Bipolar 2 From Inside and Out

Posts tagged ‘coping mechanisms’

The Tools for Tackling Bipolar Disorder

When you’re facing bipolar disorder – which is, when you have it, nearly every day – there are some things you can do to lessen its hold on you. But in order to do so, you’ve got to have the right tools. Try to collect as many as possible for best effect.

Shall we take a look at what they are?

The Usual Suspects

  • medication – to tame your symptoms, level your moods, get your brain back in gear, and/or regulate your energy
  • psychiatrist – to prescribe your medications (a primary care physician may also do this)
  • psychotherapist – to discuss with you the issues you haven’t resolved, the problems you still have, and the things the medication can’t do

Self-Care 

The two most important tools you need for self-care are sleep and food. Without either, the body can’t function properly, and if the body doesn’t function, the brain is less likely to function properly either.

Ideally, the food should be nutritious and eaten regularly, but let’s face it, that doesn’t always happen. But you’ve got to give your body something to run on. If there are carrot sticks there, eat them; if there is mac-n-cheese, eat that. If there’s Raisin Bran, well, it’s easy to eat and requires no preparation. Try for at least one substantial meal per day – two is better, if you can manage it.

(Of course, this advice doesn’t count if you have an eating disorder. In that case, see your doctor or psychotherapist or support group.)

Support

Find support where you can – a friend who’s willing to listen, a support group online or in real life. Try for a combination of these and don’t rely on any one of them for too much. Maybe you have a friend you can phone once a week; a support group that meets every two weeks; and an online group or two of people who really understand, with links to helpful articles and blogs. Before you know it, you’ve got a support system, especially if you count your therapist (which I do) or have a supportive family (which I don’t).

Spoon Theory

If you don’t know what this is, see https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/. Basically, Spoon Theory is a way to measure how much energy you have on any given day – and an understandable metaphor for explaining your symptoms to others, and a shorthand for other people who are also up on the theory. It can also help alleviate the guilt of not being able to do all the things you are “supposed” to do in a day. It’s not an excuse, but an explanation.

Distraction

Let’s face it, it’s all too easy to dwell on your symptoms and how miserable you are. And if you’re at the bottom of the depressive well and your meds haven’t kicked in yet, there may be nothing you can do about it.

But maybe there is. Do you know a person who tells good jokes – or really bad ones? Do you have music you used to play but have forgotten about? Do you know of a TV show that features people whose lives are an even worse train wreck than yours? Do you have a go-to movie that never gets old no matter how many times you see it? (Mine is The Mikado. )

Creativity

If that distraction involves creativity, so much the better. Coloring books and pages for adults have been the trend for a while now. (Some of them are really for adults.) Jenny Lawson draws and also puts together tiny little Ferris wheels. I know someone who can make little sculptures out of drink stirrers or paper clips. The point is, you don’t have to paint masterpieces. Just keeping your brain and your hands occupied is a good idea.

Comfort

Soft warm, fluffy things and smooth, silky things are soothing. They just are. Cats and dogs come instantly to mind (they also provide distraction). But I also have a collection of teddy bears and other plushies that I sometimes cuddle with. These are “comfort objects,” which is an actual psychological Thing. (I wrote about them once: http://wp.me/p4e9wS-k9.) I even took a plush bunny with me when I went to have a sleep study.

Stubbornness

This may be the most important tool of all. Be stubborn. Take those meds, even if you hate them. Eat that egg, even if you don’t feel like it. Go to that appointment, even if will take all your spoons for the day. Call that friend, even if you don’t think a joke will help. Post on your support group, even if you feel you are alone.

We can’t let bipolar disorder beat us. Not when we’ve got so much to beat it back with.

Category:

mental health

Tagged with:

Self-Care for Overwhelming Days

It’s been said that time is nature’s way of keeping one damn thing after another from being every damn thing all at once … However, every now and then the damn things gang up on you.

– me, “The Overwhelming Problem,” http://wp.me/p4e9Hv-hy

It’s also been said, by Canadian astronaut and all-around awesome guy Chris Hadfield, that he managed to stay alive in space by always asking himself, “What’s the next thing that might kill me?” If, for example, the most immediate danger were running out of oxygen, the next thing to do would be to check your tank and hoses.

I find that attitude soothing in a way, and helpful in getting through one of those every-damn-thing days. It’s not traditional positive thinking, but it does help you set your priorities.

Today and yesterday and the day before have been examples of every-damn-thing days. I’ve gotten through by asking myself, “What’s the next thing I absolutely have to do?”

It starts when I wake up and can involve the simplest of decisions: Do I take my meds first or do I pee first? Pee first. Pee first is almost always the correct answer and is one of the Mystic Rules of Self-Care.

Do I get dressed or do I eat something? I don’t absolutely have to get dressed yet, because I’m not going out anywhere yet, so eat something. Eat something is almost always the correct answer and is another of the Mystic Rules of Self-Care.

This can get me through the entire day. What is the next thing I absolutely have to do? Get dressed. What is the next thing? Go to the bank and get money. What is the next thing? Pay the power bill. Those are absolutes if I want to have a functioning computer. And I do. Very much.

Next comes a real decision: K-Mart is right next door to where I pay the power bill. Do I stop in and get the loaf of bread I need and maybe some underwear, or do I eat first? I eat first. (See above Mystic Rules.) By the time I finish my banh mi (if I’m out and dressed and in motion, I may as well make the most of it), it’s pouring rain. Do I absolutely have to go back to K-Mart, walk through a wet parking lot, and get that loaf of bread? I do not. I go home. One errand (two if you count the bank, and I do) is a major accomplishment for me.

After I get home, there is no “next thing I absolutely have to do,” so I switch to “What is the next thing I could do?” Say there are three choices: take a nap, watch TV, do some work. Obviously, the work is out. I am spoonless by now. I decide to watch TV until closer to bedtime, then go to bed.

If there is work that absolutely has to be turned in the next day, I get up early and do it when I have a fresh supply of spoons. (After peeing first and taking my meds.)

There is also an element of creative procrastination to this. (See http://wp.me/p4e9wS-ct.) It’s like sorting your tasks into three piles: absolutely, would be nice, and meh. Not that I’m recommending writing them down. That’s not flexible enough. Throughout the day, an event can wander down the progression. “Buy loaf of bread” started out as Category 2, but the rain pushed it into Category 3. I ate the other half of my banh mi for dinner and bought bread the next day. And if I hadn’t had the banh mi, I still had a jar of peanut butter as a back-up plan. Eating it straight out of the jar is pretty depressive, but you do what you have to do when your spoons run out and you still need self-care. (Have I just discovered another Mystic Rule?)

Of course, I’m describing a moderately-functioning day. There are other days when the categories shut down after peeing and meds.

Category:

mental health

Tagged with:

When You Think Other People Are Talking About You

You know when you feel sure that other people are talking about you? You notice them whispering, or looking at you, or studiously not looking at you, and you think, what are they saying about me?

Two smiling friends sharing secret in coffee talkPsychologists call those feelings “ideas of reference.” (If you alter your behavior because of the supposed scrutiny, they’re known as “delusions of reference.”) Ideas of reference are often associated with paranoia. However, if you ask clinically depressed or bipolar people, you will find that many of them have them as well.

I know I have. It’s hard not to. You already feel that you’re not really normal (whatever that means) and you’re afraid that it shows. If people can see that you’re not like everyone else, they’re bound to be talking about it. Never mind that your difference is a mental one; you’re sure that everyone can tell just by looking at you that you’re crazy.

In actual fact, the people you think are talking about you usually aren’t – until you go over to them and defensively berate them or accuse them of doing so. Then you can be sure they will be talking about you after you leave.

Except perhaps in junior high school, most people in everyday life do not spend their time discussing how odd the people around them are. (Except for those people who take pictures of others at Walmart and then post them on the internet.) But the average person is too involved in his or her own daily life to give more than a passing glance to a stranger. The people you see whispering behind their hands are most likely developing their own secrets or gossiping about someone you don’t even know.

Even if the people are talking about you, ask yourself – so what? Do their opinions really matter? I know that you want to say yes, they do. But in the larger scheme of things, they don’t. Your life will not change in the slightest if they are saying they don’t like your haircut or that they heard you bite your nails. Malicious gossip and social bullying are separate matters. But again, you don’t really know that these people are saying anything that’s actually harmful.

Perhaps you feel it’s more significant if the people you think are talking about you are family members, coworkers, or friends. They may really be talking about you. The point is, even if they are, you have no idea what they’re saying. Most of the time they speak in low tones so as not to upset you, never realizing that that upsets you more. Tell yourself they could be planning a surprise party or talking about Aunt Edna’s affair with a younger man. Not everything is about you.

Ideas of reference may be a factor in imposter syndrome – the feeling that you are not really successful, competent, or talented, but are just faking it, and that everyone around you can tell. Or perhaps your ideas of reference are like intrusive thoughts – sudden, distressing notions that pop into your head, seemingly without cause or warning. These can be anything at all, from “I wonder if my passport has expired” to “Who would miss me if I died?” to “Those people are talking about me.”

What can you do if you have ideas of reference? Resist the urge to ask if the people are really talking about you. That will only make things awkward and worse. Ignore them if you can. (This is not the same as the bad old non-advice about ignoring bullies. You know when a bully targets you. With ideas of reference, you never really know if your fears are true.) Since you didn’t actually hear what the people said, you can realistically assume they were talking about someone or something else entirely. Imagine that one is telling the other that her slip is showing. (Do people still wear slips? I know they don’t wear pantyhose anymore.)

If you feel you must react, use a minimal response such as the good ol’ side-eye, which is sufficiently ambiguous that the person (who may also have ideas of reference) can assume it’s directed at someone else.

Another suggestion I’ve heard is to work with your therapist on issues of self-esteem and self-concept, or to try cognitive behavioral therapy. Some medications may help too. Still, if you feel you can manage it, I think the best idea is to tell yourself “So what?” and move on.

Category:

mental health

Tagged with:

Getting in Touch With My Hypomanic Side

I know all about how it feels to have depression. For dozens of years, that was my diagnosis and my daily companion – unipolar depression.

In the last dozen years or so, however, I have had to come to grips with the idea that I am actually bipolar – bipolar type 2, specifically. And that I sometimes have hypomania.

It was quite a revelation.

I didn’t believe I had ever felt manic in my life. I couldn’t recall feeling anything but miserable, despondent, and worthless. Although objectively, I was doing well in school and in college, had a few friends, and was never suicidal, in fact I was a depressive mess. Later, as I learned more about mania, I was able to identify some manic – or at least hypomanic episodes that had occurred during that time, but that I had never noticed when they were happening.

When I was hypomanic, I thought I was just feeling what everyone else described as “normal” – happy, able to enjoy activities, functioning pretty well. They didn’t last long, but I didn’t realize how very tenuous and brittle those good feelings were – how they could be shattered by the slightest bump, plunging me back into the old familiar depression. It was even more depressing to think that I couldn’t even do feeling good right.

I struggled along under these circumstances for years, until at last one-half of my problem was diagnosed – the depression half, of course. It certainly was the most noticeable half, the most troubling, and the most disruptive of the problems that plagued me.

My doctor prescribed Prozac and I remember it working pretty well at first – at least when it kicked in after about six weeks of taking it. I can remember feelings of calm, contentment, and enjoyment. It changed my life, and probably saved it. Prozac didn’t alleviate all my problems, but it did let me glimpse a world in which they were not the only things that existed. It’s not too extreme to say that I rejoiced.

But, unknown to me (and my doctor), I was not purely unipolar at that time – or ever. What was happening to the lurking hypomania during while the depression was being treated? Did it disappear? Did the Prozac take care of it too?

No. With the depression more or less at bay, hypomania found new outlets to express itself – as anxiety, for example. I had a spell of being alarmed in the cereal aisles of grocery stores. There was a time (not yet completely gone) when I thought other drivers were swerving into my lane, even when I was a passenger. (That one alarmed my husband too, when I would fling out my arms and gasp or cower, shaking in my seat, at the thought that a crash was imminent.)

My psychiatrist later explained to me that these were manifestations of hypomania that came out sideways, as anxiety instead of euphoria, ambition, desire, exaltation, and assorted addictive or destructive behavior. Trust me to have the less-fun alternative. (Although somewhat less life-wrecking.)

Since that revelation, I have tried to harness my hypomania and use my power for good. I channel my hypomanic binges into writing, for example. I can’t say that it’s always good writing, but at least I get words on the screen that I can fix up later. I usually have several projects – paying and non-paying (like this blog) going at the same time, so I can switch among them as needed. That may be hypomania too.

Sometimes I can even use my hypomanic fits to enjoy myself – have a pleasant lunch out, read a book, do a puzzle, have a conversation with my husband or another friend. Of course, these activities do not always fit in well with my hypomania. At times, instead of simply enjoying these activities and sensations, I am too twitchy and nervous to relax and enjoy them.

I must admit that two of my strategies for controlling my hypomanic spells are naps and anti-anxiety pills, not necessarily in that order. But at least I am getting better at identifying when the anxiety, which I used to think of as free-floating, is actually a form of hypomania. Then a combination of hot tea, silence, cat-petting, reading, and Ativan can bring me back to some kind of stasis.

If not, I just have to accept that I’m having a hypomanic episode and try to stay away from things I can buy using my PayPal account.

Category:

mental health

Tagged with:

I’m Not Introverted. I Just Don’t Want to Leave the House.

Maybe you would call me an introvert. I stay in the house for weeks at a time, never sticking my nose out into the fresh air. I wear pajamas all day, most days. My husband does the grocery shopping, picks up my prescriptions, and does most of the other errands.

I go out when I have a doctor’s appointment or when Dan entices me out with the promise of a restaurant meal.

I don’t consider myself an introvert.

I do consider myself a social person.

Why, then, do I stay indoors?

First, because my bipolar disorder makes me sensitive to noise and crowds. Technically, I think this is more agoraphobia than introversion. I can handle being in small groups of people or audiences, but hundreds milling around, as at a mall, make me panicky. And forget places that are both noisy and people-y, like Chuck E. Cheese or other family-intensive restaurants.

Second, I like to be social – on my own terms. That largely means Facebook, Twitter, LinkedIn, various online bipolar support groups, IM, email, Skype, and the good old-fashioned telephone. In the years since I’ve been on Facebook, for example, I’ve connected more deeply with old friends and coworkers, reconnected with old schoolmates and Girl Scout troop members, gained new relationships with friends-of-friends, and discovered things I never knew about my acquaintances. I keep up with birthdays; look at baby, travel, and pet pictures; and cheer on accomplishments, as I would in person. (Except for the hugs. Virtual hugs are just not the same. But my husband takes up the slack there)

Most of all, I stay inside because I can. My husband enables me in this, as when he does the grocery shopping. We tried splitting the shopping, but even with the little runabout scooter-with-a-basket (mobility issues), I was overwhelmed and exhausted after shopping just one-half of the store.

I’m able to work, at least some, and the work I do is conducive to telecommuting. I can sit in front of my keyboard and monitor, in my pajamas, and still be a useful, productive member of society. I have clients and interact with them in the aforementioned ways.

I haven’t had an assignment that involves leaving the house in years – not even to do research. I used to have to visit libraries occasionally, and while they’re not known for being noisy and people-y, Google and the Internet put virtually any information I need right on my screen or hard drive.

Admittedly, getting out into the fresh air would be good for me. We live in a nice secluded area that would be good for walking, and there are any number of parks nearby, if I want variety. I know that going out and getting at least a small amount of exercise would be good for my bipolar depression, but I haven’t been able to force myself to do it yet. Going outside to walk involves getting out of my jammies into real clothes, and possibly taking a shower, either before I leave or when I get back. And many of you know what a challenge showers are for people with depression, bipolar or otherwise.

But again, this is a symptom of my bipolar disorder and the immobility it causes, rather than introversion. I’m not afraid of meeting people while out walking, or even having conversations with them. Usually “hi” is all that’s needed in these situations, and I have the ability to make small amounts of small talk appropriate to the occasion. (“Sure is windy today.” “Are those shoes comfortable?”) Since I seem to be riding a hypomanic swing these days, perhaps I’ll be able to get out and walk occasionally. I know my husband would heartily endorse the idea and most likely go with me to offer me encouragement.

Bottom line? I can go out amongst people if I want to. I just usually don’t want to.

Category:

mental health

Tagged with:

Blogging While Bipolar: What I’ve Learned

Next month, this blog will be three years old, an unruly toddler of a blog with jam on its face and a sticky plush animal grasped in its fist. Except for one dry spell of about a month during the first year, I have posted every week in both this and my general purpose blog, Et Cetera, etc. (janetcobur.wordpress.com).

My husband often tells me that he’s proud that I am doing this and that I have stuck with it so long and faithfully. (He doesn’t often read my posts, but that’s another matter.)

nightblogWriting while bipolar is not always easy, but blogging has taught me a few things about myself.

Blogging is a substitute for going outside and having a social life. While it’s generally true that my disorder has abated over the years, at least from its worst, I am still unable – or perhaps unwilling is more accurate – to go outside for more than a doctor’s appointment, or a brief errand and lunch with my husband. But I am still connected to the outside world through my blog. I have friends, I have conversations, I get feedback. I have special blogging friends like Bradley, Raeyn, and Dyane. (I also live vicariously through Facebook, but that’s another story.)

I need structure, and blogging gives me that. I used to post randomly, whenever I felt like it. Pretty quickly I discovered that Sunday was the day when my blog got the most traffic, so I made that my official blog post day. Working at home as I do, I tend to lose track of where I am in any given week. Is it Tuesday? Thursday? It’s hard to tell. But having a writing schedule clears that up.

On Monday and Tuesday I pre-write – think about articles I’ve read or conversations I’ve had and jot down a few titles or ideas or URLs. On Wednesday I begin writing. My goal is to have a rough-ish draft by the end of Thursday and a nearly finished one on Friday. Friday and Saturday are for tweaking the writing, selecting a visual, and tagging. Then Sunday, I proof and post. (I also tweet a quote from my most recent post on Tuesday and a quote from an earlier post on Wednesday, plus a “coming attractions” post on Friday announcing Sunday’s topic.)

It’s a loose enough schedule that I can build in actual paying work around it.

For me, blogging and other forms of writing are better than journaling. My journaling quickly turned into whining. It was boring, even for me. I need real content to interact with, whether that be my blogs, a memoir, or the mystery novel I’m working on. Writing engages and invigorates my poor broken brain, giving it something to do other than wallow or turn to mush.

Even when I think I can’t write, I can still blog. Back when I was able to work full-time, I wrote and edited for magazines and textbooks. I used to boast that I could write 1000 words on anything. Blogging is more forgiving. I can stop at 500 words if that’s all I have to say. I can pick my own topics instead of writing to order based on someone else’s priorities. And that schedule I mentioned? It’s not an actual deadline, so I don’t have to worry about it whizzing past. When the pressure’s off, I can almost always make my Sunday goal.

Blogging validates me. I have two degrees in English (one from a pretty classy university) and worked in educational publishing for about 20 years. Then my brain broke and it all went away. Now that I’m writing regularly, I feel that in some way I’m using both my education and the skills I’ve built up.

By blogging, I prove to myself that bipolar disorder may have taken away some parts of my life, but it can’t have everything.

Category:

mental health

Tagged with:

Relentless Holiday Cheer

a snowmanFor many of us with bipolar disorder, the holidays are hard to get through. There is stress caused by family, shopping, entertaining, and crowds. Or the celebrations of others can bring loneliness, isolation, immobility, and despair. Above all, there is the relentless, overwhelming, mandatory cheerfulness, and the expectation that we should feel that way.

As I write this, tomorrow is Thanksgiving. A bit over a week later is my birthday. Then comes Christmas. And, of course, New Year’s Eve and Day.

Every year these celebrations are a trial and a chore for me. I don’t know how you get through them, but this is what they usually look like for me.

Thanksgiving. We have no family in town, so it is just me and my husband. Actually, this is not bad, because it relieves us of the responsibility for massive cooking, anxiety-filled entertaining, and the always-dicey interactions with family. At most, it means we Skype with my mother-in-law while we all eat, which is taxing enough.

This year we are short on funds, so we’re having spaghetti instead of turkey. (I don’t like to do turkey anyway: http://wp.me/p4e9wS-2z.) Then we will indulge in our two traditions: the Thanksgiving episode of WKRP (“As God is my witness, I thought turkeys could fly.”) and the ceremonial playing of Arlo Guthrie’s “Alice’s Restaurant.” Then we nap. That’s it.

And what am I thankful for this year? I can’t think of much, except for my husband and cats, and that my pdoc just increased my Abilify. It hasn’t kicked in yet, except to make me sleepy, but, hey, a nap is on the schedule anyway.

Birthday. This is one of the big ones, with a zero at the end. My husband has already given me my presents (a variety of shoes and slippers). I can reliably predict that there will be a day-old baked good from where he works. No singing, no candles. That’s the way I like it. I’ll count the number of greetings I get on Facebook and feel miserable no matter what it is.

(My attitude toward birthdays is colored by the fact that a traumatic childhood event happened at a birthday party, although not my own.)

Christmas. The biggie. We exchange gifts ahead of time, without wrapping them. We go to the Chinese buffet. Dan watches a movie that I can’t stand, like Mr. Magoo’s Christmas Carol, or one I can sort of tolerate, like It’s a Wonderful Life. Or one I actually like, like Scrooged.

New Year’s Eve/Day. We used to go to a friend’s house for leftover Christmas cookies and singing “Oh, Danny Boy” on the porch (don’t ask), but she was one of the people who couldn’t put up with my bipolar isolation and tendency not to respond to invitations or to show up if I had. So that’s out now.

Dan’s family has a tradition of shaking their purses or wallets at midnight to ensure prosperity for the new year (it failed spectacularly last year). He’ll be working, so we can’t even kiss at midnight. I drink cheap champagne and go to bed early. We might have pork on New Year’s Day. Or not. But unless we have cole slaw or Dan opens a can of sauerkraut for himself, no cabbage.

If that sounds like a dreary holiday season, well, it is, but it’s all I can handle. I have tried. I really have. In years past I have bought Christmas sweaters and earrings and sent cards and entertained and done Secret Santas at work. I have had dinner with family. (Decorating is largely out, owing to the cats.) I have organized trips to fancy local buffets or restaurants. I have wrapped presents creatively (if sloppily) and even shopped off-line. I have baked spice cake and decorated sugar cookies with my friend Peggy. I have gone to community carol sings.

But no more. In many ways, like my life, my holidays have been pared down to the bare minimum. I approach them with dread and survive them with relief. They do not lift my spirits and nowadays I don’t expect them to.

It’s ironic that, though in many ways I am improving and healing and rebuilding my life, the holidays still defeat me. They are, at least for now, pieces that I can’t reclaim. I don’t think it would be much better if a bout of hypomania hit. I can just see myself buying presents for my far-flung friends, then bottoming out before I could mail them. You can’t time these things, after all.

The best I can wish for myself and for all of you is this:

Survive. Hold tight to whatever happiness you find. And please, please, get through this season any way you can.

Category:

mental health

Tagged with:

Furry Friends and Helpers

I’m sure we’ve all seen memes that say the best therapist has four legs and fur. When I’ve been feeling cranky, I have occasionally written responses to the people who post them. They demean the very hard and real work that psychiatric and psychological professionals do. And after all, what do the memes really say? “Have a mental illness? Just get a dog.”

Still, there are circumstances in which an animal can help a person with a mental or emotional disorder. It’s not as simple as going to the pound and picking out a pup, though. For an animal to assist a psychiatric (or other) patient, there are a number of hoops for the person to jump through.

Most people nowadays are used to the presence – or at least the idea – of service animals such as seeing eye dogs. Less common are Therapy Animals, Emotional Support Animals (ESAs) and Psychiatric Service Animals (PSAs). But they all have parts to play in promoting and maintaining mental health in persons with bipolar and other emotional disorders.

Therapy animals are most often used with geriatric patients and children with emotional disturbances. In some nursing homes and convalescent centers you find programs that bring small animals to interact with the residents. Even farm animals – chickens, lambs, piglets – may spark memories that had been hidden away for years. The animals help residents get in touch with those memories and caregivers get in touch with residents. Libraries sometimes bring calm, well-behaved dogs in so that children can read to them. The soothing presence of a well-trained dog can help a child self-regulate her or his emotions – and get reading practice at the same time.

Emotional Support Animals are dogs or cats (or, less commonly, other animals such as miniature horses or guinea pigs) that live with and provide comfort to a person with a psychiatric disorder. Typically, in order for an emotional support animal to be allowed in rental housing, documentation such as a letter is required from a physician or mental health professional stating that the animal’s presence alleviates symptoms of a patient’s psychiatric condition – one that qualifies as a disability under the Americans with Disabilities Act (ADA).

Regulations covering comfort or emotional support animals apply mostly to residences and airlines, but not other places where service animals are allowed, such as stores, restaurants, and public buildings. There, health codes trump emotional support.

Some folks confuse Emotional Support Animals with Psychiatric Service Animals. They think that “training” a dog to offer a kiss on command, or jump in their lap, or be hugged is a task qualifying the animal as an official service animal. While these are indeed ways that an animal can calm a person in distress, service animals, including psychiatric service animals, must receive special training that teaches them how to alleviate the symptoms of an ADA-defined disability.

Legitimate tasks for PSDs (psychiatric service dogs) include counterbalance/bracing for a handler dizzy from medication, waking the handler at the sound of an alarm when the handler is heavily medicated and sleeps through alarms, doing room searches or turning on lights for persons with PTSD, blocking persons in dissociative episodes from wandering into danger (i.e., traffic), leading a disoriented handler to a designated person or place, and so on.

In The Possibility Dogs: What I Learned from Second-Chance Rescues About Service, Hope, and Healing, author Susannah Charleson recounts how rescue dogs – the unwanted, unlikely-to-be-adopted dogs that languish in shelters or are destroyed – have been matched with persons who need them.

One of the stories she tells involves training a dog to help a person with OCD. The dog was taught to identify when the handler had returned to the stove three times (to check the burners). Then the dog would interrupt the person, leaning against her leg to distract her. For a person who could approach a door but not go outside, the dog brought a leash to encourage leaving the house for a fun activity.

By the way, forget about cats as service animals. Just try training a cat to do anything it doesn’t want to do. (I know that cats have been trained to run obstacle courses for agility competitions, but that doesn’t really qualify as a service for an individual with a disability.) If you are able to register your cat as an Emotional Support Animal or get a medical/psychiatric recommendation, you may be able to have your cat live with you in a pet-free community, or have the fee for a pet waived. But that’s about it where cats are concerned.

So, animals can’t be actual therapists, but they can assist in treatment and life skills for people who need help with mental disorders. When I’m less cranky, I keep scrolling past the pet-as-therapist memes and feel grateful that my cats offer me emotional support, whether they’re trained to do so or not.

 

Category:

mental health

Tagged with:

Self-Care and Sleep: Fact or Fiction?

Every article you see about self-care for bipolar disorder will tell you, Get enough rest or Get enough sleep.

Sleep is that golden chain that ties health and our bodies together.  – Thomas Dekker

But what did Thomas Dekker know? For many of us, proper, beneficial sleeping is easier said than done.

Neon light owlEven with my prescribed Ambien and Ativan, I’ve done the wide-awake-at-3:00-don’t-get-to-sleep-till-5:30 thing. And the unsettled-from-nightmares-afraid-to-go-to-sleep thing. (Also the just-one-more-chapter thing, but that’s my own fault.)

Then the next day I have to take a mega-nap (http://wp.me/p4e9wS-iO), which leads to guess what? More insomnia.

But this coin has another side as well. There are days when all I do is sleep. A full night plus (at least 10 hours), then a mega-nap, then right back to bed after dinner.

I don’t think I was awake for much of my childhood. I did a lot of napping. This might have been a defensive measure against encroaching depression. – Michael Ian Black

I know that part of my problem is my husband’s work schedule – third shift – and wanting to be awake at least at some of the same times that he is.

Another part of the problem is my medication. If I wake at 8:30 (yeah, I work at home) and take my meds, I’m down for the count again until at least 10:30. Or 11:00. Or even noon. I hope my clients think that I run errands in the morning or work on my projects with chat, IM, and phone turned off so as not to be disturbed.

And then there is my meal schedule, which is just as erratic as my sleep schedule. Most days I try to eat at least one good, full, hearty meal (another self-care recommendation, though they usually advise more than one meal). But after I eat – especially a hefty meal – I get postprandial torpor, the technical term for why you fall asleep on Thanksgiving after eating all that turkey. (And you thought it was the tryptophan.) And there comes another nap.

The repose of sleep refreshes only the body. It rarely sets the soul at rest. The repose of the night does not belong to us. It is not the possession of our being. Sleep opens within us an inn for phantoms. In the morning we must sweep out the shadows.  – Gaston Bachelard

But recently, it’s been the not-able-to-sleep thing. There’s a Tarot card that symbolizes the feeling – the 9 of Swords. In the Rider-Waite deck, the image is of a person sitting up in bed, hiding her face, with nine parallel swords floating in the background. I always refer to it as The Dark Night of the Soul. (The 6 of Cups usually means something like Childhood Memories, but for me it means “See Your Therapist.”)

(Note: I had a rather irregular introduction to the Tarot deck, and for me it acts sort of like a Thematic Apperception Test. I apologize to those of you I have just offended in one way or another.)

Sleep is when all the unsorted stuff comes flying out as from a dustbin upset in a high wind. – William Golding

Anyway, a recent event caused me a fair amount of trauma that I had to suppress at the time, and it came out immediately as bloody horrible nightmares the next time I slept. I haven’t had any more of those since, but I suspect they’re still lurking at the back of my brain.

That we are not much sicker and much madder than we are is due exclusively to that most blessed and blessing of all natural graces, sleep. – Aldous Huxley

I guess what I mean by all this is that sleep as self-care is wonderful, if it cooperates. But there are so many things that can go wrong and screw it all up – grief, guilt, depression, sorrow, anxiety, fear, loneliness, restlessness, obsessive thoughts, worries. It doesn’t feel like something that I have much control over.

Category:

mental health

Tagged with:

Reaching the End of My Cope

Helpless Woman Holding RopeAnymore, I don’t very often have days when I can’t get out of bed, but this week I had one. It doesn’t matter now what caused it, but I am feeling the lingering aftereffects. Today I had no choice but to get out of bed, and I thought as long as I’m up, I might as well blog.

(Actually I can blog in bed too, since my tablet will take dictation, but it’s not optimal.)

I had been headed for bed-bound all week – the slowly creeping whelms; the feeling of being nibbled to death by mice; the recent trauma of two pets’ deaths; a game I couldn’t win, couldn’t break even, and couldn’t get out of. Expected relief came three days too late.

Aside from not eating, not getting out of bed meets many of my needs – quiet, rest, naps, not having to fight off the numbness and care about anything. And yes, there’s some feeling sorry for myself in there too. I won’t try to deny it. Staying in bed is a big messy wad of self-pity, anhedonia, lack of energy, trying to stave off thoughts, and generally not being able to give a shit about anything. It is more than sadness. It is as J.K. Rowling described the Dementors: You feel as if you will never be happy again. In other words, there’s nothing worth getting out of bed for.

When I was searching for images to go with this post, I entered “end of rope.” I guess I expected to see cute kittens dangling and inspirational quotes like “Hang on Baby, Friday’s Coming!”

Instead, what I found were endless images of nooses. Nooses by themselves or with people in them. Overturned chairs under nooses. Photos, illustrations, every conceivable image of nooses. According to the visual imagination of illustrators and photographers, “end of one’s rope” means suicide. There were some images of frayed or broken ropes, but the nooses were in the lead by at least four to one. (There were also a few nautical pictures with coiled ropes, but they weren’t statistically significant.)

That’s not what I mean by “end of my rope” – not dangling kittens OR nooses. Staying in bed all day, being unable to function, is a long, long way from suicide. Indeed, I find it a mechanism that staves off thoughts of nooses. Staying in bed admits of the possibility that tomorrow, or maybe the next day, I will have the wherewithal to drag myself out of that bed. Or that something will force me out of the bed and I will have to respond, as it happened today.

Hence the title of this piece. I have not reached the end of my rope – certainly not to find a dangling noose at the end of it. I have not reached the end of my hope, because I believe that some day (I hope soon) I will be out of the bed (at least as far as the sofa, and then who knows?). But when I stay in bed all day, I have reached the end of my cope.

This is not exactly the same as reaching the end of my spoons, because I don’t use up any spoons by lying in bed. And I don’t really know, or perhaps don’t believe, that I will have a new supply the next day.

I expect that some people will beat me up for being so useless as to give up for even a day, to be unable even to try. I know I’m beating myself up over it too. But today I am out of bed, for at least part of the day, and I am writing. That means there’s at least an inch of rope left. An inch of cope.

Category:

mental health

Tagged with: