I hope that on this vacation I can do the same. I hope I won’t get depressed very much, but if I want to skip part of the many activities that our travel agent has found, or sleep late in the b-n-b, I can choose to do that. And that’s part of how I practice self-care when traveling abroad.

Simone Biles: Mental Health Is Health Too

There’s been a lot of media interest lately in Simone Biles. The gymnast described by many as the Greatest of All Time withdrew from the Olympics, citing mental health reasons. Many news outlets and commenters have been understanding, but some have not. A Texas Deputy Attorney General, for example, called Biles a “selfish, childish national embarrassment,” which he apologized for six hours later. A podcaster called her “weak,” and said that her performance showed that “when things get tough, you shatter into a million pieces.” After Biles pulled out, the team won a silver medal, with the Russians getting the gold.

Many have compared Biles with Kerri Strug, who performed the vault in the 1996 Olympics, despite having an injured leg. At the time she was praised for her courage and strength, although it turned out that the American Women’s Gymnastic Team would have won the gold even without Strug’s dramatic vault.

Biles’s situation and its comparison with Kerri Struggs serves to reinforce the idea that only physical injuries are “real” and that talking about and acting on mental health matters is not acceptable. Yes, Olympic swimmer Michael Phelps has talked about his struggle with depression, but only after the Games were over. It was brave of him to talk about it, but he received little to no backlash after deciding to talk openly about depression and suicidal ideation.

As in so many other situations, mental health and mental disorders are considered less “real” than physical disorders. And the pressure put on athletes and Olympic athletes in particular can be a factor in damaging their mental health. Athletes have long been encouraged to “play through the pain,” even when that results in severe physical injury. Few have considered how playing through psychological pain affects athletes.

Added to the stress of competition and the pressures of fans, parents, and coaches to succeed, many athletes have suffered through physical and sexual abuse. Simone Biles has commented that she is part of the #MeToo movement that has brought attention to previously unrecognized instances of sexual harassment and exploitation. In a lengthy tweet, Biles revealed that she was one of the victims of team physician Larry Nasser, who is now in jail following over 100 counts of such behavior. “As I continue to work through the pain,” Biles tweeted, “I kindly ask everyone to respect my privacy. This is a process, and one that I need more time to work through.” She could have tweeted the same thing regarding her recent mental health problems.

Another factor in the language surrounding Biles’s decision to remove herself from the Olympic competition is how many people talk about how she personally denied “us” a gold medal (as if all Americans were in contention for the medal) or ceded the victory to the Russians. Ideological matters ought not to be a point of discussion regarding an athlete’s mental health. But they are. People forget that the Olympic Games are just that – games. Too much patriotic fervor is whipped up based on the outcome and the international goodwill of the Games has been lost.

Along with the fact that an amazing athlete was strong enough not to let the pressures of competition further affect her mental health. Simone should be praised for her decision, not called weak and childish.

Manicky June, Anxious July, Overwhelmed August

Once upon a time, when I was diagnosed with unipolar depression, I wished I had bipolar disorder so that at least I could get things done when I was manic. Then I met someone with bipolar disorder and learned how foolish that wish was. Her manic phase led her to begin projects she would never finish, make loud, inappropriate jokes, and have difficulty with social interactions.

I have bipolar 2, and am fairly well controlled on medication, so I don’t get hypomania often, and when I do, it doesn’t usually last very long. Last month, however, I had a manicky time, and the results of it will affect me for several months. In June I also started on a new medication – though one for my physical health, not my mental health. My primary care physician doubled my dose of thyroid supplement. It had an almost immediate effect. After about a week, I became stronger, steadier, in less pain, and – oh yes, – rather manic.

I tend to have the rapid cycling version of my disorder, so when I do get hypomanic, it seldom lasts more than a few days. This time, however, I have had a longer time to experience the hypomania in a way I can’t remember having had before.

Some good things happened and some bad things happened. I got tickets to two live music events that I desperately wanted to see, one in August and one in September. We went out to eat at least twice. I made appointments for tattoos for both myself and my husband, both also in August. I booked us for a weekend getaway vacation in August. I bought myself a pair of earrings to replace ones I had lost.

In other words, I spent a lot of money.

Then July came and I don’t know if we will have enough money to get through it all. I snapped out of the hypomania and reverted to anxiety, which is how my depression often expresses itself. I paid the major bills during the first week. I put us on a strict budget for groceries. I put a little money aside so that I could possibly get a t-shirt at one of the concerts. I determined that the tattoo studio takes credit cards. (I don’t really want to take this option, but if we run out of cash, I may have to.)

Money worries are among my triggers for anxiety and depression, along with thunderstorms, overscheduling, noise, and too many people. When August comes, I will certainly need the bed-and-breakfast getaway, because my nerves will by then be frazzled.

The real question, though, is will I have enough energy to enjoy all the plans I have made for August?

A friend, who goes to DisneyWorld fairly often, learned that he should not do what he calls the “Bataan Fun March,” trying to cram every possible attraction and experience into a single visit. Now he prefers a more leisurely Disney experience, visiting a few of his old favorites and a few new attractions, while leaving time for relaxed dining and time in the pool.

This would probably have been a better approach for me to apply to August. A few events then, a few in September.

It would be convenient if my hypomania returned in August, to allow me to do all the fun things I have committed to. But as we know, bipolar disorder is an unpredictable beast. In the past, I have missed concerts that I had no more spoons for. I have rescheduled appointments that I wasn’t physically or psychologically in any shape to attend. (Most of these were appointments with my therapist, who sometimes agreed to a phone session instead.)

But these commitments are ones that I can’t phone in. All of them require my actual, physical presence. I don’t want to cancel any of them, some I can’t cancel at all, and I can’t phone in any of them. My best hope is that my symptoms will allow me to both attend and enjoy, if that’s possible.

Maybe the new pep I am experiencing from the thyroid meds will help. It does seem to help regulate my moods a bit, as well as affecting my body. Maybe it will allow me to have more spoons for August. Maybe in September I can decompress. Maybe in October, I will be back somewhere near level ground.

My Triggers

By shane / adobe stock.com

Bipolar disorder is a funny thing. It can come on with no warning. One moment you’re fine, and the next you’re in the infinite doldrums or jagging on a spike of enthusiasm. Most of the time, it’s like that. The moods come on unexpectedly and stay as long as they want.

Sometimes, however, there are things in your life that seem to trigger a bout of depression or mania.  This isn’t quite the same as what’s commonly called a trigger. In the usual sense, a trigger is something in your past, like a traumatic memory, that comes bursting through when you read, see, or otherwise encounter a reminder of that memory. Suddenly, you are thrown back into the situation that triggered you, reliving the trauma, feeling as if you were still there, re-experiencing it. Triggers are most commonly associated with PTSD (or Post Traumatic Stress Disorder). Many people associate PTSD and its flashbacks with veterans and war, but other traumas, such as rape, assault, and natural disasters can also cause PTSD.

Trigger warnings are controversial. Some people need a warning that the content – especially books, blog posts, or films – may trigger a suppressed or otherwise traumatic memory and leave the person caught up in the sensations during a public moment, such as in a classroom. Obviously, people with traumatic memories would prefer to avoid this, so a trigger warning is placed at the beginning of a story, novel, or even a song that deals with rape, domestic abuse, or other traumas, especially ones depicted in a particularly graphic manner.

To other people, reacting to a trigger is an admission of fragility, at best, or at worst, an excuse for avoiding content that most people can easily handle. This is part of the mindset that leads to calling the severely traumatized “snowflakes” for their perceived inability to deal with stimuli that “normal” people take for granted. They do not understand the power of traumatic memories or the power they have over people who have been through trauma. They consider such people weak. They consider themselves strong, even if – or especially if – they have been through traumas themselves.

In general, my life has been less traumatic than some, more traumatic than others. There are memories that invade my dreams, situations that cause me panic, and stimuli that rev me up. I am not in control of these stimuli, or what they do to me.

Most of the stimuli trigger depression in me, as my bipolar disorder is heavily weighted towards depression. (In fact, I was diagnosed with unipolar depression before a psychiatrist finally recognized my condition as bipolar 2 with anxiety.) When I encounter one of these “personal” triggers, I am panicked, unable to communicate, and immobilized, or nearly so, and must rely on the help of others, especially my husband, to get me through. There’s no telling how long that depression will last.

Primary among my triggers is what I call “the rotten ex-boyfriend who almost ruined my life.” It was a toxic, gaslighting relationship that left my soul sucked dry and my emotions shattered. Fortunately, I do not often encounter anything that reminds me of those days. A friend I met during that time, in fact, has helped me heal both then and for many years thereafter.

Still, I have dreams – ones where I am traveling to the man’s house, ones where I am in the house but he is not present, and ones in which he is. I wake feeling vaguely seasick and nervous. The feeling persists like a hangover through most of the next day. It interferes with my ability to do work and to interact with people. My reactions used to be much worse, with specific words even able to throw me into panic and depression.

Another thing that triggers me is disastrous financial matters, or at least ones that I perceive that way. IRS dealings are by far the worst. A letter with that return address throws me into a panic. Once I even collapsed on the street after an IRS engagement and was unable to get up without assistance. Overdue bills and dealing with personal finances are triggers, exacerbated by the fact that I pay most of the bills, despite the fact that I make less than half the money. This is one of my contributions to the household since there are many things I am unable to do. Such situations leave me with my head in my hands, shaking and catastrophizing, unable to do what must be done until I calm down. (My husband is by now adept at helping me do this.)

And I have one of the more “traditional” trauma triggers – a natural disaster. A year and a half ago, our house was destroyed by a tornado. At the time it hit, I was upstairs in the bedroom. I remember the roof coming off. I remember putting a pillow over my head and hoping for the best. For many months I suppressed the trauma. But now it has come out. When the wind blows very hard or the rain blows sideways, I panic. Despite the fact that upstairs is the very place I shouldn’t go, that’s where I end up – in bed with a pillow over my head. (I also avoid movies like Twister. I’m not even sure I should try The Wizard of Oz.)

As for hypomanic triggers, I have few. Most of my hypomanic flights are unexpected, lifting me up with no warning. Although they can be exhilarating, they are also dangerous. One of the hazards is unwise spending, which of course can lead to the aforementioned financial depression triggers.

One trigger that takes me as near as I ever get to hypomanic sexuality, though, is a sensory, rather than a situational, trigger. For some reason, the smell of Irish Spring soap brings up the heat in me. I distinctly remember the first occasion on which I noticed this. A coworker walked past me and I smelled the distinctive scent. It started my juices flowing. Later, we became lovers. My reaction to Irish Spring is less extreme these days, but it still triggers a memory of the feeling. I seldom encounter the scent anymore, as my husband prefers Zest.

At any rate, it is my experience that triggers can arise from sensory memories, from dreams, from upsetting situations. I have few triggers related to textual representations, though I am not immune to those in films (I left the movie “What Dreams May Come” before it was over and waited in the lobby until it was over).

What I can say is that people’s triggers do not make them “snowflakes.” Triggers elicit visceral reactions that are no less real for not being visible to outsiders. While I don’t advise purging any possible triggering material from, say, academic curricula, I do think a trigger warning on syllabi or blog posts is only polite, and possibly psychologically necessary.

 

Workplace Adjustments I Would Like to Have Had

by Chinnapong / adobestock.com

I missed out on the heyday of the ADA. People didn’t become as conscious of accommodating people with disabilities until much later. And even then, the most common accommodation was wheelchair ramps. But there are some workplace adjustments or accommodations I wish I had available to me, back when I worked in an office.

According to the Americans with Disabilities Act (ADA), persons with disabilities are entitled to accommodations to make it possible for them to work. Most of us think about certain kinds of lighting, closed captions, or specialized chairs. But what about when you have an invisible disability?

The ADA definition of a disability is one that impairs an individual’s ability to – among other “major life activities” – learn, read, concentrate, think, communicate, and work. Certainly, a number of psychological or psychiatric conditions qualify as producing trouble in these areas. In my case, my bipolar disorder made it difficult to do many of those in your standard office work environment.

But would the ADA have made accommodations available to me? The ADA does include some mental illnesses in its list of disabilities. Examples of mental disabilities commonly considered under the ADA are:

  • Major depressive disorder
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Obsessive-compulsive disorder
  • Schizophrenia

Examples of accommodations or work adjustments for those with psychological disabilities include, among others:

  • Flexible Workplace – Telecommuting and/or working from home.
  • Scheduling – Part-time work hours, job sharing, adjustments in the start or end of work hours, compensation time and/or “make up” of missed time.
  • Leave – Sick leave for reasons related to mental health, flexible use of vacation time, additional unpaid or administrative leave for treatment or recovery, leaves of absence and/or use of occasional leave (a few hours at a time) for therapy and other related appointments.
  • Breaks – Breaks according to individual needs rather than a fixed schedule, more frequent breaks and/or greater flexibility in scheduling breaks, provision of backup coverage during breaks, and telephone breaks during work hours to call professionals and others needed for support.

Of course, in order to receive accommodations or adjustments, it’s necessary to reveal to someone – at least your boss or maybe the HR department – that you have a psychological or psychiatric disorder.

My own experience of needing accommodations at work was not great. In the job I held the longest, I only mentioned my depression (as it was then diagnosed), to my immediate supervisor. He was sympathetic, but the work environment was not exactly conducive to my needs.

One of the things that I could have used in dealing with the anxiety that went along with my depression was privacy. At first, that was not even possible, since my entire department was located in a cube farm, where no one had any real privacy. Even the fact that I was an editor and needed to concentrate on my work did not win me a private space.

Later, when we moved to an office that had actual offices, I snagged one with a door. The only problem was that I was not allowed to close the door, or at least looked askance at when I did.

An ideal situation for me (aside from being allowed to close my door) would have been permission to work from home. There was one person at this office who had this privilege, but it was never considered for me. Admittedly, this was very much pre-pandemic, but most of my work was done on a computer, and I had one at home that was compatible with the office computers. It wouldn’t even have been necessary for the company to supply me with one.

Another accommodation that would have helped lots would have been a hotel room to myself at business conventions, which would have allowed me time and space to decompress after a long day of being “on,” meeting and greeting, and being sociable and respectable. Unfortunately, that was a privilege reserved for the men. (As I understood it, the salesmen were booked into double rooms as well, but winked at when they rebooked them into singles.) This may have nominally been due to my sex rather than my mental condition, but not having a solitary retreat from the clamor of a convention definitely had a deleterious effect.

After 17 years at that job, I was let go, most likely because I was considered “unreliable.” At the next office where I landed, I had a boss who understood bipolar disorder (as I was then diagnosed) and who was satisfied with my work.  Never a bad evaluation – until that boss left. “I’m going to miss you,” I said. “I know you will,” she replied.

I realized what she meant when I revealed to my new boss that  I had bipolar disorder. “What does that mean?” she asked. Taken aback, the only reply I could think of was, “Sometimes I have good days and sometimes I have bad days.”  It wasn’t a great description of my condition and set me up for problems. After one year of my mother’s health and my psychiatrist appointments requiring me to miss work, and my missing work in winter owing to living at the bottom of a snowy, icy hill, I received my first bad evaluation. Nothing about my performance had actually changed since my work with the first boss. I could have easily worked from home and occasionally was permitted to, but my work was dubbed sub-par once I did.

(Not that it’s a big thing, but I would also have appreciated being able to take a “brain break” such as doing a crossword puzzle, instead of a cigarette break, since I don’t smoke. And not being asked work questions when I was on the toilet.)

After that, I went freelance, worked at home nearly all the time, and was only required to attend a meeting at an office once or twice a year. I have worked that way since and it suits me. It’s only now that I’ve become my own boss that I’ve been able to get what I really need when it comes to work.

 

References

https://www.eeoc.gov/statutes/americans-disabilities-act-amendments-act-2008#:~:text=The%20Act%20emphasizes%20that%20the,shall%20not%20require%20extensive%20analysis.

https://www.sfglife.com/blog/top-10-causes-disabilities-us-and-why-you-need-disability-insurance/

https://adata.org/factsheet/health

https://www.dol.gov/agencies/odep/program-areas/mental-health/maximizing-productivity-accommodations-for-employees-with-psychiatric-disabilities

https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/cms_011495.aspx

https://www.ada.gov/pubs/adastatute08.htm#12102

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