Bipolar 2 From Inside and Out

Posts tagged ‘coping mechanisms’

I May Have Miscounted My Spoons

This week I actually got out of the house, going for lunch and a little shopping with an old friend. (Another friend of mine calls these “pants days” because they obviously require putting on pants, for going out farther than the mailbox.)

After less than three hours I went home, did some work, and promptly collapsed. All told, I think I was either active, sociable, or some combination thereof for at most five hours – most likely more like four. That for me is an exceptional day of fortitude, stamina, spoons, and hypomania.

However, I have gotten myself into a situation that will require much more than that. I am going to a writer’s conference – three days of thrill-packed seminars, lunches and dinners, and other business and social-type events. I’ve done half-day business meetings lately, but nothing so extended, crowded, or spoon-depleting. It will hit a lot of my anxiety triggers – crowds, noise, small talk, social events, and more. I know that by the time we gather for dinner in the evening, I’ll already be extra crispy.

The three days of the conference will not allow for much of any downtime – although I have fantasized about asking someone who’s staying in the hotel if I can borrow a room for an afternoon nap. (The conference is local so I don’t have a room of my own or it wouldn’t be a problem. Less of one, anyway. All I’d have to do would be pick which seminars to skip. But the idea of asking a relative stranger for the use of a room or the idea of a relative stranger letting me use a room is pretty ludicrous.) Fortunately, I have to get the car home by 10:00 so my husband can go to work. That means I can’t stay for the after-hours socializing, even though that’s said to be one of the highlights. But it does mean I get a few more hours in pjs instead of pants.

Back before I had my most recent major meltdown, I was able to attend business conventions and do at least most of the requisite functions. I could and did give little talks at power breakfasts or afternoon cocktail parties – even opened with a joke. I could meet and greet the public at our booth – “howdy and shake,” as my father would have called it. I could have lunch with potential writers. I could almost interact with our sales force.

Those days are long past. So now I ask myself, how can I build up my stamina for the writers conference? Maybe it’s time for me to try to reclaim some of those parts of myself.

It feels like I’m going to be training for a marathon – or maybe the Normandy invasion. I know that in order to get through it, I will have to prepare in advance: writing my Sunday blog posts before the conference starts, assembling my wardrobe, checking out the parking situation, stocking up on business cards, and all the other little details that make me so frantic at the last minute.

Perhaps during the next two months I can keep track of how many pants days I’m able to have and gradually increase them. Perhaps I can arrange more lunches and shoppings. Perhaps I can improve my usual record of doing only one major thing per day. Perhaps I can try to work up to three pants days in a row.

The conference itself is certainly a massive and major incentive. Plus I’ve already paid for it – yet another reason to get myself in shape to take advantage of it.

Right now the conference looks like rather an ordeal, but I hope that by the time it rolls around I’ll be in good enough shape to both enjoy it and benefit from it. At least it’ll be a group of writers, and humor writers at that. They’re known for being at least a little odd. Maybe I’ll fit right in. I’ll be the one napping on a couch in the hotel lobby in fuzzy slippers. And pants.

Category:

mental health

Tagged with:

Bipolar Basics for the Newly Diagnosed

If you have recently been diagnosed as bipolar, there are a few basics you should know. You’ll likely find them out on your own, but it might take a while.

So, here are some tips.

    1. Being bipolar isn’t necessarily a tragedy. It’s a chronic illness. At times it’s better, at others, worse. It’s not a death sentence and it’s treatable. You can still live a reasonably full and satisfying life.
    2. You need help. To live with bipolar disorder, you need a support system. Unfortunately, your friends and family may not be all that supportive. Fortunately, there are online support groups. But the most important parts of your support system, at least at first, are your psychiatrist and your psychotherapist. I recommend having one of each – psychiatrist for medication, therapist for talk or cognitive behavioral therapy, or whatever works for you.
    3. You will most likely need medication. And the odds are good that you will need it for the rest of your life. Don’t panic. After all, diabetics need insulin, usually for life. You may hate taking pills, you may hate the idea that you are dependent on them, you may hate the fact that they remind you of your brain’s difficulty functioning. But realize that meds will make your brain’s functioning less difficult. They are worth the hassle.
    4. Everyone is different. Everyone’s symptoms are slightly different. Everyone’s medications are slightly different. Everyone’s reactions to their medications are slightly different. A support group can help you with general information, but they cannot tell you what is ultimately best for you. Your particular symptoms and your unique version of bipolar disorder may well require different medications, in different amounts, than your friends. And you may have different reactions to them. Some pills have no effect at all on one person and are life-savers for another.
    5. Getting better takes time. Once you have your diagnosis and your medication, don’t expect to feel better quickly. Most medications for bipolar disorder take a while to build up in the body. Six weeks is not unheard of. Then your doctor may assess how well the medication is working, and change the dose or even the medication itself. Then you may go through another six weeks of waiting for the new dose or drug to take effect. Each case of bipolar disorder requires a medication regimen tailored specifically to the individual, and that often takes some doing.
    6. There are several different types of bipolar disorder. The two main types are called type 1 and type 2. Type 1 is the classical bipolar disorder, which used to be called manic-depressive illness. Type 2, a more recently identified version of the disorder, often manifests as mostly depression, possibly with hypomania, a less severe version of the ups that accompany bipolar 1. Other forms of bipolar disorder are rapid cycling, in which one’s mood states alter quickly, even within a few hours. Another version of bipolar disorder is called mixed states. Mixed states occur when a person experiences both extremes of emotion at the same time – for instance, depression and irritability, or fatigue despite racing thoughts.
    7. The odds are that you already know someone with bipolar disorder, or at least some kind of mood disorder. One in four Americans will have a psychiatric or emotional illness at some time during their lives. Because we don’t talk about it, though, no one may ever know. Especially when the disorder is treated properly, a person with bipolar illness can maintain function in society and choose whether or not to share the diagnosis with friends and coworkers. Many people choose not to because of the stigma surrounding mental illness. It’s a valid choice, but it cuts the bipolar person off from possible support and understanding from others who may share the disorder.
    8. Relationships can be difficult but not impossible. Relationships are difficult for everyone. People with bipolar disorder have relationships that are difficult too. The disorder may make the relationships even more difficult, especially when the family member or loved one or even close friend does not understand the symptoms, the medication, the mood swings, the anxiety or fatigue, or all the other facets of bipolar. The best cure for this is education. However, it may not be possible for a relationship to survive bipolar disorder, just as a relationship may not survive trauma, grief, addiction, infertility, incompatibility, meddling relatives, infidelity, parenting, or a host of other conditions. It may be better to look at all the circumstances surrounding a troubled relationship rather than automatically blaming bipolar disorder for difficulties.
    9. Learn all you can. Because bipolar disorder is so little understood by the public, because it manifests differently in nearly every case, because a person can be actively suffering or in remission, because a person may have any of the different types of bipolar disorder, because everyone is different – the need to educate yourself and probably those around you is essential. The more you know, the less you’ll panic when a symptom you haven’t experienced before suddenly hits. Rely on reputable sources. Medical, psychiatric, or psychological websites are usually the best. Support groups can offer much information, but the people in a support group may not be any more well-informed than you are. And there are lots of people selling “miracle cures” that can lure a person away from needed medication and other services.
    10. Keep trying. It’s hard. It’s frustrating. It’s difficult. It’s painful. It’s confusing. But bipolar disorder is something you can live with, and even something you can rise above. The secret is to keep trying. Keep seeking out therapy and friends who support you. Keep taking your medication, even if you don’t want to. (Stopping your medication without advice from your doctor can be dangerous, so don’t try that.) Be stubborn. When you feel like giving up, tell yourself that maybe things will get a little better in the morning. Hang in there. You may not realize it, but there are people who need you in the world, who need you to be functioning and happy, who need you to keep fighting the disorder.

Do you have any other tips for the newly diagnosed? Please share them in the Comments section.

Category:

mental health

Tagged with:

Am I Ready to Stop Therapy?

I got my first hint that I might be ready to stop therapy when I realized how little I was going. Over the years I have scaled down from weekly sessions to biweekly.

Then I noticed that, effectively, I’ve been going only once a month. I’ve been forgetting appointments, showing up on the wrong day, oversleeping, feeling poorly physically, or having too much freelance work to do.

Of course, those could be signs that I’m in denial, that I’m resisting therapy, that we’ve hit a bad patch of difficult issues and I just don’t want to deal with them.

But I don’t think that’s what’s happening. Here’s why.

I’m stabilized on my medications and they’re effective. When my psychiatrist moved away a few months ago, he left me with enough refills to last until this month and a list of other psychiatrists. My PCP agreed to prescribe my psychotropics if I lined up another psychiatrist for emergencies. I’ve done that, though I couldn’t get an appointment before March.

And that doesn’t alarm me. I don’t have the oh-my-god-what-if-my-brain-breaks-again panics. I don’t have the feeling that my brain is about to break again. I’ve thought about it, and I’m comfortable with letting my involvement with the psychiatric profession fade into the background of my life.

As long as I keep getting my meds.

I have more good days and I’m beginning to trust them. Oh, I still question whether I’m genuinely feeling good, happy, and productive or whether I’m merely riding the slight high of hypomania. But really? It doesn’t seem to matter very much. A few days ago I reflected on a string of particularly good days – when I accomplished things, enjoyed my hobbies, and generally felt content. And I simply allowed myself to bask in those feelings.

That’s not to say I don’t still have bad days. After a few days of hypomania, I hit the wall, look around for spoons and don’t find any, and require mega-naps to restore me. (I’m intensely grateful that I work at home and can do that. Most offices don’t appreciate finding an employee snoring underneath her desk. And my cat-filled bed is much more comfy-cozy.)

I still get low days too, but they are noticeably dysthymic rather than full-out, sobbing-for-no-reason, Pit-of-Despair-type lows that last seemingly forever. I know – really know, deep within me – that they will last a day or two at the most. And just that knowledge makes me feel a little bit better.

My creativity, concentration, and output are improving. I can work longer, read longer, write longer, take on new projects, think past today or even next week. I can trust my muse and my energy, if not immediately when I call on them, at least within a reasonable time.

I have trouble remembering how bad it used to be. Recently I’ve made connections with several on-line support groups for bipolar and mental health. I find I’m astonished at the crises, the outpourings of misery, the questioning of every feeling and circumstance, the desperate drama of even the most mundane interactions. They are overwhelming. But I realized that it’s been a long time since they’ve overwhelmed me. I recognize that I could some day be in that place again – that’s the nature of this disease. But I have a good support system that I trust to help me not fall too far without a net.

I don’t have much to talk about when I go to therapy. There are issues I need to work on – getting older, getting out of the house more, reclaiming my sexuality. But most of those I feel competent to work out on my own.  My sessions are mostly an update on what’s going on in my life at the moment, plus a recap of my recurring problems. But those problems are ones I’ve faced before and know how to cope with. I already have the tools I need and use them without needing a reminder.

So I’ve talked it over with my psychotherapist and I’m not completely quitting therapy, but I am cutting back officially to the once a month I seem to be going anyway. I know that if and when the bipolar starts giving me major trouble again, I can always call for an appointment or a telephone therapy session.

I’m not going to stop writing these posts. I still have a lot to say about where I’ve been, how I’ve got to where I am now, how things will go in the future, and all the many ways that mental illness affects society and vice versa.

You’re not getting rid of me that easily. I’m sticking around.

Category:

mental health

Tagged with:

Self-Harm Revisited

If that title isn’t enough of a TRIGGER WARNING for you, I don’t know what is.

Not long ago I saw on the web a video with the title “Is scratching self-harm?” Well, of course it is, I thought. The video agreed with me.

It seems like the low end of the spectrum, not as extreme as as what most people think of as self-harm, but a form of it nonetheless. Scratching, pinching, hair pulling, and the like are probably considered subclinical next to cutting and burning. But they are still problems. They can escalate into worse self-harm.

In another article (http://www.upworthy.com/this-researcher-who-studies-self-injury-explains-why-people-do-it-and-why-he-did-it?c=ufb1) I saw this definition for self-harm:

“Self-injury is intentional damage to body tissue (that doesn’t include body modifications like piercings, tattoos, and scarification) without suicidal intent.”

So, yes, scratching is self-harm. It is intentional. It is damage to body tissue. and it does not indicate suicidal intent.

Scratching sounds so minor. We scratch ourselves all the time when we have an itch or an insect bite. We scratch ourselves accidentally on protruding nails. Occasionally we draw blood. We wash it off, slap on a band-aid, and that’s that.

But when scratching escalates to self-harm, it can indeed be serious. For one thing, scratches have a tendency to become infected, infection of the sort can lead to further tissue damage – and if untreated, to more serious complications.

There is also the potential for further harm because the scratching will scab over. Then the desire to scratch off the scabs kicks in. When this happens, the scratches never heal. And yes, that’s both a fact and a metaphor.

My own experience with scratching came when I was working at a job that required me to monitor burglar alarms. The alarms tended to go off – whether there was a burglary or not – during thunderstorms. When a storm hit, a dozen or more alarms could go off simultaneously, or at least in rapid succession. I had to call the owners of the businesses, or emergency services as required.

One night during a particularly bad storm, I missed one of the alarms. I did not call the owners until I looked back at the record. When I called, it was 45 minutes since the alarm. I knew I had made a mistake, and a bad one. The owners of the business would not be happy. My boss would not be happy. I was not happy.

I sat alone by the monitors and imagined the trouble I was in. I started scratching my right arm – long slow strokes from nearly the wrist to nearly the elbow. Repetitively. Obsessively. Painfully. I believe I was punishing myself for making a bad mistake. Perhaps there was some thought that if I inflicted the pain, I would escape further consequences of my mistake.

Of course that makes no sense. It’s an example of the irrational thinking that goes with self-harm.

I don’t cut anymore, as I discussed in a previous post (http://wp.me/s4e9Hv-cutters). I also don’t scratch the way I did that night. I still have a tendency to pick scabs. Occasionally if I have an insect bite, I will scratch it to blood and then pick the scabs on that. I try not to. My husband helps me by reminding me not to pick at scabs or to put band-aids on them. I try to rub instead of scratch, or use lotion.

Jenny Lawson (aka the Bloggess) has admitted in her most recent book, Furiously Happy, that she scratches past the point of bleeding and pulls her hair enough to create bald spots. It’s clear that she considers this self-harm. Her husband tries to help her with it too.

But self-harm is basically a private thing – something we do and hide from the world. Some people are able to hide it even from their most intimate family and loved ones. I know I wore long sleeves to cover the dreadful scratch on my right arm. It healed from a scratch to a pink scar and then to a white scar. Now I can’t even see it anymore through the freckles.

But I don’t need the visible reminder. I remember how it felt to do it, how it felt after I did it, and how I felt as I watch the scars slowly fade. its nothing I’m proud of, except for the fact that I survived it and no longer do it.

As most cutters and other people who self-harm do, I feel shame in recalling the act, and almost never speak of it. The reason I’m sharing the story in such a public forum is to let people know that not all self-harm consists of big dramatic gestures. It can start with a tiny scratch. But it is not something to be ignored. We need to talk about self-harm, educate about it, bring it out in the open, and let others know that it doesn’t have to continue.

And that it can start with something as small as a scratch.

Category:

mental health

Tagged with:

Things That Work – Sometimes

Right now I am in the middle of a fairly deep depression. It has gone on for days, which is unusual now that I am more or less stabilized on medication. But there is no let-up in sight.

This time is one of those I-have-nothing-to-look-forward-to moments; plus the holidays; plus the need-to-see-my-therapist thing; plus the have-an-appointment-with-new psychiatrist-but-it’s-not-till-March thing; plus the whole no-spoons-to-get-out-but-really-need to-get-out-of-the-house feeling; plus the various catastrophizing-about-finances-and-the-IRS problem; plus the there’s-something-I-really-want-to-happen-but-if-it does-it-won’t-be-soon-and-may-not-happen-at-all.

Let’s see. Is there anything else?

Oh, probably, but that will do for starters. Of course to a lot of people, those would be everyday annoyances and I would be having your standard pity party. But for a bipolar person, with my brain chemistry, it’s an invitation to a deep, dark pit.

So what are the things that help pull me through, or out, or up? And what are the things I can do while I just ride it out?

Well, there’s music. I’ve written about that before (http://wp.me/p4e9Hv-42). There are two long-form musical bits that have been known to lure me out: The Mikado and The Pirates of Penzance. Occasionally when I haven’t gotten out of bed in a while, my husband will put on a DVD of one or the other and wait for me to appear in the door of his study. There is usually beer or snacks, and I can sing along (badly but loudly) to my heart’s content. Heart’s content – now there’s a good thing. Going to see live productions of Gilbert & Sullivan was an activity my sorority used to do, and one of my best memories of otherwise-difficult sorority life. (I mean, really, can you picture me in a sorority?)

Then there are distractions. These don’t actually improve my mood, but they can help me avoid dwelling on the above list of what’s-wrongs. If I have the concentration needed to read, that’s my go-to choice. (I’ve also written about “comfort reading”: http://wp.me/p4e9wS-3n.) I usually try to keep one fiction and one nonfiction going, so I can switch back and forth.

Sometimes, though, I don’t have the concentration to make it through a chapter. Then it’s time to try TV. Something familiar, non-challenging, not too fast-paced. Cooking shows work, or something like Pawn Stars. True crime or true medicine. Shows where I already know the characters and the back-stories: Castle, Bones.

When I don’t even have enough concentration for that, I go for stupid clicky games. One round of Candy Crush Soda Saga is about as mindless as you can get and still be breathing. Even playing out all five lives takes about 15 minutes. Or I can turn off my brain entirely, play obsessively, and get lost for hours of not-worrying about anything more important than making six-letter words in AlphaBetty.

Occasionally I can do light-as-popcorn forms of social interaction. Phone calls with a depressed friend or one who always has a silly joke ready or one who reads the same sorts of things that I do. Instant messaging. Facebook.

Sometimes, though not often in this state, I can force myself to work a little. Or work on my blogs. It’s difficult and not really satisfying and sometimes even painful, but if I can do it, it’s probably the best thing for me. Accomplishing something – anything – helps build a step out of the pit.

As for the usual advice – rest, exercise, nutrition, meditation – I usually can’t manage those. Except for sleeping. I’m a world-class napper. Also a world-class insomniac. Don’t ask me how I manage that. It’s a gift. I have a new exercise regimen that involves walking up and down the stairs more times than I really have to. My husband makes sure I eat at least one good meal a day. For meditation I pet a cat.

Then I wait.

I know that this will not last for weeks or months or years the way it used to. I’m just going to be miserable until I’m not anymore.

Category:

mental health

Tagged with:

The Depression Diet

It seems that Target (and other stores) can now send, well, targeted ads based on previous purchases. The example usually given is that someone who buys a home pregnancy test will start receiving coupons and discount offers on diapers and strollers.

I maintain that one way to spot depressives is through their grocery-buying habits. Just as psychologists say that odds are that the last three people in any long line are likely to be clinically depressed, I say that someone who purchases an entire chocolate chip cheesecake and a bottle of Jose Cuervo is going to be in the back of that check-out line too.

Which brings me to my point. There are certain foods that depressed people tend to eat. These foods don’t cure depression, of course, but they do seem to provide some comfort.

The first category of depression food is, of course, comfort food. We all have our own definitions of comfort food, but a lot of them seem to be high-carb, high-fat, no-nutrition sorts of food. They bring back memories of childhood, maternal nurturing, and a simpler time when calories didn’t count. Some of my comfort foods include club sandwiches, grilled cheese sandwiches with tomato soup, mashed potatoes, and macaroni and cheese.

My husband knows enough to make me comfort food when I’m stressed out. He does add tuna fish and peas to the mac and cheese to make it somewhat more nutritious. He knows my needs and does well at meeting them, though his grilled cheese will never rival my mother’s. He does pretty well on the tomato soup.

The next category of depression food is weird food. I suppose this category includes the chocolate chip cheesecake and tequila. One of my depressed friends introduced me to her particular specialty: wavy potato chips dipped in cream cheese with an M&M stuck on top. My husband starts to worry about me if I ask him to pick these up for me at the store. But it does contain all four food groups: salty, sticky, sweet, and crunchy.

When I was a kid, my favorite was a block of cream cheese with that odd, unnaturally orange French dressing poured over it, mashed with a fork, and with pickle relish if I we had any. This was my own chip dip creation. It resembled my friend’s in the cream cheese and wavy chips department, but French dressing is no substitute for M&Ms. Let’s just say my tastes have grown. (Not necessarily up.)

Another category of depression food is useless food. These are edibles that one can make with very little effort, as even small efforts can be overwhelming at this point in depression. Frozen dinners are good for this. I recommend Marie Callender pot pies if you go this route, because they have both a top and bottom crust and so feel more like a meal. Foods that come in small cups with pop-open tops are good too: Beefaroni, mac and cheese, soups.

Sometimes, however, the depression is so severe that even these simple efforts are beyond you. For those occasions, there are truly useless foods. It’s a mistake to call them meals at all. Here I’m talking peanut butter straight out of the jar (spoon optional), and dry cereal straight out of the box. During my worst days I used to keep a box of Cocoa Puffs by my bedside, just in case. As I slowly improved, I replaced that with a box of Life cereal. (The name was a coincidence, I assure you.)

I know that eating a well-balanced, nutritious diet is one of the most common suggestions for keeping depression at bay (along with exercise, sleep, and all that other good advice). I also remember that when a person is talking about suicide, one of the questions you’re supposed to ask is, “When’s the last time you ate?” Supposedly it’s harder to take your own life if you’ve recently done something as life-affirming as eating. (I don’t know if that’s actually true, but I did try it once and the person is still alive, so maybe.)

I also know that sometimes irrational thinking extends to food choices as well. I worry about my husband when he starts eating peanut butter sandwiches dipped in cold chunky soup (still in the can). I’ve been told that’s a guy thing, not a depressive thing, but still sometimes I wonder. Even at my most depressed, I’ve never been tempted to do that. Ew. Just ew.

Category:

mental health

Tagged with:

Confessions of a Crazy Cat Lady

One can be a crazy cat lady without living alone in a cavernous house with a dozen or more cats. I should know. I am one, and I don’t.

First let’s start with definitions. I’m crazy. I think we all know that by now and I don’t mind saying so. (See “Yes, I Am Crazy. Thanks for Asking” http://wp.me/p4e9Hv-4h.) I’m also a cat lady. We had dogs growing up, but I never got very close with them. I did have a rabbit that I was awfully fond of, but this was in the days before lop-eared rabbits became house pets. She lived in a cage in the garage, or in the back yard when the weather was nice.

To me a crazy cat lady is someone who has eight or more cats, lives alone with them, usually in a large house, but one not quite big enough for all the inhabitants. Often you hear news stories about crazy cat ladies who die alone and are eaten by their cats, or crazy cat ladies whose pets are taken away from them because of inadequate care – especially sanitation.

I have a friend who was had more than eight cats at once, and is just as crazy as I am. She does not, however, believe that she is a crazy cat lady because another lady down the street has more cats. And truthfully, she doesn’t meet the other requirements of crazy-cat-lady-hood. She has a family, and keeps up with the care and feeding of her menagerie.

Do crazy cat ladies have an actual mental disorder? If so, do they all have the same kind? Maybe not. The crazy cat lady on The Simpsons (Eleanor Abernathy) is pretty clearly schizophrenic, though I doubt that many are in real life. Real-life cat ladies may demonstrate obsessive-compulsive tendencies, or their isolation may be due to depression. Or something else entirely.

Psychology Today tells us there is no real basis for the stereotype.

The stereotypic term “crazy cat lady” is used in a pejorative sense to classify an older, female animal hoarder and there is no research to support such correlation. Research on animal hoarding is lacking and there is not one plausible theory that suggests why older females tend to hoard animals more than men.

https://www.psychologytoday.com/blog/when-more-isnt-enough/201106/animal-hoarding-is-there-such-thing-the-crazy-cat-lady

Still, crazy cat lady behavior may be psychologically classified as a “hoarding disorder.” Mother Nature Network reports that the condition…

…is only now getting the recognition that will prove helpful to sufferers. Recent research has revealed abnormal brain activity in people with hoarding disorder. And both experts and hoarders hope and believe that the new DSM classification will help bring about better treatment.

Read more: http://www.mnn.com/health/fitness-well-being/stories/crazy-cat-ladies-to-get-a-new-clinical-definition#ixzz3nG9WWESM

I would make the case that crazy-cat-lady-hood is actually a defense against mental disorders. Carried to an extreme, perhaps, but beneficial nonetheless.

Caring for cats – even multiple ones – gives a person another living being to care about. Patients in geriatric facilities are often brought into contact with small domesticated farm animals or cats and dogs (therapy animals), which pretty clearly help them deal with isolation and depression.

For an isolated person, cats provide someone to talk to. Not that the cats necessarily listen or respond, of course, except in the most perverse ways possible. They are cats, after all.

I got my first cat when I was living alone and recovering from several years of psychological trauma. My future husband went with me to the shelter, but was studiously unhelpful in selecting a cat, thereby proving that he had some sense and a grasp of how important it was for me to find a kitty I could bond with.

“Which one should I get?” I asked.

“Gee,” he replied, “I dunno, honey. They all look like nice cats to me.” The one I chose was Bijou, a tortoiseshell.

We as a couple have since had up to five cats at one time, and through the years a total of well over a dozen.

When my bipolar disorder was at its worst, after I had suffered a major meltdown (nervous breakdown, decompensation, or whatever you call it), I was certainly crazy, but hardly a cat lady. I was unable to take care of my own daily needs, much less those of anyone else, human or feline. My husband, who was taking up enormous amounts of slack, took over pet care as well. Now that I’m back on a fairly even keel, I can do my part with feeding, litter box tending, grooming, and so forth.

Fortunately, even when I was immobilized, my cats, in addition to my husband, gave me emotional sustenance. The therapeutic effects of a purr, a gentle kneading, and a nice snuggle are not to be underestimated. The antics of a kitten may be exhausting to watch, but they provide more than a little distraction, if that’s what you need.

Do dogs have the same therapeutic effect? I don’t know. For some people I suppose they do, but I have never bonded with a dog as I have with my cats.

In psychological terms, my cats are “comfort objects,” like furry, living security blankets, or teddy bears that shit and meow. I hope never to be without a cat again. I need them for my mental health.

Category:

mental health

Tagged with:

Social But Spoonless

In the past week I have been out of the house more and seen more people than I have in years. It’s almost like having a social life.

In the past week I have also slept more than I usually do in my sloth-like, torpid existence.

I think the two are not unrelated.

If you follow Spoon Theory (http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/) you know that each spoon represents an amount of coping that you can do.

Every day you get a certain number of spoons – not the same number every day.  You use them to perform everyday tasks that most people think nothing of – things like getting out of bed (some days you don’t even have that spoon), taking a shower (1/2 spoon for Janet’s patented “super-fast smelly-bits sink wash-up”), getting dressed, finding something to eat, fixing that something (keep a box of Cheerios by the bed in case you run out of spoons at this point), and all that is without even leaving the house. Some days that’s all the spoons you have and when you’ve used up your spoons, that’s it.

Other days you can manage to do all that and leave the house, go to work, run errands, and assorted other normal activities. But for those of us who have mental disorders, such days are few and far between.

You hear depressed people talk of not being able to get out of bed, and for the most part that’s caused by lack of spoons. I am usually notoriously low on spoons. My husband now understands Spoon Theory and we use it as common shorthand for “I’m too tired” or “That’s all I can handle right now.”

Dan, however, is an over-scheduler and I often have to rein him in by pointing out that his proposed slate of activities will not be possible because I, for one, will run out of spoons, and he may too.

The dry run for my recent spurt of socializing began last week. After I went for my final session with Dr R., I managed a trip to the bank, a trip to the place where I could pay my power bill, and since it was right next door, a stop at Kmart to buy underwear. It was a good thing that was a hypomanic day, but it floored me for the rest of that day and the next. And it started a cycle of bipolar up-and-down oscillations that were clearly related to spoon usage.

My spate of social endeavors started with a double-header. On Saturday I had lunch with a friend at a favorite restaurant I almost never get to go to. We talked about politics, social issues, and book proposals. Then I went home and had a little nap.

That evening Dan and I went to Monkey Bones for Zombie Dogz. I know that takes a little explaining. Monkey Bones is the tattoo studio where I got my semicolon tattoo (http://wp.me/p4e9Hv-9G). Zombie Dogz is a local food truck. (Also, it’s fun to say “We went to Monkey Bones for Zombie Dogz.”)

Notice that in a single day I had to get up, out of bed, and get dressed twice. That’s a lot of spoons. Sunday I was not able to get out of bed at all.

Monday did not involve socializing, but it was another hellacious spoon-eater. Dan and I spent the day scrounging for documents and information that the IRS wanted. It was taxing. (See what I did there?)

Tuesday was an extra-special social event, though it did not involve getting dressed and going out, or even interacting with other people. It was Jenny Lawson’s online book launch party. Better known as the Bloggess, Jenny has severe social anxiety. At this stage in my life, I certainly would not be able to dress up, mingle, and make polite conversation with both friends and complete strangers. The online party was a genius idea.

I sat at home in my pajamas with some red wine while the Bloggess read chapters from her new book, Furiously Happy. (You should get it, by the way. It’s about mental illness, but funny.) As low-key a social situation as that was, it still used up spoons because it was something I had never done before. Making sure I had the right URL, converting Central Time to Eastern, not being able to ask questions because I don’t Tweet, worrying that Dan was getting bored – not a lot a lot of spoons, but still some.

The effects were getting cumulative. Again I was unable to get out of bed the next day. In fact, Dan and I both slept away most of the daylight hours. For him it’s understandable because he works third shift, but I have no such excuse. Except that if you borrow from the next day’s spoons, or try to keep going without them, you will pay.

Thursday, I was determined, with or without spoons, I was going to meet a friend for coffee. I’ve seen her only once, briefly, in several years. In a way, it was a test of my ability to maintain anything approaching a real social life.

I put forth the extra effort because a mutual friend cut her ties with me because I canceled so often on social engagements. I suppose I really have nothing to prove to anyone but myself but it seems important that I do so. It’s not like coffee with a friend is an ordeal or anything. It’s just that I know I’ll be using a spoon for more than stirring my coffee.

And I hope I have enough spoons left over to work on my other blog.

Category:

mental health

Tagged with:

The Quest for a Psychiatrist

I have been seeing Dr. R. for eight years. He helped me through my major meltdown and skillfully, gradually mixed the cocktail of medications that would get me and keep me functioning at an acceptable, livable level. He got me through my near-brush with ECT (although he also suggested it).

Dr. R. is moving to another state. He sent all his clients a letter listing half a dozen or so local psychiatrists he could recommend, though he didn’t know if they were accepting new patients or what insurance plans they took. This week was my last appointment with him.

I looked at the inch-thick file he was holding. “I was really messed up back then,” I said.

“Yep,” he replied.

I left with a hearty handshake, good luck wishes, a paper stating my diagnosis (bipolar disorder, anxiety disorder – I guess there was no insurance code for bipolar 2) and six months of refills on my prescriptions. That’s how long I have to find a new psychiatrist.

So where will my inch-thick file end up next? That’s a good question.

I’ve written before about finding a psychotherapist (http://wp.me/p4e9Hv-1m), but oh, I hate the process of finding and breaking in a new shrink.

At least this time I probably won’t have to go through the whole Reader’s Digest Condensed Version of my screwed-up life, since what I really need at this point is someone who will prescribe and monitor my meds, though it will also be nice to have someone standing by in case of another major meltdown, should I have one.

My first avenue of exploration is whether my primary care physician will prescribe my psychotropics, so I can continue with just a psychotherapist. Dr. R. says that most GPs would shy away from the somewhat lengthy list of meds, but every time I see Dr. S. I update him on what meds I am taking, and I always mention the psychotropics, which have mostly been the same for years.

I have an appointment to see Dr. S. next month and sent a query about the prescription issue (his office has a robust online presence), so with luck, I may have a solution before Halloween.

My next step would be to start with the list that Dr. R. provided. Only one of the offices is at all close to me and I’ll likely start there. Does the doctor accept new patients? Does the practice take my insurance? What’s the charge if they don’t?

I’ll also need to contact my insurance provider for a list of local psychiatrists who do take that insurance, but with that I’ll be flying blind. Dr. R.’s recommendations are people he knows, and knows are good.

I hope they’re as good as Dr. R.

Category:

mental health

Tagged with:

When Anxiety Attacks

I was grocery shopping and when I came to the cereal aisle, I found myself light-headed and breathing raggedly.

My husband dropped a knife in the kitchen; I jumped and all my muscles tightened up.

We were driving down the highway, when suddenly I flung my arms out to the side and gasped loudly.

In none of these cases was anything actually wrong. (Although the incident in the car nearly caused an accident when my husband turned and yelled, “What? What?”)

My depression has always been accompanied by anxiety. That’s one of the reasons I was later given a diagnosis of bipolar disorder, type 2. It seems that, where other people get hypomania, I get anxiety. (There is a thorough explanation of bipolar disorder and anxiety (or “mixed states) at http://psycheducation.org/diagnosis/mixed-states/anxiety-and-bipolar-disorder/.)

I have had generalized anxiety, where I have no idea whether anything specific is actually wrong or doom is impending. I have had phobic-type anxiety, where I imagine that any bee in the neighborhood is going to choose to sting me and I freeze up. I have had anxiety reactions to loud noises or sudden movements, where I feel like I’m jumping out of my skin and actually do physically jump. And I’ve had irrational moments of anxiety, as when I can’t sleep because I don’t know where I put my passport. (Naturally, I have to get up and look for it.)

Now that I am relatively well controlled on medication, the various anxieties don’t plague me nearly as much. And I’ve developed coping mechanisms for a number of them. For example, when I get anxious in the car on the highway I no longer fling out my arms and gasp. My husband notices my tension and asks if anything would make me feel better. “Drive in the other lane,” I say, “and not next to the concrete divider.” I take an extra Ativan (which my doctor allows) before social events I can’t avoid. My husband warns me if he is going to hammer a nail in another room, or reassures me that the cat just knocked over a glass.

I still don’t know what was going on in the cereal aisle. I thought it might be the imposing wall of large, brightly colored boxes, visual noise that seemed to overwhelm me. My therapist at the time said that it was likely that I was just having a random anxiety attack and happened to be in the cereal aisle when it happened. After that I associated the two.

Now I’m not sure. I may have been right about the visual noise. Auditory noises certainly provoke anxiety in me, and I know that some people on the autism spectrum can be overwhelmed by visual stimuli. (I’ve never been diagnosed on the autism spectrum, but I do share certain traits with Aspies.)

I think the anxiety will always be with me, to some extent, just like the depression. My meds make them bearable and my ways of handling them improve. But I don’t think I’ll ever get used to the fact that there are bees, wasps, and ticks in the world, all of them with a thirst for my blood.

Category:

mental health

Tagged with: