Bipolar 2 From Inside and Out

Posts tagged ‘bipolar disorder’

Flap My Arms and Fly

Those of you who read my blog regularly know that I’m not a big fan of positive thinking memes. In fact, they have the opposite effect on me. Someone who claims that a positive attitude is all that I need to change my life is likely to get only a “pfui” from me. As a person with bipolar disorder, I sometimes have major depression, and no amount of thinking is going to pull me out of it. In fact, the only thinking I can do at times like that is likely only to pull me farther into the depths.

If affirmations and positive thoughts work for you, I say, good. If mindfulness and meditation are your jam, then I say, whatever works. But please don’t try to deny my perception of reality.

That perception is that there are some things that positive thinking can’t do. That there are some situations that are immune to positive thinking. That positive thinking can’t change the outcome of everything.

Admittedly, positive thinking can change one’s attitude toward one’s circumstances. One can choose, as my father did, to be determined, stubborn, and positive in the face of his diagnosis with multiple myeloma. It likely helped him live long past what his doctors expected.

But not everyone can do that, and maybe not everyone should. Elizabeth Kubler-Ross said that acceptance was the final stage of the process of dying, not the first. The same, I think, is true of grieving. Anger, denial, bargaining, and depression are natural responses to cataclysmic events, including diagnoses, and in this case, particularly diagnoses of serious mental illness.

Although my father was well-known for his “positive mental attitude” about his cancer diagnosis, I remember a time when he could not even say the word.  He swallowed it, leaving out the vowels: cncr. And I remember that at times he was in denial about his illness and tried to do things he was physically not capable of doing – even, at one point, walking down the short hall to the bathroom. Even positivity could not help him there.

I watch a lot of competition shows on TV – Chopped, Forged in Fire, etc. – and I often hear the contestants say that they are doing it to prove to their children that they can do anything they set their minds to.

A part of me always says, “Okay, then. Flap your arms and fly.”

I know that sounds cynical and bitter, but it’s also the truth. The contestant who was cut in the first round has not done what he or she intended to or believed he or she could do. After that, they espouse the more reasonable and attainable lesson that their children, or others, should try to follow their dreams and take that trial as a noble effort, even if it doesn’t end in victory.

I have bipolar disorder. There are some heights I can never fly to, no matter how hard I flap my arms. I know I will have to take medication for the rest of my life. I know that, even with medication, I will still experience mood swings. I know that I will never be able to really trust my moods – that a setback might send me teetering over the edge or a triumph might make me imagine that I can indeed fly.

And, you know what? I’m okay with that. What I’ve accomplished with the help of medication, therapy, and the support of my family and friends, is good and is good enough. My dreams are down-to-earth, not grandiose. I do not dream of flying, but of remaining as stable as I can, right here and now. I choose not to delude myself with unattainable goals.

My father didn’t think he was going to live forever, but he was determined to live as long as he could, and to enjoy what he could in spite of the pain. I think that’s as ambitious as someone with a catastrophic illness can get. I admire him for his sustained effort and his stubborn resistance to despair. I admire those of my friends – and there are some – who can choose not to be dragged down by the circumstances of life.

Maybe it’s different for me because my disorder by its nature involves a component of lowered mood. But my expectations are not to flap my arms and fly, but just to keep on keeping on.

I Can Hardly See the Scars

Scars from self-harm are reminders of dark periods in our lives, times when we felt too little or too much. Times when we thought that feeling physical pain could distract us from emotional pain. Times when we felt so numb that we self-harmed to reassure ourselves that we were still alive.

Tattoos can be a lot of things. They can indicate membership in a tribe, be a reminder of a happy occasion, commemorate the passing of a loved one, be a work of art, be a relict of a drunken night, espouse a cause, or have a personal meaning that no one else is party to.

Self-harm is something a lot of us have tried, in one form or another. And the scars produced by it have many meanings. They can be reminders that we lived through a really bad time or reminders that we chose a really bad coping mechanism. Some people look at their own scars and feel lucky to have survived. Some look and feel shame.

Now, a Philadephia tattoo studio, Crown and Feather Tattoo Co., is offering to cover up people’s self-harm scars with free tattoos. The service is so popular that the studio has had to hire more tattoo artists to keep up with the demand.

They call this effort “Project Tsukurou,” a word derived from Kintsugi, a Japanese art form that involves repairing broken pottery with resin and gold dust. I wrote about Kintsugi recently (Beautiful at the Broken Places, https://wp.me/p4e9Hv-Yj). Rebuilding oneself after a breakdown and thinking about making it a work of art was very empowering to me. Apparently, the tattoo artists and their patrons felt the same way.

I have scars from self-harm and I have tattoos. The tattoos don’t cover the scars but are located in close proximity. The scars have faded, nearly invisible now since the dozens of years since they were created. I am over that, healthier than that now. (Once someone asked me how I quit self-harm. I replied, “I didn’t need to anymore.”)

At first, I was ashamed of those scars. I tried to hide them with wide bracelets and watchbands. Later, I made my peace with them. They were now a part of me, a reminder of a time of despair and despondency. They were a reminder never to let things get that bad again. That there are things I can now do to alleviate the pain or the numbness, should it ever get that bad again anyway.

Mostly, I don’t look at the scars anymore. But my tattoos are right there next to them. One is a semicolon, a symbol and reminder of suicide prevention. (See projectsemicolon.com for more information.) The other is the :): symbol for bipolar disorder. When I look at these tattoos, I think of the reality of both my disorder and my new, better, life-saving coping mechanisms.

Of course, tattoos are not a choice that everyone is prepared to make. Some people feel that they shouldn’t modify their body in that way. But for someone who has already modified their body with scars of self-harm, tattoos can possibly give them back a measure of dignity and pride that their self-harming days are over. They can look at their bodies and see, not mutilations, but life-affirming works of art.

So far, the only tattoo studio that I know of performing this service for free is the one in Philly. But most tattoo studios are used to covering over regretted tattoos with new ones. They should be able to cover the scars of self-harm as well. And if they don’t do it for free, well, one could think of the money as an investment in healing or moving forward or creating a work of art where once there was only a reminder of pain.

 

Reference:

https://scoop.upworthy.com/tattoo-studio-covers-up-self-harm-scars-for-free-it-totally-changes-your-outlook?fbclid=IwAR0sjb_G3sS_P3FsXmImsBtRaIrFkak_8OHjcNJJjocnnSrrL1X-bBqgSlc

The Worst Side Effect of Psychotropic Drugs

I’ll admit that I’ve had a lot of side effects from the various psych meds I’ve taken over the years, and some of them were bad enough to make me ask for something different. There’s been insomnia, sleeping too much, twitchiness, vivid nightmares, and others. But as far as I can see, there are only two side effects that would make me completely quit taking a prescribed medication, even before I could ask my doctor about it.

The first is Stevens-Johnson Syndrome. It’s what they mean when they say on TV commercials, “a fatal rash may occur” (I didn’t even know rashes could be fatal). Indeed, your skin starts to come off. I think it’s always a bad sign when your insides suddenly become your outsides, like in that Simpsons episode where everyone turned inside out. Among the medications that can cause SJS are anticonvulsants, antipsychotics, and other psychotropic drugs, at least two of which I take daily. When he prescribed them, my psychiatrist told me to stop taking the meds instantly if I got a rash around my mouth and nose, and go to the emergency room. It’s that serious.

Apparently, the anti-smoking drug Chantix and maybe some others can also cause SJS, which I guessed from the “fatal rash” warnings on the commercials and later confirmed. I idly wonder if the rate of Stevens-Johnson has increased now that more of these drugs are being used.

The other side effect that I truly fear is tardive dyskinesia. Tardive dyskinesia means involuntary, repeated muscle movements, which can affect the face (tics, twitches, grimaces) and other parts of the body (legs, arms, torso, and fingers). Think John Nash in A Beautiful Mind. These movements appear after taking medications such as antipsychotics. Worst of all, the movements may become permanent and a number of people are disabled because of them. There are now medications that treat tardive dyskinesia, but I still wouldn’t want to have it.

Yet, what is the most feared, the most despised side effect of psychotropic medications?

Weight gain.

I see countless comments in online support groups asking about weight gain on particular medications and posts that say such-and-such a drug caused weight gain. A number of people post that they will not take these medications, or will stop taking them, because they can cause weight gain.

Admittedly, weight gain is not often a good thing. It can certainly lead to other health problems. But my point is that many people are more concerned about their appearance than their mental health. 

I’ve struggled with my weight too over the years, and I have written about it (https://wp.me/p4e9Hv-7o). But I’ve struggled more with my mental health, which could kill me just as surely as obesity.

There is vast stigma in our society surrounding fat people. That’s undeniable. Fat people are stereotyped as lazy, sloppy, unattractive, unhealthy, and more. Despite recent body-positivity messages and a few clothing commercials that now feature more plus-size women (I haven’t seen plus-size men), this stigma continues virtually unabated.

Of course, there is stigma around mental illness, too. Those with mental disorders are stereotyped as out of control, violent, dangerous, suicidal, and a burden on society. I can see that people are reluctant to add the two stigmas together.

But honestly, is weight gain so very bad compared with the chance to alleviate the misery and suffering that accompany serious mental illness (SMI)? Personally, I prefer to weigh more and not live my life in despair and hopelessness.

Some of the medications I’m on can cause weight gain. Some of them can cause Stevens-Johnson Syndrome or tardive dyskinesia. Fortunately, weight gain is the only side effect I’ve had, and I can live with that. Stevens-Johnson is potentially deadly and tardive dyskinesia is potentially permanent. There are things I can do about my weight if it really concerns me, or I can chalk it up to a side effect of being content, stable, and productive.

Frankly, of the possible side effects, I fear weight gain the least.

Beautiful at the Broken Places

The Japanese have an art form or maybe a philosophy called kintsugi, which involves embracing the flawed or imperfect. Cracks or breaks in a pottery or ceramic vessel are repaired using gold dust and resin.

According to Wikipedia, “Japanese aesthetics values marks of wear by the use of an object. This can be seen as a rationale for keeping an object around even after it has broken and as a justification of kintsugi itself, highlighting the cracks and repairs as simply an event in the life of an object rather than allowing its service to end at the time of its damage or breakage.”

On December 29, I posted an essay titled “Broken” (https://wp.me/s4e9Hv-broken). In it, I described the despair and depression that finally hit me after a stressful year, one that ended with the news that my second book was not going to be published. It was an awful trigger for me, considering the amount of work and hope and myself I had already invested in the book, and how near it was to completion.

Instead, I have decided to embrace the philosophy of kintsugi. I may have been broken, but nothing says I can’t put myself back together and consider my mending an improvement. In fact, my therapist said something similar after I suffered an earlier breakdown: essentially, that I could choose what parts of myself I would restore and which I could cast aside. Recently I came across an old diary from that time. I have not yet decided whether to read it, keep it unread, or get rid of it. At any rate, I don’t think I’m strong enough to decide that now, given everything else that’s been going on. But there are other things I have decided to keep.

One of my decisions is to keep my first book, Bipolar Me, alive. It was went out of print this month, but I will be self-publishing it on Amazon. I won’t let the second book, Bipolar Us, die either. Right now I am exploring ways to make sure it will be published as a paperback as well as an ebook. It’s better than my first book, I think, and I want it to be available to people that might find help or hope in it.

To celebrate this decision, I have ordered a kintsugi-style bowl. (I can’t afford the real thing.) On the bottom will be written “My Story Isn’t Over,” which is also the motto that informs my semicolon tattoo. I will keep it near my desk, where I can see it often and let it remind me that beauty can come from the broken after all.

I also hope that the rebuild on our house, which was destroyed by a tornado, will make it more beautiful at the broken places. (The only thing that remained was the basement, so it’s really going to be all new.) At last I will have a home that I have had a hand in designing, choosing materials, and decorating. No more mismatched, hand-me-down furniture. No more rental-neutral walls and carpet. I can create my study as a place of comfort as well as work, one where my self-care items are readily available and the colors and decorations reflect a calm, steady mood. Again, it is a chance to rebuild something and make it better.

Most of all, though, I need to keep working on me. There are still cracks and breaks in my psyche that need to be repaired. It will take continued hard work and loving support rather than gold dust and resin, but I hope I can eventually convert my troubled life into a work of reclaimed art.

 

Asking for What You Need

I saw a post on a bipolar Facebook page that asked what coping mechanisms people used. There were the usual responses about self-care, which is certainly a fine coping mechanism. But it’s far from the only one.

I’ve learned any number of coping mechanisms over my years in psychotherapy. There’s “looking at how far I’ve come.” There’s “leaving the room when my anxiety gets too bad.” And there’s always one of my favorites: “petting the cat.”

But the answer I put down was “asking for what I need.”

It’s a good coping mechanism because no one can read minds. No one else knows what I need. And, short of them guessing and hoping to hit on the right thing, the only thing I can really do is ask.

I can ask my therapist whether we can work on my anxiety today. I can ask my friend to check in on me daily for a while. I can ask my husband for a hug, or alone time, or some distraction.

Of course, I don’t always know what it is that I need at any given time. At times like that, I can simply ask for things that might help or have helped in the past, like the aforementioned hug or alone time. My husband has been with me for so long and is so familiar with my bipolar disorder that he knows a number of things that are likely to help, and he can suggest them. If all else fails, he suggests I go to bed, or read, or listen to music, all things which can calm or center me. Sometimes he simply puts on my favorite movie, to help draw me out.

Closely tied to the mechanism of asking for what I need is the technique of negotiation. I may know what I want or need, but the other person may not be capable of providing it, or at least not right then. If a friend can’t take my phone call, I can suggest an alternative: Call me after 10:30 or sometime tomorrow. If I need distraction and my husband has to go to work, he can suggest that we go out to lunch the next day.

We’ve developed a shorthand for such situations. When the only thing I can do is say, “help,” he responds with, “help how?” If I can then come up with a suggestion, I do. A lot of the time he is able to provide what I need. But sometimes he just isn’t. Maybe he isn’t able to get me out of the house for lunch. So instead I say, “I need comfort food.” He usually says, “You can get that.” Or he may respond with what it is that he can do: “There’s cheese and crackers here. Will that do?”

Asking for help isn’t easy, and Lord knows negotiating for what you need isn’t either. Both take lots of practice. And there is always the possibility that another person simply cannot supply what you need. That’s where self-care comes in. I know down deep that a nap, or comfort food, or music may help me, and if no one else can provide them, I can usually do it myself.

Receiving help may not be easy, either. Asking for what you need can make you feel, well, needy. And receiving help from someone else may make you feel guilty or unworthy. But the fact is that you – all of us – need help at times and that learning how to ask for and accept help is a valuable skill. And a totally valid coping mechanism.

Dealing With Other People’s Anger

Before I was diagnosed with bipolar 2 and anxiety, I thought I was just a wimp.

Anger – anyone’s anger – frightened me, even if it was not directed at me. I spent a lot of time cringing, until it became an automatic reaction.

This was not because I was raised in an abusive home. I wasn’t. My parents expressed anger appropriately when they were angry, which wasn’t very often, and didn’t take it out on us kids. Once, my father, in a fit of frustration, kicked the locked door to a room my sister and I were squabbling in, and it shocked me. But compared to what some unfortunate kids go through, it was nothing. Once my fifth-grade teacher slapped my hand when I was holding hands with a boy, but again, my main reaction was shock.

But by the time I reached my late teens and early 20s, strong negative emotions overwhelmed me. And not just my own emotions, but other people’s. I was seldom touched by their joy or relief, but their anxiety or anger really got to me. That’s when I started cringing, literally drawing back in fear and trepidation when voices were raised. At its worst, I cringed even when the voices were in another room.

Along with this, my startle reflex was in overdrive. A sudden noise from another room caused me to jump and gasp. The sound of someone dropping a kitchen utensil was enough to set me off.

I believe that these reactions were a result of the anxiety disorder that my psychiatrist eventually diagnosed me with. I always felt that the negative emotions, the anger, and the attacks would be coming at me. I was always on edge, anticipating the raised voice, the accusation, the threatening sound. And it was exhausting. There’s a certain amount of adrenaline that goes with fear and anxiety, and it can leave you shaking.

Oddly enough, I didn’t really start to get over my fear of anger until I began to get in touch with my own anger. For years, I thought that my only feeling was anxiety, but hiding behind the fear was anger. Even in situations that should have made me angry, when I had a legitimate reason to be angry, I never felt that feeling. That part of building a wall against my feelings worked, even if anxiety and depression were walled in, not out.

Gradually, I began to see that there were times when I should have been angry about something that had happened – that I had a right to feel angry. Later, I learned that I also had a right to express my anger. And I learned that neither feeling anger nor expressing it would destroy me. At that point, other people’s anger began to have much less of an effect.

I’m not completely over it. When someone expresses not simple anger, but rage, near me, I again feel the need to rebuild the walls. But I am learning to deal with it. Sometimes I am able to help the person examine their rage and explore what to do with it. Other times I can simply remove myself physically from the situation, so the rage doesn’t come pounding in on me. I learned to do that when I was dealing with simple anger and the anxiety surrounding it. But I’ve found that it works for rage, too. If I don’t have to be around it, I don’t stay within range.

Fortunately, rage is rare in the people I choose to have around me. Anger still happens, both for me and others around me, but I have learned coping mechanisms and built up the strength to withstand it.

I no longer cringe.

 

 

Do It for Yourself

The commercials advise you to do it for them. The family. The children. The laughing, smiling friends who have great social lives and adventurous spirits. You want to join them, don’t you? You have only to take these drugs to alleviate your depression, keep your bipolar disorder at bay, tamp down your manic highs.

Do it for the ones you love, and the ones who love you.

Well, that’s all well and wonderful, but what about you? Maybe you have a family that doesn’t understand mental illness. Maybe you don’t have a loving bunch of children and a husband or wife ready to embrace you if only you’d get cured and be able to do the laundry. Maybe you’re alone with your disorder and your own self.

Do you still have a reason to seek treatment and get relief from your disorder and your symptoms?

Of course you do! Whether or not you have that picture-book family waiting for you to shape up and smile, you are worthy of a better life, one free from the seemingly non-ending drag or jags of mental illness.

It’s just that our society says that one person’s not enough. We must live for others. We must thrive to spread pleasure to and with them. Only in a family, only when we fit in, only when we are properly medicated or counseled, are we whole.

I’m here to call B.S. on that. Many of us live our lives alone, without family who understand us and friends who support us. If you have those resources, great! No one is saying that you would be better off without them. But many of the mentally ill have to make do with no such support system, no back-up for when our brains go wonky, no squad to cheerlead when, at last, things go right.

And I say that’s okay. You are enough. You deserve to have mental health and stability whether or not you are part of a couple or have children. Your family may be estranged from you. You are still worthy of healing and stability. You deserve it because you, by yourself, are a human being who needs that.

Society calls us to sacrifice for our spouses, parents, and children. We are to think of ourselves last, give our all to the ones we love. They deserve our support, attention, and caring. Mothers especially are exhorted to give all for their offspring. But is our mental health truly something that we should sacrifice in the name of others?

Should we not go to counseling because our schedules are full with family activities? Should we not pay for our medication because there are other household bills? Should we not take those medications because they might affect our moods and thoughts?

We are all worth it. We all deserve mental health – the poor, the lonely, the abandoned, the difficult, the single, the friendless. We have value whether or not we are connected to the vision of society we see on our televisions and especially on commercials for psychotropic medications.

I say, do it for yourself. Seek treatment if you need it. You are enough, just the way you are. Don’t let social programming convince you that you are lesser, unworthy, just because you don’t fit into the roles that are deemed suitable for everyone.

If you need help with your mental health, seek solutions. Don’t worry that others have needs. Your need is just as valid. If you need help, go out and find it.

You are enough. Do it for yourself.

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