Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

In Remission

My bipolar disorder is in remission. I know I’m not cured. There is currently no cure for bipolar. But I’ve reached a point where I’m stable enough that I don’t expect a crash or a buzz to descend on me at just any old time.

I still get moods, of course. They’re just not severe or long-lasting enough to be symptomatic. Yesterday, for example, I spent several hours wrestling with phone trees and people who wouldn’t switch me to a supervisor when all I was trying to do was straighten out a couple of bills that contained errors. Afterwards, I felt frustrated, cranky, and a bit sad. But those were normal emotions, based on what I had just gone through. After a nap I felt better, and dinner blew out the remaining cobwebs. Napping is definitely better than staying in bed the entire next day.

Of course, I didn’t achieve remission alone. It took years of doctor visits, therapy, and medications to reach this state. I am particularly grateful for mood levelers. For me, they actually do what they’re intended to do. They keep my moods within an acceptable range, or at least one that’s acceptable to me.

Too many people fear mood levelers, I think. Level moods sound boring – as though there are no variations, just a blank, straight line. That simply isn’t so. Mood levelers have pushed the spikes that used to go wild in either direction to a less extreme range. If you think of mood as an EEG, mood levelers prevent the lines from going off the charts, settling them to fluctuate within a middle range that most non-bipolar people have naturally.

I think the term “mood leveler” scares some people. They seem to think that such a drug would make them perfectly level, robotic, unchanging. They fear that any spark of personality or creativity would be lost.

That’s not the case. Instead, with level moods – and especially for depression-prone bipolars – a person has much more ability to explore his or her creative side.  I know that’s true for me. Now that my moods are stable and level, I’m able to get more writing done, but also to tell whether the work is good or needs serious revising before I post it.

My doctor recently increased the dosage of one of my medications, a mood leveler, because I was having trouble with hypomania that wouldn’t let me sleep. And it worked. I am now getting seven to eight hours of sleep each night and have enough energy to at least face the day, if not always to conquer it.

Don’t think mine has been a case of spontaneous remission. I’m not sure I believe that’s possible with bipolar disorder. It’s taken a lot of years and a lot of work to get to where I am today. For example, it took literally years for assorted doctors and me to find a combination of chemicals, a cocktail of psychotropics, that would work for me. And during all that time, it was as if I was not medicated at all. Only the right combo of drugs and dosages would unlock my brain and level my moods.

So, here I am, in remission – and I love it. My moods aren’t blunted, they’re leveled. I am not as fearful now that my extreme moods may return and wreak havoc on my life. Oh, I still have some symptoms and side effects that remind me I’m not cured. But now I know that remission is possible, with work, with luck, and with the right mood levelers.

Nothing to See Here

Many people with SMI are afraid that it shows, that other people can see automatically that there is something wrong with them. They feel as though they stand out in a crowd. Everyone notices them, and probably talks about them.

I have the opposite problem. My bipolar depression makes me feel invisible. It’s not just that SMI is often an invisible illness. It’s that I myself seem to become invisible. I think of myself as a particularly ineffectual ghost, frightening no one and unable to affect anything in my environment. Some people call this dissociation.

At first, I made the best of it. I’m especially invisible when I’m out in public and reading a book. So I found that if I was at a business convention and wanted to remain invisible, my best strategy was to sit alone at a table and read a book. Only once did a man approach me while I was so engaged. No one else ever did.

Apparently, though, I don’t need a book to disappear. Maybe it’s anxiety that makes me keep quiet when people around me are discussing something interesting. Maybe it’s my instinct not to be noticed so I won’t be subject to derision or worse. Either way, I can’t seem to catch anyone’s eye or add my bit to the conversation. I blend into the crowd, even if it’s only a crowd of three or four.

It’s almost like there’s some aura around me when I’m out in public that says, “Don’t notice me,” like Harry Potter’s cloak of invisibility. I do not use my invisibility for pranks or mischief, though. I don’t use it intentionally at all (except for using a book, as I mentioned).

Why do I think this invisibility is part and parcel of my bipolar disorder? It could be imposter syndrome at work. I feel so unworthy that I don’t want anyone to see me for what I am. Or it might be the anxiety component of my hypomania that keeps me from presenting myself more assertively. Or maybe people can see that I have a troubled mind and simply look away.

I am slowly learning to make myself seen and heard. I find that calling people by name makes it easier for them to see me. It seems to signal them that there’s another person in the vicinity. And once I even set up an occasion where I would be the center of attention, speaking about my bipolar disorder at a signing for my book.

I also use my writing to make myself “visible.” This blog (and my other one) and my books give me a presence, though not a physical one, even at a distance. When I see likes and follows and sales, I know that someone has noticed me, or at least discovered that I exist.

I sometimes think that going out in public more – practicing being visible – might help. But actually, that’s when I feel the most overlooked, the most unseen and unheard. The most lost.

Perhaps what I need is to go out and meet a specific person, someone who expects to see me. Then I could be guaranteed of one person who would see me.

But it has been suggested to me that I may not want to be seen at all – that I would prefer to fade into the background, not put myself forward and disappear from the stresses of being seen. Perhaps that is true, or at least once was.

Now I think I would prefer to be seen, flaws and all. If someone cannot tolerate the sight of me, a mentally disordered person, or glances over me as if I did not exist, I think I shall insist on being seen. I will use my voice, my (admittedly glitchy) brain, and my human physicality to assert that I exist, that I matter, that I have something to say.

And in social situations I will try to assert myself (if politely) to join the public discourse and add my two cents, whether the subject is mental illness or the latest bestseller.

I exist. I deserve to be seen. I will not remain invisible.

Growing May Take a While

I saw a meme the other day that said, “Grow through what you go through.” I thought to myself, “This is going to take a while.”

Now, I’m not saying that the meme promotes a bad idea. I just mean that it’s not as easy as the meme makes it sound. Memes are like that. They encapsulate a difficult and painful process into a succinct platitude that never captures the reality of what it purports to express.

It is certainly possible to grow because of bad experiences that you have gone through, and I have surely done this. But it hasn’t been quick or easy. Not that it is for anyone, but especially not for people with serious mental illnesses.

Bipolar disorder, and bipolar depression in particular, often leads one to recall and obsess about the very things one would most like to forget. (Of course, this happens with unipolar depression, too.) It’s like having a recorder in your head that replays the most painful, embarrassing, humiliating, or devastating events in your life. And there is no “off” button or even a “pause.”

Getting through something is not the same as getting over something. And growing through something is something else again. It takes as long as it takes. There is no way to rush it or to speed it up.

Take grief, to choose an example that most people with and without mental disorders are familiar with. I saw a TV show once in which various characters were concerned that the hero had not “gotten over” the death of a friend as quickly as they thought he should. I remember thinking, “That’s stupid. There’s no arbitrary limit on how long a person should grieve.” I know that in days past, a mourning period of a year was customary, with restrictions on dress and activities. That’s stupid too. It may take a few months or a year or the rest of your life, depending on how close you were to the deceased and the circumstances of her or his death.

Deaths don’t have to be physical, either. The death of a relationship can be just as soul-searing, as traumatic, as a literal death. It’s still a loss and one that you may have put your whole heart and soul into.

Of course, it’s great if you can grow through the experience. It’s possible to acquire a new depth of spirit when you go through something traumatic. You can emerge stronger and more resilient and more compassionate because of the experience. I think that’s what the meme was talking about.

But if the trauma – the death or separation or other experience – is fraught with pain as well as grief, then growing through it can be even harder and take even longer. A son whose abusive mother dies has feelings that can hardly be expressed, a jumble of emotions that’s almost impossible to articulate, much less grow through. The end of a relationship with a gaslighter may evoke relief as well as grief, conflicting emotions that can impede growth. These and other situations can call up memories and feelings that one wants to escape, not dwell on. But processing them seems perhaps the only way of growing through them.

That process cannot be rushed. It may take years of bad dreams and flashbacks – at least it did for me – as well, perhaps, as a period of therapy that, like grief, takes as long as it takes to make progress in growing through whatever happened. From outside the situation, it may seem like the person is wallowing in the pain or grief. But on the inside, the process of growing may be occurring at a rate that you can’t see or understand.

In other words, if a person has been through a trauma, don’t expect him or her to “get over it” on what you think is a proper timescale. Some plants, like dandelions, grow incredibly rapidly. Others, like oaks, grow incredibly slowly. For each, it takes as long as it takes.

 

When Self-Care Seems Impossible

It seems the days when I most need self-care are also the days when I’m least able to accomplish it. I mean, when I can’t even get out of bed, I’m not likely to have the wherewithal to perform any kind of self-care regimen.

I’m not talking here about the take-yourself-to-the-spa type of self-care, either. That’s beyond my means and my capacity. What I’m thinking about are the most basic needs that must be met – meds, food, sleep, and the like. But there are sometimes things that prevent me from accomplishing even these.

Part of the reason, of course, has to do with lack of spoons. It takes energy to shower and dress, make a meal, go to appointments, and all the other tasks that should actually make me feel better. According to Spoon Theory, we wake up with an unknown amount of spoons every day and must choose how to spend them. Some days I wake up with only a few or even zero.

The other obstacle I’ve noticed that inhibits my self-care is my occasional inability to plan. Yes, I can make sure I eat at least one meal a day, but on some days only if I have gone to the grocery store earlier in the week and bought at least a box of Cocoa Puffs and some bottled water to keep by my bed. Not much of a meal, I know. It’s the bare minimum I can do, but sometimes all I can manage.

Taking my meds is the only part of self-care that is an essential that I don’t do without. I usually have that bottle of water right next to my bottles of pills, but even if I don’t, back in college I learned to swallow pills with only spit. But again, this takes a little planning – calling in prescriptions and getting to the pharmacy to pick them up.

On days when I have slightly more spoons, I have to plan and prepare for the days when I don’t have enough for proper self-care. Even the planning and preparing use up spoons.

But there are also days when I can manage a little self-care. On those days, if the spoons are low, but not completely nonexistent, I take shortcuts. I wash up in the sink instead of showering. I put a piece of salami between two pieces of bread and call it a meal. I put on clean pajamas and underwear instead of getting all the way dressed. I use mouthwash instead of brushing my teeth. I pet the cat instead of calling friends.

And I call it good enough.

Admittedly, those are some low standards for self-care. It would be nice if I could do more – and on some days I can. But on many days, the obstacles seem overwhelming. Inertia takes over and entropy sets in. I know it’s not good for me and can slow my recovery from spoon deficit spending, but that’s just the way depression is sometimes. It sucks you down into a hole that’s hard to climb out of when it’s at its worst.

But, thanks to the aforementioned meds and the minimal self-care I’m able to do, I know that one day I’ll be out of the hole and able to work on some proper self-care. Even plan for the next time that self-care seems impossible.

My Emotional Support Animals

As I mentioned last week, my home was destroyed in the Memorial Day tornadoes. Although I was upstairs in bed when it hit and blew the roof off, I emerged physically without a scratch. The emotional effects have not begun to hit me yet, except for a feeling of numbness. Part of what’s keeping me together is my emotional support animals.

The first and most important is my husband. He earned this title when I had to go to the dentist a few years ago (which terrifies me). “Can I bring my emotional support animal?” I asked, gesturing toward Dan. It was meant as a joke, to lighten the mood, but he indeed came into the procedure room with me, sat in a chair in the corner, and placed his hand on my ankle, the only part of me he could reach. And it really did help, that physical contact that helped keep me grounded, and a sympathetic pat from time to time. 

He was much more than that to me this time around. Dan was at work when the tornado hit. I called him and told him the roof was gone. “I’ll be there,” he said. Although his work is only about three or four miles away, it took him an hour to reach me. He drove into our plat until he couldn’t drive anymore, blocked by downed power lines. Then he set off on foot.

It was midnight dark and all the landmarks were gone, as the many trees had fallen or been blown away. It took him an hour to navigate that last half mile. He crawled over huge tree trunks. He fell backward into a creek. He clawed his way up a muddy bank. He lost track of where he was in relation to the house. He had no flashlight. 

But he got to me and we huddled together amongst the dust, dirt, and insulation until the rescue people came. He looked after me at the shelter, made sure I ate and got a shower, and generally acted as my interface with the Red Cross and church volunteers until we left there for a hotel, where we stayed for almost a week.

Meanwhile, back at the house, our cats remained. Every day we had to go to the shell of our home, give Toby and Dushenka food and water, and make sure they were still okay. We couldn’t get them out of the house for days because there was no way to carry them through the obstacle course of trees, branches, utility cables, roofing, boards, and other debris.

Days later a path to the house was cleared and we were able to rescue them. The motel where we were living did not allow pets, but our vet agreed to board them as long as necessary and our insurance agreed to pay for it. They were treated for the difficulties they suffered from having tried to clean their fur when it was matted with insulation. We were their emotional support animals, visiting them and loving them, and playing with them, and making sure they got good care. They needed us and caring for them gave us something to focus on besides ourselves and the devastation in our lives.

Finally, we were moved to a hotel that was pet-friendly and our little family was reunited. It really is an emotional comfort to have our cats with us again, sleeping on the bed with us, exploring the room, and returning that little bit of peace and normality to us. It’s now less of just a hotel room and more of a temporary home.

In a way, taking care of the cats has provided emotional support for us as well. When we need comfort, there is someone there to respond with affection and trust. When we are lonely, there is another being there to pet and cuddle. When we get short-tempered, we can find solace and distraction in their purring.

Our cats aren’t trained service animals, of course. But they give us emotional support just the same, especially when our ability to support each other wears thin. We and our animals have been emotional supports for each other and helped us bear up under these difficult times so that we can be the emotional support animals when needed, too.

 

Coping With Disaster

On Memorial Day, our house was hit by a tornado. I was trapped upstairs in the bedroom before my husband made it home and rescuers came to get us out. The Red Cross and the First Baptist Church took us in until we could arrange lodging at a motel, thanks to our dear friends Robbin and Stuart.

I am still quite numb from the whole ordeal, but none of us was physically injured. When the shock wears off and reality sets in, I imagine I will allow myself to freak out and let out my fears and other emotions however they choose to come out. Until then I am coping, with the help of my husband and many friends and neighbors.

I am learning new things about the meaning of self-care during the middle of a disaster.

When the fire/police/paramedics came to get us in the mandatory evacuation, they yelled, “Grab your medications and get out now!” Then they helped us through the rubble. Having those medications with us was essential. If I didn’t have my psychotropics, I would have undoubtedly fallen apart before now.

As Mr. Rogers advised, look for the helpers. They are everywhere. Don’t be ashamed to accept help or to ask for what you need.

My self-care routine has become very basic. A place to sleep, a hot meal, and clean underwear now seem to me to be the essentials of life.

Helping each other is evident throughout the area, but has never been more important to my husband and me. We remind each other to take our meds, to eat, to rest. We try very hard to understand that the other one is experiencing a flood of unfamiliar feelings too and we need to take care of each other emotionally – being accepting of what each of us thinks is important, shouldering more of the load when it all gets too overwhelming, thanking each other for small kindnesses.

We also have to be careful not to try to do too much in any one day. There are, of course, a million things that need doing, but we have found our limits. In the morning we make a plan. What absolutely has to be done today? Which of us is capable of doing it? What can we do together. My husband has done a lot of the heavy lifting of heavy lifting, while I have become the communications person. dealing with insurance, utilities, housing, and anything else that can be handled by phone or computer. Three activities in a day seems to be our limit, whether it’s visiting the laundromat, trying to get valuables undercover, or making arrangements for the next hotel we move to.

Perhaps next week in this blog I can tell you more about the psychological effects of this traumatic experience. They have barely begun to hit yet. Until then, though, we are safe and uninjured, our cats are safe and cared for, and we are muddling through the muck and the mess that surrounds us, inside and out.

Anxiety Says No, but Mental Health Says, “Do It!”

It’s tough enough for someone with bipolar or depression or anxiety to go outside, where it’s all people-y. It’s another level of achievement when such a person deliberately puts herself or himself out into the public eye.

But that’s just what I did this week. My publisher arranged for me to do a reading and signing of my book at a local branch of a national bookstore. And I agreed to do it. Thursday night was my debut.

Let me go back a few steps. I do have some experience speaking in public, so it wasn’t going to be a completely novel experience. Those occasions were, shall we say, a bit distant in time, mostly before my bipolar disorder reached its heights (or depths). In high school, I did debate and extemporaneous speaking. In grad school, I taught introductory English classes. During my somewhat-less-than-successful business years, I once addressed a power breakfast meeting. I even opened with a joke.

I was prepared to open with a joke (or at least a witticism) this time, too. But my plans soon flew out the window.

I had prepared – or over-prepared, probably – somewhat obsessively. I spent spoons like they were disposable plastic. I picked out an outfit and a back-up outfit, including earrings and back-up earrings. I did my hair. I agonized over which pieces from my book to read, then printed them out in huge type so I wouldn’t have to squint at them. I took an anti-anxiety pill and Immodium, just in case. I was fortunate that Thursday was my day off and also my husband’s, so he could be present as my emotional support animal, wearing one of my book t-shirts.

My expectations, such as they were, took a nose-dive when only two people showed up – both friends of mine, one of whom had already bought my book. It was time to rearrange my plans on the spot, not really one of my strong suits. Why had I knocked myself out making plans if the universe wasn’t going to cooperate with them? I had thought that at least half a dozen people would turn up. I was trying to keep my expectations reasonable, after all.

I’ll admit that when I saw such a small audience, I felt a wave of despair. In actuality, it proved good that they were both friends of mine, because they were a receptive audience who wished me well.

Given the meager audience, though, I abandoned my introduction (though I worked my joke in later). These people already knew me. I gave a brief synopsis of “What is bipolar disorder?” and plunged into my readings.

I had tried out one of my readings previously, when I was on a podcast for indie authors. Of course, I had no eye contact with my audience then and no real idea how my performance went over. On Thursday, I explained Spoon Theory, as it came up in one of the pieces I was to read. I had chosen two of my more light-hearted pieces, though on serious topics (psychotropics and side effects, and cognitive dissonance). Then I finished with a reading of a piece on why I write about bipolar disorder and why I put myself out there to the extent that I do in this blog and my book, and indeed my public appearance.

The big surprise of the evening came when I invited a Q&A session. My husband fed me questions to get things started and my friends also had queries. What I hadn’t been expecting, however, was that a few people in the bookstore cafe where this all occurred got sucked into the discussion and had questions of their own, though they had no idea that the event was scheduled at all. One worked at a local university and had heard his students talking about having bipolar disorder. Another was a woman studying psychology in order to become a counselor. I didn’t always have the answers, and I’m sure I bobbled some of the explanations, but I did my best to come up with reasonable answers about treatments and medications, self-care, and so on.

Then came the signing portion of the evening. I signed a book for one of my friends and the counselor-in-training asked me to sign her notebook with any little inspirational words I might have. (I winged it. I was tired by then and am not usually inclined to be inspirational.)

Then my husband and one of my friends and I went out for milkshakes, which I highly recommend as a way to decompress after such a fraught experience.

All things considered, I’m glad I took the risk and gave it the old college try, as it were. If nothing else, it was good practice for the next time I speak in public, perhaps when my second book comes out.

The reason that I write about bipolar disorder and my experiences with it is that I want to share what I’ve learned and lived. I think I did that Thursday, even if not to the extent that I had hoped. I don’t regret the anxiety and the preparation that went into it and, all things considered, count it as a win. When I think about the melt-downs I could have had – before, during, and after – I feel pride that I kept my depression and anxiety at bay for long enough to share information about bipolar and healing and mental health.

I think it was worth putting myself out there.

 

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