Bipolar 2 From Inside and Out

Posts tagged ‘depression’

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.

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Mental Health

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Does “Natural” Treatment Work for Depression?

Not for everyone. Not all of the time.

Angel Chang recently posted on LittleThings.com “The 10 best natural ways to treat depression.” (See http://www.aol.com/article/2015/11/06/the-10-best-natural-ways-to-treat-depression/21260290/?ncid=txtlnkusaolp00001357) While she does acknowledge that “clinical depression is triggered from within, and very often need[s] medical attention” and “it’s imperative to consult your physician if you notice an abrupt change in your mood, feelings, or sense of well-being,” her article is about “easy” ways to treat depression yourself.

Unfortunately, her tips are not very helpful for me and many others who suffer from clinical bipolar or unipolar depression. Here’s how I respond to them.

Meditate. This is both nearly impossible when you have racing thoughts and a way to sink even lower if you can’t clear your mind of negative thoughts, which is one of the hallmarks of depression. And if you’re manic, even sitting still in one place for any length of time can be a challenge. After you’re stabilized on medication – go for it.

Eat Foods With Vitamin B. It may be true that vitamin B has been linked to neurotransmitters that we need more of, but preparing them is not realistic when I’m in the Pit of Despair. I try to imagine myself preparing a meal of fish, Swiss cheese, spinach, and eggs, and I just can’t. Or shopping for them, for that matter. I might be able to scramble an egg in the microwave, but that’s about it. (I wrote about food and depression recently: http://wp.me/p4e9Hv-db.) I do take a multivitamin along with my bedtime psychotropics, so I guess I can follow this advice a bit.

Set goals. Chang recommends starting with “small, daily goals.” When in full-blown depression, mine are about as small as you can get. Get out of bed. Make it through the day without crying. Take my meds. Poof! Out of spoons! The expert Chang quotes gives an example of a goal to work up to as washing the dishes every other day. To me, that implies a series of goals: Gather up dishes. Find soap. Fill sink. Wash a dish. Put in drainer. Repeat. My tip: Wash the spoons first!

Sleep on a schedule. Going to bed at the same time every night may be do-able, but getting up at the same time isn’t possible for me, which is one of the reasons I can’t hold a regular job. An alarm clock awakening me before my body is ready leaves me groggy and unfit to work. And there’s no guarantee that I’ll actually sleep during those scheduled hours, even with Ambien. Chang advises not taking naps, but I seldom make it through the day without one, even if I have slept eight (or nine or ten) hours. In fact, I love naps and consider them therapeutic, for me at least. Naps are my friends.

Get out of your rut. Structure is the only thing that keeps some of us going. And if we could find joy in a painting class, a museum, or making a new friend, as Chang suggests, we probably wouldn’t be depressed in the first place. J. K. Rowling described the Dementors in the Harry Potter books: “Get too near a Dementor and every good feeling, every happy memory will be sucked out of you. … You will be left with nothing but the worst experiences of your life.” She has stated that they are metaphors for depression. With every good feeling sucked out of you, you can’t see anything but the rut. I am told that for some people, Cognitive Behavioral Therapy (CBT) lessens the tendency to keep traveling in the rut. But “easy” and “natural”? I don’t know.

Talk. Chang is advocating talking with trusted loved ones, which is good as far as it goes. What it ignores is that friends and loved ones are not universally understanding of depression or supportive in dealing with it. She never suggests talking with a therapist or doctor. I don’t know why that’s less “natural” than talking with someone who has no training. Except you have to pay them (or your insurance does), but painting or language classes or art supplies aren’t free either.

Exercise. This is a classic antidote for depression, and I understand that it works for many people some of the time. But I would put this under the same heading as setting goals. I know it would be good for me, but motivation is hard to come by and immobilization thwarts me. But I wish I could take this advice. I looked into water aerobics, but there’s not a feasible program in my area.

Responsibilities. “Because you might feel down,” the article states, “you may also want to withdraw from your daily activities in life and your responsibilities at home or at work.” Yepper. “Try staying involved as much as possible in the causes you care deeply about, and take on new daily responsibilities. These can be as simple as volunteering at your local food pantry, or going back to work part-time.” Big nope. See getting out of your rut, above. For the clinically depressed, working even part-time is unimaginable, with responsibilities of the crushing sort.

Unwind and relax. If your depression comes with anxiety like mine, this idea is a non-starter. Unless you count drinking as relaxation, though it isn’t the best idea if you’re on meds.

Stay off caffeine. Okay, I can pretty much do this one, except for one cup of coffee or a caffeinated soda to get me started in the morning.

“Did you learn something new about how to naturally treat symptoms of depression?” the article ends. Not really. Well, except for the B vitamins. We’ve all heard these kinds of advice before. They’re good tips for situational or reactive depression, but largely not feasible for the chronically, clinically, biochemically depressed. In a way they add up to the much-hated “Just stop it. You must want to be depressed or else you’d be doing all these great things.”

But try them if you can, perhaps in addition to medical treatments. Maybe some of the ones that won’t work for me will for you. In the meantime, get help. See your therapist and/or psychiatrist. Keep taking those meds. Those may not be “easy, natural” ways to treat depression, but if they work, isn’t that the larger point?

P.S. Do NOT Google “CBT.” Spell out “Cognitive Behavioral Therapy.” Trust me on this one.

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Mental Health

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Is My Cat Bipolar?

It sure seems like it. She lies around all day, barely moving. Then at any given time she races through the house pursuing nothing at all. Afterward she lies back down, immobilized again. It looks an awful lot like rapid cycling.

I’m not going to get into the debate here of whether animals have emotions or humans are simply anthropomorphizing. Of course animals have emotions, and act on them. Our cat Maggie could snub you so you really knew you’d been snubbed. Another cat, Shaker, was mortally offended if you stuck a whisker on the top of her head and made “beep beep” noises. Our dog Bridget has deep anxiety around strangers, both human and canine. She has been known to wet herself, or my husband’s shoe. Polar bears can experience boredom. I have it on good authority that sheep can hold a grudge.

But can animals experience mental illness? Recently the BBC examined the question in an article by Shreya Dasgupta.(http://www.bbc.com/earth/story/20150909-many-animals-can-become-mentally-ill)

The article is long and rather technical, citing genetic studies I’m not capable of summarizing and using words like “telomere.” But the Beeb’s resounding answer to the question is yes. Not only can animals feel emotion, they can suffer from mental disorders. The report says:

To our eyes, many animals seem to suffer from forms of mental illness. Whether they are pets, or animals kept in ill-managed zoos and circuses, they can become excessively sad, anxious, or even traumatised….There is growing evidence that many animals can suffer from mental health disorders similar to those seen in humans.

It was decades ago that I first heard about polar bears on Prozac, due to their pacing obsessively or swimming repetitively back and forth. (I did wonder how the vets calculated the dosage – by body weight or brain size.) Of course, rather than psychotropics, what the bears really needed was more appropriate-sized enclosures.

Stress and social deprivation seem to be two of the factors that can bring on mental illness – particularly depression or PTSD – in animals. Dogs that serve in combat zones have been known to have trouble adjusting to civilian life. And the death of an animal’s relative or beloved human companion has been anecdotally linked to profound grief and even death.

The BBC notes that all the evidence we have for animal mental illness comes from pets, captive animals, and research specimens:

That probably reflects our own preferences for certain animals. “It’s the animals that we find very charismatic, like elephants or chimpanzees, or animals that we share our homes with, like dogs,” that command our attention, says animal behaviour expert Marc Bekoff.

But do wild animals really suffer from mental disorders? It’s practically impossible to tell.

For one thing, wild animals cannot bare their souls to therapists. For many reclusive wild animals, we know so little of what is normal behavior that we would be hard pressed to identify abnormal responses to environmental stressors.

Still, the experts say, even invertebrates like octopi and honeybees seem to suffer from, if not what we would call mental illness, at least maladaptive reactions to trauma.

Severe psychiatric illnesses like schizophrenia seem to go with higher intelligence. (Octopi are actually quite smart.) But again, how can you tell whether a dolphin is hallucinating? It may be that animals with extreme mental illness are weeded out by evolution, as their erratic behavior may lead to early death and loss of the ability to pass on their genes.

Is this true for humans as well? Are mental illness and intelligence correlated? As yet, there is little consensus. Sometimes the debate boils down to chicken-and-egg levels. Do people with lower intelligence experience more depressed because they are unable to accomplish what they want to do? Or does depression make it more unlikely that they will accomplish what they wish for? (Most of the studies seem to relate to depression.)

As the BBC report says, “Mental disorders seem to be the price animals pay for their intelligence. The same genes that made us smart also predisposed us to madness. There’s nothing shameful in that.”

Except, of course, that in humans there is stigma. Cats, now – they can get away with acting as crazy as they want. We’ll just call it adorbz and post it on YouTube.

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Mental Health

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My New Mental Health Tattoo

Once again I have gotten a tattoo, supporting the cause of mental health.

A few months ago, I became a part of what’s called the semicolon project and wrote about it in this post: http://wp.me/p4e9Hv-9G. For those of you who aren’t up on the terminology, a semicolon tattoo represents mental health awareness, especially erasing the stigma, and suicide prevention.

The semicolon was chosen as the symbol because in writing, a semicolon indicates a place where a writer could have completed – or stopped – a sentence, but chose to go on. The semicolon says, in effect, “My story isn’t over.” The idea is to have the tattoo someplace visible – in my case, on my left wrist – and use it as a conversation starter.

Most people will assume that since I am a huge grammar nerd, my semicolon tattoo is some weird manifestation of love for punctuation. Then I can tell them that it’s a whole lot more. You can find out more about the semicolon project at http://www.projectsemicolon.org/.

My new tattoo represents bipolar disorder. Again it’s made up of punctuation: two colons and a paren. These symbols, unlike the semicolon, have no special meaning in writing and are never seen together in that order. Instead they make up a double emoticon: looked at one way, the colon and paren make up a smiley face. Looked at the other way, a frowny face.

New mental health tattoo

New mental health tattoo

This symbolism is easier for anyone seeing the tattoo to grasp. In a way, it’s a minimalist version of the comedy and tragedy masks you often see in theaters.

Again, it’s a conversation starter. Bipolar disorder is not well understood by the general public. This is particularly true of bipolar disorder type 2 – the kind I have – which many people have never even heard of.

Since I have gone public with having a mental illness, it seems only appropriate to introduce people to the disorder in a way that’s creative, nonthreatening, and understandable.  It’s a lot less abrupt than blurting out, “Hey, I have a mental illness!” Even my mother-in-law recognizes that these tattoos are not just a whim, but for a good cause.

The second tattoo is on my right wrist, so no matter which hand I extend, I can open up new understanding about a very real problem that many people live with daily.

A number of articles have come out lately questioning whether a person who gets a tattoo will regret it when they grow older. I think I can say with complete confidence that I will never regret these tattoos. They say something about who I am, something that will not change as I grow older. The disorder will always be with me and so will these symbols. For the rest of my life I can use them to educate, identify with other bipolar people, and remind myself that wrists are not for cutting.

I will say, however, that whoever thinks of these things had better put the brakes on new mental health-related tattoo designs – especially those made of punctuation – or I will soon become the illustrated editor/blogger. At the moment I have no plans for any further ink. My friends, however, tell me that tattoos are addictive. So we’ll see.

A few notes, since everyone asks: These simple tattoos take 10 minutes or less to apply. They hurt a little bit, but not much – a stinging sensation. They may fade a bit at first and need a touch-up. Because they are so quick and simple, you will not pay a lot to have them done. After you get the tattoo you have to take care of it while it heals, moisturizing it regularly for the first 3-6 weeks or so.

If you decide to get a tattoo, check out the studio before you have it done. It should be a professional operation, with high standards of cleanliness and concern for health. Tattoo artists should wear surgical gloves and change them frequently. There may be a consent form to fill out, indicating that you know what you are getting into, and even indicating whether you have various medical conditions or allergies, or have drunk alcohol within the previous eight hours. A reputable tattoo studio will not work on a drunken client.

Do you have a tattoo related to mental health? I’d love to hear about it. But don’t tell me if it’s more punctuation. I only have two wrists.

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Mental Health

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The Spike

It was The Year of Living With Rex, and for me that meant dangerously. I was undiagnosed and unmedicated, except for wine. I had already been through an episode of cutting. I was clueless and stubborn, isolated and emotionally abused. Tired to my soul and trying to claw my way through my last year of college and a relationship that has affected me to this day.

Then the pain started. Without warning, I would feel a railroad spike being driven through my right temple. It was blinding, all-consuming, and lasted for as much as 30 minutes straight, sometimes. If I was lucky, it was only a few seconds, but I was seldom lucky.

I didn’t know anything that would make it better. All I could do was lie down and weep until it went away.

As this continued, the fear grew in me that I had something dire, like a brain tumor. In addition to my major depressive episode, I was living with massive anxiety.

I don’t know how I made it through my senior year. I don’t know how I made it through the train wreck I was living.

But here’s how I made it through the railroad spike.

Actually, it was kind of amusing, if you weren’t me and it wasn’t happening to you. I went to a doctor, a neurologist, who took one look at me and said,”I can give you any test you want, but I’ll tell you what it is right now. Your jaw is crooked.”

It was Temporomandibular Joint (TMJ) syndrome. And this was before it got trendy and over-diagnosed, the way way gluten sensitivity is now.

My jaw was indeed as crooked as could be. When the doctor put his fingertips on my jaw and asked me to open my mouth, we could both feel it slipping sideways. I’ve been told it feels like my jaw is going to fall off in the doctor’s hands. It made clicking and cracking noises that I had somehow never noticed, and occasionally seemed to get stuck briefly.

How did this explain the railroad spike? When I was anxious, my jaw muscles would clench – and since my jaw was crooked, they would tighten up unevenly. Causing much pain.

“What can you do for it?” I asked.

“We could break your jaw and put it back together, but there’s no guarantee that would work,” he said. (This was in the ’70s. I believe treatments have improved since then.)

While I contemplated whether I really wanted to have a surgically broken jaw (I did not), he gave me a prescription to calm my anxiety so the muscles wouldn’t tighten up and trigger the pain spasms.

Good ol’ Valium.

Now I was officially medicated with benzos and self-medicated with wine. It did take down the anxiety, but plunged me even further into the depression. And I was still living with academic pressure, isolation, no psychiatric diagnosis. And Rex.

I finished up the year, grabbed my diploma, and lit out for my home state as fast as I possibly could. Rex threatened to send the police after me if I took my things while he wasn’t home to supervise and prevent theft of any of his goods. Fine, I thought. Just let him try. I was across two state lines before he got home from work. No, geographic cures don’t work, but sometimes retreating to a safer place can help.

So, all in all, a truly rotten experience. But did I have a psychiatric problem? After all, a crooked jaw is a decidedly, visibly, diagnosably physical ailment.

Of course I did. The crooked jaw was just one component of my condition. The anxiety was another –  a big, huge, whopping one. After all, I’d had a crooked jaw my entire life, and it never sent me railroad spikes until that year. And the depression made it all harder to see and to get away from.

If you ever needed proof the mind and the body are so intertwined that you can hardly tell one from the other, there it is. Physical problem + psychological problem = pain, of both sorts. Good luck trying to sort the two out. And medicating one without making the other worse.

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Mental Health

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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.

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Mental Health

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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.

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Mental Health

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The Bloggess and Mental Health

I met the Bloggess (aka Jenny Lawson) recently at a book signing for Furiously Happy, her second book. (Her first book was Let’s Pretend This Never Happened.)

Back row: Rory, the Furiously Happy Raccoon; middle row: me, Jenny Lawson; front row: Erma the Armadillo

Back row: Rory, the Furiously Happy Raccoon; middle row: me, Jenny Lawson; front row: Erma the Armadillo

The space at the bookstore was full to overflowing. (People had driven for as much as five hours to see her.) Jenny read two chapters of her new book to riotous laughter and applause. There was a brief Q&A session. (I figured she got the same questions all the time and wanted to ask her something that no one else had. I imagine that writers on tour need a little variety.So I asked: If you could be any animal, what would you be and why? Her answer: A tapeworm, because I could just not move and have people feed me.)

I joined the signing line (#17). She signed my copy of her book (“Our story is not over.”) and I showed her the semicolon tattoo that goes with that saying. She also signed my armadillo purse (Erma) and a piece of glass for my husband, who wants to put it over a picture of her or of a vagina; he hasn’t decided which. She laughed. He was one of the many that ask for perhaps her most famous – or at least most quoted – phrase, “Knock knock, motherfucker.” (It comes from her story about leaving a giant metal chicken on someone’s doorstep. There were also a lot of metal chickens she was asked to sign.) The bookstore personnel made sure that everyone knew it was okay to ask for that. In fact, they announced it just before the signings, reassuring the shy or inhibited.

The title of her new book, Furiously Happy, is Lawson’s way of telling depression to fuck off: If part of her life is misery and pain, she’s going to damn well make the most of the parts that aren’t. And while she’s at it, she’ll spread the word that mental illness is not a thing to be hidden or ashamed of.

This is not to say that her mental disorders are cured or that she no longer suffers from them. She was clearly anxious when reading aloud the two chapters, and visibly relieved when that part of the evening was done. Her strategy is to laugh at mental illness, joke about her meds, and speak bluntly to those in the audience who also suffer or have a person in their life who does.

Furious Happiness is a worthy goal, and her out-there enjoyment of life leads her into some of the hysterical situations she has written about in both books. These are the stories that make you say – only you, Jenny! Then she turns around and tells you that you are just like her in the ways that count.

The readers of her books and her blog – thebloggess.com – have formed an odd mutual support community. Although we may feel alone, Jenny rallies us to be alone together. Since one of the major difficulties with being a psychiatric patient is the feeling that no one else understands or experiences the same feelings, bringing people together in the virtual world or between the covers of a book is a valuable form of networking, especially for those who can’t network any other way.

Myself, I can’t manage the Furious Happiness. Too long dealing with the black dog and relatively little experience of even the mild highs of hypomania have left me depleted. Jenny will just have to do it for both of us. This is not to say I don’t love her or her work. I do, despite the blog post that I wrote, “Seven Reasons I Hate the Bloggess” (http://wp.me/p4e9wS-56). I can see myself in her and her in me, but for the moment I’m not able to follow her exuberant example. But she gives me hope. And I’m sure that’s one of her most important goals.

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The Wrong Life

Nothing prepared me for this.

This is not the life my upbringing prepared me for. I don’t just mean the special guest speakers we had in home economics class who tried to introduce us to the subtleties of silver, china, and stemware. No, I was also misled by the books I read.

If Life Is a Bowl of Cherries, What Am I Doing in the Pits? and Please Don’t Eat the Daisies led me astray. Don’t get me wrong, I’m a total fan of Erma Bombeck’s writing style, but the quirky suburban life she loved and lamented was not what I got. Bombeck and Kerr both made light – and fortunes – of portraying the petty foibles and cute misunderstandings of women and their husbands, women and their children, women and their neighbors, women and other women.

Daily disasters with dishwashers, sticky-fingered children, and clueless husbands were an endless source of amazement and amusement for them. They soldiered on, supported by an innate buoyancy, faith in the divinity, and the occasional glass of wine.

My glasses of wine have been more than occasional. My disasters have not been humorous. I do not have children, and the cats are somewhat deficient in making adorable conversation in high-pitched, lisping voices. Sometimes all I can get out of them is “meh,” which is pretty much how I feel too.

As for the trappings of the genteel life, we eat off paper plates more often then not. I did once have a set of Limoges, but only because I was acting as a pawnbroker for a friend who needed ready cash. I fed one of the cats on the Limoges saucer, just to say that I had.

My parents used to say that their house was decorated in early married junk and I have followed in that fine tradition. Most of our furnishings are a demonstration of the maxim: If it’s not from Kmart or Goodwill you won’t find it here.

No one’s life prepares them for clinical depression, hypomania, bipolar disorder, or any other mental illnesses. I’ll wager that even psychologists’ kids don’t have a clue when they escalate from picking scabs to experimenting with lit cigarettes. Maybe their parents don’t either.

Either the mental disorder has been going on so long that you don’t know what it’s like without it, or it comes on so suddenly that you desperately hope that it goes away just as suddenly. Or it comes in a way that you can just convince yourself is no big deal. “I overspend? That’s just because I love shopping, not because I have mania or need to validate myself with expensive things.”

Perhaps people who grow up with a mentally disturbed loved one have a chance of understanding the underlying mechanisms. But with the number of families who don’t discuss the “elephant in the room,” or pass it off as, “Your sister is just high-strung” or say, “Uncle Ted is a little odd. Just ignore him,” not even that exposure may help.

How do young people learn about mental illness? Or even – gasp! – get help for one? If not at home, maybe at school? The National Association of Secondary School Principals cites the U.S. Surgeon General’s report saying that “one in five children and adolescents will face a significant mental health condition during their school years” and that the ratio of school counselors to students is 471:1. Add to that the fact that most school counselors have been shifted away from offering personal and emotional support to offering academics-only services. (http://www.nassp.org/Content.aspx?topic=57948)

Most of us struggle alone. Some never find a proper diagnosis and treatment. We have to be our own resources and our own advocates much of the time, even if our illnesses do not allow us to get out of bed. If we have one family member – or even a close friend – who understands, we are lucky beyond measure.

I wish that I had been even slightly prepared for the life I now lead, instead of the one I was “supposed” to have. No one can predict the future, but why can’t we at least have a bit of mental health education in school? I suppose that’s a lot to ask, when even sexuality education varies from the merely adequate to the appalling, when schools are barely able to stay abreast of the teach-to-the-test curriculum, and when Texas’s governor vetoes a bipartisan bill allocating resources for mental health, based on lobbying by Scientologists.

Do I sound bitter because I didn’t get to live the genteel suburban life? Probably. But there are aspects of that life that likely would have actively impeded my search for mental health. So I’ve had to do it on my own, or nearly so, at least until recently. A lot of us go DIY for mental health.

But a lot of us are accomplishing it. Living the life we have and not some fictitious pie-in-the-sky one. We may not have been prepared for it, but we muddle through anyway – and sometimes even realize that imperfect real life is better than a perfect lie.

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More “News” About Mental Health

Next in my ongoing series (see: https://bipolarjan.wordpress.com/2015/07/05/new-hope-for-mental-illness/) of posts about news stories that bear on mental health, and what they may or may not mean:

Depression Damages Parts of the Brain, Research Concludes, July 2, 2015, by Sasha Petrova (http://www.iflscience.com/health-and-medicine/depression-damages-parts-brain-research-concludes_

“Brain damage is caused by persistent depression rather than being a predisposing factor for it, researchers have finally concluded after decades of unconfirmed hypothesising,” the article begins.

“A study published in Molecular Psychiatry … has proved once and for all that recurrent depression shrinks the hippocampus – an area of the brain responsible for forming new memories – leading to a loss of emotional and behavioural function.”

The article also claims that “the effects of depression on the brain are reversible with the right treatment for the individual,” though what those treatments might be is not explained.

The take-away: Depression damages the brain, not the other way around. What this means for patients is not yet known.

Link Found Between Gut Bacteria and Depression, July 28, 2015, by Caroline Reid (http://www.iflscience.com/plants-and-animals/link-found-between-gut-bacteria-and-depression)

Well, if it’s not the hippocampus, it might be your guts. According to this article, “Scientists have shown for the first time that there is a way to model how the gut bacteria in a mouse can have an active role in causing anxiety and depressive-like behaviors….

“[T]he lead author of the study… concluded that stress shortly after birth in mice, alongside the microbiome associated with stress, can lead to depression later in life.”

The take-away: More help for depressed mice. As the study author says, “It would be interesting to see if this relationship also effects humans. ….We need to obtain some human data to be able to say with confidence that bacteria are really inducing anxiety or depression…. However, so far, the data is missing.” In other words, more theory, more mice, no help for patients.

Mad Cow Disease Protein May Play a Role in Depression, by Justine Alford

(http://www.iflscience.com/brain/mad-cow-disease-protein-may-play-role-depression)

“In all likelihood, there is no single cause, but one of the leading ideas is that it results from an imbalance of chemicals in the brain, namely the ‘happy’ hormone serotonin and the ‘pleasure’ hormone dopamine.” Hard to argue with that. But here’s the meat of the article: “[S]cientists may have just discovered another contributing factor – abnormal bundles of proteins called prions.” Prions are also the culprit in mad cow disease. After some theorizing and mouse research, “the researchers propose a possible mechanism for the involvement of prion proteins in depression.”

The take-away: Interesting to scientists, but no help yet for depression sufferers. Plus, the article is a bit too technical for the lay audience – and all theory, except perhaps for the mice.

Picky Eaters May Be More Likely to Develop Anxiety and Depression, by Hannah Keyser (http://mentalfloss.com/article/67034/picky-eaters-may-be-more-likely-develop-anxiety-and-depression)

This sums it up nicely: “The study... found that picky eaters are more likely to develop anxiety, depression, and ADHD in later years….While moderate cases were associated with symptoms of separation anxiety and ADHD, severe picky eaters were more likely to have an actual diagnosis of depression or social anxiety in later years. But the scientists stressed that this is a case of correlation, not causation.”
The take-away: So, no news here. Correlation does not equal causation means this may be a coincidence, or anxiety and depression may cause picky eating, or some other factor may cause them both. Note the “May Be” in the article title – it often signals a result of little or no value.

A Urine Test Could Distinguish Between Bipolar Disorder and Depression, August 8, 2015, by Stephen Luntz (http://www.iflscience.com/brain/urine-test-distinguish-forms-depression)

“An easy and reliable method of distinguishing bipolar disorder from major depressive disorder could save tens of thousands of lives, and transform millions more. Now researchers at Chongqing Medical University, China, claim to have found just that in a study based on biomarkers in urine.” According to the study, the presence of six metabolites in urine was 90 percent reliable in diagnosing the two conditions, which are notoriously difficult to tell apart. “Studies have found that as many as 39% of patients diagnosed with MDD have unrecognized bipolar.”

The take-away: More research needed, but this could be big. Pee on a stick and find out whether you’re bipolar, instead of relying on the DSM. (Full disclosure: I was diagnosed with major depression for decades before my bipolar 2 diagnosis.)

The Startup That Wants to Cure Social Anxiety, by Robinson Meyer (http://www.theatlantic.com/health/archive/2015/05/the-startup-that-wants-to-end-social-anxiety/392900/?utm_campaignFacebook_lookalike2%25_8%2F3_Atlantic_desktop)

This is, if not new, at least a little different: Cognitive Behavioral Therapy (CBT) delivered on the web. The article claims that “[R]esearch conducted over the past half-decade shows that CBT delivered via a website can be just as effective as CBT delivered through an in-person therapist.” The service, called “Joyable,” can be accessed for $99 per month or $239 for three months, which includes a coach. The company says that the online treatment “reduces the stigma around seeking out therapy.”

The take-away: Yeah. We’ll see. And lose the name “Joyable,” for heaven’s sake. (Full disclosure: I’ve never been a fan of CBT.)

 The Healing Power of the Cat Purr (http://mentalfloss.com/article/63725/healing-power-cat-purr)
An infographic with references and everything.
The take-away: The infographic talks about physical ailments, but many of us can testify that a purring cat on one’s lap, or even by one’s side, can calm the distressed mind as well. Completely scientific, if you count anecdotal evidence.
Cats and Mental Health, Mental Health Foundation
(http://www.mentalhealth.org.uk/help-information/mental-health-a-z/c/cats-mental-health/)

Seriously, though, survey says, “Half of those people [more than 600 individuals surveyed in 2011] described themselves as having a mental health problem. The results highlighted some of the benefits of feline ownership:

  • 87% of cat owners feel that the animals have a positive impact on their wellbeing
  • 76% find that coping with everyday life is easier thanks to the animals
  • Stroking a cat is a calming and helpful activity.”

The article also refutes the myth about “crazy cat ladies” and self-harm.

My take-away: Pet therapy is a recognized technique that provides benefits to shut-ins, geriatric and psychiatric patients, those with ADD and autism, and even prisoners. My four cats increase the effects of Zoloft, Ativan, Lamictal, and Abilify. Be sure to have your pet spayed or neutered.

 

 

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