Bipolar 2 From Inside and Out

Posts tagged ‘bipolar disorder’

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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Mental Health

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Future Obsession

I used to obsess about the past. Now I obsess about the future. This is progress, I think.

A little while ago, I wrote about how our recent disaster (a tornado) had affected my obsessive thoughts and interrupted my sleep (https://wp.me/p4e9Hv-TO). At the time, my thoughts were focused backward on all the belongings we’d lost that needed to be replaced. I was losing sleep with obsessive thoughts and spending the daytime cruising the web for potential purchases. I discussed this with my psychiatrist and he prescribed an increase in one of my medications, a mood leveler, that he thought might help me turn off the insistent thoughts and allow me to get to sleep more easily. He was right. It did help.

Now, however, I am obsessing over thoughts of what will happen months from now, next spring or summer. I am anticipating the rebuilding of our house and the house-warming party that we should have. Yes, I am obsessing over what to serve at a party that is at least six months away, or perhaps even more. Two kinds of punch, obviously. Beer and wine? Cucumber sandwiches and melon with prosciutto? Cheeseboard with figs and nuts? All desserts? I’ve already changed the menu four times. I am already deciding what to wear. The red silk shirt that a friend gave me? Jeans? Message t-shirt? Butterfly dress? Something I buy specially for the occasion? And, OMG, am I channeling Martha Stewart?

This is an odd feeling. For most of my life, I have obsessed about things that had already happened. I’ve spent literally dozens of years analyzing a failed relationship and how it has affected my mental health and emotional stability. To be contemplating and obsessing about the future is unfamiliar territory.

Obsessive thoughts are one of the hazards of bipolar disorder as well as depression. I can well remember having a mental recording device that played back for me every stupid thing I ever did or social faux pas I made. I still remember when one cute guy asked me for a glass of water and I gave it to the wrong cute guy. I still remember being mortified. I know this is not just a thing that I experience because I have compared notes with others. It seems to be A Thing amongst many fellow sufferers.

This time around, I worked out the thoughts of the past with choosing what things to replace now and what to postpone to a more appropriate time, like closer to when the house is rebuilt. I know I don’t need a new desk yet (though I have bookmarked several online). Ruined books I allow myself to replace, along with my husband’s wedding ring.

I do not know how to work out the thoughts of the future. The future is strange to me. I have so much trouble living in the present instead of the past that the future rarely occurs to me. If my husband asks me to make a decision about an event that’s one week off, I reply, “I can’t think about that yet.” My husband actually lives in the future a lot and asks me to make choices that are years or even decades hence. It’s tiring on some existential level. I don’t know what to do for dinner and he wants me to discuss how we’ll spend our Golden Years.

Given what I know about myself and my disorder, it’s likely that the closer the time comes to moving into the rebuilt house, the greater my anxiety will become. You’d think it would be a time of great joy, but I am already feeling pre-overwhelmed at the thought.

Even so, I think it is perhaps a touch healthier to be obsessing forward instead of backward. It acknowledges that I do believe I have a future, that I can plan for it, and that I can take some pleasure along with the obsessions. I can learn to appease my obsessive thoughts by giving them the more sensible parts of what they seem to demand. I can, to some extent, live in my present with work to do and deadlines to meet that keep me anchored in the now.

What will happen in the future, of course, I can’t predict or control. But perhaps I can train my brain to experience anticipatory enjoyment instead of anticipatory anxiety. That’s my goal, anyway.

 

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Mental Health

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Black-and-White Thinking

 

My husband used to have only two categories when he reacted to something: It was fabulous or it was wrecked. There was nothing in between. If he cooked a dinner and I said it was “okay,” he heard “wrecked.” If I said “good,” he heard “wrecked.” Only the most superlative of adjectives would convince him that I appreciated his efforts.

Of course, this was a holdover from his childhood, one called “black-and-white thinking” or “all-or-nothing” thinking. And what that is, is a kind of cognitive distortion, a skewed way of thinking that does not represent reality,

Cogbtherapy.com has this to say about the subject:

A cognitive distortion is an automatic way of repeatedly interpreting a situation that causes us to not consider other ways of thinking about it. When we over-rely on cognitive distortions, we usually interpret events in such a way that fuels emotions such as anxiety, depression, or anger. All-or-nothing thinking is one such distortion.

All-or-nothing thinking refers to thinking in extremes. You are either a success or a failure. Your performance was totally good or totally bad. If you are not perfect, then you are a failure. This binary way of thinking does not account for shades of gray, and can be responsible for a great deal of negative evaluations of yourself and others.

http://cogbtherapy.com/cbt-blog/cognitive-distortions-all-or-nothing-thinking

Indeed, my husband was prone to depression and thinking poorly of himself. He would never be as good as his brother, as successful as his father and mother, as artistic or musical or smart as he wanted to be.

Fortunately, he eventually got over this. It’s really tiring to keep thinking of better and better ways to describe dinner. Now I can give accurate feedback, like “satisfying,” or “good enough.” Not everything has to be fantastic.

I must admit that I share in this kind of cognitive distortion. I think it may go with bipolar disorder, which, after all, includes swings from one end of the emotional spectrum to the other. But some people attribute it to my having been a Girl Scout or making straight As in school. What I remember is learning it from my parents. When a cousin, for example, screwed up, they would say with a tone of disgust, “Well, I guess some people have to learn from their mistakes.” What I heard was that some people, the good, smart people, didn’t have to learn from their mistakes because they didn’t make mistakes. It was a perfect set-up for making a little girl try to be perfect.

Later in life, I found some flaws in that line of thought. My first experience with a grade of D came in high school in Enriched Geometry. The “Enriched” part was having to do three-column proofs instead of two-column proofs, with the third column being the name or number of the theorem of corollary you were using. I thought that was stupid. You could always look up the theorem or corollary if you really needed to know it. As long as you knew how it worked, I thought, that should be enough. So I didn’t memorize them and I got a D. (Many years later, I was able to hang five pictures, four in a square and one in the middle, which proved to me that I did indeed know enough geometry to get by, theorems and corollaries or not).

I also learned that, according to my parents, perfection was only for me, not for other people. When some work friends of mine started living together, I expected my parents to freak at the sinfulness. They didn’t. But when I did the same thing, they refused even to enter the house.

I know that Cognitive Behavioral Therapy specializes in counteracting distorted ways of thinking, and maybe it would have helped me (or my husband) get over it more quickly or efficiently. But the lesson I eventually learned was that I could be not-perfect and it wouldn’t destroy me. I hung those pictures. I moved on from that relationship and my parents accepted me. I did end up in a job (editing) that requires one to be as nearly perfect as one can regarding as many details as possible, and I suppose that’s an example of turning a negative into a positive.

But if – that is, when – I make a mistake or miss perfection by however wide a margin, my thinking isn’t so disordered that I assume I’m a failure. Black-and-white has been replaced by all manner of shades of gray. That’s really where everyone lives.

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In Remission

My bipolar disorder is in remission. I know I’m not cured. There is currently no cure for bipolar. But I’ve reached a point where I’m stable enough that I don’t expect a crash or a buzz to descend on me at just any old time.

I still get moods, of course. They’re just not severe or long-lasting enough to be symptomatic. Yesterday, for example, I spent several hours wrestling with phone trees and people who wouldn’t switch me to a supervisor when all I was trying to do was straighten out a couple of bills that contained errors. Afterwards, I felt frustrated, cranky, and a bit sad. But those were normal emotions, based on what I had just gone through. After a nap I felt better, and dinner blew out the remaining cobwebs. Napping is definitely better than staying in bed the entire next day.

Of course, I didn’t achieve remission alone. It took years of doctor visits, therapy, and medications to reach this state. I am particularly grateful for mood levelers. For me, they actually do what they’re intended to do. They keep my moods within an acceptable range, or at least one that’s acceptable to me.

Too many people fear mood levelers, I think. Level moods sound boring – as though there are no variations, just a blank, straight line. That simply isn’t so. Mood levelers have pushed the spikes that used to go wild in either direction to a less extreme range. If you think of mood as an EEG, mood levelers prevent the lines from going off the charts, settling them to fluctuate within a middle range that most non-bipolar people have naturally.

I think the term “mood leveler” scares some people. They seem to think that such a drug would make them perfectly level, robotic, unchanging. They fear that any spark of personality or creativity would be lost.

That’s not the case. Instead, with level moods – and especially for depression-prone bipolars – a person has much more ability to explore his or her creative side.  I know that’s true for me. Now that my moods are stable and level, I’m able to get more writing done, but also to tell whether the work is good or needs serious revising before I post it.

My doctor recently increased the dosage of one of my medications, a mood leveler, because I was having trouble with hypomania that wouldn’t let me sleep. And it worked. I am now getting seven to eight hours of sleep each night and have enough energy to at least face the day, if not always to conquer it.

Don’t think mine has been a case of spontaneous remission. I’m not sure I believe that’s possible with bipolar disorder. It’s taken a lot of years and a lot of work to get to where I am today. For example, it took literally years for assorted doctors and me to find a combination of chemicals, a cocktail of psychotropics, that would work for me. And during all that time, it was as if I was not medicated at all. Only the right combo of drugs and dosages would unlock my brain and level my moods.

So, here I am, in remission – and I love it. My moods aren’t blunted, they’re leveled. I am not as fearful now that my extreme moods may return and wreak havoc on my life. Oh, I still have some symptoms and side effects that remind me I’m not cured. But now I know that remission is possible, with work, with luck, and with the right mood levelers.

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Nothing to See Here

Many people with SMI are afraid that it shows, that other people can see automatically that there is something wrong with them. They feel as though they stand out in a crowd. Everyone notices them, and probably talks about them.

I have the opposite problem. My bipolar depression makes me feel invisible. It’s not just that SMI is often an invisible illness. It’s that I myself seem to become invisible. I think of myself as a particularly ineffectual ghost, frightening no one and unable to affect anything in my environment. Some people call this dissociation.

At first, I made the best of it. I’m especially invisible when I’m out in public and reading a book. So I found that if I was at a business convention and wanted to remain invisible, my best strategy was to sit alone at a table and read a book. Only once did a man approach me while I was so engaged. No one else ever did.

Apparently, though, I don’t need a book to disappear. Maybe it’s anxiety that makes me keep quiet when people around me are discussing something interesting. Maybe it’s my instinct not to be noticed so I won’t be subject to derision or worse. Either way, I can’t seem to catch anyone’s eye or add my bit to the conversation. I blend into the crowd, even if it’s only a crowd of three or four.

It’s almost like there’s some aura around me when I’m out in public that says, “Don’t notice me,” like Harry Potter’s cloak of invisibility. I do not use my invisibility for pranks or mischief, though. I don’t use it intentionally at all (except for using a book, as I mentioned).

Why do I think this invisibility is part and parcel of my bipolar disorder? It could be imposter syndrome at work. I feel so unworthy that I don’t want anyone to see me for what I am. Or it might be the anxiety component of my hypomania that keeps me from presenting myself more assertively. Or maybe people can see that I have a troubled mind and simply look away.

I am slowly learning to make myself seen and heard. I find that calling people by name makes it easier for them to see me. It seems to signal them that there’s another person in the vicinity. And once I even set up an occasion where I would be the center of attention, speaking about my bipolar disorder at a signing for my book.

I also use my writing to make myself “visible.” This blog (and my other one, http://butidigress.blog) and my books give me a presence, though not a physical one, even at a distance. When I see likes and follows and sales, I know that someone has noticed me, or at least discovered that I exist.

I sometimes think that going out in public more – practicing being visible – might help. But actually, that’s when I feel the most overlooked, the most unseen and unheard. The most lost.

Perhaps what I need is to go out and meet a specific person, someone who expects to see me. Then I could be guaranteed of one person who would see me.

But it has been suggested to me that I may not want to be seen at all – that I would prefer to fade into the background, not put myself forward and disappear from the stresses of being seen. Perhaps that is true, or at least once was.

Now I think I would prefer to be seen, flaws and all. If someone cannot tolerate the sight of me, a mentally disordered person, or glances over me as if I did not exist, I think I shall insist on being seen. I will use my voice, my (admittedly glitchy) brain, and my human physicality to assert that I exist, that I matter, that I have something to say.

And in social situations I will try to assert myself (if politely) to join the public discourse and add my two cents, whether the subject is mental illness or the latest bestseller.

I exist. I deserve to be seen. I will not remain invisible.

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Hypomania, Shopping, and Sleep

I hate shopping. Loathe it. Grocery shopping. Clothes shopping. Shoe shopping. Practically the only thing left for me is online shopping, and that can be treacherous – and not because I can so easily spend too much money.

Online shopping can push me over into hypomania. So can thinking about online shopping.

Recently, our house was destroyed by a tornado. We lost everything. And we have to replace everything. (Fortunately, our insurance company is paying for most of the lost items, as well as rebuilding the house.)

When I first got the inventory of things that needed replacing, I was too overwhelmed to do much about it. A window-shopping trip to La-Z-Boy left me bereft of spoons, as shopping always does. So I turned to the internet.

Do you have any idea how many companies are willing to sell me chairs, sofas, rugs, computer desks, jewelry armoires, electric fireplaces, and even walking sticks (to mention but a few items)? Lots. Lots and lots. Now I even get messages from many of them on my email and Facebook feed.

I have spent literally hours browsing online. And then I try to sleep. It’s an instant case of “Hamster Brain,” as my friends and I call it. I can’t sleep, even with my prescribed sleep aid and prescribed benzo. My mind starts whirling and my thoughts start racing.

Hypomania takes over. Oh, I don’t run to my computer and start ordering stuff. I’m keeping hands off my PayPal account, for the most part. But I lie in bed, eyes closed, trying to picture every purchase in what will be its new setting. I compare various color schemes for each room in the house, then change them each night – gold, brown, and cinnamon for my study? Blue and green with coral for the living room? And, oh, God, what about the bathrooms and the kitchen? I even arrange the furniture in my head – which wall will the computer desk go against? What will go beside the chairs? Tea cart? End table? Should we have a corner breakfast nook or a proper dinette set?

And how do I explain to my husband what my visions are? I can’t even decide between boho and country comfy. I can’t even define for him what I mean by boho. How do I keep him from sprinkling the house with 50s pieces (now called mid-century)? How can I integrate his treasures without spoiling my visions?

Most nights now I am up until 2:30 at least, which is when I take the benzo. When I wake, though, the hypomania is not over. It’s back to the computer with a new thing to search for, adding item after item to my favorites lists, comparing prices. I spend hours doing this. I email pictures back and forth with my husband as he gets caught up in my frenzy. This afternoon I spent several hours online buying replacements for books that were ruined. Tonight may be another case of no sleep till who-knows-when.

I’d like to stop, or at least slow down. Realistically, I don’t have to do anything now. I certainly don’t have to order or even browse choices. The house will not be rebuilt until at least the spring and we have no place to store any purchases until then. It’s silly to make decisions now, when between now and then thousands more choices will become available.

If I keep going at the pace I’m at now, I will be supremely sleep-deprived by the time I actually need to make purchases. And between now and then I see myself with a copy of the floor plans, making little cut-outs of different-sized furniture and trying them out for size and fit like those sliding puzzles we used to do as kids.

I see my pdoc this weekend and I’m going to ask him what to do about the hypomania and the lack of sleep. I get hypomania so seldom and it usually goes away so quickly. It’s impossible to think about it continuing at this level and going on for months.

Of course, it’s too simple for someone to tell me to calm down, not to think about it until the time comes. This is hypomania. That’s exactly what I can’t do. Once again, my brain is in control and running riot. And it won’t shut up, not even when I really need it to.

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Mental Health

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Where Is My Home?

You know that feeling of dislocation you get when you’re bipolar and depressed? Like you don’t belong anywhere. Like you just don’t fit in. Like even the things around you aren’t real. That has happened to me concerning one of the things that gives most people contentment and grounding and even joy: home.

I’ve never been literally homeless, unless you count the day I spent in a Red Cross shelter after a tornado destroyed our house. I have no idea what it’s like living on the street, though I know a lot of the seriously mentally ill do. It’s just that none of the places I have lived have felt like home to me.

Maybe it’s the fact that I have real difficulty bonding with things and places (and, even at times, people). Making the emotional investment seems pointless when everything seems unreal, when anything can be taken away or even just disappear, like so many things have: my stability, my capacity for positive emotions, my ability to feel.

I don’t remember the house my family lived in when I was born. I don’t even remember how old I was when we moved into the house where I grew up. I have a vague memory of standing on tiptoes, trying to peer over the counter and into the sink, so maybe four? Whenever it is you’re that tall. 

That home is the only one that ever felt like home to me, and I had to stake a claim on a space within it to feel that. One day, in a burst of hypomania, I decided to move out of the room I shared with my sister and lay claim to the other bedroom, one that we saved for visits from Grandma, which happened once a year or less. One roller and some yellow and orange paint later, I had a room that no one else wanted to stay in. It was mine, one square corner of the house.

But inside I always believed that I belonged – could belong – somewhere else. When the time came for college, I attempted the “geographical cure” and moved out of state to what I thought would be a more stimulating environment, one conducive to fitting in.

It worked about as well as the geographical cure ever does, which is to say, not very. All the time I was there, I never experienced anything that felt like a home. I lived in a different place every year: dorm room, sorority house, rented apartment, and a house with other people. (That house was designed, built, and possessed by someone else. There was never a chance that it would be my home.)

After college came a series of apartments. I don’t remember even trying to make them more homelike. In one of the places, I remember hanging bedsheets over the windows instead of buying curtains. Not even clean, new sheets. (One astute friend remarked, “You didn’t think very much of yourself back then.”)

Next came marriage and another series of rentals. Someone else had a key to them and could – and did – come and go whenever they wanted. Eventually, we landed in a house we had a chance to buy from the owner. But it was dark and shabby and pedestrian and fed right into my recently diagnosed depression.

The desire to find a home of our own grew. We managed to find a house that was above our price range, really, but irresistible. This was a place, I thought, I could finally call home.

The only thing was, it wasn’t a home to us. My husband still thought of his parents’ house as “home.” This house, as special as it was, wasn’t his home and therefore wasn’t our home. I loved the house, but felt somehow detached from it. It had all the comforts of home, but something was missing. Something inside me. This was the house that the tornado destroyed.

We moved from shelter to hotel to rental house, which is where we’re living now. All the furniture and even the dishes are rented too. We’ve hung some of our art collection on the walls, which has helped, but there is no way that this can ever fill that need in me for a home.

Our old house is being rebuilt. We are working with an architect and a contractor to make it a space that we have contributed to, helped shape, and will get to furnish, pretty much from scratch. I have hopes, especially now that my bipolar depression shows itself less often, that this can be my home. There will not even be the specter of Dan’s parents’ house, which has been sold, his ties to it broken.

Will this house be the home I’ve been looking for? Will I be able to fall in love with it, to bond to it, the way you do to a special person? I don’t know. I haven’t really had such a space in my life.

But maybe this is my chance. Maybe this will be the place I truly belong. My home.

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Do Distractions Help?

Well, not when you’re driving, certainly. But when you have bipolar disorder, sometimes they do.

Of course, bipolar disorder is a distraction from life itself. And that’s not good. But every once in a while, it’s worthwhile to give bipolar a taste of its own medicine. Now, I’m not saying that distractions are good when you’re trying to meditate or in a therapy session. But sometimes, when you’re locked in your own head, you need something outside of you to unlock it.

Personally, I need distractions a lot. And, given the popularity of coloring books and fidget spinners, so do a lot of other people. Fortunately, I have found many ways to be distracted. Some of my favorites are music, bad jokes, cooking shows, sleep, and cats.

These don’t always work when I’m in the depths of depression, though I try them even then. But when I’m hypomanic, buzzing around without a landing site, they can help.

Music gives me both a chance to focus and a place to dissipate my energy. There are plenty of songs that express my feelings of depression, but also a number that encourage me to let out the feelings of flying, of soaring, of digging life – Little Richard’s version of “Get Rhythm,” for example, or the songs that have punctuated my life with my husband.

Again, bad – or even good – jokes are no help to me when I’m depressed. But when I’m obsessing about some anticipated (perhaps never to materialize) crisis, they can pull me back from the edge. (Once I called up a silly friend and said I needed a distraction. He said, “Look at the grouse! Look at the grouse!,” a joke I didn’t get until later, when someone explained it to me.)

Cooking shows keep me grounded in a way. So does actual cooking. I’ve found that when I’m tense and about to lose it, making a cup of tea or heating a pan of soup grounds me, even if I have no desire for tea or soup. Making it for someone else is even more grounding. Cooking shows, even if I have no intention of ever trying the recipes, have a similar grounding effect. Unlike movies or dramatic shows, I know that nothing terrible will happen, unless you count a chef cutting her finger.

Sleep may be hard to do when my brain is whirling, but if I can accomplish it, my brain gets a reprieve and perhaps even a respite with a hot-n-juicy dream (though not nearly often enough). I love the feel of cotton or flannel nightshirts or pajamas. I love the quiet and the dark. I love the giving up of the stresses of the day and surrendering to temporary oblivion.

Even sleep in the middle of the day soothes me. If I’ve been unable to sleep the night before, a mega-nap the next day can reboot my brain and replenish my spoons. It may seem like an escape (and in some ways it is), but sometimes escape is what I need.

And as for cats, they help me in so many ways. I find watching them wash themselves hypnotic and comforting. I find snuggling with them in bed soothing. I find their antics infinitely distracting. I find caring for them takes me out of myself and requires that I focus on another being.

If I’m able to focus (which is not always the case), I find reading a suitable distraction as well. I have a few “comfort books,” old favorites that I can return to with an assurance that nothing too alarming will happen. I can lose myself and my anxieties in the struggles and triumphs of others. I can find distraction in tales of things I will never experience, like mountain climbing or space flight.

I have tried some of the tried-and-true distractions as well. I have several coloring books and a plethora of colored pencils. I have sudoko and mahjong programs and word puzzles on my computer. I have my writing, which, while not always soothing, does refocus my concentration and provide an outlet for any troubling feelings I may be experiencing.

Being bipolar, I find that my brain is both my enemy and my friend. It sustains me and betrays me. And it provides me ways to escape from its less sustaining moments. After all, if I didn’t have distractions, I would be locked within my brain with no relief from the tricks it plays on me. I’m glad that there are ways that I can escape, at least for a little while.

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Mental Illness: Fact and Fiction

I’ve had a bit of experience with mental health and nonfiction, though none so far with bipolar fiction. But lately, I’ve been thinking about it.

Bipolar nonfiction is (comparatively) easy to write. There are numerous memoirs, essays, and blogs – including my own. Bipolar disorder has not appeared much in fiction, however. There are reasons for this.

First, let’s tackle the idea of mental illness in “genre fiction” (fantasy, science fiction, mystery, horror, and the like – not mainstream fiction, anyway). A friend of mine recently attended the World Science Fiction Convention in Dublin, Ireland, where they had a panel discussion on just that topic.

My friend reports that the panel “had a mental health nurse, a psychologist and some writers talking about portrayals of mental illness that got it right or wrong.”

He went on to add, “Consensus seemed to be that the Punisher completely nailed PTSD, that Drax in the first GotG movie nailed Aspie but that they rewrote him into a cute Manic Pixie Dream Creature for the second one; and the depiction of Sheldon from Big Bang is an abomination against God and Man.” (To unpack that just a bit, the Punisher is a character from Marvel, GotG means the “Guardians of the Galaxy” movies, and “Manic Pixie Dream Creature” is a riff on “Manic Pixie Dream Girl,” a trope in which one woman (the MPDG) opens the hero’s eyes to life lived fully so that he can then go off and win his One True Love, who is not the MPDG.)

I myself have no experience with the Punisher and saw only one of the GotG movies. Sheldon from The Big Bang Theory is a character I know a little more about. As I understand it, Sheldon Cooper is not intended to represent a person with any particular sort of mental illness (as he always points out, “My mother had me tested”). Still, the character exhibits behaviors that are often associated with Asperger’s, OCD, and perhaps some other mental illnesses or conditions.

I have read that Jim Parsons, the actor who portrays Sheldon, did no research on any of those conditions or illnesses because he didn’t want Sheldon to represent a person with any particular disorder. This allows the viewer to read into the character whatever he or she believes Sheldon’s “problem” is (if any).

But an important point was brought up in the book Philosophy and The Big Bang Theory. One of its essays questioned whether the audience should feel comfortable laughing at Sheldon. If one believes that he has a mental illness or Asperger’s, the answer is, of course, “no.” Yet most of the audience does – apart from those who see the portrayal as an “abomination.”

It’s so hard to get a portrayal of mental illness right, on TV or particularly in genre fiction. Take bipolar disorder, for example. Abigail Padgett’s Bo Bradley series of mysteries features a protagonist who has bipolar disorder. But most of the depiction depends on whether or not the character is having a manic episode at any given time. While the depiction is laudable – and I like the series immensely – it is telling that bipolar depression is seldom a plot element.

Perhaps this is because depression is too, well, depressing to write or read about. A character who is unable to leave her bed or who questions her very existence is hardly likely to move the plot forward. Searing depictions of depression, both bipolar and unipolar, have been written about, but almost exclusively in nonfiction. Even those can be hard to read for someone who experiences clinical depression.

Depression, however, did become a metaphor in the writing of J.K. Rowling. She has said that in her portrayal of “Dementors” in her Harry Potter fantasy epic, she was specifically thinking of depression and its soul-sucking effects on those who suffer from it. That’s genre fiction and that’s doing mental illness right.

In talking about mental illness and genre fiction, I’m deliberately ignoring the many portrayals of sociopaths in shows such as Dexter. Those are stereotypes too, but I’m wondering about less “drama-friendly” mental illnesses. Dissociative identity disorder seems to be one of the few other mental illnesses that feature prominently in popular forms of fiction, usually in the psyche of a villain. You could also count the many detective characters suffering from PTSD, a commonly used trope that is seldom examined closely but rather serves as a personality trait associated with violence.

I wasn’t at the convention and didn’t hear the panel (though I would have loved to), but it raised interesting questions. What would a protagonist (or other character) with bipolar disorder be like or do in what is too often a formulaic plot? Can a mentally ill character be portrayed accurately within the confines of genre fiction? Can mental illness be anything but a metaphor – or be experienced by a character other than one played for laughs? Is there any such book that I should be reading?

I don’t have the answers. But we need facts in fiction. We need understanding. We need representation. I haven’t tried to write fiction featuring a bipolar character, much less a main character who is bipolar. 

Maybe I should.

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Mental Health

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Did Bipolar Disorder Lose Me Jobs?

I lost two jobs, one that I had held for 17 years, because of my bipolar disorder. I only realized this comparatively recently. In both cases, I readily admit that my work had gone downhill, but at the time (at least for the first job), it never occurred to me that bipolar disorder was the reason for my dismissal.

I was working at a publishing company as an editor, having worked my way up from editorial assistant. I had been the editor of two different magazines, assistant editor for a couple of others, and writer and proofreader for them all. (It was a very small company.)

As time went on, though, I became less and less reliable. I edited my magazines, but I had trouble dealing with people. I had particular trouble with an art director who didn’t like my cover choices (despite the fact that several of them had won awards), humiliated me in a staff meeting because of it, and reminded everyone about it later. She was toxic, sure, but I was unable to deal with the situation or even stand up for myself.

There were other humiliations that I tolerated because I didn’t have the wherewithal to quit. When, during the financial crisis, salaries were cut by 20%, mine was cut by 40%, which to me meant that I was twice as useless as, say, a salesperson.

I stayed, but I isolated myself. My office had a door and I used it, the only person in the company to do so. I knew that people thought this was odd behavior, but by that point, I didn’t care. I was let go with no explanation given.

Yes, the company was a toxic environment and no, I didn’t deal with it well. But the situations I put up with exacerbated my bipolar disorder until I was headed for the crash. When I was on the upswing I was able to do my assignments and, I like to think, do them well. But when things went bad, I was prey to the voices that told me I was no good. Losing the job proved that to me.

The next job I went to was editing textbooks. My supervisor knew me and knew that I had bipolar disorder. The fact that she understood helped me keep on an even keel for a while. I developed little techniques to stave off difficulties. But some of my coping mechanisms were unacceptable. (Apparently, it’s okay to have a cigarette break but not a crossword puzzle break.)

Then my supervisor left. I said to her, “I’m going to miss you,” and she replied, “I know.” Prophetic words. I was open with my new supervisor about having bipolar disorder and was quite taken aback when she asked, “What does that mean?” Unprepared to give a proper explanation, I blinked and replied simply, “It means I’ll have good days and bad days.”

From that point on, my performance and their satisfaction with me fell, until I received a bad review, the first one I had ever had. Before the six-month probation period was up, I left of my own accord, determined to make it as a freelancer.

There were personal circumstances at the time, including my disorder, that made me less capable. I became responsible for my mother’s health and finances. I could easily miss half a day of work just getting her to her various appointments. That no doubt affected many of my job functions, particularly my attendance and my ability to concentrate. My major breakdown began not long after I left that job.

The thing is, in 2008, the Americans with Disabilities Act (ADA) added bipolar disorder as a covered condition. Employers were (and as of this writing still are) required to provide “reasonable accommodations” to affected individuals. Examples of reasonable accommodations include job restructuring, part-time or modified work schedules, and “a change or adjustment to a job or work environment.”

To receive accommodations under the ADA, an employee must disclose their bipolar disorder (which I did, at least at the second job) and request accommodations (which I didn’t do, other than offering to work from home).

The EEOC (2009) has a publication called “Psychiatric Disabilities and the ADA,” which is available online at http://www.eeoc.gov/policy/docs/psych.html. Among their recommendations to help a bipolar employee continue to function in the work environment – maintain stamina and concentration; stay organized and meet deadlines; work with supervisors; and handle stress, emotions, and attendance issues – are these:

  • Allow flexible scheduling
  • Allow for time off for counseling
  • Allow work from home during part of the day or week
  • Provide space enclosures or private office
  • Allow telephone calls during work hours to doctors and others for needed support
  • Provide flexible leave for health problems
  • Allow the employee to make up time missed
  • Maintain open channels of communications between the employee and the new and old supervisor in order to ensure an effective transition

I know there are those who would consider such accommodations “coddling.” And I wouldn’t have needed them all, or all of them at the same time. But even an understanding of my closed door and my need to work at home would have helped.

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Mental Health

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