Bipolar 2 From Inside and Out

Posts tagged ‘coping mechanisms’

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.

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.

When Self-Care Seems Impossible

It seems the days when I most need self-care are also the days when I’m least able to accomplish it. I mean, when I can’t even get out of bed, I’m not likely to have the wherewithal to perform any kind of self-care regimen.

I’m not talking here about the take-yourself-to-the-spa type of self-care, either. That’s beyond my means and my capacity. What I’m thinking about are the most basic needs that must be met – meds, food, sleep, and the like. But there are sometimes things that prevent me from accomplishing even these.

Part of the reason, of course, has to do with lack of spoons. It takes energy to shower and dress, make a meal, go to appointments, and all the other tasks that should actually make me feel better. According to Spoon Theory, we wake up with an unknown amount of spoons every day and must choose how to spend them. Some days I wake up with only a few or even zero.

The other obstacle I’ve noticed that inhibits my self-care is my occasional inability to plan. Yes, I can make sure I eat at least one meal a day, but on some days only if I have gone to the grocery store earlier in the week and bought at least a box of Cocoa Puffs and some bottled water to keep by my bed. Not much of a meal, I know. It’s the bare minimum I can do, but sometimes all I can manage.

Taking my meds is the only part of self-care that is an essential that I don’t do without. I usually have that bottle of water right next to my bottles of pills, but even if I don’t, back in college I learned to swallow pills with only spit. But again, this takes a little planning – calling in prescriptions and getting to the pharmacy to pick them up.

On days when I have slightly more spoons, I have to plan and prepare for the days when I don’t have enough for proper self-care. Even the planning and preparing use up spoons.

But there are also days when I can manage a little self-care. On those days, if the spoons are low, but not completely nonexistent, I take shortcuts. I wash up in the sink instead of showering. I put a piece of salami between two pieces of bread and call it a meal. I put on clean pajamas and underwear instead of getting all the way dressed. I use mouthwash instead of brushing my teeth. I pet the cat instead of calling friends.

And I call it good enough.

Admittedly, those are some low standards for self-care. It would be nice if I could do more – and on some days I can. But on many days, the obstacles seem overwhelming. Inertia takes over and entropy sets in. I know it’s not good for me and can slow my recovery from spoon deficit spending, but that’s just the way depression is sometimes. It sucks you down into a hole that’s hard to climb out of when it’s at its worst.

But, thanks to the aforementioned meds and the minimal self-care I’m able to do, I know that one day I’ll be out of the hole and able to work on some proper self-care. Even plan for the next time that self-care seems impossible.

When Trauma and Mental Illness Happen Together

Couples who experience serious trauma may go through the experience together, but they do not always stay together afterward. The death of a loved one, infidelity, the onset of a disease – many things can test a couple’s ability to cope with the event and with each other.

Serious mental illness can also be a relationship killer. Dealing with symptoms, treatments, medications, setbacks, hospitalization, mood swings, and just generally going off the rails is more of a task than many couples can handle.

Combine serious trauma and serious mental illness, though, and what you’ve got is a recipe for a new level of disaster.

One of the potential pitfalls is two people who grieve in different manners or on different timescales. One partner may feel it necessary to process events aloud and at length, while the other may prefer to process feelings internally, without conversation. One person may take a year to get over a death, while the other is still grieving after three or more.

Then there’s couple who have different agendas when it comes to whatever is troubling them both. One may feel that moving on is the best response to a traumatic event, while the other person can’t let go of the past.

Many relationships crack and break apart under the strain. And those are just for couples who don’t have mental disorders.

Now take an example (not completely at random) of a couple who have lost their home in a natural disaster. He suffers from depression. She has bipolar disorder. He grieves the loss of their home and all their belongings to a point that she considers excessive. She kicks into hypomania and focuses on the small details of their situation. He thinks she doesn’t grieve. She thinks he needs to help her address the future.

It will be easier for this couple to stay on track and stay together if they can talk about what has happened and what is happening. That may well involve talking with other people – a trusted friend, a professional counselor, even each other. But it’s important that both people feel that they are being listened to and, more importantly, being heard. And that’s not always something that the other partner can provide.

If the couple can talk to each other, their communication skills will be severely tested. Depressed people and those with bipolar disorder both tend to isolate in times of stress. Processing feelings may not be either person’s greatest strength. And those different timescales and differing agendas are likely to throw up roadblocks should they try to talk about it all.

Being aware that trauma and mental illness both have detrimental effects on a relationship may help. Although even previously strong relationships can be stressed to the breaking point, stepping outside oneself to try to understand the other person can be enlightening. Feelings that seem callous or stubborn or flippant or shallow can just be different ways of dealing with trauma. Thinking the way you feel is the only way to feel will severely impede healing.

If it sounds like I am trying to remind myself of all these things, well, I am. We lost our home in a tornado, and my husband and I were dealing with mental difficulties before that happened. I feel that I must be on alert now for any signs that our relationship is cracking. But it’s not just my problem. The disaster, and the mental disorders, and the relationship are things that we share. They have led to a tangle of emotions and reactions that aren’t predictable or rational or even helpful.

We know the basic things we need to do – take our meds, practice self-care (and help each other do so as well), talk when necessary and be alone when that is what’s needed. We have to keep our eyes on what’s important: our mental health and getting through these difficult times intact both personally and as a couple. And we need to see the humor where there is any. But this isn’t the ordinary sort of disagreement that lasts a day or a week. It’s something we’ll be working on long-term.

Wish us luck.

Emotional and Mental Work

I am weary to my bones and to my soul. As the spoonies say, I’m so out of spoons I can’t eat soup.
Physically, I haven’t done that much to wear myself out. A little light housecleaning. Running some errands. Answering emails and making phone calls. No heavy lifting, unless you count the time I had to help my husband push the washer back into place.
No, the heavy lifting I have been doing is emotional and mental. Make no mistake, that is work and it is exhausting. I am responding to a physical and emotional crisis that happened almost exactly a month ago. After the disaster (a tornado destroyed our house), my husband has done almost all of the physical heavy lifting.
The mental work is stuff that I’m easily capable of doing on a good day: dealing with bureaucracy, organizing the trivia of paperwork and daily life, paying bills, etc. Now, however, there is so much of it to deal with that I am falling behind. I haven’t kept up with sorting our receipts. I haven’t returned the phone call about the hole the cable guy made in the wall. I haven’t even listened to the voice mail about it. I haven’t responded to a friend’s request to look over an official letter she is writing.
The emotional work is entirely different. My husband is dealing with issues of grief, loss, and anger regarding the loss of our house and our possessions. Somewhere inside, I must be having similar feelings, but his are closer to the surface and he is able to express them more.
And I am having some difficulty dealing with this. First of all, angry men distress me, even if I’m not the object of their anger. It’s a throwback to other times and other relationships, a button that was pushed and has stayed mostly stuck in that position. Dan is doing his best to accommodate this quirk, trying to keep his voice down and his conversation rational when we speak of it. But I hear him when he is alone in his study, bellowing or wailing in emotional pain about something I do not fully understand.
My husband and I are operating from different places, with differing agendas, regarding the loss of our house and belongings. He invests his memories and emotions in things much more than I do. I look at what can be replaced and he looks at the irreplaceable – artifacts from his trips to Africa and Israel, for example. Those can’t even have a price put on them and there is no way to replace them. His grandfather’s diamond ring could be physically replaced, but not the sentimental value he attaches to it.
I do understand this, though not at the gut level he does. I do (or did) have possessions that meant a lot to me – a guitar, paintings a friend did, some carvings in semi-precious stones, some photos, of course (though some are stored on my computer, which survived). And I think the salvage company did a poor job of inventorying what they had to throw away and keeping what was small but important, letting us participate in the process. But my anger doesn’t extend to revenge fantasies.
All these feelings, both expressed and unresolved, are sapping my strength and my energy. I have gone back to my therapist for reminders of my coping mechanisms and validation on what I have been able to do – and to have a safe space to vent when all of this does begin to spill over.
And now I have decided to go back to work, on a reduced schedule at least. I don’t know if this is a good idea or a bad one, but it seems a necessary one. Perhaps it will provide a missing piece of familiarity in my life, something to anchor me. Perhaps a different kind of work will distract me from what I have been dealing with.
I know there’s still a lot of emotional and mental labor to do, but with help from my husband and my therapist, I believe I will get through it, especially if I pay some attention to self-care: taking my meds regularly, sleeping and eating regularly, taking breaks when I need them, taking comfort in our cats, and trying to eat the elephant one bite at a time.
This is one of the biggest elephants I can remember, though.

My Emotional Support Animals

As I mentioned last week, my home was destroyed in the Memorial Day tornadoes. Although I was upstairs in bed when it hit and blew the roof off, I emerged physically without a scratch. The emotional effects have not begun to hit me yet, except for a feeling of numbness. Part of what’s keeping me together is my emotional support animals.

The first and most important is my husband. He earned this title when I had to go to the dentist a few years ago (which terrifies me). “Can I bring my emotional support animal?” I asked, gesturing toward Dan. It was meant as a joke, to lighten the mood, but he indeed came into the procedure room with me, sat in a chair in the corner, and placed his hand on my ankle, the only part of me he could reach. And it really did help, that physical contact that helped keep me grounded, and a sympathetic pat from time to time. 

He was much more than that to me this time around. Dan was at work when the tornado hit. I called him and told him the roof was gone. “I’ll be there,” he said. Although his work is only about three or four miles away, it took him an hour to reach me. He drove into our plat until he couldn’t drive anymore, blocked by downed power lines. Then he set off on foot.

It was midnight dark and all the landmarks were gone, as the many trees had fallen or been blown away. It took him an hour to navigate that last half mile. He crawled over huge tree trunks. He fell backward into a creek. He clawed his way up a muddy bank. He lost track of where he was in relation to the house. He had no flashlight. 

But he got to me and we huddled together amongst the dust, dirt, and insulation until the rescue people came. He looked after me at the shelter, made sure I ate and got a shower, and generally acted as my interface with the Red Cross and church volunteers until we left there for a hotel, where we stayed for almost a week.

Meanwhile, back at the house, our cats remained. Every day we had to go to the shell of our home, give Toby and Dushenka food and water, and make sure they were still okay. We couldn’t get them out of the house for days because there was no way to carry them through the obstacle course of trees, branches, utility cables, roofing, boards, and other debris.

Days later a path to the house was cleared and we were able to rescue them. The motel where we were living did not allow pets, but our vet agreed to board them as long as necessary and our insurance agreed to pay for it. They were treated for the difficulties they suffered from having tried to clean their fur when it was matted with insulation. We were their emotional support animals, visiting them and loving them, and playing with them, and making sure they got good care. They needed us and caring for them gave us something to focus on besides ourselves and the devastation in our lives.

Finally, we were moved to a hotel that was pet-friendly and our little family was reunited. It really is an emotional comfort to have our cats with us again, sleeping on the bed with us, exploring the room, and returning that little bit of peace and normality to us. It’s now less of just a hotel room and more of a temporary home.

In a way, taking care of the cats has provided emotional support for us as well. When we need comfort, there is someone there to respond with affection and trust. When we are lonely, there is another being there to pet and cuddle. When we get short-tempered, we can find solace and distraction in their purring.

Our cats aren’t trained service animals, of course. But they give us emotional support just the same, especially when our ability to support each other wears thin. We and our animals have been emotional supports for each other and helped us bear up under these difficult times so that we can be the emotional support animals when needed, too.

 

Rebuilding Myself

After my last (and, I hope, last) major bipolar breakdown, my therapist pointed out that I had a unique opportunity: I could reclaim those parts of my life that had fallen away, or I could leave them behind.

I could choose. That idea was very powerful.

I had a lot of irrational feelings and associations that I needed to reconsider after leaving a toxic relationship. I had given up needlework after making an elaborate set of chair backs destined to be inherited by someone else’s children that I would never see. I got to dismiss those feelings and reclaim my creativity. I chose to take up needlework again. Whoever’s children can have the chair backs.

In fact, I had bad associations with nearly everything associated with that relationship: folk music, guitar lessons, cooking and entertaining, even blue spruce trees and cobalt blue glassware, for God’s sake. I reclaimed the music and the cooking, but let the entertaining largely fall by the wayside, as it triggered my bipolar disorder as well as my memories. I got over the blue spruce and learned to shrug at anything cobalt blue, though I still don’t buy any.

None of these things caused my major meltdown, though they may have contributed to my shaky mental state. They were simply things that I had lost along the way. And since I was in the process of rebuilding myself afterward, I could view them as stones to build something solid with or as broken bricks to discard.

Rebuilding from the bipolar breakdown was not as easy as merely taking back a few hobbies and interests. It involved reevaluating large parts of my life. Would I go back to school and get another degree? I would not. I weighed the idea and decided it would be too much stress just to add a few more letters after my name. Would I resurrect my mostly-dormant writing career? Yes. And I’ve taken it further than I ever thought I would. Would I reconnect with the country music I loved best but had been shamed for listening to? Of course!

The process of putting myself back together is one I have been through several times now, and each time I got to choose what to bring with me and what to leave behind. Bipolar disorder, much as I hate what it has done to me in so many ways, has at least given me that chance to reinvent myself if I wished to or resurrect myself if I felt like it.

I’ve always hated when people say about some bad experience I’ve had such as my appalling relationship or my bipolar condition, “But you’ve learned so much from it!” I always think, “Maybe so, but the lesson wasn’t worth the price I paid.” But having the opportunity to rebuild myself – and especially to choose what I want to be part of the new me – is very nearly worth it. I owe that epiphany to my longtime therapist, Dr. B. But I’m the one doing the work. And it is indeed very much a work in progress. I am a work in progress.

Bipolar disorder is one of the bricks I have to rebuild with, and it always threatens to make my new structure a bit shaky rather than completely solid. But isn’t every life a work in progress? Don’t we all have bricks or timbers or stones that are at least a little unsound or misshapen, that we have to shore up or fit in as best we can?

I can’t guarantee that my structure won’t crumble again, though it has been relatively stable for some time now. But at least now I know that I have the ability to start over yet again. And to choose myself. That choice is both powerful and empowering. Just as it is said that all writing is rewriting, all my building is rebuilding.

And I’m okay with that.

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