Bipolar 2 From Inside and Out

Posts tagged ‘depression’

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.

The Stressor I Didn’t Realize I Had

You’ve seen those lists of life stressors, the ones where they assign you so many points for each stressful life event that occurred during the past year and use the total to calculate the likelihood of your becoming physically ill. Death of a spouse or child is at the top of the list, for 100 points. Marriage, divorce, taking out a mortgage (or losing your home), and even retirement are on the list.

The lists you find in various places differ in the details. Some list only ten major stressors, while others list 20 or more. (Nowhere in any of the lists does being diagnosed with, or living with, a serious mental illness appear. Apparently, only physical illnesses are considered stressful.)

I’ve managed to avoid a lot of the major stressors this year, though I can count retirement, my husband’s heart attack, and losing our home in my total. But there was one life event on one of the lists that I hadn’t even considered: changing one’s residence.

When I thought about it I could understand it, though. Moving is a major disruption of your life. It entails endless details, physical effort, and a need for psychological stamina. Packing up your life in boxes is itself a stressful process. (Hell, I get stressed just packing for a vacation.)

In the past month and a half, we’ve moved a total of four times, if you count the night we were evacuated from our tornado-damaged house to the Red Cross shelter. (Not that we did any packing for that. The rescue squad just yelled, “Grab your medications and come with us!”) We then moved to a hotel, then a pet-friendly hotel, and finally to a rental house where we can stay for up to a year while our house is rebuilt. (We had good insurance.)

It was the last move that was possibly most traumatic, though it was the one that brought us closest to a “normal” situation. A whole house. A full kitchen. A backyard. A mailing address. Like the hotels, it came with various rented amenities such as linens and dishes that made the transition easier, but it was still foreign to us.  We’ve been here for a couple of weeks now and are adjusting, but it’s undeniable that the whole process has stressed us very badly.

I know that we are fortunate in so many ways. The closest we came to true homelessness was the day spent in the Red Cross shelter. We both survived the tornado physically intact, and so did our cats. We know we still had a lot to be thankful for, and we were, and are.

The tornado was the really big stressor, but I only recently realized how much stress the constant moving added to the toll. As a person with bipolar disorder, I find all these moves jarring as well as stressful. I like to cocoon, rarely leaving the house. I want my comfort objects around me. The series of moves tapped into my fear of abandonment, my anxiety around packing, and my feeling of being overwhelmed by life. My husband, who is given to depression, feels the loss of all the things that embodied his memories very keenly. Our local paper observed that many of the tornado victims were suffering PTSD. I may be among them, as I have had tornado dreams and other sorts of upsetting ones.

Will we succumb to stress-induced physical illness? Who knows? Have we been suffering from the psychological effects of stress? Definitely. If you had asked me two months ago whether moving was a stressor, I would most likely have said yes.  But I had no idea of the reality. We had intended to stay in our home for the rest of our lives. When suddenly that became not an option, we came unmoored both physically and psychologically.

Stability has always been a problem for me, but now my husband and I have even less of it than usual. When we finally get a chance to settle in, take a deep breath and a day off, perhaps the stress will lift a little. But until then, we’ll keep slogging through it.

 

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.

When Will My Breakdown Happen?

For those of you who follow this blog, this is another chapter in the saga of our experience with the Memorial Day tornado, which destroyed our house. My husband, who lives with depression, and I have been coping very well so far.

I saw my psychiatrist on Saturday. During the session, I mentioned that I hadn’t had a breakdown yet, but that I knew it was coming. “I hope not,” he replied.

Frankly, I think he’s being unrealistic. I keep saying it will come when we are settled in a living space, which we now are (a rental house) and when I don’t have to deal with insurance, housing, furniture, landlords, finances, utilities, and the thousand-and-one things that I’ve been in charge of dealing with. (Dan has been in charge of the more physical stuff, like salvage at our dearly lamented former house. He’s better at that and I’m better at working the phones and the computer.)

I think my brain will want to decompress with a crying jag and a couple of days in bed, at the very least. I plan to start work again next Monday, so it will likely happen during this next week. I know you can’t schedule these things, but I hope that’s the way it works out.

Dan is already at the ragged edge. He went back to work a couple of weeks ago, though physical health problems interfered with that somewhat. On Saturday he slept the whole day, having worked all night without sleep, owing to our moving out of the hotel and into the house in just a couple of hours. His emotions are also closer to the surface, too. He’s expressed anger at the salvage people and a need to cry when he sees what’s left of the house and our belongings.

Much as I dislike having breakdowns, or mini-melt-downs, or whatever you call them, I think sometimes they are both necessary and inevitable. When a bipolar brain gets too clogged up with the effort of coping during especially trying circumstances, it seems only natural that when the stress lets up even a little, that brain will need to let out all the feelings that have been suppressed while dealing with the crisis.

Bottling up your feelings is generally not a good idea, but sometimes you just have to in order to keep going. But like a shaken bottle of soda, the pressure builds up and there has to be a way to release it. The metaphoric bottle may simply explode, spraying shrapnel and its contents over everyone and everything within reach. This is not pretty, but it is understandable.

Keeping your feelings suppressed too long – putting them in a box and sitting on the lid – is not healthy, either. If you don’t allow yourself to feel the emotions and deal with them, they may fester and spring out of the box at the most inopportune time. Or you may turn off your emotions entirely and not be able to feel anything – including relief and satisfaction, in addition to the distress, anger, and/or despair that are in that box. A lot of us, including me, have done this for years in the course of our disorder. Feeling nothing but numbness can seem appealing if the alternative is chaos and pain.

So, in a way, I am hoping that I do have a bit of a breakdown, in a safe space where I can rage, weep, isolate, and grieve what we have lost. I don’t think I’ll be quite whole again until I have gone through the emotions that I’ve been putting off.

This week I’ve made an appointment with my psychotherapist, whom I stopped seeing about a year ago. I hope that she will be able to help me process the process, as it were. I think it’s definitely time for a “check-up from the neck up.” Maybe in her office, I will find that safe space and begin to feel the feelings that I know are hiding somewhere deep inside me.

 

Bipolar Moonshine

Honestly, the things they ask on Quora these days! Quora, for those of you not familiar with it, is a website that allows people to ask questions for “experts” to answer. Somehow, I have become one of the people that others come to with questions about bipolar disorder. (Also the Ivy League, but that’s another story.)

Some of the questions are serious, but others are less so. “If you could stay hypomanic all the time, why wouldn’t you?” “How can I get my bipolar dad to stay on his diabetes meds?” I actually had an answer for that: You can’t. And bipolar has nothing to do with it. 

I’ve answered a few of the questions if I had the time or if a good answer hadn’t already been given. Many of the answers are written by doctors, who can do a much better job than I.

Recently, however, I saw a question that I thought it wouldn’t take a medical degree to answer:

“Is bipolar disorder causally linked to lunar cycles?”

Impressed that the writer knew the difference between “causally” and “casually,” I responded:

“No. The cause, as far as we know, is a glitch in the brain between the synapses. There may also be a genetic or hereditary component. But nothing to do with the moon.”

To my surprise, I received a reply. The writer, while asserting that he or she was also bipolar, said that my response was “no answer at all” and incorrect. Acknowledging the genetic component I mentioned, the author then proceeded to enlighten me with an “unpublished hypothesis.” (He or she also claimed to be “a bipolar scientist,” though not a neurophysiologist.)

The argument was based on several points.

  • Sexual reproduction is always in response to lunar cycles.
  • This is based on gravity, illumination, and diurnal and lunar cycles/high tides.
  • Bipolar disorder is a disruption of sleep.
  • It first manifests at or near puberty, with the onset of hormonal cycles.
  • Something about teenagers having a different sleep cycle than adults, staying up later to reproduce while the parents sleep. (I can’t say I understood this part.)
  • During the full moon, hospitals and police report increases in both people out late at night and odd behaviors and emergencies.
  • Anecdotally, the writer noticed “elevated and depressed moods not necessarily linked to lunar cycles, but not necessarily independent of them either,” noting that “periods of mania occur during full and nearly full/new moon.”

The writer’s hypothesis, if I follow it correctly, is that bipolar disorder involves sleep-hormonal cycles related to the full moon, which evolved in the days before artificial lighting. This apparently gave a reproductive advantage of being awake at night because bipolar disrupts the sleep cycle. This is noted to be “an obvious evolutionary reproductive strategy.” There was more, but that was enough for me. (The writer admitted that statistics to prove any of this did not exist or had to be derived from “Bayesian statistical methods,” which one source I looked at called “a measure of the strength of your belief regarding the true situation.”)

So, where to start? First, if the writer thought he or she already knew the answer, why write in with the question? Obviously, to seek validation or to promote a theory (or to make me look like a fool).

I could answer each point individually. (I’m not a neurophysiologist either, but I do have some experience with rhetoric and logic. And bipolar.) But let’s just take a few.

Not all animals’ reproductive cycles are based on the moon, and neither are humans’. Women have menstrual cycles at all times of the month, and men don’t. (And what about bipolar men?)

Bipolar disorder can certainly cause a disruption of sleep, but is not caused by it. That is too simple an explanation for a complex disorder.

We’ll just skip that one about teenagers reproducing while parents sleep. Its connection with bipolar disorder is slim at best.

That one about the full moon is most likely anecdotal, as reported by police and emergency room workers, but no statistics (other than perhaps Bayesian ones) seem to bear this out. And the moon is full, nearly full, or new for more than half the month. Let’s also disregard the fact that bipolar cycles are seldom exactly a month in length. I had a depressive crisis that lasted several years.

Many causes have been theorized for bipolar disorder, from gut bacteria to early trauma to brain wiring. At the moment, as far as I know, the jury is still debating. Perhaps all of these are components of the cause, though I favor brain wiring as the principal cause. But given the actual science, I’m betting that the moon isn’t the answer.

What Does “Normal” Mean?

When I was young, I wanted like anything to be normal. I didn’t know what normal meant, but I knew I wasn’t it.

I had a lot of the trappings of what passed for normal in that day and age: parents still married, one sister, suburban house in a town with good schools, church down the street, same-age children living within a block, working father, stay-at-home mom, abundant books and toys, and vacations to visit the relatives.

But I knew. There was something different about me. Everyone else knew it too. I wasn’t normal. I was too sensitive, whatever that meant. I was precocious. I didn’t fit in and I didn’t know how to.

As I reached my tween and teen years, I encountered a dilemma. I desperately wanted to be normal. Normal kids had friends, got to hang out with each other, laughed and smiled a lot, wore what was in fashion. They gave off an aura of being normal. I longed for that. I was in love with the idea of normalcy.

But every time I tried, I failed. I was always too weird, too emotional, too smart, too something.

So I began to hate the idea of normalcy. If I didn’t fit in, then by God, I would scorn the idea of fitting in. I would embrace non-normalcy. I would hang with the few other misfits I could find. I would eschew the latest fashions and trends. I didn’t rebel, exactly. I was too timid for that (yet another too).

And I blamed the suburb and the Midwestern state where I lived. Maybe this kind of normal was bland, spiritless, and hum-drum. Maybe I was right not to want to be of it.

So, of course, I tried the geographical cure, going away to college, where I thought the people would be more like me, where there would be enough diversity that I could find others like me and finally fit in. Be normal within a different definition of normal.

And it worked, at least partially. But by that time it was too late for me to ever be normal.

What happened was that bipolar disorder caught up with me. I had probably been struggling with it all the time I was a weird kid who didn’t fit in. Other kids threw rocks at me. My moods were extreme. I cried and laughed at things that were neither sad nor funny. Being betrayed by a friend sent me into a severe meltdown.

By the time I was in college, there was no doubt that I was struggling with a mood disorder, although we didn’t have that term for it at the time. At the time it seemed like major depression and for the most part, it was, or at least that was the only mood I could identify.

Years later, when I got a proper diagnosis and the right medication, it was easier to look back and see my bipolar tendencies slowly building over the years. But I’ll admit something – I still both love and hate the idea of normalcy. I still want to fit in and I’ve found a few groups where I seem to. But I also want to embrace my oddness, celebrate my differences, glory in my assorted varieties of geekiness.

I never want to go back to that lost, lonely, spinning-out-of-control kid who was always too much or not enough. My lifestyle helps since I don’t have to try to fit in at a nine-to-five office job. My husband helps, as I was at least normal enough to find one. And my writing helps, so I can work out some of my conflicting emotions and bipolar moods through this blog and other venues.

Here’s another reason to hope: Matt Norris, a blogger at The Thinking Orc, recently wrote:

Disapproving of people who aren’t “Normal” went from a virtue to vice within my lifetime. The shift in public morals changed the rules on what it took to be seen as a good person. It used to be about not doing anything weird, and looking down on anybody who did. Now it’s about not doing anything cruel, and looking down on anyone who does.

Besides, to quote songwriter Steve Goodman, “I may not be normal, but nobody is.” I know that now. So in that sense, I do at last fit in.

I Hate My Job, But I Don’t Hate My Life

The other day I found myself thinking, “I hate my job. I hate my life.” But then I stopped. The truth was that I do hate my job, but I don’t hate my life.

There have been times when the two thoughts absolutely went together. I well remember getting up in the morning and thinking, “Now I have to go to the bad place where they make me unhappy.” Unfortunately, the thought would color my whole day. Instead of unwinding after a rotten day – or a whole series of them – I brooded about what came before and dreaded what would come the next day. I was caught in a loop of bad thoughts and they wouldn’t let me go, or enjoy, or relax. My life seemed to stretch out into an unending series of more of the same.

Of course, that was when I was deep in bipolar depression, improperly medicated, and unaware of self-care. Oh, the job was indeed pretty terrible. I was an editor, a writer, and a proofreader, tasks and occupations I normally enjoy. There’s something wonderful about taking something mediocre and making it good, or even taking something bad and making it better. Once or twice I even got compliments on the job I was doing.

But at that time, when I hated it, the job was a misery. A reorganization had put the editorial department under the marketing department, which had been true in fact for a long time but was now formally acknowledged, with a resulting new chain of command. Anything I wrote was essentially a puff piece for some advertiser. Three senior editors were fighting over my time and attention, each determined that I should work on their project first and foremost.

I wasn’t quite ready for a major breakdown, but I was close. I hated both my job and my life.

Now I have a tedious and basically unfulfilling job. I transcribe audios of boring business meetings and lawyer consultations, relieved only by the occasional podcast. On top of that, I’m a really crappy typist, so it takes me hours to do a job that others could zoom through. Add in foreign accents and mumblers, and you get a job that brings me no joy, but only a modest paycheck.

But for some reason it also suits me. I work four days a week, at home in my pajamas. No one is looking over my shoulder. If I make my deadlines (and I do), I can expect fairly steady work, except during the holiday season. I earn enough to supplement my social security without going over their limit on extra income.

I also have medications that stabilize me and a much better knowledge of self-care. Working at home for only one boss is part of that. So is taking meal breaks whenever I want them and spending that time with my husband. Eating nutritious meals. Letting myself say, “I hate it! I hate it!” after a particularly trying assignment. Reading a book before I go to bed. Snuggling with the kitties. Allowing all these things to seep beneath my skin and feed my soul.

I don’t belong to the regular-massage-and-decadent-chocolates school of self-care. Maybe I’m a simple soul, but I prefer the everyday comforts that make my life not a misery and help me appreciate what I can of my situation. Not that I’ve got anything against either massages or chocolate. But to me, they are special indulgences rather than a part of my daily self-care.

In the end, medication and self-care are what keep me going, hating my job, but not my life.

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