Bipolar 2 From Inside and Out

Posts tagged ‘depression’

Family Matters

No one in my family understands me.

Actually, no one in my family understands my illness.

My mother-in-law doesn’t believe that mental illness exists. And in a way she has a point. If she hasn’t experienced something, for her it doesn’t exist. Most people are a bit like that sometimes, especially regarding mental disorders. There are only a few varieties of broken arms, and when you’ve got one, you know it. When you’re talking synapses and neurotransmitters, thoughts and feelings, it’s obvious why “invisible illnesses” aren’t obvious or well understood.

I didn’t understand my disorder at first, either. I remember driving past a building with a sign: South Community Mental Health. I didn’t know what I was feeling, but I was pretty sure it wasn’t mentally healthy. I went in and began the journey.

My family had the following reactions when I told them I was going into therapy and when I first started taking medication:

Dad: Just as long as I don’t have to go.

Mom: I’ve heard Prozac is a ticking time bomb.

Mom (later): I thought you would feel better after you found a good job.

Sister: Why should you spend $100 a month just to talk to someone? (The clinic was on a sliding scale, so I actually paid only $5 per visit.)

I understand some of those reactions. Dad had heard about how psychologists blame parents for messed-up kids and he wasn’t going to someone to be told he was crazy, and a bad parent besides. And his fear was not that unreasonable. Dysfunctional kids often do come from dysfunctional families. But underlying my disorder was brain chemistry. I never asked him to join the couch gang.

Mom watched Phil Donahue (for you youngsters, think Dr. Phil). And there was at first over-prescribing of Prozac and suicides once the patients gained enough energy. Plus she thought my depression and anxiety were reactive and would clear up when my living situation was more stable.

My sister, I don’t know. I don’t understand her either. I’m sure she has psychological problems too, of one sort or another. But I’ve been diagnosed, so I’m the crazy one.

My husband, who has a background in psychology, “got it” a little better once he stopped trying to “fix” me. But he never understood in a visceral way until he had his own first meltdown.

“You know how you’re feeling now?” I said. “Try feeling that way for a couple of years instead of a month.” Later he did. So at least he knew what half of bipolar was all about. He still hasn’t felt the rapid cycling or the constant roller coaster or the extreme physical and mental battering of going on and off medication after medication, hoping the next one will do more than make his hands shake worse or his memory turn into Swiss cheese.

Still, it’s better to be partly understood than completely dismissed, and to have a family that tries. And to have a family of choice that does understand, because a lot of them are in the same leaky, patched boat.

I could have done a lot worse.

 

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All in Our Heads

Well, mental disorders probably are mostly in our heads, or at least our brains (and genes), but I keep seeing news features that “offer hope” for new diagnostic tools and treatments that “may someday” alleviate the suffering.

Here’s an example from the University of Pennsylvania:

Many factors, both genetic and environmental, have been blamed for increasing the risk of a diagnosis of schizophrenia. Some, such as a family history of schizophrenia, are widely accepted. Others, such as infection with Toxoplasma gondii, a parasite transmitted by soil, undercooked meat and cat feces, are still viewed with skepticism. A new study used epidemiological modeling methods to determine the proportion of schizophrenia cases that may be attributable to T. gondii infection. The work suggests that about one-fifth of cases may involve the parasite.

Great. I am sure that schizophrenics will be comforted by the thought that their problems are caused by brain parasites and cat poop.

I noticed that the study showed that only 20 percent of schizophrenia “may” involve the parasite. What about the other 80 percent? Are those cases caused by some other parasite? And how will the parasites be detected? Blood test? Brain biopsy? Could be a world of horrors there for the already mentally unstable. And, perhaps most important, will real-world results back up the computer simulations?

Schizophrenia is far from the only illness being studied. Bipolar disorder and our old pal depression come in for their share of lab work too. USA Today recently reported on a procedure that might help with depression:

The treatment — transcranial magnetic stimulation — was approved by the Food and Drug Administration in 2008 for the treatment of patients with medication-resistant depression.

Magnets generate a directed, pulsed magnetic field — similar to an MRI in strength — to the prefrontal cortex, the front part of the brain behind the forehead. The magnetic fields induce small electrical currents, which encourage a mood-lifting chemical reaction in the brain.

The treatment is daily, for four to six weeks. If the patient improves enough, the treatment is then provided as a periodic booster.

Never mind that it’s entirely subjective when a patient has improved “enough” or even shows anything other than a placebo effect. And never mind the effects of having 42 MRI-strength treatments in a row.

Apparently scientists and insurance companies are battling it out on the money front (there’s a surprise).

Plus, as always, there are nay-sayers:

The National Institute of Mental Health describes the treatment as effective for some patients, but notes that studies of its efficacy have been “mixed.” The American Psychiatric Association’s guidelines for depression treatment states the procedure conveys “relatively small to moderate benefits.”

To the desperate, any potential “cure” or even palliative treatment eventually seems worth a try. I should know. I came that close (imagine several millimeters here) to having a go at electro-convulsive therapy (ECT). Formerly know as shock treatment.

The thing is, you only hear about theories that “might” be correct and treatments that “may” help. Studies are hardly ever published that say, “You know that treatment we said was going to relieve the suffering of millions? Turns out, not so much.” If the general public even gets to see the negative results, they may still cling to the hope offered by the earlier reports.

Just look at the anti-vaxxers. It has been repeatedly proved that childhood vaccines do not cause autism. The experiment that reported that finding was a fraud and the author (Andrew Wakefield) has been discredited – investigated and found guilty of “four counts of dishonesty and 12 involving the abuse of developmentally challenged children.” Basically, he’s been kicked out of medicine altogether and given the Lifetime Achievement in Quackery award by the Good Thinking Society. (I’m not making that up.)

And yet epidemics of measles and other deadly diseases continue to rise as parents yield to fear and refuse to have their children vaccinated.

I’m not trying to say that a parasite doesn’t cause some cases of schizophrenia or that magnetic therapy will never relieve anyone’s depression.

I’m just saying that if those theories are proved false, we’ll likely never hear about it from the popular press.

 

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Happy Humbug

It’s a truism that holidays are difficult, not to say hazardous, for those of us with mental disorders. But there are a variety of reasons and a variety of reactions and – dare I say it – a variety of coping mechanisms.

First, let me say, that despite the fact that I was already depressed or bipolar as a child, the holidays were marvelous. Our granny, maiden aunt, and uncle lived a few hours away and we spent Every Holiday there. (My uncle drank, but not when we were kids.)

On Thanksgiving, we’d arrive, the adults would eat themselves into a coma, and then nap while we kids were sent of to the movies.

Christmas was similar, except that we’d get up, open presents from our parents (and “Santa” for the biggies), pile into the car, and head to granny’s. The adults would eat themselves into a coma, and then nap while we kids were sent of to the movies. (I specifically remember The Sting and The Andromeda Strain, during which I saw my first picture of a naked male butt.)

There was no tension involved – no grand dining table, no fancy dress, no distant relatives, no formal manners. We’d simply fill a plate with home cooking, perch on a sofa (which was called the davenport) or chair, and chow down.

My birthday falls between Thanksgiving and Christmas, but poised well enough between the two that it was never combined with either one. Back then, birthdays were simple – cake and frosting from box mixes, four to six neighbor kids, presents (no gift bags), and maybe a couple of party games. (It was at someone else’s birthday party that I was traumatized during a game of Pin the Tail on the Donkey.)

How could anything in later life measure up to those?

Well, it couldn’t. My first Thanksgiving away from home was when I was at college, and we ate lasagna, not turkey. I believe it was the first time I had lasagna. Ever.

Since then all the holidays have gone downhill, or I have.

Any more, they’re a chore, a relentlass gray blob from November through January. (Halloween starts it off. I can’t get with that either.)

For years, I kept up some of the traditions for my parents’ sake. My mother in particular loved everything to do with Christmas – the Macy’s parade, the tree with my father’s favorite old smudge-faced angel on top, crocheted holiday sweaters and snowflakes and handmade ornaments from her foreign penpals and neighbors and church friends.

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My first Christmas in my own apartment, I had a small fake tree. When I got married my husband and I tried to get into the spirit with surprise gifts and selecting and decorating my mother’s tree and inviting a divorced friend to dinner with us.

But I was sinking rapidly. At various places I worked, all the ladies sported store-bought Christmas sweaters and sweatshirts (Halloween ones, too) that I thought were just awful. But one year, in a desperate attempt to fit in, I bought holiday sweaters on sale in January to wear the next year. Of course, by then I had lost the job.

Dan and I continued the tradition of dining with our friend John, but our venue changed to Chinese restaurants, where we were kept company by Jews, pagans, atheists, and, no doubt, other depressives and bipolars.

One year Dan was visiting his mother and I was on my own. I tried. I really did. I trotted out a festive holiday sweater and little wrapped-present earrings, and went out to a buffet that offered turkey and beef and ham. But I sat by myself and listened surreptitiously to my iPod. And not holiday music, either. By then about all I could stand was the Christmas jazz from the Charlie Brown TV show.

This year, we ate out on Thanksgiving – but not at the swanky hotel buffet we sometimes took my mother to, or any of the other mega-buffets. We went to a diner that John used to love. I had pork chops and lemon pie. On Christmas I’m likely to be by myself again and may just get festive with a Stouffer’s mac-n-cheese.

Comfort food seems appropriate, and the cats like to lick the dish. Then for dessert – Zoloft and Ativan and Lamictal and Abilify and Ambien. Yum. Visions of psychotropics dance in my head.

 

P.S. I wrote about a Thanksgiving with John on my other blog. If you’d like to see it, go to http://janetcobur.wordpress.com/2014/07/25/thanksgiving-ratatouille-and-a-near-death-experience/

And if you’d like to see my rant about the “War on Christmas,” go to http://janetcobur.wordpress.com/2014/11/09/lets-call-a-truce-on-christmas/

 

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Missing Friends

Last week I wrote about the controversial subject of self-harm. In my post, I said:

One of my dearest friends once said that if he ever found out I was a cutter, I would never hear from him again. Except for his publicly mocking me for being so stupid.

Naturally, this sort of reaction, though common, is not helpful. I didn’t tell him (or practically anyone else). And I didn’t tell him that at least two other people he knew – one fairly intimately – were also cutters.

Anyway, Tom, if you’re reading this and still feel the same, I guess this is goodbye – just not the long goodbye. I would rather skip the public mocking, though. I’ll just assume you’ve done it while I wasn’t there, mm-kay?

Finally, I got tired of wondering, withholding a part of my past from someone with whom I have practically no secrets, sometimes to the point of TMI.

So I called him and asked, “Are we OK?” At first he didn’t know what I meant, since he hadn’t read the post, but after a brief nudge I could tell he knew exactly what I was referring to.

Just as a (very rational) mutual friend had predicted, Tom chalked it up to the hyperbole of his callow youth and reassured me that we were fine.

Still.

I had lived with the fear of losing that important relationship (and being publicly mocked) for over 20 years. I had never dared mention it to any people in our circle either.

And, let’s face it, I have lost other friends and can attribute at least some of these losses to my bipolar disorder. It harms me, but it also harms those around me, and especially relationships.

I have shot my mouth off and driven away friends and colleagues with bitterness and sarcasm but without realizing how I sounded.

I have ratted out a friend to his therapist and his wife when he was suicidal, which he found unforgivable.

I have turned down invitations to go out or agreed to and then backed out one too many times. My friend gave up the effort since I wasn’t responding.

I have abused the hospitality of friends. When I was at my still functioning moderately well, I would visit and we would enjoy activities, food, conversation, and music. When I was near or at the depths, I would invite myself to visit and turn into an uncommunicative, disengaged, immobilized lump. I was a mooch and a leech, and a real downer generally. I didn’t like spending time with myself, so it’s no wonder they didn’t either.

And I miss every single one of them. I wish I hadn’t driven them away. I wish I could make things right again, now that I’m functioning at a higher level. But I can’t. And that hurts.

In some cases, I’ve tried – sent brief notes of apology. They have been acknowledged with cold politeness that does not invite more contact. I don’t know what else I can do.

Bipolar is a cyclical illness and, though I’m much improved, I can’t promise that I will never sink that low, be that inconsiderate, offend those I deeply care about again. And I can’t blame them for not wanting to deal with that. I don’t want to deal with it.

But I have no choice in the matter. And that hurts too.

Fortunately, there’s one friend I cannot lose, no matter what – my husband. He’s ridden the roller coaster with me, put up with the huge mood swings, ignored the irrational remarks, offered to help in any way, encouraged me to go out but understands when I can’t, and dispensed hugs on a regular basis. He respects alone time and is there when I need company or distraction. If things are really bad, he gets me to eat and helps me shower and takes care of the pets and picks up my refills and does whatever else needs doing.

He’s a man who takes “in sickness and in health” seriously. I wouldn’t have made it this far without him. And I won’t ever lose him, till death do us part.

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Maybe Another Manic Monday

The great Abilify experiment continues. I’m still roller-coastering, which is “normal” for me, but I really can’t tell whether the drug is affecting the ups and downs.

The highs and lows do seem to be higher and lower (respectively). I am dubious about this being a Good Thing. For several days I was so thoroughly depressed that I was ready to call Dr. R. and tell him I need to stop taking the drug. Then I leveled out to my usual place on the continuum – functioning, but not spectacularly well or consistently.

Now I think I’m starting to get manicky. One way I can tell is that I actually had fun, laughing and playing with my husband the other night and exulting in getting an old friend to walk straight into an awful joke. (Me: Have you heard the new Ebola joke going around. Him: No, what is it? Me: Eh, you probably won’t get it. Him: No, c’mon, try me. Me: That WAS the joke. Him (in evident pain): Oh! Oh! Oh! Oh! Oh! Oh!)

But the real clue that the upswing may be swinging more than it should. I’m thinking about starting more blogs.

I already have two – this one and a general purpose blog called Et Cetera, etc. (janetcobur.wordpress.com, if you’re interested). For over six months I met my goal of posting something in both of them once a week.

Then the big low hit me. But I’m back on track now, after several weeks’ absence.

The thing is, I have ideas for two other blogs. I just don’t know if I could handle them.

One would be Cats, Etc. – stories and anecdotes about life with cats, cat care and health, and so forth. We have three cats right now (Louise, Garcia, and Dushenka), plus many former fur-family members, so there would be no shortage of material.

The other idea is Books, Etc. I’m an avid reader, and though the bipolar has sapped my concentration so much that it varies between 20 minutes to two hours at a time, I’m starting to see some progress. And I find myself wanting to write about what I’m reading – maybe book reviews, maybe lists or quotations, maybe even some lit crit (my original background).

But could I maintain them? And not have them drain off the limited energy that I should use to do the freelance work that pays the bills.

I think it is a sign that I’m still fairly well anchored that I haven’t rushed off and started them already. But the yearning to do more reading and writing keeps getting stronger. Maybe I could keep my current two at once a week, and do the others on alternate weeks. But that would still mean three blog posts per week, plus the freelance. Frankly, I don’t know if I could handle it. I keep asking myself, should I try? Or should I wait to see if my moods level out on the Abilify and it becomes clear whether they are Good or Bad Ideas, or even possible.

Words – both reading and writing them – have sustained me for most of my life. It was a sign of my most profound depression when I found myself unable to maintain enough focus to read. Now that I can again read and write to some extent, do I dare to push myself, push the boundaries? Can I? Should I?

Good thing I see my psychotherapist today.

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Abilify: News or Not

I’ve been taking Abilify for several days now. Is it working? It’s hard to say.

I’m pleased to report that I haven’t had any side effects I can’t handle. In fact, I don’t know whether I’ve had any side effects at all. I’ve had a tiny bit of dizziness and some drowsiness. But I have those anyway, either from my other meds or from other physical conditions.

On the positive side, I’ve had a bit of an increase in energy and concentration – as you could probably tell from the fact that I’m blogging again. But is this attributable to the new drug, or is it just the usual up cycle of my own personal roller coaster?

It’s probably too soon to expect anything definitive. Like most psychotropics, it probably needs to build up in my system a bit. Or I may just be one of those people Abilify doesn’t affect, for good or ill.

I recently read an article in Discover magazine called “The Power of Single-Person Medical Expepriments.” The article discussed the fact that the usual clinical studies of new drugs and treatments – randomized, double-blinded, hundreds or thousands of participants (the “gold standard” of tests and trials) – give results that are only averages. The techniques will work for some people and not for others. Some experimental subjects will experience side effects to varying degrees. Or not.

The only way to see whether a given treatment works for an individual is for that person to try it. The odds may say it has a better-than-50% chance of working, but until the patient tries it, whether it will work for that one individual is basically a crap-shoot.

I think this may be particularly true of psychotropics. Every time I’ve asked how this or that med works, the answer has been, “We don’t really know.” Factor in the number of different meds I’m on, psychotropic and otherwise, and their potential for interactions with each other, and any new treatment’s effectiveness is likely a matter of trial and error.

I’ve certainly gone through a long, tedious, disappointing (or unpleasant) series of weaning off and ramping up different meds in hopes of mixing just the right cocktail for my particular brain.

I think that’s why they call it “practicing” medicine.

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Mental Health

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Dear Folks: Sorry I Haven’t Written Lately

This has been the longest trough I’ve had in a while, and I’ve been spending all my spoons on work, because the cats do insist on eating.

Tomorrow begins a new adventure: My psychiatrist has prescribed Abilify. The $800/month price tag seemed a tad bit high to me. We have insurance, but the benefits don’t really kick in until we meet the absurdly high deductible. A few months of Abilify would probably do it. (We couldn’t afford the gold plan. I think ours is aluminum, or maybe tin.)

The manufacturer does offer a free month’s trial and a discount card, so at least I can see if it works for me. If it does, I’ll figure out how to pay for more. (BTW, if your meds are way expensive, check out needymeds.org. They have a database of manufacturers, discounts, requirements, and contacts. My psychotherapist turned me to that.)

When Dr. R. prescribed Abilify, he told me that it could make me restless. “How will I know whether it’s the drug or my usual twitchiness?” I asked. “You’ll know,” he said. After reading the literature, I can see what he means.

So here I am with three work assignments (not particularly tight deadlines, though) and am about to start a drug that could feel either heaven-sent or hellish. Or just “meh,” I suppose, which would leave me exactly where I am now.

Wish me luck.

And tell me if you’ve had any experiences with Abilify. I know anecdotal evidence doesn’t mean squat to scientists, but I’m interested in hearing from people who have tried it, or seen how it worked (or didn’t) for a friend or relative.

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Going Public

I just posted this on my Facebook page. Now we wait and see what happens.

Along with the news of Robin Williams’s death have come discussions of mental illness and suicide. I’ve decided to go public with my own experience. I have bipolar disorder – type 2 (which means that I have lots of depression and anxiety, but very few manic phases). I’ve had this all my life, most likely, so whenever you met me, I had it.

Some of my friends already know and I’m sure others have guessed or suspected it. It is the result of a biochemical imbalance in my brain and is now treated with medication and therapy. I’m working on it.

Anyway, I ask for your understanding when I sometimes go hide under a rock for a while or say or do something odd or rude or unkind. My social skills have never been great, and having a disorder like this doesn’t improve them. I’m working on that too.

But you don’t have to do anything special or tiptoe around me. I’m still who I always was. I don’t freak out when people call me crazy or nuts or weird.

If you are interested, I blog about it: bipolarjan.wordpress.com (I also have a general purpose blog: janetcobur.wordpress.com.) Anyone is welcome to visit. I can also recommend other resources.

Here is the article about Robin Williams that noodged me into taking this step: http://www.slate.com/blogs/xx_factor/2014/08/12/robin_williams_and_mental_illness_when_depression_is_breaking_news.html

I Bet Robin Williams Knew He Was Loved. Unfortunately, Love Doesn’t Cure Mental Illness.
http://www.slate.com
It is jarring when a beloved celebrity dies of something you could possibly die of yourself—when all of a sudden everyone is talking about the illness you have, the one that they usually…

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Read Your Way to Sanity

As reported in Smithsonian magazine, “Doctors are now prescribing books to patients with depression, hoping that reading will help them find connections.”

Here’s the link, but I’ll hit the high spots for you. http://www.smithsonianmag.com/smart-news/doctors-are-now-prescribing-books-to-treat-depression-180948211/?no-ist

First, let’s note that this is third-hand information – from the U.K. National Health Service to the Boston Globe to the Smithsonian. (Fourth-hand, if you count this blog.) Many of the details and even the explanation of the concept may have lost quite a bit in the transitions. But here are the basics:

 If your primary care physician diagnoses you with “mild to moderate” depression, one of her options is now to scribble a title on a prescription pad. You take the torn-off sheet not to the pharmacy but to your local library, where it can be exchanged for a copy of “Overcoming Depression,” “Mind Over Mood,” or “The Feeling Good Handbook.” And depression is only one of over a dozen conditions treated.

There are also books prescribed for other conditions including, I presume, bipolar disorder. And they sound a lot the old self-help books of the sorts we read in the 1970s, of the Women Who Are Ambivalent About Women Against Women Against Feminism sort (h/t The Bloggess for that awesome title).

Back then I was diagnosed with depression, and back then the Common Wisdom said, “Depression is anger turned inward.” Now that we know more about brain biochemistry, neurotransmitters, and such, advice from a book called “Mind Over Mood” is not likely to be all that much help. And God spare me from anything called “The Feeling Good Handbook.”

Of course the Brits’ prescriptions are not actual bibliotherapy, which is a real thing, defined by  The American Library Association thusly:

The use of books selected on the basis of content in a planned reading program designed to facilitate the recovery of patients suffering from mental illness or emotional disturbance. Ideally, the process occurs in three phases: personal identification of the reader with a particular character in the recommended work, resulting in psychological catharsis, which leads to rational insight concerning the relevance of the solution suggested in the text to the reader’s own experience. Assistance of a trained psychotherapist is advised.

This is a much better idea, but again, it’s advisable to check the publication dates on those books. The extremely popular book I Never Promised You a Rose Garden was written before anyone really knew about the genetic and biological components of schizophrenia.

I’m sure there is modern fiction that would be useful in bibliotherapy. Personally, I think that the Dementors in J.K. Rowling’s Harry Potter books provide as good a description of depression as I’ve ever heard:

[T]hey glory in decay and despair, they drain peace, hope, and happiness out of the air around them… 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.

Rowling herself has spoken about the connection:

It was entirely conscious. And entirely from my own experience. Depression is the most unpleasant thing I have ever experienced. It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It’s a necessary thing to feel. Depression is very different. I think [dementors] are the scariest things I’ve written.

As for me, I find insight into mental disorders primarily in nonfiction – though not necessarily in books with a psychiatric or psychological perspective. The Noonday Demon: An Atlas of Depression by Andrew Solomon is, I think, essential for any collection. It combines the author’s own experiences with historical, cultural, philosophical, and other ways people have thought and written about depression.

Generally, though, I prefer memoirs of people who have lived through or with the conditions they write about. Although my diagnosis is bipolar disorder type II, I also read memoirs about people with other conditions. There are many similarities of experiences, symptoms, feelings, and other aspects that I find familiar or helpful.

Being an ardent bibliophile as well as a psychiatric patient, I believe in the potential of bibliotherapy. Being a former consumer of self-help books, I sincerely doubt that genre will do much good.

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On Dithering

If dithering were a power source, I could light up Chicago. Good thing it burns nerve endings instead of fossil fuels.

The last couple of weeks have seen a lot of dithering and anxiety. I hardly ever get to enjoy the rush of hypomania – except for that one brief spell a few weeks ago – because it comes out sideways as anxiety.

I also have a third-degree black belt in catastrophizing.

Both have gotten a workout lately, since a cyst was discovered in my left breast. (I wrote flippantly about mammograms on my other blog, so irony gifted me with this.)

I checked my usual sources (Mayo Clinic website and a friend who is a biologist and had a lumpectomy), and the consensus was that I had only the remotest chance of the anomaly turning out to be anything really dire.

Do you think that stopped my dithering?

Hell no! Of course not!

What could have gone wrong?

They could have stuck a needle in my breast to aspirate fluid and get a sample for the lab. (A friend who should know tells me that some people do this kind of thing for fun. Somehow, it doesn’t appeal to me.)

If the results were worse, I could have been scheduled for a lumpectomy. There was extra anxiety on this one because my friend almost had a mastectomy instead of a lumpectomy when the surgeon started making the wrong incision. (An operating room tech noticed, saving the day and the breast.)

And of course, my anxiety told me that a mastectomy could be in my future (either on purpose or accidentally, I suppose). My mother had a mastectomy, which added extra oomph to the dithering.

A mastectomy would suck for oh so many reasons. Cancer, surgery, body image issues, obviously.

Also, I would keep falling over to the right. And before the operation I’d have to take my breast on a farewell tour for all its friends and admirers.

Maybe worst of all, I would have to put up with all the pinkness and positivity. Not to denigrate this strategy for those who find it helpful, but I am not that person. Anyone with my brain chemistry is not going to respond to slogans and cheerleading and daily affirmations. (Reminder – As always with my posts, YMMV.)

Barbara Ehrenreich has written about this phenomenon in Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America.  Apparently many breast cancer survivors feel they must get something positive from the experience – appreciating life and family more and so on.

We’ve come a long way from Betty Rollins’s First, You Cry. Now it seems like we’re never supposed to.

The anticlimactic but welcome result came today: Everything is OK. I just need to keep up with yearly mammograms.

And now I can move on to the next thing that needs dithering about – the work I wasn’t able to do while I was catastrophizing.

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