Bipolar 2 From Inside and Out

Posts tagged ‘emotions’

Are Lobotomies Gone for Good?

By alexlmx/adobestock

If I were a few decades older, I might have undergone a lobotomy. Treatment-resistant bipolar disorder (or manic depression, as it was called then) and schizophrenia are some of the disorders lobotomies were recommended for. It was thought that such mental illnesses were caused by faulty connections in the brain and that the cure was to sever those connections. Lobotomy pioneer Antonio Egas Moniz received a Nobel prize for inventing the operation.

The main problem was it didn’t always work as planned. There were other problems as well, such as the flattening of affect and severe brain damage (what a surprise). The most noted person to have a lobotomy (also called leucotomy) was Rosemary Kennedy, the developmentally delayed sister of John and Robert.

There were two kinds of lobotomies, though only the method differed. The prefrontal lobotomy involved drilling holes in the patient’s skull in order to get to the frontal lobes, where the trouble was thought to lie. The other, and to me more alarming, version was called the transorbital lobotomy. The “orbit” in transorbital refers to the eye socket. An instrument was introduced into the brain by going through the eye socket (without disturbing the eye) and used to sever the connections between the frontal lobe and the rest of the brain. Around 50,000 lobotomies were performed in the U.S., most between 1949 and 1952

Doctor Walter Freeman was the champion of the transorbital lobotomy, often called “icepick surgery” for the slender instrument that was inserted and then swooped about, in hopes of severing the faulty brain wiring. Dr. Freeman was so adept at this that he could perform many of these surgeries in a day, and indeed performed around 3,500 during his career, including 2,500 icepick lobotomies. He once performed 228 of the procedures in a two-week period and taught the technique to countless other doctors. Some of his patients underwent more than one lobotomy.

Eventually, the lobotomy came into disrepute for A) being the horrible invasion that it was, B) reducing many patients to an emotionless or brain-damaged state, and C) being depicted in Ken Kesey’s 1962 novel One Flew Over the Cuckoo’s Nest as a punitive, brutal, and unnecessary procedure. The lobotomy all but disappeared from the psychiatric and surgical landscape.

But wait! Lobotomies may be out of fashion, but psychosurgery (or “functional neurosurgery”) is still performed for treatment-resistant mental illnesses. In these operations, however, rather than randomly severing neural connections, the surgeon removes the areas of the brain thought to be the cause of the psychiatric problem. Modern versions of psychosurgery include “amygdalotomy, limbic leucotomy, and anterior capsulotomy,” none of which I know enough about to comment on. Suffice it to say that the days of drilling burr holes in patients’ skulls or taking an icepick to their brains are, as far as I can determine, gone. 

Psychosurgeries are now performed rarely, deep brain stimulation being the preferred form of treatment, especially for non-psychiatric conditions like Parkinson’s or treatment-resistant seizures. And they’re always performed under anesthesia. The patient’s consent is required.

Electroshock therapy is much less invasive and is still used today, although in a lower-key and safer manner than the original procedure – under sedation and with lower amounts of electricity. It still has side effects, such as the loss of short-term memory for the period surrounding the treatment.

Electroshock therapy was considered in my case because of my long-term, treatment-resistant case of bipolar 2, which involved years-long depressive episodes. At first I was terrified, but after doing some research and talking to knowledgeable people, I was just about ready to agree to it. At that point my psychiatrist suggested we try one more drug first – which worked, alleviating (though not curing) my condition like turning on a switch.

(Side note: When I began researching lobotomies, I found that the book My Lobotomy, by Howard Dully, was particularly interesting. The story didn’t follow the usual pattern. Instead, it seems, Dully’s hospitalization and operation (in 1960, when the boy was 12) were largely instigated by his stepmother, who wanted him out of the way, though schizophrenia was diagnosed by Dr. Freeman (see above) before the transorbital procedure.)

 

 

Caregiving: What We Owe Our Animals

By fantom_rd / adobestock.com

I’ve written before about emotional support animals and what a difference they can make in the life of a person with a mental illness such as bipolar disorder. And that’s still true. Emotional support animals and trained service animals can make a vast difference in helping a neurodivergent person cope with life and their disorder. (A thorough guide to emotional support and service animals can be found here: https://adata.org/guide/service-animals-and-emotional-support-animals.)

It’s unfortunate that misunderstanding and misuse of emotional support and service animals have made it more difficult for persons who really need them to have the comfort and utility of such a companion when they really need it. The fact that pet “vests” labeled Emotional Support Animal are available willy-nilly online is a disgrace. (I saw one site that sold all kinds of vests with assorted patches, ID cards, and collar tags. It had “It is fraudulent to represent your dog as a service animal if it is not” in really small type on only one page.) Real service animals require thorough training and provide specific kinds of support to their humans.

There are many animals that provide comfort, companionship, and emotional support without being official, trained service animals. Cats, for example, are notoriously bad at being able to perform actions such as diverting a person with OCD out of a behavior loop or reminding a person to take medications. Hamsters, rats, and fish, while providing hours of comfort and emotional diversion, are not really qualified as service animals. Monkeys can be officially accepted as service animals, as can pigs and miniature horses. But the ADA (Americans with Disabilities Act) makes no provision for emotional support sloths, lizards, or rabbits. People who take these animals onto airplanes or into restaurants – or people who take untrained dogs there – screw it up for those who truly have need of nonhuman support.

But that’s not what I’m here to talk about today. I want to discuss people with mental illness and what they owe to the animals they live with. Caregiving.

It’s great that animals can act as supportive caregivers to human beings in need, but the animals have needs, too, and it is up to the human being to accommodate them.

Unfortunately, when I had my worst major depressive episode, I was not able to provide proper care for my companion animals. The cats needed regular food and water, a clean litterbox, and appropriate medical care, at a minimum. Fortunately, when I was too ill to provide those, I had a caregiver (my husband) who was. If he had not been available and willing to take over the pet-care duties, they would have been neglected, and suffered for it.

This is not to say that people with mental illnesses should not have pets. Companion animals can be a wonderful solace and comforting presence. My cats’ purring, lap-sitting, and other behaviors have been soothing and peaceful at times when I really needed it. Just their presence could bring me out of myself for a while. Caring for some other being is a powerful adjunct to therapy.

Even persons with severe mental illnesses can benefit from the presence of animals and are able to care for them, sometimes even better than they can care for themselves. Think of the homeless veteran with PTSD who cares for a companion dog, making sure it eats even if he doesn’t, and finding it shelter from the cold. It’s hard to say which is doing more for the other. And people with depression, for example, may find that caring for an animal brings them out of themselves, at least a little, and connects them with a world wider than the inside of their head.

What I am saying is that people who know they may be incapacitated by their mental illnesses probably should make preparations for a time when they are not able to care adequately for their animal companions. I was lucky to have a caregiver who was as emotionally invested in caring for the cats as I was. He took over the caregiving for them as well as for me.

It is, however, only sensible to make plans for your animal companions if you know you may be unable to give them proper care – for example, if you know you are facing hospitalization. Pet-sitting or boarding arrangements can be made in advance and called upon in case of emergency. Even a pet feeding and watering station that provides several days’ worth of sustenance can make owning a pet more practical when your coping skills disintegrate.

I wouldn’t give up my cats for anything. Unless giving them up was the only way to ensure that they received proper care. No animal should suffer just because I do.

All Mixed Up

Leigh-Prather/Adobestock.com

As I mentioned a few posts ago, my psychiatrist and I are working on a medication change that will, I hope, pull me out of bipolar depression. The medication that we changed was a mood-leveler, which sounds like a productive way to start.

We’re increasing the dose, which means it shouldn’t take the time it would for the old drug to “wash out” of my bloodstream (and/or brain) while we’re waiting for the new one to kick in. I’ve been that route before, and it’s miserable.

While I haven’t noticed my moods becoming exactly stable since the change, I have noticed certain effects. I am able to get through the minimum of what I need to do each day, though nothing more. And I have noticed that I am getting irritable. This does not happen so much when I’m depressed. When I’m depressed, I don’t care enough about anything to be irritable.

In fact, irritability is one of the ways that hypomania manifests for me, before I get to the euphoria/super-productive/reckless spending stage. I get snappy with my husband about all his annoying habits, like never giving me a straight answer to a simple question. (What are you watching? A movie. What did you get at the store? Food.) I think he thinks he’s being funny, but I find it frustrating. Not that I don’t have annoying habits too, especially when I’ve either depressed or irritable.

So, I guess in one way, the irritability is a good sign. It doesn’t mean I have level moods yet, but it seems to mean that I’m not totally stuck in the depression. (I explained to my husband what was happening with me, and he seems to understand more. Though it remains to be seen if he’ll answer simple questions informatively.)

I think what I’m experiencing is a phenomenon know as mixed states. If to be depressed is to care about nothing and mania is to care about everything, a mixed state is some hellish combination of the two. Imagine being immobilized and jumpy all at the same time. That’s what it’s like, paradox that it is.

I haven’t had mixed states too often in my life, though I have had emotions that swerve drastically from happy to depressed in an instant (which is an extreme version, I think, of what’s known as ultra-rapid cycling). This is something different, though.

Now, I use up all my spoons early in the day and nap, or I stay up but go to bed at around 8:00. Ordinarily, if I went to bed that early, I’d read for a couple of hours, but these days half an hour or 45 minutes is it, tops.

Still, I think (or hope) that this mixed state of affairs is a step along the way to level moods that are higher than the numbness and not-caring of depression. It’s not comfortable to go through, but then neither is depression or mania, even hypomania.

It’s been about six weeks since the change in my medication. Within another four to six weeks, it will likely become apparent whether the change, once set in motion, will have an outcome I can live with. Until then, I need to spend my spoons as wisely as I can and try to remember not to snap at my husband, even when he’s being annoying.

Take a Hike: Nature and Mental Health

photo from the author’s collection

 As a child and as a teenager, I was a Girl Scout. We hiked. We camped. We did all sorts of nature-related crafts. We ate wild plants. Well into my 20s, I was an outdoorsy-type person, hiking on the Appalachian Trail, walking to all my classes through the leafy green environs of my college campus, even trudging contentedly through the copious snowfall. One year I lived in a log cabin on a hilltop so far from civilization that you had to go to town to pick up your mail.

All the while, I had bipolar disorder, and it was relentless, I experienced the inevitable mood swings, the crashing lows, the tempestuous highs, the confusing mixed states. 

Now, everywhere you turn, there are articles and memes touting how time spent in nature is good for various psychiatric conditions. When you look more closely, though, the studies often refer to simply alleviating bad moods or improving cardiovascular health. Very few of them seem to apply to actual mental illnesses. Perhaps this is to be expected, since improvements in emotions or mental health are largely self-reported or tracked by means of a survey. It’s hard to quantify mental health. But let’s take a look at some of the studies anyway.

Harvard Men’s Health Watch published an article called “Sour Mood Getting You Down? Get Back to Nature.” The subtitle on the piece read, “Research suggests that mood disorders can be lifted by spending more time outdoors.” Then the article went on to suggest that “ecotherapy” shows “a strong connection between time spent in nature and reduced stress, anxiety, and depression.” 

The subtitle suggests that the outdoors has an effect on alleviating mood disorders. The body of the article, though, stresses alleviating unpleasant moods in general, not primarily what psychiatrists would class as mood disorders. The article cited a 2014 study saying that “people who had recently experienced stressful life events like a serious illness, death of a loved one, or unemployment had the greatest mental boost from a group nature outing.” Stressful and sad events, certainly, but not mood disorders such as PTSD, clinical depression, or bipolar disorder.

The article also cites a report published online March 27, 2017, by Scientific Reports, which suggests that “listening to natural sounds caused the listeners’ brain connectivity to reflect an outward-directed focus of attention, a process that occurs during wakeful rest periods like daydreaming. Listening to artificial sounds created an inward-directed focus, which occurs during states of anxiety, post-traumatic stress disorder, and depression.” It does mention psychiatric disorders, but it says only that inward-directed focus occurs during these states, not that inward-directed focus causes them.

Greater Good published an article that claims, among other things, that “scientists are beginning to find evidence that being in nature has a profound impact on our brains and our behavior, helping us to reduce anxiety, brooding, and stress, and increase our attention capacity, creativity, and our ability to connect with other people.” Again, this says nothing about actual psychiatric disorders.

The article also cited a Japanese study: “Results showed that those who walked in forests had significantly lower heart rates and higher heart rate variability (indicating more relaxation and less stress), and reported better moods and less anxiety, than those who walked in urban settings.” The researchers concluded that there’s something about being in nature that had a beneficial effect on stress reduction, above and beyond what exercise alone might have produced.

This, of course, does not apply to those in urban settings who do not have much access to forests or sometimes even parks. And the abstract of the Japanese study says, “Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity.” It doesn’t really deliver what the headline offers: “How nature makes you kinder, happier, more creative.” Good heart health is, of course, a good thing, but to extrapolate that to mental health benefits is quite a stretch.

The UK’s Mind.org does offer a link between ecotherapy and mental health in one instance, at least: “Being outside in natural light can … be helpful if you experience seasonal affective disorder (SAD), a type of depression that affects people during particular seasons or times of year.” This article also acknowledges that there are “other options for treatment and support – different things work for different people….You might do an ecotherapy programme on its own, or alongside other treatments such as talking therapies, arts and creative therapies and/or medication. Some ecotherapy sessions follow a set structure, and incorporate types of talking therapy, such as cognitive behavioural therapy (CBT). People in the group may or may not have experience of mental health problems, but the main focus is usually working together on the shared activity.” This at least sounds both more scientific and more likely to produce results.

If a walk in a natural setting does you good and alleviates your symptoms of mental illness, then by all means, make it part of your routine (or do it as often as you can manage). My bipolar depressions, however, are so debilitating that I am unable to plan, much less embark on, a walk in nature, even as far as the mailbox. Bringing nature indoors is, of course, an alternative. But the little plant pictured here, which needs two ounces of water once a month, is all I can really handle.

Resources

https://www.health.harvard.edu/mind-and-mood/sour-mood-getting-you-down-get-back-to-nature

https://greatergood.berkeley.edu/article/item/how_nature_makes_you_kinder_happier_more_creative

https://www.hindawi.com/journals/ecam/2014/834360/

https://www.mind.org.uk/information-support/tips-for-everyday-living/nature-and-mental-health/how-nature-benefits-mental-health/

A Letter From the Future to Bipolar Me

by sosiukin via adobestock.com

Dear Me:

You’re 13 years old now, and there are a few things you should know.

You have bipolar disorder. No one knows this, not even you. But a lot of people notice that you act “weird” at times. You have decided to embrace your weirdness, which is fine, but what you really need is psychological help. And medication.

Don’t pass up any chance to get that help. Your high school will recommend to your parents that you get counseling. When your parents leave the choice up to you, take it. It will not go on your permanent record, and you will still get into a college. A very good college, in fact.

I know that at times you sit alone and cry. Other times you laugh at things no one else finds funny. This is not just “weirdness.” This is a mood disorder, called bipolar disorder, type 2. Your mood swings will make it difficult for you to make and keep friends. Keep trying. The friends you will find are worth it and will stand by you when you really need them. You will not be alone in dealing with this.

Your choice to go to college out of state will be a good one. There you will have a variety of experiences that will make you grow in unexpected ways. Your mood disorder will go to college with you, though. Leaving Ohio will not mean you will leave bipolar disorder behind. You will still feel the mood swings, and most of them will be depression.

It’s a good idea to take that year off between freshman and sophomore year. I know it will feel scary, but at that point you will be in no shape to carry on with academics. Instead, you will get a job which, while not great, will introduce you to more new people and new ways of life. At least one of those people will stick with you till you are old and gray.

Returning to school will be a good decision. Your parents will support you in that decision. They won’t object to your year off, because they know you will go back. It still won’t be easy, but you will have a core group of friends that accept you, even though you are different from them.

Your bipolar disorder will follow you back to college. It will make you miss some opportunities and choose others that will not be good for your mental health. You will be unhappy most of the time, but you will find that music helps you through it.

Try not to self-harm. I know you will feel numb and want to feel something else, but cutting yourself is a bad decision and will not help. You will carry those scars forever.

When you meet Rex, though, you will be encountering a problem too big for you to handle, and the relationship will leave you scarred as well. It would be best if you were to steer clear of him altogether. But then again, you will find some true friends in his circle, and it would be a shame to miss them. Try your best to hold yourself together, remember what I said about self-harm, and don’t give up on who you are. You are not your disorder, and you will get through this, despite everything.

I know you never gave a thought to marrying, but you will meet a man and in a few years you will marry him. This, I assure you, is a good decision. He will stick by you no matter what and help you find help.

Going into the building that says “South Community Mental Health” will be a good decision. Whatever you will be feeling at this point – most likely misery – it’s not mentally healthy. This will be the place where you will start to climb out of the hole you have found yourself in.

At last, a doctor will tell you that you have bipolar disorder – most often depression, but also anxiety. He will work with you to find a combination of medications that will help you. When that happens, you will become reacquainted with your brain and relearn how to function in the world at large. Your brain will function in a new way, one with fewer out-of-control feelings. You will experience life more fully and be glad of your new outlook.

It won’t be quick, and it won’t be easy, but you will have therapists, and friends, and work, and love, all of which will help see you through. You will have bipolar disorder all your life, but it will not be your life, though it seems that way now.

Reach out for help whenever and wherever you find it. Cherish your friends. Keep trying, even when you want to give up. Better times are on the way.

I promise.

Love, me (older and maybe wiser)

Psychological Tactics of Abusers, Gaslighters, and Cults

Image by Vadim Gushva via adobestock.com

Once upon a time, I lived with a man who, I later realized, was a gaslighter. (This was in the time before gaslighting became trendy and well-known.) For a while after I left, I had no notion that I had any harsh feelings towards him. It was only later, after I had been away for a while, that I realized what my buried feelings were and what damage he had done. The experience was responsible for parts of who I am today, including my strength and resilience.

For a time, though, right after my deeper feelings began surfacing, I realized that I had been psychologically controlled. I began to read up on the phenomenon. Some of the subjects I devoured were accounts of and theory of domestic physical and psychological abuse, mind control, and cults. They fascinated me – how the human mind and spirit could be so affected by another person or persons that they acted in irrational ways, defended their abusers, changed their personalities, and gave up their lives, either figuratively or literally. I don’t mean to compare my experience to the suffering that the people I read about have gone through, or to the suffering that still exists. All that I knew was that I had been manipulated, and was desperate to find out how, if not why.

I started with the easiest subject to find information about – domestic abuse. I will say that my gaslighter never harmed me physically and only once said something that could be taken as a violent thought towards me. But I learned, particularly, about intermittent reinforcement. This happens when the abuser switches between telling the victim that he loves her and she is wonderful, and that she is stupid or ugly or otherwise worthy of abuse. These mixed signals keep the victim coming back, on the theory that sometimes the person is so nice and loving. “It must be that I make him mad without meaning to,” she thinks.  Thus, she is hooked and less likely to leave.

My gaslighter also used intermittent reinforcement and mixed signals to keep me hooked. I stayed much longer than was good for my mental health.

Learning about mind control – “brainwashing,” kidnapping, and so forth, gave me little insight into my own situation, except that some of the principles were to isolate the person being controlled, to control the environment such as when the person slept or ate, and to be that person’s only source of information or reality. I had been relatively isolated physically, had little control over schedules, and, while TV news was available, it was always filtered through the gaslighter’s sensibilities and opinions. Again, I am not comparing my suffering to that of other people. I don’t believe, really, that suffering can or should be compared.

Learning about cults took me even farther from my own experience, but I was fascinated by it nonetheless. I soaked up information about Jim Jones and Jonestown, Heaven’s Gate, Scientology, and others. Especially interesting to me were stories of people who had escaped from cults. (One of my Facebook friends escaped from a religious cult, which took advantage of her PTSD and bipolar disorder to ensnare her. She supports others who have been victimized by cults and spreads information on cults and the tactics they use.) All I can say is that leaders of cults are usually charismatic, often reject societal sexual norms, and mentally coerce their followers to isolate from family and to finance the cult leader’s lifestyle.

Gaslighting, which I have written about many times (https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-C2, https://wp.me/p4e9Hv-Ir, https://wp.me/p4e9Hv-Cu) most resembles domestic abuse, though usually without the physical violence. It uses the tactics of intermittent reinforcement, isolation, verbal abuse, cults, and mixed signals to convince the victim that her perceptions of reality are invalid – in extreme cases, that she is going insane.

All of these forms of abuse do harm to their victims, in varying degrees. I was lucky to be able to leave my gaslighter when and how I did, and I will forever be grateful to the people who have helped me heal from the experience.

If you are in any of these situations – domestic violence, emotional abuse such as gaslighting, or being victimized by a cult, the best advice is: Get out now. Leave while you still can, before something worse happens. And get help, both from your friends and family, if possible, and from a professional counselor who has experience with these issues. It could save your happiness, your sanity, or even your life.

 

Resources

https://www.goodreads.com/list/show/72664.Nonfiction_resources_on_abuse_and_domestic_violence

National Domestic Abuse Hotline https://www.thehotline.org/

https://nymag.com/strategist/article/best-books-on-cults-reviewed-by-experts.html

https://www.women.com/sophiematthews/lists/books-on-gaslighting-101718

Yes, It Was That Bad

By patpitchaya/adobestock.com

There’s a tendency, once you’ve started to heal from the wounds that mental illness has left you with, to forget how bad it really was at the time. It’s not that time heals all wounds. It’s just that the memories fade as they flow backward into the past. You find yourself asking, was I really that miserable? That irrational? That out of control? Once therapy and medication – or whatever works for you – have gotten you past the crisis stage, it gets harder to remember what it all felt like at the time.

Nor do we want to. Going through an episode of serious mental illness is hard enough when you do it once. Reliving it is devoutly to be avoided, if possible.

Still, the memories get a little fuzzy around the edges. Now that you are mentally healthier, you know that you would never tolerate the kind of treatment you used to, or be so self-destructive, or put yourself down so thoroughly. The times when you did those things, when you felt those ways, seem in some sense unreal.

I think that’s one reason that some people go off their meds. It’s not just that they feel better or think that they’re cured. It’s that on some level they can’t remember how bad it really was back then. So why should they need psychotropics?

Well, I’m here to tell you that, yes, it’s much better now, but yes, it was that bad back then. You may not remember the weeping and wailing and total despair. You may not remember that you were immobilized for months at a time. You may not recollect pushing away people that were trying to help you. But all that happened.

Perhaps you don’t recall what it was that led you to consider self-harm or suicide. You wouldn’t think that way now, of course – you’re so much more stable. Perhaps you think to yourself that an abusive partner wasn’t really all that bad. After all, you got away from him/her/them. It was survivable, so it must have been not that big a deal.

But it was that big a deal. Denying the experiences you’ve had and minimizing their effects on you make it harder to see the long way you’ve come. It’s hard for me to remember now the major bipolar depressive episode that lasted for literally years, when I wasn’t able to work, or write, or read, or be there for my husband or even myself. But it happened, and I can’t deny it. I’d be lying to myself if I tried.

I’m not recommending that you wallow in the memories of the horrible times. I’d rather think about it as keeping little bits of them in a box on a shelf. Every now and then, on a day when you feel particularly strong, you open the lid and peek in. It may be shocking to realize how bad off you were, but a positive relief when you consider how far you’ve come. As the saying goes, the bad times make the good seem so much better.

Bad and good, your experiences have made you what you are today. Denying or minimizing the bad makes it seem like your journey was less long and hard than you know it was. In a way, mental illness is the yardstick by which we can measure mental health. Moving onward and upward are important, but so is being realistic about the past. Yes, it was that bad.  And yes, you made it through anyway!

The Demise of a Bipolar Support Group

By Artur / adobestock.com

Funny, but I thought support groups were supposed to be supportive. Recently, though, I ran into one that was anything but.

I won’t name the group, since some people may still get something out of it, but as far as I could see, it was a group of over 5,000 people out of control. Many posts were off-topic, sexually-oriented, political, and even abusive. Of course, many people never contributed at all, so I don’t know whether they approved, ignored, or simply watched from the sidelines.

I have my own opinions about bipolar support groups – they should be focused on bipolar disorder, its symptoms, treatments, and lifestyles. Within that large umbrella, there are lots of topics to be covered.

To me, it is legitimate to have “getting to know you” posts – Where are you from? What is your favorite comfort food? What kind of music do you like? Such posts and responses enable people to reach out and make connections, to realize that there are people in the world who experience life in the same way that they do – or in different, equally valid ways.

Similarly, it is understandable that people post about their symptoms – Do you ever wake up angry? Do you often get hypersexuality as a symptom? What do you do about it? Is there anything that alleviates your feelings of being alone? These posts encourage people to share commonalities and suggest ways to deal with them.

I can even see some good in comparing medications, though I don’t much like them. Has anyone tried Vraylar? Do you have much weight gain with Abilify? As far as I can see, the only answers to such questions are: Ask your physician or pharmacist. Medications affect everyone differently. Yes, I have, but your mileage may vary. The only truly useful things I can think of to say are: Don’t stop taking your medication without a doctor’s help, and If you get a rash, especially around your mouth and nose, see your doctor immediately. But if it gives comfort to know that someone else has the same reactions you do, that may indeed be helpful.

What this particular support group got into, however, was way off-topic remarks, sexual solicitations, stalker-like behavior, politics, name-calling, and general nastiness. It seemed like some of the participants went out of their way to be offensive. One poster asked, “Do you know what ‘tea-bagging’ is?” A few others got into a, shall we say, heated discussion about Black Lives Matter and Blue Lives Matter that involved calling each other not just racist, but “cunt” and “fucking POS.” Yet another complained about the cursing appearing in such posts and was met with a long list of responses, all of which said, “Fuck you.”

Part of the problem seemed to be inexperienced or overwhelmed moderators. They did not take down the most offensive posts. They did not try to steer the discussion in productive directions. Admittedly, moderating a support group is not an easy thing to do, and dealing with a group that experiences symptoms such as anger, despair, hypersexuality, sensitivity, and irrational thinking, as well as the normal responses of outrage, insult, offense, anger, retribution, and hurt, is that much more complicated.

Perhaps the majority of the 5,000 group members don’t mind such interactions, but there were more than a few who did, and said so. Some quit the group or went off to start their own. Others decided to stay around for a while to see if things got better.

I am torn. I hate the group the way some members are currently behaving. I hope that more administrators/moderators can get the group back on track to something that is truly a support group. But my time, attention, and patience are limited. Unless I see some changes – and soon – I’m outa there. I may not be missed, but neither will I miss them.

When My Carer Needs Care

By Farknot Architect / adobestock.com

My husband is the mainstay of my support system and, in large part, my caregiver. I cannot count the things he has done for me and does for me every day. We’ve been married for over 35 years and during that time he has helped me through daily life, major depression, anxiety attacks, loneliness, irrational thoughts, school, therapy. He makes sure I practice self-care and cares for me as needed.

Recently, though, he needed my help and care. The other day he experienced distressing eye-related symptoms – a large “floater” (dark spot) in his vision and unexpected flashes of light. What could I do about it? First, I answered his request to get a flashlight and look in his eye, but I saw nothing.

Next I arranged an appointment for him at our eye doctor. Dan used to be terrible at admitting when he needed medical treatment, but since a heart scare he’s been much more amenable to seeing a doctor. That particular evening, he was scared and cranky, and made up excuses. He left his phone in the car. That’s okay. I had mine right there. He didn’t know the number. That’s okay. I have it programmed into my phone. I waited on hold. “Forget it,” he said. “Never mind,” I replied. “I’ve got nothing else to do.” He said he didn’t see the floater any more. I pointed out that his eyes were closed. I got through to the doctor and made him an appointment for the next day.

Naturally, I drove him to the appointment, as they would have to dilate his eyes. Then, afterward, I drove him on several other errands (including an appointment with a different doctor) and made sure he ate lunch. I canceled one of the errands and put off others when I saw how tired and nervous he was getting. I took him home and tucked him in bed. (The floater turned out to be nothing truly alarming, just an effect of his aging eyes. He named it “Freddie the Free-Floater.”)

Dan has done almost exactly the same for me, many times. I could usually make my own appointments, but he encouraged me to do so. He has driven me to appointments countless times. He makes sure I eat. When I run out of spoons, he cancels or postpones errands, or even runs them for me. He reminds me when I need to have a lie-down or to sleep or to shower.

It was unusual for me to be the caregiver in this situation, and at times difficult, but I didn’t begrudge it. How could I possibly?

Of course, later in the day, I had a crisis and a mini-meltdown of my own, and there was Dan, ready to be with me, talk me through it, and make sure I didn’t skip a meal.

I know this is what marriage is supposed to be – partners helping each other through their individual and mutual times of difficulty. I also know that mental illness can put a terrible strain on a relationship. I admit that I am very needy at times, and was even more so at other times in my life.

But this time I got to be the strong one and take care of his needs before my own. And I was pleased and proud to be able to do that. Often there’s little enough that I can do for him, except offer him encouragement and remind him that I love him and appreciate him and all he does for me. If he asks for something he needs, I try to make sure he gets it (except for the $900 woodchipper, I mean). And I do what I can that benefits both of us – working to bring in money, paying the bills, doing computer research, handling phone calls, reminding him of appointments when I can – mostly stuff that involves computers and phones and recordkeeping and occasionally knowing where missing stuff is. And reassuring him when he gets trapped in the depression that he also suffers from that I love him and that he is strong and good and that he needs to take care of himself, and that if he can’t, I will try and do my best.

My Hypothetical Baby

By pololia / adobestock.com

Having bipolar disorder was one of the reasons I decided not to have children. Really, it was having major depression, which was what I was diagnosed with at the time.

I wasn’t so much concerned with passing my condition on to any potential offspring, since, at the time when I was contemplating motherhood, the genetic links were not yet that firmly established. Now that I know more about it, I think that might have been another deterrent. My parents had no idea what to do with me when bipolar symptoms started happening, and there’s no guarantee that I would have done any better. I’d like to think I would, but there’s no telling, really.

No, what I feared was having to go off my medication while pregnant (and breastfeeding, should it come to that). I was terrified of being unmedicated and I knew that psychotropic drugs were not good for pregnant women or their developing babies. Once I had discovered the benefits of Prozac and other mood-regulating meds, I knew I never wanted to be without them again. I never wanted to again fall into the pit that I had clawed my way out of. (In truth, that pit was waiting for me anyway, when I experienced a major depressive episode many years later.) 

Postpartum depression scared me too. I had heard the horror stories of women killing their children and/or themselves while suffering from the illness. I knew how out of control I could get with just plain ol’ garden-variety depression and anxiety. Adding postpartum hormones to the mix could be a really bad thing.

But the main reason that I decided my bipolar disorder made it unwise to have a child was that it would be unfair to the child. How to explain to a toddler that mama couldn’t get out of bed today or that she burst into tears for no apparent reason? How to explain weeks or months like that? How to deal with a child jazzed up on mama’s sudden hypomanic jag, who would then be let down when she crashed? How to soothe a child’s anxieties when mine were making me jump out of my skin? How to take care of a child’s essential needs, when I suck at taking care of my own?

Is that selfish? I know there are people who would say it is. That when the time came, I would suck it up and do the best I could. And I might. But would that “best I could” be good enough? I’ve heard it phrased that I was too involved with giving birth to myself – a relatively stable, reasonably happy, mostly functioning self – to give birth to someone else. And I think there’s some truth in that. It’s been a struggle, filled with despair, misery, hard work, setbacks, immobilization, dangerous thoughts, and living too much in my own head. To do the work of bringing myself to some baseline of functioning while trying to nurture and bring up another person daunts me.

I do understand that there are women with bipolar disorder and even postpartum depression who have children and that those children can be happy, healthy, and as well-adjusted as any modern child ever is. I don’t know how they do it, though. I was fortunate that I had a choice of whether or not to have children. I know that not all women do, and that many are delighted with their choice – whichever way they decide. I know that there are those who desperately want children and are unable to have them. I was fortunate that my husband didn’t push the issue, despite the fact that he would have welcomed a child.

I also had irrational thoughts about that potential child. I imagined that if the child were a boy (which run in my husband’s family), Dan (whose inner child is, shall we say, close to the surface) and the little boy would be natural allies and I the odd one out. He would be the fun dad and I the not-fun mama. And while that’s somewhat irrational, it also might be partly true. It took a long time for me to learn how to relax and have fun and share it with another person.

The one time I was open to having a child was when my father was dying a slow death. I thought that if he was going to see his grandchild, I’d better produce one promptly. Fortunately, it didn’t happen. I later realized that that was a really poor reason to bring a new life into the world.

What I’m saying is that the decision is not – was not – an easy one. Having a mental disorder makes it even more difficult.

 

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