Bipolar 2 From Inside and Out

Posts tagged ‘being overwhelmed’

What Bipolar Disorder Has Cost Me

black backgroundWe lose a lot when we live with bipolar disorder – function, memory, friends, and even family.

But we also lose something more tangible – money. Or at least I did, and I know that a number of others have experienced this as well. Here’s how it went for me.

Work. I quit my full-time office job (possibly in a fit of hypomania). I had a new boss and had told her about my disorder. Her only question was, “What will that mean?” My answer was, “Sometimes I’ll have good days and sometimes I’ll have bad days.” (It caught me by surprise, so I didn’t have a more coherent or accurate answer.) Immediately after that, I began receiving bad evaluations, which I never had before. Was my performance really declining? It probably was, as I was heading into a major depressive episode.

But I wasn’t out of work quite yet. For a while I worked freelance, and pretty successfully. Then my brain broke, and there I was – unemployed. I had savings in a 401K, and we ran through all of that. Then my husband had a depressive episode and we ran through his 401K as well. And the money we got from refinancing our house.

Disability. Sometime in that stretch of time, my husband realized that our money was going to run out. He asked me to file for disability. Many of you know that story. I was denied. I got a disability lawyer. By this time – years later – I was able to work freelance again a bit, and my lawyer told me shortly before my appeal hearing was scheduled that the hearing officer’s head would explode when he learned what my hourly rate was.

Never mind that I could work only a few hours a week – maybe five, in a good week.

Insurance. Then there was insurance. As a freelancer, of course, I didn’t have any. My husband’s good county job had covered us, until he became unemployed too. I’m sure a lot of you know that story as well. No insurance. Huge pharmacy bills, and psychiatrist and psychotherapist, and doctor visits and the odd trip to Urgent Care.

Meds. Then my doctor put me on a new drug which cost $800 a month. I got a couple of months free from the drug company – just enough to discover that it really worked for me and I didn’t want to give it up.

Then, with remarkable timing, the Affordable Care Act (aka Obamacare) came along and we were able to get insurance again. It wasn’t really affordable, though, costing only slightly less per month than the new drug. But it covered all our other prescriptions, too, so we came out a little ahead.

Budget. Since then, that’s the way it’s been going – month to month and disaster to disaster. My work is irregular and I never know how much I’ll get in any given month. My husband’s pay is steady, but meager – a little above minimum wage. We have managed to make our mortgage payments and keep the house, which my husband doubted we’d be able to do when I couldn’t work. I know in that respect, we’re way luckier than many families struggling with bipolar disorder.

Our latest disaster came this week, when our only remaining partially working vehicle (no reverse gear) blew out second gear as well. The money we had borrowed and put aside for major dental work that the insurance wouldn’t cover disappeared with a poof – and still wasn’t enough. We had to borrow more from an already fed-up relative. I don’t blame her. She never expected to have to keep bailing out her grown son and his wife when she herself was past retirement age.

Our Future. I don’t see anything changing. My mental disorder is under much better control, but I know I’ll never be able to work in a full-time 9–5 job again. Job opportunities are few for people our age anyway, despite anti-age-discrimination laws. And I’ve never tried applying for a job where I must ask for accommodations to offset my illness, but I’m sure employers find lots of reasons not to hire people who need those. Again, despite the laws.

So why am I telling you all this? Am I just whining and feeling sorry for myself? Well, yes, I am, but that’s not the point, really. Bipolar disorder takes a brutal toll on our emotional lives, our families, our relationships, and more. It can also put us on the brink of poverty, or in our case, one paycheck and one more disaster away from desperate straits. I know that there are bipolar sufferers, including some of my friends, in much worse straits.

It’s stressful.

And we all know how stress affects a person with bipolar disorder.

Badly.

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Stuffing Your Feelings in a Box

Cardboard box with the zipper isolated on white backgroundWe all know it’s a bad idea to stuff your feelings, especially if you then pile food or alcohol on top of them.

The thing is, sometimes you need to suppress a feeling, for just a little while, in order to get through a difficult situation. When that happens, I put my feelings in a box.

Here’s an example. My father was dying, and had only days to live. We all knew it. My mother, who didn’t drive, asked me to take her shopping for something to wear at his funeral. “Do you mind if I don’t wear black?” she asked. “If you don’t mind that I do,” I replied.

It was my first encounter with a close family death, and I had to get through this awful, wrenching shopping trip. I had to keep my composure so that my mother could keep her composure. I had to steer her away from a flowered dress, which would have been fine for church, to a navy suit and a lighter blue top, which would be suitable for a funeral but not so somber that she couldn’t wear it for anything else. All while my father lay in the hospital, dying painfully of bone cancer.

My feelings were complicated and I absolutely could not afford to feel them at that time. I had to stuff them in a box and close the lid on them until my mother’s needs had been met. Then I could let them out, in a time and place where it was safe to, in the presence of a person I could trust with those feelings.

When such circumstances arise – and they will, in one form or another – I recommend using a box, one in which the feelings will be out of sight for a while. A box is small; only a few feelings will fit in it. If you think the feelings are going to leak out, you can sit on the lid. Then, when it has served its purpose, you can rip the box open (or gently lift the lid) and feel the feelings. Cry. Rage. Grieve. That’s the important part.

You have to experience the grief or fear or even the crushing weight of guilt in order to come through it and heal.

But why put feelings in a box instead of something stronger? Who wants to feel those negative emotions anyway? Aren’t we better off without them? Shouldn’t you just build a wall around them to keep them from breaking out?

We’ve all tried it. It works for a while. But a couple of consequences go with the practice. First, all of your feelings get trapped behind that wall – the good as well as the bad. When you find yourself disconnected from all your feelings, life is a gray blur. In your depression or anxiety or fear or rage, you may not have had many good feelings. But when you build that wall, you cut off even the possibility of having them.

Second, you’re only postponing the pain. The wall will leak sometimes; your unpleasant feelings will come out some way – in your dreams, around your eyes, in sudden spurts, or trickling back into your everyday life. Worse, the wall may shatter – fail altogether, releasing all those feelings in an unstoppable torrent, only stronger and more concentrated from having been confined. They overwhelm both you and anyone in the vicinity. It’s not pretty. And it’s destructive – to you, your mental health, your healing, your employment, your relationships – to every aspect of your life.

If feelings are behind a wall, you may be able to tell yourself they don’t exist. But if you stuff them in a handy box, you can choose the time and place to open it – and yourself – back up.

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The Fire and the Window

fire orange emergency burning

When Anthony Bourdain died by suicide and I told someone the news, he asked me, “Why?”

I was taken aback. “What do you mean, ‘why’?” I replied.

“You know,” he said. “Did he have money trouble? Break up with his girlfriend? Have some disease?”

That’s a common reaction to suicide and it’s uninformed. Real-life stressors can contribute to suicide, but they are almost never the whole story. People die by suicide when the pain of living seems greater than the pain of dying.

Gregory House, the misanthropic, genius title character of House, M.D., once said, “Living in misery sucks marginally less than dying in it.” People who kill themselves don’t believe that. They believe the opposite.

The best metaphor I ever heard for suicide was the plight of people in the World Trade Center’s upper floors on 9/11. There were the flames. There was the window. And that was the choice. Suicide happens when a person sees only two alternatives and both are equally horrible, or nearly so.

The bullied child does not take her own life because she was bullied. She was in pain, for a variety of reasons that included bullying. It was a factor, but it wasn’t the reason. She was hurt. She was isolated. She was depressed. She didn’t believe that things would improve. She wanted the pain to stop. She believed she faced the choice between the fire and the window.

The politician who dies by suicide in the face of a major scandal does not kill himself because of the potential scandal. He dies because he sees his choices limited to shame, humiliation, despair, and ridicule. He believes that what happens to him will be as bad as dying. He is caught between what he sees as the fire and the window.

Mental illness can make it difficult to see that there are other choices. The distortions of thinking associated with serious mental illness can make us see only the fire and the window.

The one time that suicidal ideation got the better of me and I was close to making the choice, my thinking was just that twisted. I was faced with a choice that seemed to me would ruin someone I loved. I thought that I could not live with either choice – to ignore the behavior or to turn him in. One was the fire and the other, the window.

My thinking, of course, was severely distorted by my mental disorder. The thing that I thought might rain destruction on the other person was much smaller than I believed. There were ways out of the dilemma other than dropping a dime or killing myself. If we continue the metaphor, the fire was not that big, or that implacable, or that inevitable, but I couldn’t see that. In the end, I hung on long enough for my thinking to clear and for me to see other options.

I don’t actually know what was going on in the minds of the souls who were trapped in the Twin Towers. I don’t mean to lessen the horror of their deaths or wound their families by speaking of suicide this way. The reality of their choice is so far distant from the choices that other people who consider suicide face.

But that’s kind of the point. People who die by suicide don’t see any other way out. If they seem to be responding to what most people see as survivable hurts or solvable problems, people say they can’t understand how someone that rich, that successful, that beloved, that full of potential could have not seen that help was only a reach away.

The person who dies by suicide doesn’t see the hand reaching out. Only the fire and the window.

If you are considering suicide, call the Suicide and Crisis Lifeline: 988.

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My Emotional Protection Animals

I have what I refer to as emotional support animals – principally my husband. He goes with me to places and into situations that upset me, like a dentist appointment or a class reunion. He puts a comforting hand on my shoulder and encourages me.

My cats provide emotional support as well. They ground me when I’m upset and help me calm down. They give me something to focus my attention on instead of the turmoil in my head. They soothe me with their purring and distract me with their antics.

You would think that the animals I identify with most would be cats. I do believe that if I could be any animal, I would choose to be a cat – as long as I could be one of my own cats and not an unwanted, feral stray.

But the animals I identify most with are bunnies and armadillos. Here’s why.

There’s an expression among chefs – when they’re absolutely slammed with work, falling further behind with each passing minute, they describe the situation as being “in the weeds.” I use the phrase a little differently. I was experiencing a mixture of anxiety and depression, totally overwhelmed, though not necessarily with work. Every day brought new challenges that terrified me. Every day I found myself immobilized. And every day I found myself retreating. I felt like a little bunny hiding in the weeds.

That became the shorthand my husband and I used to describe the feelings. He would ask me how I was feeling, and I would reply, “I’m hiding in the weeds.” When I couldn’t express what I was feeling, he would say, “Are you hiding in the weeds?” and I would nod. That’s how I felt – like I had to hide from the flood of feelings and problems that beset me. Like I needed a screen of weeds to offer me what little protection they could. Like I had to be ready to jump at any minute the next time I sensed a threat.

I moved past this phase. After years of therapy and medication, I no longer need the weeds. I have stronger forms of protection that come from inside now. (My husband does calls me “Bunny” as a term of endearment, though.)

Armadillos are another story. Again, though, my fascination with them was in relation to another form of protection, seemingly more solid than weeds.

Armadillos are covered, of course, with bands of scales that protect them from most dangers. They can also roll up in a ball to protect their soft underbellies. I tried to develop hard scales that would prevent trauma from invading my fragile emotional makeup. At times I even rolled up into a ball (or at least a fetal position) when I had a meltdown.

Eventually, I did learn that if you wall off your feelings, it’s hard to get back in touch with them. And the good emotions get blocked off as well as the bad ones. The armadillo armor was not a viable solution for the long term.

I also learned that the armadillo has another defense mechanism. It jumps straight up about two feet into the air, presumably to escape from or startle any predators. Unfortunately for the armadillo, their main predator is the automobile. The little critter’s jump puts it at just the right height to be smashed by the car’s bumper. As a defense mechanism goes, it’s not really what you’d call successful.

That’s when I realized that neither were mine. When I got jumpy – when my anxiety was out of control – I was often smashed by onrushing difficulties, the very ones I was trying to escape.

So, bunnies are out. Armadillos are out. Where can I find an animal to identify with in terms of protection? We’re back to cats, I guess. They at least have claws that they can choose to extend or sheathe. I like the idea of bringing out a defense mechanism only when I really need it.

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When I Need to Feel Normal

A lot of the time, I live with sort of a low-grade dread, kind of like coming down with a fever. I’m well-known for overthinking and catastrophizing. The combination is exhausting.

When anything alarming happens, I ratchet up into an agitated state. It could be anything – a relationship problem, a looming financial disaster, a health scare. I respond with racing thoughts, trembling hands, and sleep disturbances. I find myself at 2:00 a.m., wide awake though a little bit foggy, with no real idea what I should do. Most of the time, there isn’t really anything I can do.

This happened a lot when I was in college. My life was complicated then – well, it always has been and still is. I wasn’t particularly worried about my grades or about graduating. No, it was other things that occupied my troubled mind. A difficult relationship was ending in great turmoil. I had lost a lot of weight and didn’t look or feel healthy. I had to pack, move, and find a job. My parents were coming for the graduation ceremony and I didn’t want them to see me in such distress. It was all overwhelming.

I had insomnia that summer. I would find myself lying on the sofa, wide awake, my brain on overdrive, with only a large black cat to keep me company while everyone else in the house slept. That cat kept me anchored in a way. He distracted me with his solidity and his insistent purring. He was a soothing presence that helped me not feel totally alone, without putting any demands on me.

It was that summer when I learned a technique I could use when everything seemed to be spinning out of control. I found that I could ground myself and stop all the whirling thoughts, at least for a while, by doing something small and totally normal. Making myself a cup of tea was my go-to. The familiar actions of finding a mug and a teabag, heating the water, and steeping the tea gave me something physical to do that would get me out of my head and back into my body. No matter how distraught I was, I could always manage to make a cup of tea. It’s not a demanding task. I could do it practically by rote. But it was so familiar – so completely normal – that it was a form of reassurance.

It turns out that the feeling of normalcy can soothe other people too. Once that summer, my uncle Phil was also having a hard time sleeping. Like me, he was afflicted by personal problems and feeling out of touch with his body and tangled up in his head. I busied myself making him a can of soup. It kept me from getting swept up in his turmoil, and it helped him become calmer as he watched me puttering around the kitchen. Again, it was all so normal that it soothed us both.

Now, when I have racing thoughts and distress, I try to find something manageable and entirely normal to do – something I can do automatically, without expending any thought. Putting out fresh food for the cats. Making lists. Watering a plant. Anything that I can do with little expense of energy or thought. In a way, it’s kind of a mindfulness exercise, paying attention to the steps involved and experiencing every movement as I go about accomplishing my normal little task.

This technique doesn’t work for me if I’m having a full-blown panic attack, but maybe it at least helps me stave one off if I catch it creeping up on me. It’s one of my more effective – and non-counterproductive – coping mechanisms.

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Feeling Better Than Average

I was chatting online with a friend the other day and asked how she was doing. Knowing that we both suffered from depression and complicated lives, I didn’t expect a throwaway answer like “fine.”

What she said was, “better than average.” She didn’t have time to say more because she was in the waiting room for her therapy appointment. I would say that I have been better than average lately, too.

But it all depends on what “average” means, doesn’t it? For me, an average day (or week or perhaps even month) means I don’t have extreme depression or hypomania, don’t leave my house but can if I have to, and am able to work on my writing. To an “average” person – if there is such a thing – it may not sound like much, but it is my baseline, my average. Better than average means that I have intentionally gotten dressed in something other than pajamas and gone somewhere, have a handle on our finances, and made a lot of progress on my writing. Today, I would say, is an average day. Not great, not awful, but average.

Average is a good place for me to be. It means I’m fairly stable, not troubled overly by symptoms of my bipolar disorder. Better than average is okay, too, though it makes me more wary of whether I may be going over the edge into hypomania. Any better than “better than average” and I know I’m in its grip. “Below average” translates to “low” for me, and means that I’m on the lookout for depression to descend.

My friend, though, has been having an average year that would not be average for me. Her baseline is a lot lower than mine, with several years of family and financial crises, career reverses, and severe depression. Occasionally, she has been even lower than just below average. So, to hear her say that life has been above average of late is encouraging but not necessarily terrific. I hear her “better than average” as saying, “not as bad as usual” – though still not good.

She doesn’t have bipolar disorder, but I can’t remember a time when she was truly better than average by any reasonable definition, at least not in the last ten years or maybe longer. It’s one of those situations in which all I can do for her is listen if she wants to talk. So to hear her admit that she feels better than average seems like something to be celebrated, even though I fear that it is illusory and bound not to last.

I’ll be interested to hear the next time we talk what made her feel above average and whether it has lasted. Was it a momentary improvement in one of her many difficulties? Was it something her therapist can help her maintain? Has her dopamine or serotonin or whatever kicked in? Has her baseline truly gotten better? Or will I see a retreat to her normal below-average (or worse) baseline?

I can’t help feeling that it’s too soon to celebrate. But I do so want it to be real and to celebrate with her. Even if the improvement is only temporary, I know how good that feels and the hope it gives. And I wish that for her. I hope the next time she’s in touch with me, she still feels at least better than average.

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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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