Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

Managing My Anger

Many people need to control their anger by learning not to let it out. They can take anger management courses.

My anger problem is keeping it all in. I never know when it’s safe to let some of it out. And I don’t think they have courses for that.

Why do I need to let my anger out? Wouldn’t I be happier and life be easier if I were pleasant and agreeable all the time?

No. There are reasons I need my anger, and need to express it.A LOADING Illustration with Black Background - Anger

I need to vent. I was at the office once and a coworker had done some crazy thing or other. I went to my boss and spouted off. Wisely, he just tsk-tsked about it and didn’t try to fix anything. He knew that it was just a frustrating situation and I needed to express my feelings.

Stuffing your feelings is unhealthy. It’s especially bad if you push the feelings of anger down and then try to smother them with food or alcohol. A character on Dharma and Greg once said, “If you’re going to bottle up your feelings, you might as well pickle them first.” Taking advice from sitcoms is usually not the best idea.

Swallowed feelings don’t go away. They stay inside you and fester. Sooner or later you may explode and cause real damage – the kind you can’t fix. Better to let off a little anger at times than to save it all for later.

Sometimes, anger is justified. Anger at injustice or when you’ve been wronged is appropriate. If you don’t express it, the injustice or wrongful behavior will simply continue.

Having bipolar disorder makes dealing with my feelings of anger even trickier. I’ve spent too many years not recognizing that I even have anger and that it’s sometimes an appropriate feeling. That leads to being a doormat, which I also have years of experience with.

Dealing with my bipolar issues has meant dealing with anger as well. Here are a few things I’ve learned.

There are people I can vent to. One of them is my therapist; some of my male and female friends provide good outlets too. These are not people I am angry at, at least not at the time I vent. As with my former boss, I just need someone to hear and acknowledge my feelings of anger. I have separate categories – a friend to discuss my husband with, another one for work issues, and so forth – so no one has to listen to too much of my anger spillover.

I need to pick my battles. Living with anyone causes friction, which can lead to anger. Just this week I was mad at my husband. I wanted to shout at him, “If you had done your errands yesterday instead of watching movies, you wouldn’t be jammed up today and laying them off on me!” But really, how would that have helped? Could he go back to yesterday and do the errands himself? Would it have helped to refuse to do the errands and then sulked all day? Was there any real reason I couldn’t help out? Best to let this one go.

I have to measure my words. Perhaps I do this too much, but some amount is necessary. What was helpful this week was to say to my husband (after I had run the errands), “I need to tell you that I’m frustrated that you left all these errands until today and I had to take over some of them. There were other things I needed to be doing today.” (My things could be postponed; his couldn’t.) By that time I had cooled off enough that “frustrated” was more accurate than “angry,” and less likely to trigger a major shouting match. (Also notice the “I” statements that psychologists recommend.)

If I am angry and I do express it, it’s survivable. My husband and I have gotten through some very bad spells when both of us have been extremely angry. Some of them have required couples therapy, while others have been solved through time and negotiation. Other parts of my life have not turned out as well. I had to cut ties with a toxic relative for whom I had an unhealthy level of anger, with no hope of either of us changing.But I survived – and was the better for it, mentally and emotionally. Sometimes that’s necessary, for either your own or the other person’s mental health and safety.

It helps to have a good emotional vocabulary. Seriously. I don’t have to jump straight to anger when something upsets me. Maybe I really am just frustrated. Or disturbed. Or annoyed. Inconvenienced. Irritated. Miffed. Insulted. Disappointed. Cranky. Those feelings are easy to mistake for anger. It may be better for me to step back and ask, “Do I really feel angry?”

It helps to have a repertoire of behaviors. Not all anger has to be dealt with the same way. I could lash out and say something hurtful. But I could also walk away until I calm down, or have a good cry. I could say, “I’m too angry to discuss this now.” I could release my anger in a physical activity (actually, my husband is much more likely to do this). I could write a “never-send” letter (or a “to-be-sent” one).

But the first step to all of these is recognizing that I do indeed feel anger, and have a right to own my anger and express it. Anger may be harmful, but denying it is harmful too.

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Mental Health

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Out of the House – At Last

Brandywine Falls

Brandywine Falls

If everything goes according to plan (which we all know it never does), this post will be publishing itself while I am at or on my way to this scenic location, Brandywine Falls in Cuyahoga National Park.

I was attracted to this particular location when I read on the Internet that, in addition to access via a 1.75-mile hiking trail, the falls could also be reached using a wooden boardwalk from a nearby parking lot.

This easy access appeals to me because I have balance problems and sometimes use a cane, as well as because I seldom leave the house and have difficulty walking any distance. My husband encourages me to get out and walk, reminding me that exercise is good for depressive episodes, but just getting out of the house for doctors’ appointments and a few errands leaves me with no spoons for recreational walking. It’s a pretty dreary life, though there is a nice window in my study, through which I can see shrubs and trees, the occasional hummingbird or squirrel, or that stupid bird that sometimes flies straight into the glass and bonks itself silly.

There were actually tears in my eyes when I mentioned the expedition to Dan.

“What’s the matter?” he asked.

“Would you drive a long way with me to do something that requires very little time to do?”

“What do you want to do?”

“See this waterfall,” I said, pointing at the screen. I explained about the parking lot and the boardwalk.

“How far is it?”

“Near Cleveland. About three hours. Each way.”

It sounded ridiculous even as I said it. A six-hour drive to walk a very short distance and look at a waterfall.

“We could stop along the way to get something to eat. Or we could pack a picnic. You could bring your camera and take nature photos.”

I needn’t have worked so hard to make it sound attractive. Getting out of the house to go see something scenic and outdoors is something my husband has been longing for us to share.

Naturally, as soon as we agreed to go, my brain went into overdrive, doing my usual job of trying to anticipate everything. We would need to GoogleMap directions, of course. We would need some kind of waterproof bag with cold packs and bottles of water. Bandanas to moisten and wipe our sweaty brows (the temperature will likely be in the 80s and I don’t do well in heat). Bug spray. My cane and maybe a walking stick for him. At times like this, I tend to plan the Normandy Invasion.

This is a ridiculous idea/plan. After the last month and a half I’ve had, it’s a wonder that I’m not just crouched in a corner going beeble-beeble-beeble. But if it works, we may make the same drive in a few weeks to go to a horticultural center and canopy walk, if only so I can make the old, bad joke (You can lead a horticulture, but you can’t make her think) and we can meet up with some Cleveland-area friends we haven’t seen in far too long.

So. Getting out. Exercise. Nature. Relaxation. Fresh air. No computer access. Potential socializing. I don’t know whether these things will have any actual positive effects, but I like to think that my therapist will be proud of me.

Never mind that there are plenty of places nearer – even locally – to walk short distances and see nature. Never mind that my therapist often recommends that I take baby steps. This is a baby step. For God’s sake, I used to be able to hike in the Adirondacks. To travel. To Europe. By myself.

I don’t know why I was able to do that then, but can’t now. Bipolar disorder didn’t strike me suddenly, after I had done all those things. Maybe back then I was better at functioning. Maybe life and bipolar had not yet overwhelmed my ability to cope. Maybe I was in remission (or whatever they call it). Maybe I was hypomanic. It’s a mystery to me.

But maybe, just maybe, I can take this baby step toward reclaiming some of the things that used to bring me pleasure. It’s about damn time.

 

 

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How a Cat Helped Me Stay Sane

Queen LouiseAny pet can help with mental health, really. But in my case, it was a cat.

I was living alone after a bad breakup that had shattered me, mind and spirit. After moving twice, once from another state and once from an apartment complex after I lost the job that paid for it.

I was damaged, and I was alone, in the upstairs of a small house in a small town. I asked my landlady if I could have a cat. She was dubious, but said yes.

I found a cat at a shelter. She was an adult tortoiseshell calico named Bijou. She was small and shy and quiet. The first night I took her home, she slept across my throat.

We needed each other. I needed someone to care about, to focus my attention outward on. She needed someone  to draw her out of her shell, to care for and about her.

We took it slowly. At first she didn’t like to be held. When I got home from work she would meet me at the door. I would pick her up, give her a quick kiss on the head, and set her right back down. Soon she learned that being held wasn’t such a bad thing.

Since then I have never been without a cat.

And they have improved my mental health. Pets do.

Pets entertain when we need distraction.  They can make us smile and even laugh.

Petting them brings tactile comfort and purring offers a soothing sound.

Caring for a pet makes us feel – be – needed. Even when we have a hard time caring for ourselves, a pet becomes a responsibility bigger than we are.

Losing a pet teaches us about the process of necessary grieving. Then getting another pet teaches us about the process of loving someone new, opening our hearts again.

Pets listen. They don’t judge.

Pets communicate with us, and teach us their personal language.

Pets are now being used as therapy animals and comfort animals for the anxious, the aged, prisoners – and psychiatric patients. The laws and policies regarding “assistance animals” are only just beginning to be enacted. They are far from catching up with the need.

Even visits with farm animals – lambs and chickens and ponies – are fulfilling vital roles in people’s lives.

I’ve written about “crazy cat ladies” before and even identified myself as one (http://wp.me/p4e9Hv-bI). There is a stigma that goes along with the label – yet another kind of stigma that we would be better off without. Admittedly, we can become obsessed with our companion animals, even to an extent that is unhealthy. They can be burdens, and annoyances, and expenses.

There are some people – perhaps people with rage issues, for example – who should not own pets. Having pets is a choice that should only be made if they and you fit together well. We’ve all read the stories and seen the pictures online of people who abuse pets horribly. Now those are the ones that I consider crazy.

Pets may not me be the right choice for other reasons. A person who travels a lot, or has extended hospital stays, may not be able to make the commitment. Germophobes and emetophobes may not be able to handle the inevitable messes that come with pets. Even pet fish need their bowls cleaned.

Personally, I would avoid fish, unless the care of, say, tropical fish fascinates you. And their placid swimming can be calming. But for most of us, a pet that interacts with us is preferable. Birds aren’t very cuddly, but they make agreeable (to some) sounds. Reptiles have their own fascination and aficionados. Me, I want something I can pet.

The picture that accompanies this post is of Louise (aka The Queen of Everything). She is 20 years old and, although she is hanging in there, I will be devastated when she goes. My husband’s 17-year-old cat, Garcia, has some health problems, though again, not terrible ones considering his age. Then there are our youngsters, Dushenka and Toby.

I don’t think it’s too much of a stretch to say that they are as much a part of my support system as I am theirs.

 

 

 

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How I Learned a Few Social Skills

I thought my social skills were bad until I encountered a woman who asked me, “Do you have mental problems?” (She recognized me from our mutual psychiatrist’s waiting room, but still….)

expression

With practice, however, I have been able to improve my casual conversation skills, at least enough to get by in some situations, as long as they don’t last more than an hour. Here are my secrets. They do take practice. I have been fortunate to have had people to practice with – friends, coworkers, and of course my husband.

Introductions. Actually, I taught this one to my husband. Often when we met someone that he knew, he would fail to introduce me, leaving me standing there like the proverbial bump on a log. He claimed that the problem was that usually he couldn’t remember the person’s name. “Just point to me and say, ‘This is my wife, Janet.'” Then I will stick out my hand to shake and say, “And you are?” That way we both learn the person’s name. It works like a charm, every time.

Very Brief Conversations. Conversation with strangers – just a sentence or two – is also relatively easy to learn. The trick is the innocuous comment and there are two ways to go about it. The first is to make the comment yourself – “Those are great shoes! They make your feet look really small.” “What a lovely handbag. My mother had one that was similar.” Make an observation and then a related remark, usually complimentary. They don’t even have to be true technically. If you can’t think of anything else to say, a comment on the color of an outfit is usually good. There’s hardly any way someone can take offense at “That’s a great shade of blue on you.”

The other side of the equation is to get someone else to make a comment to you. This requires a prop most of the time. I used to carry a purse shaped like an armadillo, and that proved a great conversation starter. I memorized several responses that I could use when the other person said, “Oh, what an unusual purse!” I could say, “My mother gave it to me for Christmas one year” or “A friend found it in some catalog.” The purse went over  big, especially if there were children present.

Longer Conversations. These require more practice. Luckily at one of the jobs I had, there were a couple of people that I could invite out to lunch and practice conversation with. (I suspect that they knew what I was doing, but they never mentioned it. In effect, they played along.) Mary, for example, had two adopted children, and questions about them we’re always good for a few minutes of interesting listening. They also had a cat and a snake. Pets and children make good topics.

Sometimes it’s best to steer clear of work-related subjects, but if the person is really understanding, you may be able to vent. You should also be able to listen to the other person too. The secret to that is not to try to fix the problem. Simply listen and validate the person’s feelings. “That sounds awful! Does she do that all the time?”

Formal Settings. Mary also provided me with the opportunity to learn about a sometimes-necessary but difficult situation – funerals. Mary and a few other people invited me to go with them to the viewing of a person that I knew only slightly in a work context, so the stakes were low. From watching Mary and her friends, I learned that the proper procedure is to stand briefly at the coffin looking solemn, then go to the bereaved, shake hands or hug (depending on whether they proffer a hand or two arms), and say, “I’m sorry for your loss” or “My deepest sympathy” and at least one remark about the departed. It can be as simple as “He was a pleasure to work with” or “Everyone at work is going to miss her.”

Not Melting Down. Another important social skill is not having a major meltdown in front of other people. When I first visited my husband’s family, I became very uncomfortable quite often because everyone seemed to be yelling at each other. Loud, angry voices tend to upset me, especially if they continue for any length of time. The technique I developed was to go into the other room and make a cup of tea. Making tea is socially acceptable. (If you’re in the kitchen, go to the bathroom or step outside for fresh air.)

Much later I learned that my husband didn’t realize that his family reacted to even minor questions with argumentative responses in loud voices. To him, and to them, this was simply the normal style of conversation. It wasn’t what was normal in my family, and it triggered my aversion to confrontation. I guess whatever you grow with grow up with seems normal to you.

One other piece of advice: Don’t attempt flirting unless you have a coach. It’s really tricky and possibly dangerous. Not for the novice (especially not the kind of novice who wears a habit).

 

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A Bipolar Child

I suppose I was a bipolar child. I don’t really know, but I assume I was, because now I’m a bipolar adult.

I think I was more of a depressed child, which actually makes sense, since I have bipolar 2, with depressive episodes far outnumbering hypomanic ones. There were some times, though, when I would laugh loudly and inappropriately in class, triggered by a word that reminded me of something funny I’d read. There were times I’d walk around with a village-idiot grin because of some minor accomplishment like winning a live goldfish at a school fair.

Depressed child with toyBut mostly I remember misery. Tears. Loneliness. Hysterics. Confusion. Isolation. Hurt. Despair.

I’m fairly sure my depression wasn’t reactive, mostly, although parts of it surely were. The bullying, betrayals by friends, not understanding social conventions – all these were things that could easily make a person depressed, regardless of brain biochemistry.

But by and large my life was what would be considered pretty damned idyllic. I had stable, loving parents, a comfortable home in the suburbs with good schools, all the food I wanted, and as many toys as I could play with. I had a sister and a neighborhood full of children my age, but I remember being perpetually lonely. I had a good education, but looking back I realize that my illness prevented me from getting the most from it. There was no sexual or physical abuse or neglect. No one close to me died or suffered major trauma, at least until I was in high school and my parents suffered illnesses. Even then, they did a good job of keeping life as normal as possible. At the time we never felt it was a tragedy. It was just something we got through together.

That just leaves endogenous depression. Or at least the depression half of bipolar disorder. I remember one day walking home from elementary school and thinking, “All these houses look so pretty, but the people in them aren’t all happy.” It was somewhat of a revelation to me.  I had several major meltdowns, which I’ve written about before, and hundreds of smaller depressive episodes (http://wp.me/p4e9Hv-6J). I had nervous twitches and tics, and was prescribed Valium for them.

During my high school years, it was suggested that perhaps I ought to go to the school district’s psychologist. (This was probably during the episodes of inappropriate laughter in class.) My parents, who were not really familiar with mental illness and psychiatry, asked me if I wanted to go. I didn’t. I probably should have, although back then – the seventies – it’s fairly unlikely that I would have been diagnosed with bipolar disorder, of any type. I might have gotten some help for the depression, though. They might have taken me off the Valium.

Like most lonely and misunderstood kids, and perhaps most depressive children, I found my salvation in books. They were friends, distractions, instruction manuals on how to survive, food for my emptiness, a place to lose myself when the world was too much with me. By and large it worked, at least as well as anything could – a self-prescribed and self-regulated form of instinctual bibliotherapy.

These were not books on how to make friends, or ones that promised to teach a child how to cope with emotions. They were for the most part pure escapism. Fantasy and science fiction, mysteries and adventures, literature and bestsellers – a complete mishmash of classics and trash. Those were my doctors, my therapists, my Prozac, my mood stabilizers.

I look back now on myself as a child – mentally disordered, undiagnosed, untreated – and wonder how I survived  as much as I did.

If I were a child these days, would I get the help that I needed then? Would my parents recognize that I was not just odd and unhappy, but mentally ill? Would I have been diagnosed properly? Medicated properly? Counseled properly?

With all that needs to go right and all that can go wrong during the process, it feels like getting help for a bipolar child certainly was – and perhaps still is –pretty much of a crapshoot. I made it through, but I hope it’s easier for a kid like me these days.

 

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The Week of Living Alone

Sometimes, when I get tired of my complicated life, I imagine what it would be like to start over someplace new, or what it might have been like if I had made different choices. I envision myself, living alone (well, with one cat), in a small town like Benson, AZ. I would have a small used book store or secondhand shop and live in a small apartment over it or behind it. I would have a couple of friends I met in my shop and go out to lunch or dinner once in a while, but mostly spend my free time listening to music, watching TV, or on the Internet.

Sounds simple and peaceful, doesn’t it?

Portrait of a young woman drowning, shark fin on the backgroundThis past week has convinced me that even such a stripped-down existence would not be possible for me. My husband was out of town for nine days, and I could barely manage.

Those of you who follow this blog know that my husband is my rock and my support. I often say I could not get through without him, and my recent experiences only reinforce that.

I didn’t begrudge his leaving, though I wish he had not been gone quite that long. His mother needed him to help her get ready to sell her house and move, and nine days was barely enough time to start on all that needed to be done. There are times she needs him as much as I do.

But coping on my own was difficult. I have paid work I have to do. It matches perfectly with my skill-set and I’m grateful to have it, but sometimes it’s just plain hard to do and hard to make myself do. And I have two blogs (the other is at janetcobur.wordpress.com) that I have made a commitment to posting in once a week, each. Plus, I have started writing a novel.

We have four cats, two of them ancient, and one dog, also ancient. I was afraid that one of them might die while my husband was away. (None did.)

As scary as the idea of coping with a dying or dead animal on my own was, just caring for them was difficult. They keep demanding food several times a day, you see, and they have no thumbs to open cans with. Then there’s the water bowls and the litter boxes. I used to live alone with one cat and manage okay, but that was many years and many meltdowns ago.

Then there was feeding me. Dan had stocked up on things I like before he left, but after the French bread pizzas were gone, I lived largely on salami sandwiches, cheese and crackers, and cereal. (I did eat vegetables. I had a small tray of sliced veggies and dip.) Once I made a couple of baked (frozen) fish sandwiches early in the week, but later I had devolved to the extent that my evening meal was peanut butter on a bagel. Another night I had mashed potatoes and a glass of red wine. Other meals I simply skipped.

Then there was Dealing With Stuff. Life Stuff. You know. The Stuff that happens to everyone sometimes piled up on me. I had to talk to (argue with) the utility company and the IRS. I had to pay bills. Life stuff leaves me exhausted.

Plus, I kept having to Go Out. Deposit my check. See the doctor. Pick up prescriptions. Buy cat food when I ran out. I wore pants more days last week than I had in the previous month. (Dan wanted me to water his butterfly garden daily, but it rained every day or night, so I didn’t have to put on pants and go out for that.) I treated myself to lunch twice when I had to go out to do those errands, but it was nearly impossible to decide where to eat.

Now Dan is back. I had to put on pants again so we could return his rental car.

But you see what I’m getting at here.

My fantasy of retreating to a simpler life is not feasible. It simply wouldn’t work. The everyday tasks and trials of managing a shop, caring for myself and a pet, negotiating all the stuff of life would overwhelm me. Oh, when I’m hypomanic and can sometimes focus, I might do all right for a while, but life – even a very basic one – would eventually overwhelm me. There are so many things I can no longer do, at least not without serious amounts of help and support.

I can muddle through for a while mostly on my own. I am getting better. But not better enough to live independently, at least not right now.

 

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Senses and Sensitivity

When I was a child, I was often told that I was “too sensitive” – meaning that I took things too much to heart, especially criticism and the taunts and bullying of other children. It was something that I assumed was innately wrong with me, and that I didn’t know how to fix.Sensory Overload in Children

These days, however, I’m too sensitive to sensory input.

I used to be able to write or read or edit with music on (instrumental music, at least). I used to be able to hold a conversation while the television was on. I used to be able to drive a car and look at the scenery around me.

Not anymore.

A fan is about all the sound I can handle while I write, and sometimes quiet is the only thing that will calm my nerves. I can barely process remarks anyone makes about the TV show we’re watching. And if I’m driving, I never even notice a deer in a field off to the side of the road. I doubt that I would notice a hippopotamus.

I’ve written before about my brain being overwhelmed with too much input, meaning too many thoughts, anxieties, and fears. But over the years – at least since my last major meltdown – I have trouble processing more than one sensory signal at a time.

It’s not just a matter of focusing in too completely on just one thing. (I have in the past entered into some movies so thoroughly that I’ve nearly killed my husband when he has asked questions like, “Will you look at this pimple on my back?” or whispered to me, “I think I know what makes that spaceship fly.”)

My ability to focus – to concentrate intensely – has been a casualty of my mental disorder. At my lowest point, I couldn’t even read a book, which is something I’ve been doing since I was three or four. I still can read only one chapter or one magazine article in a sitting

Now that I’m recovering (thank God and Drs. R. and B.), I can concentrate enough to read, and write, and edit. What I can’t do is separate out multiple sources of information on the way from my senses to my brain. If my husband talks while a TV show is on, it’s not just that I can’t make sense of what he’s saying, I can’t process either signal – the TV or him. It’s all a jumble.

If I went to cocktail parties (I don’t), I would be unlikely to have an intelligible conversation because of all the ambient noise and clashing voices. I recently went to a workshop that held a mix-and-mingle event on the first day. Having people chatting all around me was not just distracting, but almost painful and immobilizing. Focusing on one person at a time was the only way I could get through it.

And forget about Chuck E. Cheese or Cici’s Pizza! No. Just no. Video arcades – are you kidding? It’s a good thing I have no reason to frequent places like that. When I go to a regular restaurant, I have to ask not to be seated near any birthday parties or office functions. I wish they had a “no screaming” section.

I understand that sensory processing difficulties sometimes occur in persons with autism spectrum disorders (ASD) and/or ADHD. I have never been diagnosed with ASD, though I may have manifested Asperger-like traits in my youth (well, OK, in my adulthood too). And I have been told by doctors that I have hyper-sensitive nerves. Is that the same as what I experience? I don’t know.

Most of the research and discussion of sensory processing and bipolar disorder occurs in the context of children, though I never noticed such difficulties when I was a child. But just as articles about autistic adults are rare (except, of course, for the high-functioning) and learning disabilities are forgotten about as soon as a person leaves school, it seems that sensory processing problems in adults also get little attention.

I can’t be the only one dealing with this.

As I learn more about my own difficulties and conditions that affect others, there is one conclusion I’m rapidly approaching:

Neurodivergent is neurodivergent. We may have different diagnoses, but there is much we share.

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Who’s a Spoonie?

With all the talk about cultural appropriation lately, I’m hesitant to wear Kokopelli earrings or eat at the Chinese buffet. I understand that some people object to Canadians playing Englishmen who are pretending to be Japanese for a production of The Mikado is offensive or racist. I don’t always agree, but I understand the principle involved. Even I, a WASP, find Mickey Rooney’s character in Breakfast at Tiffany’s to be egregious, appalling, and insulting to everyone involved, including the audience.

Hand XrayBut recently there’s come the claim that those who are not entitled to it are appropriating Spoon Theory language. And in this case, “entitled to it” means someone with an “invisible illness” – chronic pain, chronic fatigue, and other conditions that do not announce themselves to the public with visible cues such as wheelchairs, crutches, missing limbs, or guide dogs.

If you don’t already know Spoon Theory, you should. You can find the explanation here: http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/. Basically, “spoonies” have only a limited amount of energy units per day, represented by spoons. Spoonies must use a ridiculous amount of spoons to get through tasks that others accomplish normally in the course of life – showering, driving to work, driving home, fixing dinner, et endless cetera.

In fact, on any given day a Spoonie may not have enough spoons to get out of bed and get showered and dressed. It’s not that Spoonies are lazy; they may have only three metaphoric spoons that day, compared to a non-Spoonie’s typical, oh, I don’t know, 20? 30?

A few weeks ago, I wrote about whether bipolar disorder and other mental disorders are invisible illnesses: https://bipolarjan.wordpress.com/2016/03/06/is-bipolar-disorder-an-invisible-illness/. (I said they mostly are.) As far as I’m concerned, we’re Spoonies and “entitled” to Spoonie language. Most of us have had the experience of not having enough spoons to spend on a morning shower, having to choose between hygiene and, say, eating breakfast.

So now, apparently, the general public is picking up Spoonie language – saying “I’m out of spoons” when they simply mean “I’m tired” or “That was an exhausting day. I’m done.” And some Spoonies resent that. See http://m.dailylife.com.au/news-and-views/dl-culture/stop-appropriating-the-language-that-explains-my-condition-20160113-gm4whc.html

I have two things to say about it. The first is that language is always growing and changing. But it does it on its own, without our control. (Unless we’re France. France at least tries.) We may wish to eradicate the “n-word,” but we can’t. It’s less socially acceptable to use in polite company, but you know people still use it. Read the comments section on any social media post about President Obama if you don’t believe me.

The second thing is that at least Spoon Theory and language are entering the mainstream. People without invisible illnesses are at least getting a clue of what it means. They may not have the details right, but at least now when we explain it to them, they won’t be starting from scratch.

And after all, isn’t that how Spoon language started – as a way to begin a conversation on what invisible illnesses are and how they affect our lives? Not a secret language that only those who know the password and handshake can use.

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Mental Health

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What Is Sanity?

And who is sane?

Negatives Positives Computer Keys Showing Plus And Minus Alternatives Analysis And Decisions
These are questions you don’t hear much anymore, at least outside of judicial proceedings. Even there, the phrase “guilty but mentally ill” is gaining currency. “Not guilty by reason of insanity” made people think a criminal was getting away with something. And indeed, the “insanity defense” has been misused.

We’re much more comfortable talking about health and illness, concepts we all understand, than about seemingly fixed states like sanity and insanity. They sound so final. At least illness can be treated; health can improve.

Before the deluge of psychiatric labels and the DSM, how to tell if a person was sane or insane was a vital question. The insane were put away – in an asylum if they were poor or kept discreetly out of sight at home if they were wealthy.

But were all the people in asylums insane? And what kind of treatment did they receive? Investigative journalist Nellie Bly determined to find out. Her 1887 exposé Ten Days in a Madhouse was a muckraking revelation.

Bly feigned amnesia and delusional fears, was reported to the police by her landlady, and declared incurably insane.

While she was at the Women’s Lunatic Asylum on Blackwell’s Island, she experienced cold, hunger, brutality, and no diagnosis or treatment. Several of the other inmates were, like Bly, sane by any modern standard, but poor, friendless and alone. The newspaper she worked for arranged to have Bly released, but the other women remained to be beaten, choked, starved, humiliated, not treated and driven insane if they weren’t already.

Bly’s ordeal and testimony did prompt a grand jury to recommend an increase in funding of $850,000 – quite a large sum in those days – for the Department of Charities and Corrections, which oversaw asylums. (It is ironic to note that the word “asylum” originally meant a place of protection, safety, or shelter.) But it mainly went for better physical conditions – warmer clothes, edible food, more and better-trained nurses – rather than actual diagnosis and treatment of the women’s “insanity.”

The question of who is sane and how you can tell was revisited in 1973 by psychologist David Rosenhan. A professor at Stanford University, he devised a simple experiment. He sent eight volunteers, including both women and men, to psychiatric hospitals. Each person complained of hearing a voice saying three words – and no other symptoms.

All – all – were admitted and diagnosed, most of them as schizophrenic. Afterward, the “pseudopatients”  reported to their doctors and nurses that they no longer heard the voices and were sane. They remained in the psychiatric wards for an average of 19 days, beating Nellie Bly’s experience by nine days. They were required to take antipsychotic drugs as a condition of their release.

Rosenhan’s report, “On being sane in insane places,” created quite a stir. Indignant hospital administrators claimed that their staff were actually quite adept at identifying fakes and challenged Rosenhan to repeat the experiment.

This time hospital personnel were on their guard. They identified over 40 people as being “pseudopatients” who were faking mental illness. Rosenhan, however, had sent no volunteer pseudopatients this time. It was a dismal showing for the psychiatric community.

Times have changed, of course. Few people are confined in locked wards for life. Diagnosis is, if not yet a science, less of a guessing game, backed up by the DSM and assorted checklists of symptoms. And insurance companies hold the keys to psychiatric units as much as medical personnel do.

Still, the fundamental questions remain. Are neurotics sane and psychotics insane? I have bipolar 2. Am I mentally ill? I would have to say I am, since my condition will require treatment, barring any dramatic scientific advances, for the rest of my life. And my illness does affect my ability to function “normally.” Yet I think that few would consider me insane (unless I were suddenly to start shooting people in a public place, of course).

Speaking freely about mental illness and mental health is, presumably, supposed to make such disorders more understandable, less fearsome, less stigmatized. I suspect, however, that there are those who would rather we remained out of sight – if not locked away in asylums, then restrained in the virtual straitjackets of strong psychotropic medication.

And while group homes and other sorts of assisted living situations are now more available (though not nearly as accessible as the need for them would require), the general public prefers that such facilities, along with halfway houses for addicts and parolees, be constructed “NIMBY” – Not In My Back Yard.

Out of sight, out of mind.

Maybe the conversations surrounding such issues are reducing the stigma of mental illness, or insanity, or whatever you choose to call it, but I’m dubious about the level of success. There’s still a long way to go.

 

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Mental Health

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Support and Non-Support Groups

My family has never been big on support groups. When my father had multiple myeloma (which killed him after 15 years), he turned down any opportunities he was given to join cancer support groups with names like Make Today Count. He preferred to go it alone. He was stubborn.

So am I.

I have actually been to support groups for mental illness once or twice, but they were never a success or, I guess, just never right for me.

The first one was when I was in college. That one was a bust because I wasn’t really ready to address my problems and because I had the ability to appear “normal” for an hour at a time while sitting cross-legged on the floor. I couldn’t do that now. (The floor-sitting part.)

The second time was after I saw a brochure for a group called High Flyers and Low Landers, which met in the church I was going to at the time. (I don’t think the organization still exists. The church is still there.)

It was a very odd experience. Everyone had a book, many with needlepoint covers. It was their bible, though not the Bible, which I know many people needlepoint covers for, or at least did back then.

The meetings consisted of a little ritual. One person read a passage from the book. Then each person in the circle had to tell an event that happened to them in the past week. The recital had to be in a specific format: what happened, what symptoms the person experienced (dry mouth, racing thoughts – there was a list), how the person would have handled it before reading the book, and how the person did handle it. There was much quoting of the book and certain specific phrases that everyone had to use.

Some of the quotations were helpful, or at least true. (People do things that annoy us, not to annoy us.) But as I recall, those were the only sorts of comments the people in the circle were allowed to make. Not “How did that work out?” or “What did your mother do next?” or “I hate when people get passive-aggressive.”

It was just too weird and formulaic for me, so I never went back. (As I was leaving, I offered someone a mint. Everyone laughed and said, “Dry mouth!”)

Since I don’t seem to do so well in actual support groups, I recently thought I would check out some virtual ones. I’m not going to name the groups I joined or where I found them, because all of them stressed privacy and confidentiality.

What I found was both support and non-support.

Some of the groups were associated with national organizations or publications, and they pretty much stuck to sharing articles about scientific research or political news about mental illness, along with lists of resources, hotlines, and the like.

So far, so good.

Other groups were more like traditional support groups, with members asking questions or relating accounts of what had happened or how they felt. There were administrators who tried to keep the members to more or less stick to the topic and rules of the group (give trigger warnings, no suicide threats, or whatever).

Some of the groups were peaceful. People asked standard questions (Who’s on this med? Should I take something else too?) and received fairly standard answers (Worked for me. Didn’t work for me. Ask your doctor.) People related similar events and how they handled them, or asked for more specifics so they could understand the situation better. People posted assorted uplifting memes and affirmations.

Then there was the other sort. People did not know how to use trigger warnings or simply didn’t bother. Others shared people’s posts without removing identifying information. Some posted truly vulgar jokes that had nothing whatsoever to do with bipolar disorder. Negativity overflowed. Arguments raged. (Some of the topics were “Bipolar is not an excuse for bad behavior” and “Don’t buy into the drug companies’ propaganda by taking meds.”) There was the online equivalent of name-calling and shouting. People reported other people to the admins. People accused people of reporting people to the admins.

The administrators did try to keep a handle on these groups, but couldn’t always, most likely because they were busy with their own lives and issues and difficulties.

It got so bad that I took to lurking instead of participating. Every week or so I would go back to take a peek and check on the drama llamas. Mostly they were still running around spitting. I think I had helpful things to add to the discussions and times when I needed help with feelings, but I just couldn’t trust enough to jump back in. I know other people left these groups for similar reasons, and some were blocked or banned or given warnings about their behavior.

In general, I have this to say about online support groups. You’d do well to sit back and watch their interactions before you try participating on anything but a “Congratulations! You got a job!” level. If the group seems truly helpful – supportive – then dive in. You may be able to give and receive help.

But non-support is exhausting. And I’m too stubborn to put up with it.

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Mental Health

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