Bipolar 2 From Inside and Out

Posts tagged ‘depression’

A Response to the Dalai Lama

This Friday, my Facebook newsfeed included a quotation from the Dalai Lama.

Depression seems to be related to fear, anger and frustration. When you’re in a bad mood, even if you meet with your friends, you don’t take pleasure in their company. But when you’re in a good mood, even if things go wrong, you can cope with them without difficulty. This is why putting yourself in a good mood, making a point of developing a sense of loving kindness gives you greater inner strength.

While I respect and admire the Dalai Lama, on this subject he is wrong.

I wrote a blog post to tell him and his followers so. I posted it on Blogher.com. (Blogher is a site for women bloggers that sometimes syndicates content. It is more general than what I usually post here, so I wrote something special for them.)

As I researched, trying to find when and where the Dalai Lama said this (I couldn’t), I discovered several articles about research into depression and Buddhist principles and techniques.

One was an article by Kathy Gilsinan at The Atlantic
(http://www.theatlantic.com/health/archive/2015/07/dalai-lama-neuroscience-compassion/397706/). It talked about “high-amplitude gamma-oscillations in the brain, which are indicative of plasticity.” What that is or has to do with depression, I don’t know. It sounds like “handwavium” to me.

One that made more sense was this, from Jeanie Lerche Davis at
WebMD: http://www.theatlantic.com/health/archive/2015/07/dalai-lama-neuroscience-compassion. (The feature was reviewed by Louise Chang, MD.)

While meditation can help many who are depressed, it’s not a sure-fire cure, [Charles W.] Raison [psychiatry professor and co-director of Emory’s Collaborative for Contemplative Studies] tells WebMD. “In fact, many people with mood disorders find they can’t do meditation when they’re depressed.” Their thoughts are too overwhelming. They are anxious, nervous, and can’t sit – and likely they need antidepressants, he says.

That’s more like it.

In my response to the Dalai Lama, I said,

Real, clinical depression is not about being in a “bad mood.” It’s true that a truly depressed person does not find pleasure even in ordinarily pleasurable things, such as meeting with friends. But we cannot simply put ourselves in a good mood.

That’s the hell of depression. We want to enjoy the good times. We want to put ourselves into a place of inner strength. But we can’t. Not without help.

In fact, your advice is hurtful to depressed people. Too many times we have been told, “Cheer up.” “Smile! You’ll feel better.” “Think about someone else for a change.” “What do you have to feel bad about?”

Don’t you think we would if we could?

Remarks like these remind us that we have an illness and we cannot cure ourselves by willpower alone – no more than a person with hepatitis or tuberculosis or even schizophrenia can. We need help, and most of us need medication.

You do a disservice to people with depression when you tell them to put themselves in a good mood. You, an enlightened spiritual leader, may be able to do it, but we can’t.

Certainly we can benefit from practicing loving kindness and developing inner strength.

But without treatment for depression, how many of us can do that?

It angers me when people say that depression – or any mental disorder – is something people can or should be able to cure with an attitude adjustment. I’ve heard it too many times from people in my life, and I’m sure you have too.

What’s really disappointing is that someone like the Dalai Lama, with his legion of followers and enormous credibility, is perpetuating this old way of thinking.

This lie.

Category:

Mental Health

Tagged with:

Sense of Self

The air is still and blankets all my sense.
I’m muffled, muzzled in the sheltering dark
But dare not hope for fire, with bright, intense,
loud flames that rend the silence with a spark.

I breathe or not. It’s sometimes hard to tell
When swathed in dimness. Stifling, musty scent
Fills up my nostrils and my brain as well –
Which cannot will the veil be shredded, rent

to save from suffocation. How shall I
Withstand this cycle till the day appears
And breezes blow the dust away from my
Stopped ears and eyes and lungs, plugged full with fears?

Pull off the cover and let free the soul.
Take broken breath and heal it into whole.

Category:

Mental Health

Tagged with:

We’ve Got Demons in Our Heads

I posted this just after the Charleston shootings, but it needs saying again.

The media don’t say it in so many words, but that’s what they mean when they talk about “mental illness” after a tragedy, especially one that involves gun violence and mass murder.

Demons are responsible. And those demons are the mentally ill (and/or) their medications (or lack of medications). Any way you look at it, we are the demons.

Here’s one of my favorite examples lately:

“It seems to me, again without having all the details about this, that these individuals have been medicated and there may be a real issue in this country from the standpoint of these drugs and how they’re used.”

This was from Rick Perry, Daily Kos reminds us, “the fellow who destroyed his last presidential bid after a bizarre debate performance that he later blamed on prescription painkillers he had taken beforehand.”

(Don’t you love that part about speaking without having the details?)

And this, from Mike Adams, who calls himself “The Health Ranger” and Editor of NaturalNews.com:

The headline is “Every mass shooting over last 20 years has one thing in common… and it’s not guns.” The article is actually a reprint of “an important article written by Dan Roberts from AmmoLand.com.”

(NaturalNews sounds maybe okay, but when the source is AmmoLand, you’ve got to wonder about bias.)

Here goes:

“The overwhelming evidence points to the signal [sic] largest common factor in all of these incidents is the fact that all of the perpetrators were either actively taking powerful psychotropic drugs or had been at some point in the immediate past before they committed their crimes.”

Then follows a list of people, crimes, and drug names. The list was compiled and published to Facebook by “John Noveske, founder and owner of Noveske Rifleworks just days before he was mysteriously killed in a single car accident.”

(Again note the source and possible bias, plus the hint of conspiracy theory. Gotta love it.)

Want something more mainstream? How about Newsweek?

“Charleston Massacre: Mental Illness Common Thread for Mass Shootings,” by Matthew Lysiak:

“…. If history is any indication, the shooter most likely has a history of severe mental health issues that have either gone untreated or undiagnosed.”

He then provides a list of crimes and psychiatric diagnoses with a number of the same instances as the AmmoLand account, though not a listing of medications.

The author goes on to say that the “rise [in mass shootings] correlates directly with the closure of the mental health institutions in 1969, according to mental health experts.”

(Correlates with – not caused – please note. That’s important. I’ll have more to say about that, probably next week.)

Lysiak goes on to say that the requirements for civil commitment (read: involuntary) are too loose. He quotes Liza Gold, a forensic psychiatrist in Arlington, Virginia: “The commitment requirement needs to be less strict. Today it currently requires both mental illness and dangerousness to have someone committed. I think we need to focus more on the dangerousness and keep these people from getting guns.”

If that’s so, we should be worried more about “sane” people such as abusive partners with histories of violence and restraining orders than about the mentally disordered, shouldn’t we? Comments revealing that “most people who commit acts of violence don’t exhibit signs of mental illness, and most people who are mentally ill are not violent” are buried near the end of the article.

Fortunately, not all the media are demonizing the mentally ill, though the dissent doesn’t seem to be coming from the major media. Slate and Salon have published articles that question the automatic connection.

The article on Slate, by Anne Skomorowsky, is long, and refers to the Germanwings airplane deaths, but it’s thoughtful reading and well worth the time.

“Because Germanwings pilot Andreas Lubitz killed himself when he purposefully drove a plane carrying 149 other people into a mountain in the Alps, there has been an assumption that he suffered from “depression” — an assumption strengthened by the discovery of antidepressants in his home and reports that he had been treated in psychiatry and neurology clinics.” She adds, “Lubitz did not die quietly at home. He maliciously engineered a spectacular plane crash and killed 150 people. Suicidal thoughts can be a hallmark of depression, but mass murder is another beast entirely.”

And the take-away: “Many patients and other interested parties are rightly concerned that Lubitz’s murderous behavior will further stigmatize the mentally ill.”

Salon’s Arthur Chu talked about the more recent Charleston, SC, shootings and other incidents in “It’s not about mental illness: The big lie that always follows mass shootings by white males.”

“I get really really tired of hearing the phrase ‘mental illness’ thrown around as a way to avoid saying other terms like ‘toxic masculinity,’ ‘white supremacy,’ ‘misogyny’ or ‘racism.’

“’The real issue is mental illness’ is a goddamn cop-out. I almost never hear it from actual mental health professionals, or advocates working in the mental health sphere….Seeking medical help for depression or anxiety is apparently stronger evidence of violent tendencies than going out and purchasing a weapon….Doing the former is something we’re OK with stigmatizing but not the latter.”

I’ll let that be the last word, fellow demons. Until the next time, that is. Until the next time.

Correction: The Skomorowsky article appeared on Slate, not Business Insider, as originally stated. I have fixed the text and regret the error.

Here are the references for the articles cited, in order:

http://www.dailykos.com/story/2015/06/19/1394713/-Rick-Perry-says-guns-aren-t-to-blame-for-Charleston-accident-it-was-prescription-drugs

http://www.naturalnews.com/039752_mass_shootings_psychiatric_drugs_antidepressants.html

http://www.newsweek.com/charleston-massacre-mental-illness-common-thread-mass-shootings-344789

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/germanwings_co_pilot_mental_illness_suicide_is_linked_to_depression_but.html

http://www.salon.com/2015/06/18/its_not_about_mental_illness_the_big_lie_that_always_follows_mass_shootings_by_white_males/

Category:

Mental Health

Tagged with:

Me and My Brain: A Story of Love and Dysfunction

As they say, of all the things I’ve lost, I miss my mind the most. Or anyway, a properly functioning brain.

I love my brain, despite all the trouble it’s given me. For many years I thought it was the only measure of my worth, the only thing about me that made me special, the only thing that I could truly rely on.

I reveled in learning, in thinking, in reading, in questioning, in contemplating, in discovering. My body was not dependable; my brain was.

Little did I know the biochemical pitfalls that were waiting for me. Little did I know that my brain was ill. Disordered. Unbalanced. At the very least, uncooperative.

For instance, my brain decided other people were always pointing and laughing at me. Sometimes they were, of course, but that paranoia became my baseline assumption. (Shrinks call that “ideas of reference.” I just called it life.)

My brain played back for me every socially awkward or embarrassing thing I ever did, either randomly or at the worst possible moments.

My brain made me cry at the stupidest times – at an upbeat sitcom theme song, when someone mentioned foreign travel, when opening boxes from the garage, when thinking about my college years or birthday parties. Whenever I was confronted with how damaged I am.

My brain had irrational thoughts. Bad thoughts. Cutting. Worse. You know what I mean.

Eventually my brain refused to let me live any kind of a normal life – go out, talk to people, care for my house or my pets or myself, or even read, once the greatest joy of my life, the thing my brain and I best liked to do together.

But my brain also worked just well enough to send me looking for the help I needed. I’ve gotten back parts of who I was and what my mind was. And for that, I’m grateful. Even with it disorderly and uncooperative, it’s still the best part of me.

Category:

Mental Health

Tagged with:

Crazy Pills

Once upon a time in the land of Jublia lived a kind and powerful queen named Lunesta. One day the dragon Cialis and the evil sorceress Humira attacked the castle, but Jublia was saved by Lunesta and her faithful dog Boniva.

And the peasants rejoiced.

Honestly! The names that pharmaceutical companies give their drugs these days! It’s bad enough that the drugs have a list of side effects longer than the symptoms they’re supposed to cure. Not to mention the drugs where the side effects are the same symptoms they are supposed to cure, or the ones where the side effects are considerably worse than the condition they’re being prescribed for.

My favorite has always been, may cause death (excuse me, “increases risk of death”). That has to be the ultimate side effect. You’ll be dead, but your toenails will look great for the funeral. Leave instructions that include sandals.

I made a list of all the drugs that I’ve been prescribed in my pursuit of something resembling sanity. It’s quite long. I’ve tried almost every class of drugs there is – tricyclics, atypical, SSRIs, anti-anxiety drugs, and hypnotics – in various combinations and assorted doses, and even for off-label uses. (TIL that Abilify can be classed as an “atypical atypical,” which makes me feel a certain kinship with it.)

The only ones I know I haven’t taken are lithium and the MAOI inhibitors. which is a good thing, because I do so like red wine and cheese.

Here’s the list, as nearly as I can remember:
Abilify
buproprion
Desyrel
Effexor
Inderal
Lamictal
Lexapro
desipramine
Prozac
Sinequan
Tofranil
Topamax
Wellbutrin
Zoloft
Ativan
BuSpar
Ambien
Valium

I may have missed a few, what with the brand names and generics, the decades over which all this occurred, the memory deficits, and the ones I took for only a month or two before the side effects became too heinous.

The side effects I’ve encountered along the way include:
dry mouth
memory loss
nightmares
agitation
lethargy
weight gain

Not all at the same time, of course, thank heavens. Right now I seem to have dry mouth, residual memory loss, and weight gain. Given the alternatives, I can live with these. More or less. (That is to say, I have to.) The memories, I understand, are not coming back. I just hope I don’t lose any more, especially ones of the hot-n-juicy variety.

The side effects I haven’t suffered include:
death (obviously)
fatal skin rash (Stevens-Johnson Syndrome, which I wrote bout a while back: https://bipolarjan.wordpress.com/2014/03/07/saving-face-or…-die-from-that/)
tardive dyskinesia

I hope the drug regimen has settled down for a while. I must admit that I don’t follow the instructions to the letter. They’re simply too overwhelming: Take this one on a full stomach, this on an empty stomach, another with milk or never with grapefruit juice; something else at bedtime or half an hour before bedtime, or with the noon meal. And don’t forget the non-psychotropics (cholesterol, blood pressure, etc.), or the vitamin, fiber, and calcium pills my GP prescribes or recommends. Well, and the OTC Benadryl, Tylenol, and Immodium, as needed.

(Yes, I did once look up all my meds in a drug interaction database. Every one interacts with every other one. Maybe that’s one reason mixing an effective cocktail has been such a crapshoot.)

I knew a woman who took so many different drugs for her variety of illnesses and conditions that she had a kitchen timer that she continually set and reset every time she had to take a dose of something. Her meds were more precise than mine, though. If she screwed it up, the consequences would be dire. Her side effects did include death.

The regimen I’ve settled on is this: one set of pills when I wake up (whenever that is) and one set at 11:00 p.m. I eat whenever I’m hungry, and I don’t like grapefruit juice anyway. Anything more complicated than that I can’t be sure of remembering. It’s still complex, what with the only-in-the-morning pills, the only-at-night pills, and the take-twice-a-day things.

I have little tricks to help me remember the routine – daytime-only pills in a plastic bag, nighttime-only on the lamp base, twice a day on the tea cart. Turn the vitamin bottle upside down after taking morning pills. I suppose I should get one of those daily pill caddy things, but they never seem to have enough, or big enough, compartments.

Is this routine crazy? You should see me without the pills.

Well, no, you shouldn’t.

Category:

Mental Health

Tagged with:

Where’s the Anger?

Depression used to be defined as anger turned inward. Now we consider depression to be a biochemical imbalance in the brain. At least that’s the current thought as the pendulum swings back and forth between brain and mind.

There is a case to be made, though, that anger is at least one component of depression. And that anger may indeed be turned inward.

Take, for example, the anger you may feel when a loved one doesn’t understand what depression makes you go through, or when a coworker says something clueless and cruel. These are incidents that can make you justifiably angry.

It’s all too easy to turn that anger inward. You say to yourself, “I’m crazy or I’m broken or I’m damaged and it’s no wonder they don’t understand. Maybe they’re right. Maybe most people can just cheer up and I’m defective because I can’t.” These thoughts, in addition to prompting anger, are likely to depress a depressed person even more.

When anger masquerades as depression, it becomes difficult to recognize the anger for what it is. After a difficult relationship ended – badly – I was unable to see that I was indeed angry. I could have sworn that I wasn’t. In fact, I told people that I wasn’t angry. It took a long time for me to recognize and acknowledge that anger. By then it was too late to do much about it, except work through it with my therapist. But that’s all right, because that’s what I needed to do with the anger anyway. I’m at that awkward age when I can be tried as an adult.

So while I don’t think that depression is caused by anger turned inward, I do believe that depression can cause you to internalize anger and beat yourself up for things that you can’t control, like your brain.

Depression makes a hash out of feelings. Is it anger? Is it pain? Is it loneliness? Is it despair? The answer, usually, is one from column A and two from column B.

Category:

Mental Health

Tagged with:

The Hypomanic Blogger

When I thought I had unipolar depression, I used to wish I were bipolar, on the theory that I could get a lot more done. (I later found that not to be true, as I’m sure many of you can attest.)

I had a lot more experience with depression than with mania. My bipolar disorder is Type 2, which means I get hypomania instead of full-blown mania. And most of the time the hypomania comes out sideways as anxiety and/or irritability.

(Don’t ask me why I get the full-monty-style depression and only a smidge of hypomania. I don’t know. If my shrink does, he hasn’t told me.)

Looking back, I can remember only one hypomanic episode before my new diagnosis made me more aware of the possibility. I was working at writing and editing – the same things I do now, only then I could do it in an office full-time instead of at home and freelance. A woman came to me, asking about how she could become a writer for magazines.

I positively burbled and babbled. I gave her all sorts of advice on query letters and Writer’s Market and niche publications and getting bylines and clips. I told her about how I started, writing for I Love Cats magazine and editing my martial arts club’s journal, and working my way up. (Incidentally, I am, as far as I know, the only person ever to have articles published in both Black Belt and Catechist magazines.)

The woman went away inspired, she said, though I never heard how she made out.

Now I can more easily recognize hypomania when it hits. I still get the anxious and irritable sort, but now I get more of the buzzy kind. And even though it makes me twitchy, I can make use of it.

It was in a bout of hypomania that I decided to start this blog (and my other, general-purpose one – janetcobur.wordpress.com).
It’s hypomania that has kept me going for over a year so far. Though I can now, thanks to medication, force myself to work while in the dysthymic stage or the “meh” stage, if I hit a spell of hypomania, I can use it to write and edit. Right now I’m using a hypomanic swing to stockpile ideas and first drafts against the inevitable downswing.

Of course, the ramblings that go with hypomania are not worth posting (or submitting to a client) the way they hit the screen. When I’m less jazzed, but not in the Pit of Despair, I can re-read, edit, and improve. It’s a fine balance, a tightrope I’m learning to walk. And it takes both therapy and medication to maintain.

In essence, the not-properly-treated bipolar 2 made my work go downhill (even as I did), until I was unable to work at all. Now that my diagnosis and my meds are more on track, so am I. I may not be well, but I certainly am better. I can live with what I’ve got, and even re-learn how to use some of the abilities I lost in my most recent, largest, most devastating crash.

I wouldn’t recommend mania or even hypomania to anyone, but as long as I’ve got it, I might as well make it be good for something.

Category:

Mental Health

Tagged with:

I Have This Friend . . .

To have a friend, be a friend.

That’s how the saying goes, and it goes double for friends with mental disorders.

But.

There are limits. Boundaries. You may call them self-serving or self-saving, but there they are.

When you are depressed, you neglect friends, and I have certainly done that. I permanently lost one friend over it. But another kept reaching out to me and I eventually responded. (We then had a good game of “I’m a bad friend.” “No, I’m a bad friend.” She thought she hadn’t reached out often enough. I was glad she put up with my silence as long as she did, until I was able to reach back.)

But I have this friend. We used to be tight. When we were both depressed, we shared our misery and so lessened it. But now that the Pit of Despair is no longer my permanent abode…I have to limit my contact.

Why? My social skills have never been terrific, but now I frequently find myself walking that invisible line between Bad Friend and burnout.

Why is it so hard to be a Good Friend?

First, there is the Disaster Report. Whenever I talk to her, I hear a litany of all that is going wrong in her life. Almost never anything else. I’m no fan of relentless positivity, but its opposite is sometimes hard to bear too, even though I’ve been guilty of the same.

Then there is the fact that any suggestions are pushed away, denied as impossible, dismissed as unworkable. Granted, we have completely different styles of coping, but I feel discounted, unheard. Eventually I gave up sharing anything but a few of my own tribulations, some awful jokes, and commiseration.

Then I get off the phone or off Facebook, usually after half an hour or so. That’s about my limit.

I still keep reaching out. I don’t want to be a Bad Friend. I know I can’t fix her, or even her day-to-day difficulties, the kind even non-depressed people have. But I sure wish there were a way I could help, short of climbing down into the Pit with her. I hope that listening, even half an hour at a time, does some good.

And when I talk to other friends of mine, I try to remember to ask how their day was and what’s new in their life and have they seen any good movies and what is a mutual friend doing. I try to listen if they have something to share, good or bad, and I try not to overwhelm them or play whose-life-sucks-the-most. I try to be a Not-Bad Friend, even if I do have to lean on my friends, at times pretty heavily.

And they do likewise, when they can.

Category:

Mental Health

Tagged with:

Depression Hurts

You’ve probably seen those commercials where the announcer and the actress playing the part of a depressed person try to answer the question: Does depression hurt?

Once when we saw this commercial, my mother turned to me and asked whether my depression hurt me physically.

I had to say yes. I don’t think I ever took Cymbalta, the medication that the commercial was touting, but I was clear on the fact that physical pain is involved along with the psychological suffering of depression.

My head and eyes hurt from all the crying spells. My back hurt from lying in bed all day. I had painful knotted muscles from the anxiety that went with the depression. I had intestinal cramps because my overactive nerves led to irritable bowel syndrome. I had headaches and eye strain from the over sensitivity to light and noise. And I had the general flu-like malaise that is practically the hallmark of depression. You know the one. Every bone and muscle aches, but you can’t think why.

Were these aches and pains psychogenic? Undoubtedly some of them were. But others, like the irritable bowel, were all too demonstrably physical phenomena.

The mind and body and soul are inextricably intertwined. We know this to be true. Depression affects them all.

And it does hurt.

Category:

Mental Health

Tagged with:

Mr. Fix-It

Him: I just groomed the cat. I used a cat-a-comb.

Me: *total silence*

Him: Hey, honey! I just groomed the cat – with a cat-a-comb!

Me: *more silence*

I was depressed, and he was trying to cheer me up. Using exactly the same joke that had gotten no response only seconds before. I don’t know why he thought it would work better the second time.

Many men have the instinct that, when confronted with a problem, they will try to solve it. When something is broken, they will try to fix.

I wasn’t broken, exactly, but I was deep in the Pit of Despair, aka the lower mood swing of my bipolar disorder. At that stage I am immobilized, uncommunicative, and utterly humorless.

The fact that Dan had worked in hospitals and psychiatric facilities was actually a bad thing, despite what you might expect. He had run laughter therapy groups, he knew the jargon, and he sincerely wanted to be helpful.

But he didn’t know – viscerally – what depression was like. How it felt in your body and mind and soul, how it damped down your personality and blunted your reactions and removed your ability to view life as anything other than miserable. Certainly not funny.

Later Dan learned all this when he experienced his own bout of clinical depression and became another one of my Prozac pals. But until then, he would occasionally come shrinking at me, until I had to tell him to stop. I could accept a hug, but not a joke or a “remedy.”

But all that was early in our relationship and before I had begun to heal or even get proper treatment. And I literally would not have made it this far without Dan. I need him and likely always will.

When it’s Pit of Despair time again (which it sometimes still is), he checks on me to see if I need that hug, or some food, or a kind word, or just to be left alone. When I am better, he still does the cooking and shopping, and reminds me to eat regular meals and take showers and tells me I smell nice after I do. Sometimes he can coax me out of bed with a tape of The Mikado or out of the house with lunch at Frisch’s. If I’m too nervous to drive to my appointments, he takes me. When I’m together enough to work, he keeps the house quiet and fixes food when I need a break and validates me for being able to bring in money, even when it’s difficult.

But he can’t fix me. And now he knows that.

Category:

Mental Health, Uncategorized

Tagged with: