Bipolar 2 From Inside and Out

Posts tagged ‘bipolar disorder’

New Diagnosis, New Drug

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While never leaving the category of persons with a serious mental illness, I seem to have also become a person with an autoimmune condition. Here’s what happened.

About two months ago, I noticed a hard lump growing on my forehead and another developing underneath my eye. Then one night, I rolled over in bed to feel a strange sensation in my right forearm – an area of thickened, hardening flesh under the skin about the size and shape of a cuttlefish bone. This seemed sudden and alarming compared to the forehead lump, so off I went to the emergency room. They diagnosed cellulitis and gave me a scrip for antibiotics.

A follow-up visit to my PCP revealed no change in my arm, but again a provisional diagnosis of cellulitis and another course of antibiotics.

When that failed to clear matters up, the doctor decided to biopsy the lump on my forehead and send me for an ultrasound and MRI on the arm. The biopsy revealed the lump to be a sarcoid, which immediately changed the thinking about my arm and cellulitis. It now seemed likely that that was sarcoidosis too.

Sarcoidosis is, according to the Mayo Clinic, “a disease characterized by the growth of tiny collections of inflammatory cells (granulomas) in any part of your body — most commonly the lungs and lymph nodes. But it can also affect the eyes, skin, heart and other organs.” I’m lucky that in my case, only the skin appears to be affected. Having my lungs affected would be pretty scary right about now. (The Mayo Clinic adds, “The cause of sarcoidosis is unknown, but experts think it results from the body’s immune system responding to an unknown substance.”)

Then the real fun began. The treatment my doctor prescribed was steroids (cream for the forehead, pills for the arm), which makes sense, but didn’t play well with my bipolar condition or meds. “Mood changes” appears on the Mayo Clinic’s list of potential side effects, along with agitation, irritability, and a host of other physical and psychological difficulties.

After a few days on the steroids, I began experiencing chills, raging headaches, insomnia, and the dry heaves. A tele-consultation with my doctor later and my dosage was reduced, which seems to have helped (and the steroids seem to be helping reduce my mysterious cuttlefish).

“Steroids are a bipolar sort of medication,” my doctor told me.

“Appropriate,” I said. (My PCP knows about my bipolar disorder. He’s read my books.)

Dr. S. continued, “One time steroids can make you feel terrific and another time they can make you feel miserable.”

“I’m gonna say miserable,” I replied. “I haven’t slept or eaten in three days.”

“Well, they can get you so revved up that you can’t sleep.”

“Actually, it was the dry heaves that kept me up,” I explained.

A mutually agreeable course of action was decided on. I would lay off the steroids for a day, then resume with a lower dose. That’s just what I have done, and my symptoms are better. At least I’m no longer retching.

What does the future hold for me? It’s hard to tell. Potentially steroid injections in my arm, and having the lump on my forehead removed if the steroids don’t resolve them. Potentially mood swings that I won’t know whether to attribute to my bipolar condition or to the steroids.

I hate the thought that this is an autoimmune disorder – that my body is attacking itself. Of course, my brain has been attacking me for so long, I really ought to be used to it by now.

 

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How I Became a Mental Health Blogger

Of course, blogging didn’t exist when I started writing. It was quite a journey ending up where I am today. Even mental health services were a big blank to me when I was young, something that no one I knew experienced or even talked about, except to make jokes about going to “Wayne Avenue,” the location of the nearest insane asylum (as we called it then).

But it’s hard to remember a time when I didn’t write. Childish poems fueled by voracious reading. Hideously depressive poems fueled by burgeoning bipolar disorder. (I still commit poetry from time to time, writing sonnets and villanelles about bipolar disorder.)

But before I returned to poetry with more structure, I indulged in free verse – unrhymed, unmetered verse that relied on the juxtaposition of images rather than formal style. I studied creative writing in high school and college. But the bipolar disorder was undeniably with me, influencing the topics I wrote about: “Two Ways of Looking at the Same Pain” and “Whiskey on the Knife,” a poem about self-harm, are two examples.

As my poetry developed, it started reading more and more like prose, strung out in sentences that relied on line breaks with twists and jarring pauses to create poetic effects. Eventually, I gave up on poetry and simply gave in to prose. I made my living doing prose, and nonfiction at that, writing for magazines about education, technology, child care, and even martial arts.

Bipolar disorder took that away from me. After being diagnosed with clinical depression for years, I finally was identified as having bipolar 2. It was treatment-resistant for many years and during that time I was often unable to write.

My mental health blog, which you’re reading now, grew out of a journaling exercise. I began by listing what I did each day – not much, as I was stuck in a major depressive episode and not able to do much. But once again, what started as something else turned into prose. And by that time blogging was a thing.

I started blogging largely as an exercise for myself, to explore bipolar disorder, its symptoms and treatments, and my particular version of it. I set myself the task of posting once a week, a schedule that I still keep. I wrote short essays and longer pieces, whatever I was thinking about at the time. Hardly anyone read the blog. I sometimes wonder if the title “Bipolar Me” was a turn-off, but really that summed up my knowledge about bipolar – my own experiences.

Slowly, I started finding my voice. and finding things to say with it. Things other than what was inside my own head. Oh, I still wrote about my symptoms and my meds and my coping mechanisms, major depression and hypomania, mood swings and roller coasters. But I also started approaching the wider world of bipolar. Bipolar in the news. Bad science reporting about bipolar. TV commercials about bipolar meds. Bipolar disorder and gun violence. All of this was still through the lens of my own experience, as I have no degree in psychology, counseling, or biochemistry, for that matter.

And I started reaching a wider audience. My writing appeared in The Mighty, Invisible Illness, IBPF, Thought Catalog, Medium, and as guest posts on other bloggers’ sites. Eventually, I had enough material to make Bipolar Me into a book of the same name. And then a sequel, Bipolar Us. Both are still available on Amazon and through other outlets.

I know I’m not in the same league with mental health bloggers like Pete Earley and Gabe Howard. They are true activists and influencers, as well as terrific writers. Their work reaches thousands of people with information, analysis, inspiration, and more impact than I will likely ever have.

But I won’t give up blogging just because I’m not the best. I’ll be here every Sunday, posting my bipolar thoughts and opinions, sharing my bipolar experience, and chronicling my bipolar life.

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Do I Need Advice or Do I Need to Vent?

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Sometimes we need advice. But sometimes we just need to vent. This is true of all people but especially true of people with mental illness.

Venting is the act of getting something off your chest. It may come explosively if it has built up for a while. There may be one final incident, however tiny, that sets you off. All you really want is to feel heard, that someone acknowledges your distress and understands it. All you really need is a sympathetic ear and maybe a pat on the shoulder.

Venting acts as a safety valve. It allows you to “let off steam” that might otherwise build up pressure until it comes out violently, or at least excessively.

Why do I say this is particularly true of people with mental illness? So often we have feelings we can’t articulate, thoughts we don’t understand, or events that trigger us in both large and small ways. It’s natural to want to keep all these things inside. We’re taught to do that – not to “let the crazy show,” to keep all those messy thoughts and feelings to ourselves. Eventually, we get to the point where we think that no one will understand anyway, so there’s no point in giving voice to these feelings.

Then, when we do finally vent, inevitably someone says we’re overreacting. Because, you know, crazy.

If I’m venting, the wrong thing to do is to give me advice. Unless I specifically ask for advice, that is. But even well-meaning advice can easily go wrong. People who do not suffer from psychiatric conditions often offer advice regarding what works for them when they feel a certain way. And yes, a walk in the fresh air and sunshine can certainly be uplifting. But when I’m too depressed to get out of bed, it can be an impossibility. It can even make me feel worse about myself.

To me, suggestions for possible remedies for my disorder are even worse. It’s taken me and my assorted doctors years to assemble the right medications at the right dosages to tame my bipolar disorder down to something livable. When someone tries to tout the latest remedy they heard about – Pilates, elderberries, juice cleanse, probiotics, or whatever – it feels to me like “pill-shaming,” like I’m being blamed because none of my meds will “fix” me thoroughly enough. Add the fact that these suggestions come from questionable sources – laypersons or bogus “studies” – and I’m likely to dig in my heels and feel offended.

At times, though, I do need advice. When I do, I usually get it from my therapist, someone else who shares my disorder, or an old friend who has been there for me on my journey. Sometimes I need a reality check – am I just catastrophizing or is it really true that something bad might be happening? Sometimes I need help dealing with a specific person – what can I say to my sister to help her understand my condition? Sometimes I need a reminder that I really ought to make an appointment with my therapist and get a “check-up from the neck up.”

And it should be understood that advice is just that – a suggestion that I am free to take or leave. Even my therapist, who usually gives very good advice when I ask her, sometimes suggests techniques or approaches that just don’t work for me. And even she knows that sometimes I just need to vent, to feel the feelings of sorrow or hurt or rage and let them out in a safe place. To quote Jimmy Buffet, “It cleans me out and then I can go on.”

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The Importance of Alone Time

Alone time is a precious thing. But right now, with the self-isolation that accompanies the pandemic, many of us are experiencing too much “alone time.” But many of us need more.

Alone time has been important to me as I have struggled with bipolar disorder. I have a loving, supportive husband who is there when I need him to be. But even he knows that sometimes what I need is to be left alone.

Sometimes the world is too much with us, and we long to escape – read a book, hide under the blankets, just sit in the corner and think. At times like that, interacting with another person can feel like an intrusion, an annoyance, unwelcome. Alone time can allow you to catch your breath, calm yourself, practice mindfulness, or simply be alone with your feelings.

Of course, getting alone time is not always easy, especially now when we may be cooped up with our nearest and dearest, with no respite in sight. In my opinion, these are the times when a bit of alone time is even more necessary. Even with people you love, being with them 24 hours a day, every day, will begin to wear on you all. Stress builds and you may be triggered by noise, conflict, or other stimuli.

I’m lucky. That supportive husband knows, if his other efforts at drawing me out (offering me food, or a movie, or music) have failed, the greatest gift he can give me is alone time. He’ll even ask me if I need alone time, in case I don’t realize that is exactly what I do need.

I’m also lucky that there is a dedicated space in my house that is perfect for alone time – my study. It has a computer, music, comfort objects, games, favorite pictures, and more. It even has a comfy chair so that I can just sit and think if that is what I need to do. I know that I come at this topic from a place of privilege.

Making mental and physical space for alone time is harder when you have a roommate or a family that doesn’t understand the concept of alone time. The TV may be blaring, the washer clanking, the kids yelling, the spouse being needy. There may be someone in every room of the house, making noise or demanding your attention. Sometimes you can’t even be alone in the bathroom. You want everything to stop, just for a while.

In situations like that, you may have to ask for alone time. First, realize that it’s a reasonable request. Suggest ways to make it happen – I need to be alone in the basement (garage, kitchen, yard, whatever) for a while. Don’t disturb me unless someone’s bleeding or something’s on fire. Offer to return the favor. If you’re feeling pent up, chances are someone else in the house is too.

Of course, too much of a good thing is not necessarily a good thing. Even though I need a fair amount of alone time, too much can leave me stuck inside my own head, not always a comfortable place to be. I can brood, catastrophize, feel lonely or bored, give in to depression. It helps if I can recognize when alone time is turning toxic like that. When I’ve had enough alone time, I can choose to leave that behind and rejoin the world in a better frame of mind.

As far as I can see, alone time is vital for every person, even the very gregarious. It allows us to let go and drop our metaphoric masks. But alone time is particularly necessary for those with mental illness. The ability to be alone with oneself can be a powerful step in understanding and healing. And whether time alone is the norm or the exception now, people’s mental health suffers. Connection is what we hear most about – virtual meetings, video chats, texts, and calls – but alone time is vital too. Treasure it when you get some. 

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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.

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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

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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.

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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.

 

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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.

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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.

 

 

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Mental Health

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