Bipolar 2 From Inside and Out

Posts tagged ‘depression’

A Tattoo Is for Life…

…this one, especially so.

As soon as I learned about the semicolon tattoo, I knew I had to get one – and not just because I’m a huge grammar nerd. Because I’m bipolar and want to spread the word about mental health issues.

In writing, the semicolon indicates a place where a writer could have finished a sentence, but instead chose to go on. This makes the semicolon an effective and beautiful symbol for suicide prevention efforts and those who struggle with mental disorders.

Every day we choose to get out of bed; choose to take our medications; choose to make and go to our therapist appointments; choose to live another day; and choose to go on with our story.

This is not something I invented. Here are the people behind it: http://www.projectsemicolon.com/. And here are some stories about the phenomenon that have been working their way through the media and around the internet.

http://www.upworthy.com/have-you-seen-anyone-with-a-semicolon-tattoo-heres-what-its-about?c=ufb1

9 beautiful semicolon tattoos our readers shared to destigmatize mental health challenges

Here is my story.

I am possibly the last person you would ever expect to get a tattoo. I am probably the last person I would ever expect to get a tattoo. I’m in my 50s, a former English teacher, married for over 30 years, fond of reading and word puzzles and cats.

Nevertheless, the professionals at Monkey Bones Tattoos in Beavercreek, OH, did not seem surprised when I showed up one day and presented my wrist.

The naked wrist.

The naked wrist.

When I explained what I wanted – to put down a deposit and book an appointment to get a semicolon tattoo – I learned that they had a cancellation and could ink me right away.

What the hell, I thought. Might as well. I had learned about the tattoos about a month before and had thought it over plenty. It was by no means a spur-of-the-moment (or drunken) impulse.

Mike Guidone showed me into his studio and explained the procedure.

The tattoo artists work station.

The tattoo artist’s work station.

He presented me with stencils of three different sizes of semicolons. I chose the in-between one. My wrist is fairly small, so the big one would have looked out of place, but the small one wasn’t noticeable enough. The idea is for people to see it and ask, so you can share the meaning and talk to them about mental health and combatting the stigma.

I sat in the dentist-type chair, listened to a brief explanation, got answers to some questions, and was ready to start.

In progress.

Did it hurt? Not particularly. It was a feeling between a scratch and a sting, and took only about ten minutes. Some aftercare instructions and I was done.

finished1

Success!

Then I paid ($80, the shop minimum), tipped Mike, and was on my way. Now I care for the tattoo while it heals, anointing it with unscented lotion several times a day, avoiding sunlight or soaking, and trying my very best not to scratch or pick at it.

The results.

The results.

Am I happy with it? You bet!

And, like I said, it’s for life! My story isn’t finished yet.

Mini-Meltdowns and Many Meltdowns

When my brain broke back in 2001 or so, I thought it was the first time that had happened. Later, on reflection, it turned out that wasn’t so.

The 21st-century breakdown was certainly the most dramatic. Although I had just quit working in an office to start a freelance career, I found myself unable to work after a few months.

I had become unable to work in the office because of mounting difficulties that I now realize were warning signs of the impending breakdown: inability to concentrate, increased anxiety (the feeling that an angry badger was about to claw its way out of my stomach), lessened ability to interact with coworkers, sudden flares of temper, turning people away with unintendedly cutting remarks and sarcasm, isolating, inappropriate affect, catastrophizing – you name it, I had it.

What was causing all these symptoms? My bipolar disorder, obviously. But I’ve had that for years. What was pushing me over the edge this time? I had trouble at work. My boss left and, when I “came out” to my new boss as depressed (which is what I was diagnosed with at the time), she reacted with wariness and incomprehension. She gave me the first bad review I ever had at that job.

My mother’s health was deteriorating seriously, too, about then. I lost time at work taking her to various appointments and I had to have “the talk” with her about how much longer she could live alone. Eventually I took over her finances – and by then I was scarcely handling my own.

I experienced a lift when I quit my job and began freelancing. Hypomania? You bet! My new flexibility allowed me to take better care of my mother, and the assignments kept coming in.

Then everything came crashing down. I screwed up my finances and my mother’s. She began having worse falls and injuries, hospital stays and drug reactions, even hallucinations which scared the hell out of me. I emotionally judo-ed my sister to come up and help, then fought with and resented her, and had to take care of parts of her life as well.

Those and other difficulties on top of my mental disorder added up to a non-functioning me. I dumped all the chores and coping onto my husband, which was a rotten thing to do, fought with him, sobbed for no discernible reason, became unable to work, or care, or do much of anything except think up at least three different ways (and reasons) to kill myself. Fortunately, I was too immobilized to try any of them.

I’ve written before about the things that helped me get back to some kind of functioning – a proper diagnosis, the right meds, time without work (as we gutted our retirement savings), lots of psychotherapy, and my wonderful, patient, ever-helpful, devoted husband.

But now, looking back, I can see that it had happened before, though not so dramatically and completely. In childhood, in my teens, in college – at every stage of my life I had at least one breakdown, often triggered by the circumstances of my life, but fueled and stoked by my mental illness. In every one, my ability to function deteriorated a little more.

The first one that I remember clearly was when I was around 12. My best friend and I were in charge of a birthday party for her younger sister and some friends. This was the old-fashioned kind of party that everyone in the neighborhood had then: cake and ice cream, party games, presents, and not much else. It happened during pin-the-tail-on-the-donkey. I was blindfolded – literally – and my friend kicked me in the ass – again, literally. In front of all those younger children.

I ran home sobbing. And I curled up into a fetal ball and didn’t quit for at least three days. Non-functioning, non-responsive, non-everything. What finally brought me out of it was seeing my mother’s pain at this inexplicable (to her) meltdown.

I had a mini-meltdown in my freshman year of college, which involved sitting in my nightgown in the hallway, staring for hours at a richly detailed poster of a fantasy realm. (I managed to frighten an intruder by arising, ghost-like, in my pale yellow shroud as he entered the suite.)

This one was triggered by my realization that I had probably chosen the wrong major and that there were no job prospects ahead for me. (It turns out I was wrong about that. Maybe I should have stuck with it, but my next choice turned out pretty well.) I took a year off college and took a job as a cashier in a restaurant, where I spent a lot of time crying into the roller towel and being told I should smile more. This convinced me that going back to college, with a new major (and even fewer job prospects), was the right thing to do.

The next meltdown was major. I had finished college, endured a year-long train wreck of a relationship, and lost a job as an assistant restaurant manager (I hadn’t fully learned that lesson yet). I got unemployment, which meant I lay around the apartment for most of the week (except for making half-hearted attempts at job hunting).

One notable symptom of this breakdown was my near-complete immobility. One errand in a day – say, going to the post office for stamps – made it a productive one for me. I had maybe three of those a month, with one being the obligatory visit to the unemployment office – a supremely depressing place to be depressed.

I had some truly irrational thinking that time, too. I thought I could cheer myself up by watching light, fluffy sitcoms on TV. But as I lay there on the couch, I found myself crying with every upbeat, cheery theme song that came with them. Laverne and Shirley making their dreams come true. One Day at a Time, which advised me to get up on my feet because somewhere there was music playing. And, oh, Mary Tyler Moore. Love is all around, my ass.

After that, it was a long, slow slide to my major breakdown. It wasn’t unrelieved misery. I got married. I got a master’s degree and a job in publishing. We acquired a house and cats. We traveled. But the Big One was waiting for me.

Nowadays, I still have mini-meltdowns, but they usually last a maximum of three days, rather than weeks, months, or even years. They still tend to be triggered by stressful life events, especially financial ones. But when I get one, I know I’ll be coming out of it soon. And that’s a wonderful feeling buried in all the misery.

 

 

Music Charms the Troubled Mind

Once I knew a man whose wife was going to leave him. I knew he was in a lot of pain and despair about it, though he also turned into a huge asshole before everything was said and done. He was also suicidal for a time.

One day when I was trying to talk him through a bad patch, I asked whether he might turn to music to help him. “What?” he said. “Do you think I should listen to country music and cry in a beer?”

I wasn’t suggesting that at all. I just knew that he was a singer and songwriter of talented amateur status and was known for this in various circles. I honestly thought that music might help.

On the other hand, I always forget, when I am on the downswing, how much music can do for me. It soothes and heals, but it also lets me tap into the emotions that I have been suppressing.

Do I have the inexplicable blues that are part and parcel of my condition? There’s a song for that. Am I feeling unrequited love? Unrequited lust? There’s a song for those too. Is the world spinning too fast for me? Do I need to know that everything will be all right? Or do I just need to know that someone, somewhere and somewhen, has also felt this way? I can turn to music.

“Music, uniquely among the arts, is both completely abstract and profoundly emotional. It has no power to represent anything particular or external, but it has a unique power to express inner states or feelings. Music can pierce the heart directly; it needs no mediation.”
– Oliver Saks, Musicophilia

Saks also says, “The power of music, whether joyous or cathartic, must steal on one unawares, come spontaneously as a blessing or a grace.” There he and I part company.

Music can certainly steal on us unawares, whack us upside the head with a memory, a feeling, a piercing stab of emotional intensity, all the stronger for being unexpected.

But we can also choose to bring music into our lives when nothing else seems to touch us. We can tap into those memories and feelings – good or bad – and let the music wash over us as we listen and feel.

According to scientific experiments with fMRI, music uses more parts of the brain than almost any other activity. The neural connections fire all over the place – more so if one is playing an instrument, but even when just listening. The memory centers, artistic areas, language centers, emotional areas – even the motor complexes – are stimulated.

My problem is remembering all that music can do for me. When my emotions are dulled, flattened by the steamroller of depression, I sometimes forget that I can be any other way. The music I love is always there for me. I can bathe in it, wallow in it, be uplifted by it, float on it, join in with it, feel it emotionally and viscerally and intellectually all at once or one at a time. It can express the things that I just can’t.

When you’re depressed is a time for writing bad poetry. Or you can let good poets and songwriters take you with them as they explore the human condition in ways you’re not capable of. I think that’s why they do it – create their art. The really good ones anyway.

There’s also something to be said for music as distraction. A song from years ago – even a frivolous one – can take you away from your troubles, even if only for a moment. This is not the time for exploring new musical avenues. Remembering that things once were good can feed your sadness, your depression, but it can also give you perspective. If you took joy in this music once, there will come a time when you will again. And maybe that time is now.

Perhaps the most amazing power of music is to provoke catharsis. Certain songs leave me sobbing like a baby. They don’t even have to be sad songs, though many of them are. “The Mary Ellen Carter” by Stan Rogers is about as life-affirming as you can get, but it can still turns me into a weeping puddle. (https://www.youtube.com/watch?v=Fhop5VuLDIQ) His song “Lies” has nothing to do with my situation personally, but its evocative power touches me nonetheless. (https://www.youtube.com/watch?v=D79XOc1vKzQ) And almost no one I know can make it through Kathy Mar’s “Velveteen.” (http://www.last.fm/music/Kathy+Mar/_/Velveteen)

Afterwards, I feel drained and, if not exactly better, less emotionally constipated, I guess you’d say. Clearing away a bit of blockage can be cleansing. If music can do that – and it can – then I don’t care if its country with a beer, jazz with a glass of wine, or hip hop with an energy drink. Even easy listening with a glass of milk, if that’s your thing.

So thank God and Apple for iTunes. And here’s hoping that my Swiss cheese of a memory will give me a nudge in the right direction when I need it next time.

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.

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.

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/

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.

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.

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.

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.