Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

Positivity and Acceptance

Those who follow this blog have seen me rail against toxic positivity. When it’s not absurd, it’s insulting to those of us with mood disorders. No, we can’t just cheer up. If we could look at the bright side, we wouldn’t have depression or anxiety. You may be able to choose happiness, but I can’t. I’ve needed medication and therapy just to feel meh at times. If I could turn bipolar disorder off like a light switch, don’t you think I’d do it?

Toxic positivity can be seen nearly everywhere, in a lot of different situations: the self-help movement, of course, but also business, medicine, and even religion – as well as endless memes. American society is rife with toxic positivity. It appears in motivational business conventions and TED Talks. Salespeople are advised to think positively and envision success. Breast cancer survivors are advised to keep a positive attitude, to the extent that they are encouraged to tell how the disease has had a positive effect on their lives and relationships. (Expressions of fear, anger, and other natural emotions in response to the diagnosis are downplayed or discouraged.) Religions can exhort us to count our blessings or “manifest” our wants and needs by using positive thoughts to attract them.

Positivity becomes toxic when it is seen as the only method of coping with problems in life, even ones that have other solutions or none. Toxic positivity presents relentless cheer as the only acceptable reaction and a panacea for every difficulty. And toxic positivity leads people to demand that others take up the mindset and apply it to every situation, even devastating ones. As such, it denies the reality of human suffering and normal emotional responses. It’s a form of non-acceptance.

So, what is the alternative? What is a more natural – but still effective – technique for dealing with difficulties? How can those of us who have mood disorders or any other brain illness find ways to navigate through life without slapping on a smile and coercing our emotions to fit a certain mold?

Radical acceptance is one answer. Radical acceptance means that you accept your inner feelings and your outward circumstances as they are, especially if they are not under your control. You acknowledge reality without trying to impose a set of emotional mandates on it. Your acceptance and acknowledgment may involve pain or discomfort, but those are understandable, normal human conditions. They are natural conditions that evoke a natural response.

Rooted in Buddhist teachings and given a name by Marsha Linehan, the psychologist who developed dialectical behavior therapy (DBT), radical acceptance uses mindfulness to help people learn to face and regulate their emotions. Interestingly, one 2018 study found that accepting your negative emotions without judgment is a factor in psychological health.

With radical acceptance, when you encounter difficult situations and emotions, you note their presence without trying to suppress them. You accept them, as the name implies. This attitude can address – and reduce – feelings of shame and distress that you may feel, especially when you are not able to simply shut off those feelings and replace them with positivity. That doesn’t mean that you wallow in unpleasant feelings or allow unfortunate circumstances to stunt your responses.

Instead, you note the feelings – accept that they exist – and “hold space” for them within you. You appreciate that your emotions can lead you to new understandings of and reactions to your circumstances. For example, instead of adhering to the unattainable maxim that “Failure is not an option,” you can recognize when you have indeed failed and accept it as a natural part of life. You can then move on to a mindset of growth where you use that failure to inform your future actions. You develop a more accurate picture of the world and can begin implementing real solutions.

Of course, there are situations where radical acceptance is not appropriate. Abusive situations, for one, shouldn’t simply be accepted without being addressed. But neither will positive thinking resolve them. They require action, from seeking help from a trusted individual to leaving the situation to contacting law enforcement or an organization that can help.

But in other circumstances, radical acceptance may be an answer for some. For myself, I’ll just be satisfied if radical acceptance helps drive out toxic positivity. I don’t think it will, but a person can dream.

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Mental Health

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Beating Bad Thoughts

I saw a meme today. It said:

“Just do what you can today, okay? It will be enough.”

Instantly my brain said, “No, it won’t.”

My brain, uncooperative at all but the very best times, has a habit of telling me bad things when I’m in a depressive episode: “You’re useless.” “You’re pathetic.” “Everything you do fails.”

For some reason, positive thinking memes and slogans bring out the worst in my brain. If a pass-along or a bumper sticker tells me that tomorrow will be brighter, my brain says, “No, it won’t.” If a meme says, ” I hope the situation you worry about favors you in the end,” it says, “Yeah, like that’s gonna happen.”

Is my brain simply cranky and uncooperative? Well, yes. But these intrusive thoughts reinforce and deepen my depression, chip away at what self-esteem I still have, deny my progress in healing, and make me resent the whole happy, smiley world that apparently everyone but me can see.

Is there anything I can do to make my brain shut up, or at least pipe down with all the negativity?

I’ll tell you what doesn’t work for me: daily affirmations. My brain tells me these are lies and that I shouldn’t believe them. I can’t look into a mirror and repeat five times, “I am a good, worthwhile person” or “I deserve happiness” or “I will overcome my problems.” It’s like the problem of seeing cheery, encouraging memes on the internet, only having to inflict them on myself. If anything, they make me feel worse.

If these sorts of things work for you, fine. I’ve no objection. I won’t make fun of you. I’m truly glad you’ve found something that helps you.

They just don’t work for me.

So what can I do?

I have gleaned two helpful hints from my therapist. Both are visualizations, and both are metaphors. And both involve animals. (They are variations on a technique called “thought stopping,” which is simpler and more direct. But I find visualizations easier to remember and do. I love metaphors.)

The first comes from a mindfulness meditation that Dr. B. asked me to try. I’m not much good at meditation, because of both my intrusive thoughts and my anxiety. Sitting still for that long is difficult, and so is emptying my mind of thoughts to concentrate on my breathing, for example.

The narration that guided the meditation had a solution for this. When your mind wanders and your thoughts drift off to somewhere else, think of them as puppies that wander away when you’re trying to teach them something. Gently corral them and nudge them back in the right direction. You don’t have to panic and shout, “There they go!” and run off after them. You just give them a little push toward where you want them to go. If they wander again, do the same thing. “What about the mortgage payment? Come back, little puppy. Over here.”

The other technique is for the kind of bad thoughts that I often get: anti-affirmations or negatives that deny any suggestion of peace or happiness or accomplishment. For these, Dr. B passed along an idea that another client had given her. Imagine that your bad thoughts are naughty cats, who jump on the kitchen table or try to go fishing in your aquarium. Then imagine spraying the bad thought (cat) with a bottle of water to make it stop what it’s doing and scram. “I never do anything right. Psssst! Psssst!”

When I’m profoundly depressed, I doubt even these clever dodges will work, though I’m certainly going to try them. But when I’m just starting on the slide down, I predict they’ll be just the thing to trick my brain into submission.

Take that, brain! Psssst! Psssst!

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Mental Health

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The Therapeutic Hug

The common wisdom is that a person needs four hugs a day for survival, eight for maintenance, and twelve for growth. I doubt that this is confirmed by any scientific studies and I doubt that it is true. If it were, there would be millions of people on Earth who would not survive. I would be one of them. Despite being married to one of the two truly world-class huggers I’ve met in my life, I do not get my four-a-day. And certainly not twelve. Assuming eight hours a day for sleep and eight hours a day for work, that would leave eight hours to work in twelve hugs. That’s one and a half hugs per hour, and I suspect half a hug just won’t do. In fact, I know it won’t. Scientific research has been done on the 20-second hug. It releases oxytocin, a pleasure and bonding chemical in the brain. Half a hug would need to be 40 seconds long to do the proper amount of good, and young lovers and newlyweds tend to be the only people who give hugs of that duration. Then there’s the question of what constitutes a hug. For greatest oxytocin effect, I would recommend the full body hug – toe to toe, torso to torso, heads on shoulders, arms tightly squeezing. But you probably can’t give that particular hug when you run into an acquaintance in the supermarket, especially not 20 seconds worth, without blocking the aisles. Other variations of hugs that may be less effective are the side-by-side one-shoulder squeeze (and the multi-person variant, the Big Group Hug), the manly back-thumping, and the A-frame hug (standing a distance apart and leaning in for a hug from the shoulders up). Then there are the virtual hug, often written ((hug)), with the number of parens indicating the length/intensity of the hug, and the proxy hug, in which you delegate a person to pass along a hug when you’re not able to be there. None of these seem really conducive to the 20-second, made-for-thriving hug. But, on some level, we know that hugs are therapeutic. Oxytocin or whatever, they make us feel better. Lots of hugging goes on at support and 12-step groups, and people who go to those daily might indeed make their recommended quota. I go to private psychotherapy, however. I’ve never hugged my therapist, and am not even sure whether it’s appropriate for therapist and client to hug. It would be awkward to ask, “Can I have a hug?” only to hear, “No. That’s unethical.” But I suppose it depends on the therapist and the client and how each feels about the subject. I know sex between therapists and clients is unethical, but hugs may be a gray area. Perhaps someone can enlighten me. Of course, there are people who do not like to – or are afraid to – touch other people. People who are aware of and skilled in responding to others’ body language may be able to see the little (or, let’s face it, large) cringe when one person sees another moving forward with open arms. If the non-hugger is quick enough, he or she can quickly stick out a hand for a hearty handshake, or the potential hugger will abort the hug and retreat to a friendly tap on the shoulder. But there are people who will swoop in and envelop you in an unwanted embrace and maybe even air kisses with smacking noises. I suspect these would be more likely to shut down oxytocin entirely, and possibly release adrenaline instead in a fight-or-flight response. As with sex, the safest route is to ask for consent – “Can I have a hug?” – and take no – “I’d rather not” – for an answer, without taking offense or pressuring – “Aw, c’mon” – and making things even more awkward. Still, the best advice I can give is to be proactive about hugging. Say, “I need a hug” when you do. Ask “Do you need/want a hug?” when a person you know seems to be in distress. Avoid hugging strangers, though. That hardly ever helps. At least wait until you’ve been properly introduced.

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Mental Health

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I Want to Go Home to Bed With My Kitties

Kittens. Jumping. I want to go home to bed with my kitties. These are my mantras. Or something. I repeat these phrases, under my breath if anyone is around who doesn’t know I do this. At least I think it’s under my breath. I have at times walked out of a restroom stall to see people looking at me strangely. My husband says they are “grounding statements,” though I understand proper grounding statements are usually more like affirmations – “I am safe.” “I can handle this.” “I am a good person.” How I ended up with mine I don’t quite know. I do know that I mutter or say them when I am anxious. “Kittens” indicates a general level of anxiety, while “jumping” is reserved for increased levels. “I want to go home to bed with my kitties” is an all-encompassing statement of stress or dissatisfaction and the only one that I can say nearly out loud around people with only mild looks of incomprehension. A very few people who know me well are used to this phenomenon and even have responses. When I say, “kittens,” my friend Leslie says, “puppies,” and my husband says, “Do you like them?” When I say, “jumping,” he says, “up and down?” and my friend Robbin said, “You must really be nervous.” My husband occasionally joins me in a chorus of “I want to go home to bed with my kitties.” (The extended version is “I want to go home. I want to go to bed. I want my kitties.” The short form is “Home. Bed. Kitties.”) I know that I use these vocalizations a lot when I have anticipatory anxiety or after a protracted spell of having to be competent, social, and appropriate. I say them a lot in my car or after coming home from braving the outside world. In a crowded, noisy space like a restaurant, I say them in a very matter-of-fact manner, as if I’m having a conversation with my husband. I assume the background noise covers them up. The National Mental Health Association says, “People with obsessive-compulsive disorder try to cope with anxiety by repeating words or phrases.” Fair enough. I do have a few OCD-like traits, though no diagnosis. (That’s all I need – another diagnosis!) But to me, the grounding statements explanation makes the most sense. I would argue that for me, home, bed, and kitties are all things that remind me of safety and bring me comfort. How jumping fits in, I’m not sure, except that I have hyperactive nerves and do a fair amount of it. But it certainly isn’t associated with safety or comfort. Quite the opposite, in fact. The New York Times called it “kitten therapy” in a personal story of how a kitten helped lessen a man’s depression. I can testify to that effect. Cats or kittens have stayed up with me through bouts of insomnia, snuggled when I needed touch, purred gently when I needed quiet, demanded attention when I needed distraction, and yes, even jumped on me when I needed amusement. Home is a touchstone for me. My parents’ house was home to me, but after I moved out, nothing ever seemed like home again. Not the dorm, of course. Not the sorority house. Not the basement apartment. Not the house I shared. Not the apartment. Not the second floor. Not the half-double. Not even the rent-to-own house. (That one came close.) But the house that I found, looking like it grew up out of the ground, has felt like home, has been home. Even when it was destroyed by a tornado and had to be rebuilt, it was home. While we moved among motel, hotel, rented home, and crummy apartment, home was just waiting around the temporal corner for us to come back to. Bed is wonderful. I can stay in it all day – and have, when depression hits hard. It’s sturdy Amish furniture that made it through the tornado. In fact, I was lying on it when the tornado took the roof off and all I could do was put a pillow over my head and hope for the best. I love its solidity. I love the cozy quilts that I can wrap myself up in like a burrito. And yes, I love it especially when the kitties come and join me. Is it any wonder that “home, bed, kitties” is my mantra?

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Mental Health

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Owning My Bullying

bullying, written on vintage metal texture

I have written many times before this on the subject of bullying – and now I have to admit that I have been a bully, too.

Bullying is often seen in stereotypical terms as a larger kid extorting money from a smaller, weaker one, or torturing someone in the locker room with “swirlies” and other indignities. But there are many kinds of bullying. There is physical bullying – the kind most people think of. There is ostracism or social bullying – the stereotype of which is the clique of mean girls or arrogant jocks. There are racist bullying, ethnic bullying, socioeconomic bullying, ableist bullying, sexual bullying, and just about any other type you can name.

Nowadays, one of the most vicious types of bullying, with the most harmful and longest-lasting effects, is cyberbullying. The tools of connection are being used to separate, exclude, and destroy reputations and even lives.

None of those is the kind of bully I was.

I was an intellectual bully. And since I realized that – only recently – I am ashamed.

I am not ashamed of my intelligence or my educational accomplishments. Those were the products of nature and nurture that I had little control over. It was what I did with those advantages that is shameful.

I used my smarts and my vocabulary to squash other students.

It may have started as a defense against the bullying I received – physical and social and whatever else. Intelligence seemed like the only weapon I had, and I wielded it as one. I was taking revenge in the only way I knew how. And that is something I should never have done.

I may not have intended it that way, but every snarky remark, every intellectual put-down, every sesquipedalian word flung back at my bullies carried a message. I was telling them that they were stupid and inferior and that I was smarter – better – than they were.

If that’s not bullying, I don’t know what is. And I’m sure it caused damage to egos and self-esteem, as well as perpetuating the cycle of be-bullied-and-bully that leaves countless perpetrators and victims in its wake.

Later in life, as my bipolar disorder deepened, I turned the bullying inward. I made self-deprecating remarks, snarked at myself, even made fun of myself for being overeducated and pedantic. I thought I had to do these things to myself before someone else did them to me. It was at once a measure of my profoundly low self-esteem and a way to lower it even further.

In essence, I was bullying myself. And I’ve known other people who have done likewise. (For what it’s worth, I’ve since learned that it can be profoundly irritating to listen to a person tear himself or herself down this way.)

Intellectual bullying is a hard habit to break. The words, the ideas, the sarcasm are there for the using. The consequence, of course, is driving people away, sometimes without even realizing it. I have done this and seen it only when looking back at the potential or actual friends lost, the coworkers who thought I was a jerk, the people I’ve hurt.

I’ve been trying to break myself of the habit. Oddly, the Internet helps. It is, as has been noted, true that there are few ways to convey tone of voice in chat or email. There is no sarcasm font. But there are ways to let the recipient know that you do not mean a message literally or unkindly. You can place <snark> after a remark or a  😛 emoji or a sticker that demonstrates you mean well. I’ve even seen people use <sarcasm on> and <sarcasm off> around their messages to make them clearer.

But mostly, I try to guard my speech. I have to install a little censor (or sensor) that says, “Ooh! That’s funny! But is it insulting?” before I make a remark.

I’d rather pause for a second and look like a doof than go back to being a bully.

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Mental Health

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Who’s Crazy Now? A Guide to Gaslighting

“You’re crazy. I never said that.”

“That’s not the way it happened. You’re crazy.”

“No one believes you. You’re crazy.”

“You’re crazy. You’re just overreacting.”

What do these statements have in common? Obviously, they involve one person telling another that she or he is crazy.

More subtly, though, the speaker is saying that the other’s perceptions and feelings are invalid, untrue – wrong.

And that’s gaslighting.

Gaslighting describes a mind game that emotional abusers use to control their victims. (Gaslight is also an old movie, in which a husband uses the technique to try to convince his wife that she is insane. The victim of gaslighting is usually a woman and the perpetrator usually a man. Of course this is not always true. Either sex can be the gaslighter and either sex the gaslit.)

But what does gaslighting have to do with bipolar disorder? Someone who is in the depressive phase of bipolar – especially one who is undiagnosed – is especially susceptible to gaslighting. The very nature of depression leaves a person wondering, “Am I insane?” To have another person reinforcing that only strengthens the idea.

Back when I was undiagnosed and in the middle of a major depressive episode, I had an experience of being gaslit. My grasp on reality was not entirely firm at the time, both because of the depression and because I was physically, socially, and emotionally cut off from the outside world, family, and most friends. This isolation left the gaslighter, Rex, in a position of control.

I endured everyday denials of reality, like those mentioned above, but the most obvious one – the one that made me aware that I was being gaslit – happened when I suggested that we go for couples counseling. Rex asked if I was sure I wanted to, as he and the therapist could declare me a danger to myself and others and have me put away. That, of course, was not true and I knew it wasn’t, which gave me my first clue that something was amiss.

When we got to the sessions, Rex tenderly held my hand and spoke of how concerned he was about me and how much he wanted to help me get better. In other words, he was saying that I was the crazy one and that he wasn’t. That is the very basis of gaslighting – to make the other person seem or possibly even become crazy.

Once a person recognizes the gaslighting for what it is, she can begin learning to trust her own perceptions again. For a person in the grips of depression or mania, this will not be easy. I know it wasn’t for me.

It took a long time and a lot of healing before I could recognize what had happened, how my circumstances had been controlled, how my perceptions had been invalidated – how I had been gaslit. That was a vast revelation. It was like turning the tube of a kaleidoscope and seeing a different pattern come into focus. The elements that made up my life may have been the same, but the new perspective changed everything.

Having someone outside the situation who can validate your perceptions is an important tool in recovery. Sometimes a friend or family member can perform this function, but mental health professionals who have been trained in the process are often more successful. They are the people we often turn to to tell us that we are not crazy, that our feelings are valid, and that the mind game of gaslighting has affected us.

Getting help for the depression or bipolar disorder is also an important step in escaping the effects of gaslighting. With proper therapy and/or medication, a person’s thinking becomes more clear, accurate, and trusted. Turning off the gaslight is like turning on a different kind of light – one that illuminates your life, improves your clarity of vision, and begins to break through the gloom and despair.

And that light is more powerful than gaslight.

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Mental Health

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Stuffing Your Feelings in a Box

Cardboard box with the zipper isolated on white backgroundWe all know it’s a bad idea to stuff your feelings, especially if you then pile food or alcohol on top of them.

The thing is, sometimes you need to suppress a feeling, for just a little while, in order to get through a difficult situation. When that happens, I put my feelings in a box.

Here’s an example. My father was dying, and had only days to live. We all knew it. My mother, who didn’t drive, asked me to take her shopping for something to wear at his funeral. “Do you mind if I don’t wear black?” she asked. “If you don’t mind that I do,” I replied.

It was my first encounter with a close family death, and I had to get through this awful, wrenching shopping trip. I had to keep my composure so that my mother could keep her composure. I had to steer her away from a flowered dress, which would have been fine for church, to a navy suit and a lighter blue top, which would be suitable for a funeral but not so somber that she couldn’t wear it for anything else. All while my father lay in the hospital, dying painfully of bone cancer.

My feelings were complicated and I absolutely could not afford to feel them at that time. I had to stuff them in a box and close the lid on them until my mother’s needs had been met. Then I could let them out, in a time and place where it was safe to, in the presence of a person I could trust with those feelings.

When such circumstances arise – and they will, in one form or another – I recommend using a box, one in which the feelings will be out of sight for a while. A box is small; only a few feelings will fit in it. If you think the feelings are going to leak out, you can sit on the lid. Then, when it has served its purpose, you can rip the box open (or gently lift the lid) and feel the feelings. Cry. Rage. Grieve. That’s the important part.

You have to experience the grief or fear or even the crushing weight of guilt in order to come through it and heal.

But why put feelings in a box instead of something stronger? Who wants to feel those negative emotions anyway? Aren’t we better off without them? Shouldn’t you just build a wall around them to keep them from breaking out?

We’ve all tried it. It works for a while. But a couple of consequences go with the practice. First, all of your feelings get trapped behind that wall – the good as well as the bad. When you find yourself disconnected from all your feelings, life is a gray blur. In your depression or anxiety or fear or rage, you may not have had many good feelings. But when you build that wall, you cut off even the possibility of having them.

Second, you’re only postponing the pain. The wall will leak sometimes; your unpleasant feelings will come out some way – in your dreams, around your eyes, in sudden spurts, or trickling back into your everyday life. Worse, the wall may shatter – fail altogether, releasing all those feelings in an unstoppable torrent, only stronger and more concentrated from having been confined. They overwhelm both you and anyone in the vicinity. It’s not pretty. And it’s destructive – to you, your mental health, your healing, your employment, your relationships – to every aspect of your life.

If feelings are behind a wall, you may be able to tell yourself they don’t exist. But if you stuff them in a handy box, you can choose the time and place to open it – and yourself – back up.

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Mental Health

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Bipolars, Rollercoasters, and Sex

Wooden RollercoasterThe rollercoaster is the most common metaphor for bipolar disorder. But is it really the best one?

After all, a rollercoaster has long, abrupt downward swoops, and anticipatory highs. (At least the ones I’m familiar with. I won’t go on the ones that turn you completely upside-down. I understand the physics, but no. Just no.) Rollercoaster highs crank slowly, grindingly up. Mania isn’t like that. Boom! You’re suddenly at the top.

Nor are rollercoaster lows like the lows of depression. If they were, the downward slide would not be the exhilarating, thrilling part of the ride, and would not immediately be followed by another high. Instead, the rollercoaster would plod along through a lengthy trough, or maybe a tunnel (though not of love), with no idea of when the next up would come.

Perhaps a seesaw is a better metaphor. Its ups and downs are quick, and you can stay stuck in either position for an undetermined length of time. And a seesaw is all about balance.

But no. A seesaw requires a second person to operate correctly, and that is certainly not the experience of a bipolar person. Our brain chemistry or genetics or trauma alone is enough to get us going up and down.

A pogo stick? The spring gets squashed and then rebounds. But it’s a rhythmic bounce, not one that you don’t see coming until you’re in it. (If then.)

The basic problem with most of the usual metaphors is that they involve fun at some level. Bipolar is not fun. Oh, the mania may be enjoyable – for a time. But the gut-wrenching drop does not make you go whee!

So how about a soufflé? It can rise or fall, and you never quite know which it’s going to do.

Or a computer? It can open up the world, but is going to crash sometime, inevitably when you most need it to work.

I suppose we could split it up. Mania is a fountain and depression is a ditch. Depression is a b&w rabbit-ear TV and mania is streaming with 1000 services. Mania is a battery and depression is a dead battery.

The root of the problem is that no metaphor can adequately explain bipolar disorder. Even Spoon Theory, useful as it is, explains only the effects, not how the disorder itself works. A metaphor may capture one half of the experience – the ups or the downs – but not the reality of both.

If it’s not possible to explain bipolar disorder with a metaphor, why do we so often try to? Because, really, only people with bipolar know what it is like, and the experience even differs from person to person. A psychologist or psychiatrist may understand the mechanisms and the causes and the complications and the medications. But she or he is essentially watching from the outside.

My husband didn’t really “get” depression until he fell into depression himself which lasted a couple of weeks. “Now,” I said, “try to imagine that feeling lasting for months.” He couldn’t, but at least he was closer to understanding.

My mother-in-law, who doesn’t “believe in” mental illness, now has a clue too, since she experienced a profound reactive depression.

Neither of them really “gets” mania.

Maybe the best metaphor is that bipolar disorder is like sex. You can’t adequately explain it to someone who’s never had it. And even when you’ve had either sex or bipolar disorder, you only know what it’s like for you. You can generalize your experience and share commonalities, but basically, every case of bipolar is something a person goes through alone, or maybe alone together, as Jenny Lawson says.

Bipolar disorder.

It is what it is.

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Dear Bipolar Disorder

Dear Bipolar Disorder,

We’ve had a relationship for decades now, though it’s one I never chose. To tell the truth, I can’t even remember when we met. Gradually, you just moved in. So I guess we’re stuck as roommates for the rest of my life. You can’t break your lease and I can’t move out. That being said, there are some things I need to talk to you about. We’ve never been friends. We never will be. I have some issues with you; there are compromises we need to make.

I’ll take my meds faithfully if you back off when I do. By that I mean no major depressions of longer than a week and no panic attacks while I’m trying to sleep.

I’ll pay for those meds, as long as you settle down enough to let me keep working and earning money and paying for meds. Just leave me enough concentration to do that and to read, and I’ll be satisfied.

I won’t go to Chuck E. Cheese or Cici’s Pizza or shopping at a mall anytime after Thanksgiving if you will let me go out at other times to other places without getting your figurative undies in a bundle.

I will try to minimize the stress in my life (see above) if you will cut out the physical symptoms when there is stress anyway. You know the ones I’m talking about. Ick. Just ick. I hate cleaning up after you.

And can we talk about spoons? I know you only give me a limited number per day, but it would sure help if I knew what that number was. Is there any way you can be more consistent? If I have to borrow spoons from the next day or force myself to attend to some vital call or lengthy errand despite not having spoons, I promise to spend the next day in bed, just to satisfy you.

Please, if you can, give me some non-anxiety-laden hypomania so that I can go out and enjoy things with my husband and friends. If you agree to this, I will occasionally let you buy things off the Internet, for $20 or less.

And while we’re on the subject of enjoyment, I would appreciate it if you would give me back my libido. So would my husband. I know you don’t take orders from him, but it would be esteemed a favor.

Don’t even talk to me about hurting myself. I won’t listen. No matter how loud you get.

Don’t get between me and my friends. You’ve done that too often already and I just can’t put up with it anymore.

No more screwing with my memories. I’ve already lost enough. You can keep the ones of everything stupid I’ve ever done, but I will not watch when you push play on my internal video playback.

Now that I’ve finally got some self-esteem back, you just keep your claws off it. I need it and you don’t.

No dogs allowed. Especially large Black Dogs.

Oh, and tell your buddy Depression to leave my husband alone.

No love,

Me

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The Question I Hate the Most

There are many things you shouldn’t say to a bipolar person: Cheer up. Smile. What have you got to worry about? We all have mood swings. Calm down. You’re overreacting. You don’t look depressed.

Each of these remarks contains a hidden assumption, from simple – you can choose your moods; to dismissive – your anxiety is not as severe (or as important) as mine; to possible gaslighting.

I’ve gotten all of those and more. Once I revealed my disorder to a coworker and she’d ask me, “How are you?” with a concerned look several times a day, taking my emotional temperature. But the question I hate most is a simple one.

Are you off your meds?

Let’s unpack this, shall we?

First, the underlying message is that, to the speaker, you are acting in a strange, inappropriate, frightening, incomprehensible, or otherwise “off” manner.

The second assumption is that you must be on medication in order to appear “normal” at times.

Third, that since you do not appear “normal” to the speaker, the only explanation is that you must not be medicated at the moment.

Fourth, that the speaker has the right to give you advice on how medicated you need to be in order to appear “normal.”

And, finally, that “meds” are the answer to all your problems. If you want to fit into society you must be on your guard at all times and medicate until you are acceptable to them.

There is a slightly less offensive version of the question: Have you taken your meds today?

This might be marginally acceptable from a loved one, who knows that you take medication for your disorder and also knows that you are sometimes forgetful.

But really. Most psychotropic medications build up in a person’s system over time and leave the body over a long time as well. Missing a single dose is not likely to have an appreciable effect on a person’s moods or actions.

There are some anti-anxiety medications that have short-term effects, and a bipolar person might have forgotten a dose or two.

But unless the speaker is the bipolar person’s caregiver, official or unofficial, it’s still rather parental and demeaning – suggesting that we aren’t competent to handle something as vital as our own medications.

Of course, sometimes it may be necessary to help a loved one remember to take medication, whether that person is bipolar or not. On a vacation, for instance, when one’s normal routine is disrupted, a gentle reminder may not be amiss. When one has just started treatment and the routine is still unfamiliar. Or if the person actually is a child.

You wouldn’t ask an adult with the flu “Have you taken your antibiotics today?” You wouldn’t say to a blind person “Now, don’t go out without your service dog.” Most people, most of the time, are deemed competent to know their needs and take care of those needs themselves.

But bipolar disorder and other psychiatric conditions, being largely “invisible illnesses,” seem to invite meddling. Everyone else knows what’s best for us, from a different drug to herbal medicine to a walk in the park to prayer.

They know a little bit about the disorders, perhaps, largely through television and celebrities. But they don’t know your particular version of the disorder (bipolar 1 or 2, rapid cycling, dysthymia, hypomania, anxiety, etc.)

So if I snap at you, or seem anxious, or don’t want to go out, don’t assume. I have regular “normal” moods too, even when I’m on medication. Sometimes I get annoyed if my husband has lost his cell phone for the third time this month. Sometimes I feel sad if my picnic is rained out. Not every mood is pathological.

So don’t assume you know what’s going on inside my head. Unless I ask for help, refrain from putting in your oar.

And don’t ask me, “Are you off your meds?” It’s an insult, not a question.

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Mental Health

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