Bipolar 2 From Inside and Out

Posts tagged ‘bipolar disorder’

Take a Hike: Nature and Mental Health

photo from the author’s collection

 As a child and as a teenager, I was a Girl Scout. We hiked. We camped. We did all sorts of nature-related crafts. We ate wild plants. Well into my 20s, I was an outdoorsy-type person, hiking on the Appalachian Trail, walking to all my classes through the leafy green environs of my college campus, even trudging contentedly through the copious snowfall. One year I lived in a log cabin on a hilltop so far from civilization that you had to go to town to pick up your mail.

All the while, I had bipolar disorder, and it was relentless, I experienced the inevitable mood swings, the crashing lows, the tempestuous highs, the confusing mixed states. 

Now, everywhere you turn, there are articles and memes touting how time spent in nature is good for various psychiatric conditions. When you look more closely, though, the studies often refer to simply alleviating bad moods or improving cardiovascular health. Very few of them seem to apply to actual mental illnesses. Perhaps this is to be expected, since improvements in emotions or mental health are largely self-reported or tracked by means of a survey. It’s hard to quantify mental health. But let’s take a look at some of the studies anyway.

Harvard Men’s Health Watch published an article called “Sour Mood Getting You Down? Get Back to Nature.” The subtitle on the piece read, “Research suggests that mood disorders can be lifted by spending more time outdoors.” Then the article went on to suggest that “ecotherapy” shows “a strong connection between time spent in nature and reduced stress, anxiety, and depression.” 

The subtitle suggests that the outdoors has an effect on alleviating mood disorders. The body of the article, though, stresses alleviating unpleasant moods in general, not primarily what psychiatrists would class as mood disorders. The article cited a 2014 study saying that “people who had recently experienced stressful life events like a serious illness, death of a loved one, or unemployment had the greatest mental boost from a group nature outing.” Stressful and sad events, certainly, but not mood disorders such as PTSD, clinical depression, or bipolar disorder.

The article also cites a report published online March 27, 2017, by Scientific Reports, which suggests that “listening to natural sounds caused the listeners’ brain connectivity to reflect an outward-directed focus of attention, a process that occurs during wakeful rest periods like daydreaming. Listening to artificial sounds created an inward-directed focus, which occurs during states of anxiety, post-traumatic stress disorder, and depression.” It does mention psychiatric disorders, but it says only that inward-directed focus occurs during these states, not that inward-directed focus causes them.

Greater Good published an article that claims, among other things, that “scientists are beginning to find evidence that being in nature has a profound impact on our brains and our behavior, helping us to reduce anxiety, brooding, and stress, and increase our attention capacity, creativity, and our ability to connect with other people.” Again, this says nothing about actual psychiatric disorders.

The article also cited a Japanese study: “Results showed that those who walked in forests had significantly lower heart rates and higher heart rate variability (indicating more relaxation and less stress), and reported better moods and less anxiety, than those who walked in urban settings.” The researchers concluded that there’s something about being in nature that had a beneficial effect on stress reduction, above and beyond what exercise alone might have produced.

This, of course, does not apply to those in urban settings who do not have much access to forests or sometimes even parks. And the abstract of the Japanese study says, “Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity.” It doesn’t really deliver what the headline offers: “How nature makes you kinder, happier, more creative.” Good heart health is, of course, a good thing, but to extrapolate that to mental health benefits is quite a stretch.

The UK’s Mind.org does offer a link between ecotherapy and mental health in one instance, at least: “Being outside in natural light can … be helpful if you experience seasonal affective disorder (SAD), a type of depression that affects people during particular seasons or times of year.” This article also acknowledges that there are “other options for treatment and support – different things work for different people….You might do an ecotherapy programme on its own, or alongside other treatments such as talking therapies, arts and creative therapies and/or medication. Some ecotherapy sessions follow a set structure, and incorporate types of talking therapy, such as cognitive behavioural therapy (CBT). People in the group may or may not have experience of mental health problems, but the main focus is usually working together on the shared activity.” This at least sounds both more scientific and more likely to produce results.

If a walk in a natural setting does you good and alleviates your symptoms of mental illness, then by all means, make it part of your routine (or do it as often as you can manage). My bipolar depressions, however, are so debilitating that I am unable to plan, much less embark on, a walk in nature, even as far as the mailbox. Bringing nature indoors is, of course, an alternative. But the little plant pictured here, which needs two ounces of water once a month, is all I can really handle.

Resources

https://www.health.harvard.edu/mind-and-mood/sour-mood-getting-you-down-get-back-to-nature

https://greatergood.berkeley.edu/article/item/how_nature_makes_you_kinder_happier_more_creative

https://www.hindawi.com/journals/ecam/2014/834360/

https://www.mind.org.uk/information-support/tips-for-everyday-living/nature-and-mental-health/how-nature-benefits-mental-health/

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A Letter From the Future to Bipolar Me

by sosiukin via adobestock.com

Dear Me:

You’re 13 years old now, and there are a few things you should know.

You have bipolar disorder. No one knows this, not even you. But a lot of people notice that you act “weird” at times. You have decided to embrace your weirdness, which is fine, but what you really need is psychological help. And medication.

Don’t pass up any chance to get that help. Your high school will recommend to your parents that you get counseling. When your parents leave the choice up to you, take it. It will not go on your permanent record, and you will still get into a college. A very good college, in fact.

I know that at times you sit alone and cry. Other times you laugh at things no one else finds funny. This is not just “weirdness.” This is a mood disorder, called bipolar disorder, type 2. Your mood swings will make it difficult for you to make and keep friends. Keep trying. The friends you will find are worth it and will stand by you when you really need them. You will not be alone in dealing with this.

Your choice to go to college out of state will be a good one. There you will have a variety of experiences that will make you grow in unexpected ways. Your mood disorder will go to college with you, though. Leaving Ohio will not mean you will leave bipolar disorder behind. You will still feel the mood swings, and most of them will be depression.

It’s a good idea to take that year off between freshman and sophomore year. I know it will feel scary, but at that point you will be in no shape to carry on with academics. Instead, you will get a job which, while not great, will introduce you to more new people and new ways of life. At least one of those people will stick with you till you are old and gray.

Returning to school will be a good decision. Your parents will support you in that decision. They won’t object to your year off, because they know you will go back. It still won’t be easy, but you will have a core group of friends that accept you, even though you are different from them.

Your bipolar disorder will follow you back to college. It will make you miss some opportunities and choose others that will not be good for your mental health. You will be unhappy most of the time, but you will find that music helps you through it.

Try not to self-harm. I know you will feel numb and want to feel something else, but cutting yourself is a bad decision and will not help. You will carry those scars forever.

When you meet Rex, though, you will be encountering a problem too big for you to handle, and the relationship will leave you scarred as well. It would be best if you were to steer clear of him altogether. But then again, you will find some true friends in his circle, and it would be a shame to miss them. Try your best to hold yourself together, remember what I said about self-harm, and don’t give up on who you are. You are not your disorder, and you will get through this, despite everything.

I know you never gave a thought to marrying, but you will meet a man and in a few years you will marry him. This, I assure you, is a good decision. He will stick by you no matter what and help you find help.

Going into the building that says “South Community Mental Health” will be a good decision. Whatever you will be feeling at this point – most likely misery – it’s not mentally healthy. This will be the place where you will start to climb out of the hole you have found yourself in.

At last, a doctor will tell you that you have bipolar disorder – most often depression, but also anxiety. He will work with you to find a combination of medications that will help you. When that happens, you will become reacquainted with your brain and relearn how to function in the world at large. Your brain will function in a new way, one with fewer out-of-control feelings. You will experience life more fully and be glad of your new outlook.

It won’t be quick, and it won’t be easy, but you will have therapists, and friends, and work, and love, all of which will help see you through. You will have bipolar disorder all your life, but it will not be your life, though it seems that way now.

Reach out for help whenever and wherever you find it. Cherish your friends. Keep trying, even when you want to give up. Better times are on the way.

I promise.

Love, me (older and maybe wiser)

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Mental Health

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A Sensory Self-Soothing Room

Photo from the author’s collection

Not long ago, I read in the Creativity in Therapy blog (http://creativityintherapy.com/2016/05/create-a-sensory-self-soothing-kit/) an article by Carolyn Mehlomakulu, art therapist, called “Create a Sensory Self-Soothing Kit.” The idea was that a box filled with items that engage your five senses is an excellent tool for being grounded when you need centering or self-care. The recommendations were for any five things that appeal to the senses of touch, sight, hearing, taste, and smell. I tried the exercise and came up with the following:

Touch – plush animal

Sight – amber necklace

Hearing – iPod playlist

Taste – caramel

Smell – Oolong tea

I never actually made myself such a self-comfort box, but I remember the exercise as a way to think about my senses and how nourishing them can nourish me.

Lately, though, I have acquired a room of my own and have been decorating it to suit myself. Recently, I realized that it has all the requisites of a comfort kit toolbox.

Touch – I have quite a collection of stuffed animals stashed around the room. A great many of them were gifts from my husband, who knows my history with stuffed animals (as we used to call them). Every Easter there was a new stuffed rabbit in our Easter baskets, along with the chocolate bunny and the jelly beans.

Perhaps the most important plushie in my room is named “Trauma Bunny.” My husband found her in the store he works at, squashed behind two huge bags of dog food in the pet aisle, rather than in toys where she belonged. Of course, he bought her and brought her home to me. Now she sits on my desk, guarding my headphones and cellphone, close enough for me to reach out and pat her on the head or fondle her ears.

Sight – I have furnished my room with many things I like to look at, from travel souvenirs to prints and paintings that have significance for me. Even the walls are a toasty rusty-brickish color that makes me feel warm just to look at. I also have a television, where I can watch shows that comfort me, such as ones on the Food Network. I have two windows, and the blinds are always up on at least one of them. The view isn’t terrific, but the sunshine is welcome.

Hearing – I do have iTunes on my computer, with more music than I could listen to in a week. Among the tunes are ones recorded by some of my singer/songwriter friends, as well as the well-known artists I like best, ones you don’t hear on the radio anymore. There is also instrumental music, from Vince Guaraldi to Béla Fleck, if I want something less distracting than voices and lyrics.

I also have a cat tree by the window, where my two cats love to sit or sleep. Both cats purr nicely and loudly. One of them even snores when she sleeps – daintily, but she definitely snores. (Of course, petting the cats also qualifies as touch, and watching them bathe themselves, which I find soothing, counts for sight as well.)

Taste – My husband keeps my room stocked with things he knows I like such as Cocoa Puffs. There’s always diet cola in the bottom drawer on the lefthand side of my desk. Right now there are honey-roasted peanuts in case I need a more proteinaceous snack.

I generally eat only one meal a day, and when I’m really depressed sometimes skip eating altogether. It’s good to know that there’s something here that is easy to access, requires no cooking, and meets some of my basic needs and likes.

Smell – Since I’ve transferred most of my library to an ereader, there are fewer books in my room, but most of the ones I still have are old and retain that almost-indefinable book smell – dust, paper, and some other distinctive aroma that I remember from trips to the used book store as a kid.

I also have a candle that smells like snickerdoodle cookies. I’ve never lit it, but sometimes I just pick it up for a deep sniff. Then there’s my tiny Mr. Coffee, which I use for tea, including oolong, herb tea, and possibly my favorite, the spicy smell of Constant Comment tea.

I practically live here, even though the house is fairly large and there are sensory delights in the other spaces as well. But what I have here, I recently realized, is a comfort box that’s just the size of a room.

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Mental Health

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Mental Health Privilege

Vectorarte / Adobestock.com

These days we hear a lot about privilege – class privilege, white privilege, first-world privilege, male privilege, and, I’m sure, many more. The idea is that people who have privilege don’t have problems that other people deal with every day and. In fact, they don’t usually realize that they have this privilege and benefit from it.

I know that I am privileged in many ways. I am white and heterosexual. I have a house, a husband, and work I can do. I have an Ivy League education and grew up in the suburbs, the child of loving parents who never divorced.

But what I don’t have is mental health privilege. I have bipolar disorder.

When a person has mental health privilege, they don’t have to take multiple medications just to keep their brain functioning in something like a normal manner. You won’t get pill-shamed for the meds you take or have random people suggest your problems will all be solved with prayer, yoga, apple cider vinegar, or acupuncture.

(I do recognize that there are many people who take meds for a variety of disorders, including life-threatening ones. I don’t mean to discount their struggles. Physical health privilege and ableist privilege also exist.)

When you have mental health privilege, you don’t have to question whether or when you should inform a boss, a potential employer, or a friend or romantic partner that you have a mental disorder. You don’t have to fear that that one fact will make it more unlikely that you can achieve a stable work situation (or any work situation) or a stable relationship.

When you have mental health privilege, you don’t have to try to find a therapist who specializes in your problem and can actually help you. You don’t have to repeat your whole psychiatric history every time your therapist gets another job, causing you to start all over with a new therapist. You also don’t have to ask your primary care physician, who may or may not know much about psychotropic meds, to prescribe for you until you find a psychiatrist or when one isn’t even available to you.

When you have mental health privilege, you don’t worry that people will avoid you because you act “peculiar,” miss appointments and dates, or can’t handle crowds or even family gatherings. 

When you have mental health privilege, you don’t have to fear that you may have to stay for a while in a mental ward or have treatments like ECT.

When you have mental health privilege, you won’t get shot by a police officer just because you have a meltdown or a really bad day or a psychotic break.

Of course, the privileges I do have protect me some. Realistically, there is less chance that I will be killed by a police officer than would a person of color. In fact, my race and income make it easier for me to access mental health care.

The Journal of Psychosocial Nursing and Mental Health Services, in its July 3, 2017 editorial, makes clear that mental health privilege affects not only people who have mental disorders, but also the people who care for them.  The piece, written by Mona Shattell, PhD, RN, FAAN and Paula J. Brown, MBA, points out, “More than 70% of all health care providers in the United States are White (U.S. Census Bureau, 2017), and many, if not most, have unconscious (or conscious) biases (Institute of Medicine, 2003).” Their level of privilege may interfere with their treatment of their clients. The authors of the editorial encourage those with privilege to use it to help others.

Racial privilege is particularly problematic when considering mental health providers and their clients. NAMI Illinois “reported studies found that ‘black professionals make up only 2.6% of mental health clinicians in the United States, which is low considering that approximately 20% of black Americans seek mental health specialty treatment within a 12-month period.'” “While access to culturally diverse providers is low, the cost of mental health treatment remains high,” they add, “which serves as an additional impediment to bridging the gap between the onset of symptoms and accessing professional care.”

Education about mental health privilege may or may not help. Many people pooh-pooh the idea of any kind of privilege and bridle at the idea that they themselves have privilege by virtue of their health, sex, economic status, or other attributes. Some people’s eyes can be opened. (My husband didn’t recognize male privilege until I pointed out that no one suggested he change his name when we married or that we were “shacked up” because he didn’t.)

It’s understandable in a way.  People have a hard time envisioning that they themselves might ever be mentally ill or poor or homeless or denied work or discriminated against in any number of ways.

But with mental health privilege, it’s even more difficult to get people to understand. Until a close friend or family member faces mental or emotional difficulties – suffers from PTSD, experiences major depression, develops schizophrenia – people will not usually have the opportunity to realize the mental health privilege they have. And they may not even then.

As with any kind of privilege or stigma, if there is to be any improvement, people need to be educated. It’s not easy to open their eyes. But doing so can make a difference in the lives of people who do not share that privilege.

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Mental Health

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Yes, It Was That Bad

By patpitchaya/adobestock.com

There’s a tendency, once you’ve started to heal from the wounds that mental illness has left you with, to forget how bad it really was at the time. It’s not that time heals all wounds. It’s just that the memories fade as they flow backward into the past. You find yourself asking, was I really that miserable? That irrational? That out of control? Once therapy and medication – or whatever works for you – have gotten you past the crisis stage, it gets harder to remember what it all felt like at the time.

Nor do we want to. Going through an episode of serious mental illness is hard enough when you do it once. Reliving it is devoutly to be avoided, if possible.

Still, the memories get a little fuzzy around the edges. Now that you are mentally healthier, you know that you would never tolerate the kind of treatment you used to, or be so self-destructive, or put yourself down so thoroughly. The times when you did those things, when you felt those ways, seem in some sense unreal.

I think that’s one reason that some people go off their meds. It’s not just that they feel better or think that they’re cured. It’s that on some level they can’t remember how bad it really was back then. So why should they need psychotropics?

Well, I’m here to tell you that, yes, it’s much better now, but yes, it was that bad back then. You may not remember the weeping and wailing and total despair. You may not remember that you were immobilized for months at a time. You may not recollect pushing away people that were trying to help you. But all that happened.

Perhaps you don’t recall what it was that led you to consider self-harm or suicide. You wouldn’t think that way now, of course – you’re so much more stable. Perhaps you think to yourself that an abusive partner wasn’t really all that bad. After all, you got away from him/her/them. It was survivable, so it must have been not that big a deal.

But it was that big a deal. Denying the experiences you’ve had and minimizing their effects on you make it harder to see the long way you’ve come. It’s hard for me to remember now the major bipolar depressive episode that lasted for literally years, when I wasn’t able to work, or write, or read, or be there for my husband or even myself. But it happened, and I can’t deny it. I’d be lying to myself if I tried.

I’m not recommending that you wallow in the memories of the horrible times. I’d rather think about it as keeping little bits of them in a box on a shelf. Every now and then, on a day when you feel particularly strong, you open the lid and peek in. It may be shocking to realize how bad off you were, but a positive relief when you consider how far you’ve come. As the saying goes, the bad times make the good seem so much better.

Bad and good, your experiences have made you what you are today. Denying or minimizing the bad makes it seem like your journey was less long and hard than you know it was. In a way, mental illness is the yardstick by which we can measure mental health. Moving onward and upward are important, but so is being realistic about the past. Yes, it was that bad.  And yes, you made it through anyway!

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Mental Health

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Missing the Finer Things in Life

By GoodIdeas / adobestock.com

One of the ways I know when I’m slipping into bipolar depression is when I lose my sense of humor. Not even my husband’s awful jokes get a rise out of me. I also lose interest in many things that I ordinarily enjoy – reading, puzzles, and games, to name a few. The joys of life are few and far between.

Lately, I’ve noticed that I seem to be slipping again. I don’t feel overly depressed yet, but the signs are creeping up on me.

I think I first noticed it when it occurred to me that I had not done the New York Times crossword puzzle for at least a week. The Sunday Times puzzle is, or was, something I looked forward to every week. Now, I may not get around to playing it till mid-week or simply wait for next week’s, in hopes that I feel better. Most of my other entertainments have fallen by the wayside as well.

I know part of the problem is lack of spoons. I have been taking on extra work in my transcription job, simply to make extra money, which we do need. But it means I have given up almost all my days off and have had to get up very early to finish assignments. There’s little of me left over to do frivolous things, the things that bring joy.

On top of that, I have a house to furnish from top to bottom. I do not find shopping relaxing or enjoyable. In fact, I loathe it. Yet there I am, once or twice a week, at the vast home improvement store, picking out lighting or flooring or something else the contractor needs right away. It’s exhausting, not rewarding, and it eats into my spoons and my days off even more. It’s almost like having a second job, what with all the research, phone calls, appointments, choices, and decisions. Perhaps I’ll be able to rejoice in our new digs when it’s all done, but right now I can barely picture it.

The lockdown isn’t helping, either. One of the things I used to enjoy was going out to my favorite restaurants or discovering new ones. Now that is right out. I know some people are again indulging, but I’m not willing to risk my life for a cheeseburger and a brew or even tiramisu. My space and my life are constricted to a one-bedroom apartment, with a laundry/utility area substituting for my beloved study.

I do still have some comfort in my life, which is a mercy. When it all gets too much for me, I knock off for a while and watch some cooking shows on TV, which I find soothing, or read a chapter in a book before I fall asleep. At least I haven’t lost my ability to read, which I did once during a major depressive episode. And I’ve been able to maintain my blogs, which gives me satisfaction.

But as to joy, there is none. Life has become a tedious slog through one damn thing after another. One of the questions they always ask you during the depression screener at the doctor’s office is, “Do you no longer enjoy things you used to?” 

I’d say that’s true. Or at least I no longer have the wherewithal to do the things that I used to enjoy. Is it a marker of bipolar depression, or simply a reaction to all the things piling up on me right now? And which one causes the other?

On the surface, my retreat from joy is not excessively alarming. It has not yet reached the point of a major depressive episode. I can still do my work and my work on completing the house. What I can’t do is find a way to take mental time off – and I know that’s not good for my emotional stability.

I guess I’m just afraid that, in my life as it stands right now, there is no room left over for enjoyment. And that feels a lot like psychic numbness and depression. Perhaps when life settles down a little bit – if it ever does – I will get some of the enjoyment back. Perhaps it will become clear to me whether this exhaustion is circumstantial or anhedonia, a symptom.

Nevertheless, I plod onward, hoping for the day when satisfaction, relaxation, engagement – joy – will return. So far, it always has, though sometimes it seems forever before it does. That’s the nature of this illness and of recovery.

 

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Mental Health

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When You Face Too Many Options

Delphotostock/ from adobestock.com

It often seems that bipolar disorder and especially bipolar depression narrow your life down to the fewest possible choices. Try to take a shower or stay in bed. Eat a handful of cereal or skip eating. Cry or … cry. And that’s all true. These disorders are quite limiting.

However, it’s also true that sometimes we’re faced with too many choices. Right now I am in the process of having our house rebuilt after it was destroyed by a tornado. Every other day it seems the contractor has something new we have to pick out – paint colors, floor coverings, lighting fixtures, ceiling fans – even the color of the grout between the tiles in the kitchen, an aspect of decorating I didn’t know even existed. It’s overwhelming.

The worst was the paint colors. Sherwin Williams has a color palette about 100 pages thick, with seven different shades on every page. My husband and I have a hard time trying to pick a place to go for lunch, much less what color paint we’ll likely have to live with for the rest of our lives.

Needless to say, I dithered for a long time about the colors. The only reason that it didn’t totally immobilize me is that I employed the technique of weeding. Once I had decided on a color for each room (my husband left that largely up to me, except for his study), I began looking at the paint samples and not choosing what I liked, but pitching out what I hated. No beige anywhere. No teal, not even for the bathrooms. And so on. What was left was a much smaller assortment of choices, which hubby and I were able to process. He always liked the lightest version of a color and I the next darker, but we were never far apart.

We got through the process in just a couple of weeks, and with only one real regret (the green we chose was yellower than we really liked, but we’ll mitigate that by covering the walls with photos, posters, and art prints).

Exhaustion is another aid to making choices. I have some mobility issues and can’t walk for very long, especially on the concrete floors in home improvement warehouses. And I’ve always hated shopping, except on the internet. At some point in the process of looking and comparing, I just throw up my hands and say, “What the hell! That’ll do!” and arbitrarily pick one of the two light fixtures that have most attracted my attention. It’s not like my world will fall apart if I don’t get the one, exact light fixture that complements the room. I just need to be able to see. Then I go home, have some iced tea, and put my poor, tired feet up.

One of my therapists once taught me another technique for making decisions – flipping a coin. This sounds obvious, but it’s not. The simple act of coin-flipping can work in one of two ways. Either you can leave the choice in the hands of the coin (as it were), or the result of the flip can focus your mind on what it is you really want. Any number of times Dan and I have played, “Heads, lunch at Frisch’s; tails, Waffle House.” If it comes up tails, we often instantly realize that it was Frisch’s we were wanting all along.

Frankly, I don’t know whether it’s better to have a limited number of choices or a lot. Either way can be mind-numbing, a seemingly insoluble riddle that threatens to stymie you into making no choice at all. (Or, as the therapists tell us, “Not to decide is to decide not to.”) But it is possible to develop techniques that allow you to make those choices and continue with your life.

Of course, I know these are comparatively trivial decisions. I sure couldn’t have figured out “leave or stay” by flipping a coin, especially as seriously unmedicated and out of control as I was at the time. “Get a job or go back to college” was also an important one, but ultimately an easier one to make – I envisioned the situations and asked myself which I’d rather be doing, writing press releases or reading books. The choice was clear at that point. Both were major turning points in my life, but one was excruciating and the other just another choice. I attribute that in large part to the medication and therapy I’d had in between and the coping mechanisms that I had learned and practiced.

 

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Fear of Offending

By Drobot Dean from Adobestock.com

I have to keep a close watch on what I say in public or post online. I am afraid of offending people. Many times I have lost friends because of things I’ve said or done.

Is losing friends because of my bipolar disorder? In a way, yes. Is being afraid of offending others because of my bipolar disorder? In a way, yes.

I was not very well socialized as a child. The house I grew up in was very insular. My parents made few attempts to mix and mingle with neighbors or other school parents, so I didn’t see much of that as a young person and learn the unwritten rules. (My father did mix and mingle with the local gun club, but there were not many persons of my age and gender there.) I never went to preschool because I had a sister, we were very close in age, and my mother figured we could simply play with each other. (This was in the days before formal “playdates.”)

As I got older and my bipolar disorder began to manifest, I was even more out of sync with what the other kids were doing and saying. My mood swings left me laughing uproariously at things no one else thought were funny, or being gloomy and surly as a self-isolating hermit. I never learned the rules at school, either, of how to negotiate the complex patterns of behavior required as a student. I didn’t even know enough not to show off my intelligence, which didn’t win me many friends.

As I grew older, I got in the habit of tapping my face – symbolic slaps – whenever I said something that I realized I ought not to have said. (This was both puzzling and annoying to my companions.) It was a reminder to me to keep more of what I thought under wraps.

Of course, at the time I didn’t know that I was bipolar. I thought I was just weird. It never occurred to me that my brain was different, that I reacted in peculiar ways because of something I could not, at the time, control. I tried to be quiet and unobtrusive, but the manic humor kept leaking out, usually when no one else thought whatever it was was funny. I garnered a reputation as an oddball, even among the odd people who befriended me.

Later on, in the world of work, I was even more out of my depth. I still didn’t know how to socialize. I couldn’t manage “team-eating,” the mysterious rituals of the groups of workers who lunched together. I consciously practiced my socializing with the few people who would put up with me. I observed social interactions, but I never really internalized them.

I made statements that were meant to be funny, but they came out sarcastic, and I lost friends. I made statements that were meant to be assertive, but they came out bossy and I lost friends. I became more and more afraid to say anything that might be seen as hurtful, but I still did.

All of this made me afraid to offend people, so I began to shut down. I kept my jokes to a minimum. I didn’t even try to join the ladies who lunch. My social life was practically nonexistent.

Then came the internet and, especially, Facebook. Every time I wanted to post something, I had to run the content through the internal filters I’d built. Was it too racy? Too political? Too self-revealing? Too something? Would it offend someone and lose me more friends?

I developed techniques to soften my replies to other people’s posts. I’d agree with any part of a post I could and then add my real opinion, very softly. (I agree with you that there’s a lot wrong with our economic system, but it’s very complex and I think more regulations will be needed to improve it. I agree that most police are protective and well-regulated, but I think training in dealing with mentally ill persons would benefit everyone.) I became wishy-washy.

How does this reflect my bipolar disorder? Losing friends was one of the big traumas I went through as a child and I never wanted it to happen again. My first physical trauma was at the hands of other children, who threw rocks at me. My first bipolar “break” was a result of being humiliated by my best friend. (“Kids can be mean,” my parents said, but I knew deep inside it was all my fault.) Losing friends became one of my major triggers, something I would try anything to avoid. I just wasn’t very good at avoiding it.

Gradually, I am getting better at socializing and at speaking up without the constant fear that my words and actions will drive away people who care about me. I still try not to be confrontational, but if a meme expresses something I care deeply about, well, I will repost it. I still try not to insult the persons closest to me, but sometimes it takes me a while to figure out how to say something with just the right words in just the right tone of voice.

Bipolar? I think my glitchy brain got sidetracked by the illness when I should have been learning the ways most people behave. Now that my illness is mostly under control, I am trying to make up for lost time.

 

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I Don’t Need a “Pep Talk”

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Here’s the thing. Many people, when you mention a problem, feel obliged to help you fix it or fix it for you. When the problem is related to mental illness, though, that can be counterproductive.

The fact is, most serious mental illness can’t be fixed, at least not by a friend or loved one. To try is to invite frustration on the part of the fixer and worse feelings on the part of the fixee.

Some of the worst help we are offered are pep talks, which are meant to be encouraging. Smile more. Keep trying. Other people have it worse. Everyone goes through this.

No, says my stubbornly glitchy brain. Everyone does not go through a major depressive episode. And when I’m having one is not the time I can concentrate on what constitutes “worse.” I can try all I want, but my bipolar disorder isn’t going to just go away. And smiling when I’m ready to cry is a suggestion that denies my perception of reality and encourages me to lie about my feelings.

You can see much of this kind of advice on Facebook, for example. There are always memes that exhort you to look on the sunny side, have a positive mental attitude, or choose to be happy. But it’s easy enough to scroll by them.

These pep talks hurt more when they’re offered in person by someone you know or even love, especially when that person knows you have a mental disorder. You can’t just scroll by someone you love telling you that, in effect, it’s your own fault that you don’t get better.

I know these sentiments are kindly meant (except for the ones that blame you for your own condition). But the reality is that we can’t cure ourselves of SMI by smiling, or jogging, or thinking happy thoughts, or eating turmeric. We can’t cure ourselves at all.

But we can make things better, through therapy and medication, and yes, through some things that are not cures themselves but adjuncts to healing – physical activity, engagement, mindfulness, self-care, and the like. Who knows? Maybe even turmeric.

So, if pep talks don’t work, what can you do instead? What might actually help your friend or loved one? Here are a few suggestions.

Treat the person with mental illness the way you would treat a person with any other illness. I’m not suggesting sympathy cards are appropriate, but a phone call or text message saying you care is usually welcome.

Listen without judgment. Don’t offer advice. If the person opens up to you, respect that. Don’t minimize the problems. If the person doesn’t respond, wait a while and try again.

None of that will “fix” the person, but you know what? Neither will a pep talk. My brain, for one, is simply unable to process them, digs in its metaphoric heels, and says, “Oh, yeah?”

So, what are some things you can say instead of giving a pep talk? Try these.

I’m here for you.

You can always call me.

I’m sorry you’re hurting.

Tell me if you need anything.

Do you need distraction?

Do you need to be alone for a while?

Do you need to talk?

What can I do for you? (The answer may be, “nothing,” but at least you cared enough to ask.)

If you are also suffering from SMI, there is even more you can do. You can say, “I understand how you feel,” and mean it. You can recommend a therapist. You can congratulate the person on any accomplishment, the kind that wouldn’t seem like an accomplishment to anyone else.

In general, stay away from platitudes, feel-good sentiments, and quick fixes – unless you know that the person responds well to that kind of encouragement. They’re too easy to say and too hard to follow through on. Save them for people who are simply having a bad day, not someone who has mental illness.

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Mental Health

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The Big Disruption

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I don’t know if I’ll be able to make a blog post next week unless I can write an extra one this week and save it. Next week at this time we’ll be moving from the three-bedroom house we’re currently living in to a one-bedroom apartment, where we expect to stay for three months at the maximum.

The circumstances that led to this situation are complex and the whole process has been feeding into my triggers and issues. No, bipolar disorder won’t stay on hold for even two weeks so we can get this accomplished.

Overthinking. First and perhaps foremost, I hate cleaning, packing, and moving, especially when there’s a time limit on them. I even hate packing for vacations. (I’m okay once the vacation has started. It’s just the lead-up to it that gets me.) When I pack, I always overthink and almost always overpack, as if I’m planning for the Normandy invasion. This is exhausting.

Anxiety. I often have anxiety dreams about packing and moving, usually having to do with moving into or out of a dorm at college. This was indeed a stressor for me, as I lived someplace different every year and went home over the summer. Apparently, it has never quite left my psyche. This set of moves will be unpleasantly like those – a massive, frantic rush at the beginning of summer and another set of the same, though one hopes not as frantic, at the beginning of fall.

Uncertainty. What happened to us is that our house was destroyed by a tornado a year ago. Since that time, we have been living in a house provided for us by the insurance company. Now, however, they’ve put us up here as long as they care to and our former house isn’t completely rebuilt and ready for re-occupancy yet. We’ve had just over a month to make alternative arrangements. Combine that with trying to get a three-month lease, and a one-bedroom was all we could find. (We call it “The Shack.”)

Belonging. I’ve had a hard time bonding with places where I’ve lived – they’ve never truly felt like home to me – and I hope that the rebuilt house, which we are completely furnishing, will have that feel of “mine.” But The Shack will feel the least like home since any I’ve lived in since college. Even my study, where I do my writing, will be a utility room with a table and chair rather than a desk. Nor will we have much in the way of furnishings. A bed, a television, two chairs, boxes for bedside tables, and not much else. The rest is in storage or not to be delivered until permanent move-in.

Immobilization. It is the one-year anniversary of the tornado and we will be swept up in a virtual tornado of packing and moving. I have already noticed tornado dreams and severe storm-related anxiety as the date approaches. I anticipate being virtually immobilized just when I need to be most productive and proactive. It already feels overwhelming.

Isolation. And no, there is no one around who can help us move. It’s just me and my husband, with maybe a little help from U-Haul and Two Men and a Truck. My husband suffers from depression, and between that and my bipolar disorder, we’ve been isolating so much that even with pizza and beer we couldn’t pull together a work gang.

We’ll get through, I know. And we’ll get through living in The Shack until it’s time to go home at last. I just wish I could see a clear path between now and then.

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Mental Health

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