Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

What My Husband Has Learned From My Bipolar Disorder

First, let me say I’ve learned a lot from my husband and from my bipolar disorder. The two of us have been married for more than 35 years and I’ve been bipolar all that time. I’ve learned a lot from him about caregiving, steadfast love, and coping, among many other things.

But he’s also learned a few things from living with me and my disorder. I asked him to tell me about it, and here’s what he said he learned.

He can’t fix me or control my emotions. (Of course, the corollary to this is neither can I.) “It’s not necessarily my fault when she feels bad and it’s not my responsibility to make her feel better,” he says. This particular lesson caused both of us a lot of trouble early in our marriage. Dan would blame himself for my moods and become angry when he couldn’t do anything to make me feel better or even respond to his attempts. He was in there trying, but he had to learn to let go and help me find ways to work toward my own healing.

He knows my comfort items and my triggers. Over the years, Dan has learned that while he can’t make me better by himself, he can help me get the things that bring me comfort and avoid the things that trigger me. For example, he knows I find watching cooking shows calming. Him, not so much. But often he joins me on the sofa while I indulge. “Sometimes I’ll sit and be with her even if I’m not really interested in the cooking shows,” he says. “Just to be with her. I do it because I want to be with her.” Sometimes I do that with him too, when he watches shows about treasure hunting or weird science. Sometimes we even sit together and watch shows we both like, such as Forged in Fire.

He has also learned about things that trigger my anxiety, such as loud noises. “I have to be mindful if she’s in a place where loud noises affect her,” he says.  “If I do have to hammer or pound on something, I give a warning so that she’s not blindsided or startled by it.” “There’s going to be a crashing noise,” he says, or “Everything’s okay. I just dropped a pan.” He also lets me know where he’s going to be and how to get hold of him in case I panic badly.

He knows to ask, offer, or get out of the way. I can be needy at times, but don’t always know what it is I need. At times like that he’ll ask, “Do you need a hug? Do you need to eat?” Other times he’ll simply give me that hug or put on one of my comfort movies (The Mikado or The Pirates of Penzance usually draws me out of bed). If neither one of us can figure out what might help, he’ll simply let me alone until I feel better or until I think of something.

If I do ask for something I need he’ll say, “You can get that.” If he can’t do what I need, we’ll sometimes negotiate a partial solution. Or he’ll give me the tools to do it myself.

He knows how to help with self-care. Like so many people with bipolar disorder, I find that taking a shower, getting dressed, and going out requires quite a number of spoons, sometimes more than I have. Dan helps with that. For example, he’ll give me a clean towel and clean clothes, and remind me that I need that shower. Or he’ll encourage me to get out of the house by negotiating how many errands we’ll do on a given day or by including a stop at a bookstore or a favorite restaurant among them.

He knows that self-care is important for him too. Sometimes he’s the one who needs that hug or that alone time, and he asks for it. He knows that I have learned that he needs these things too and that I will ask him what he needs, or offer it, or say, “You can get that” to him. As the saying goes, you can’t pour from an empty vessel.

A lot of what we’ve both learned from my bipolar disorder are just the things that any partners need to learn: Tolerance. Give-and-take. Negotiation. Touching. Sharing. Civility. Support. We’ve both grown from the experience and that to me is very important. This marriage would never have worked if either one of us had stayed stuck in the way we were in the early days.

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Ridding Your Life of Toxic People to Save Your Mental Health

It’s hard to cut toxic people from your life, even if the person is a gaslighter or other abuser. There’s always the temptation to give the person one more chance, believe his or her protestations of love or change, or to feel it is up to you to change the situation or the other person.

But sometimes it’s necessary to end the relationship.

A toxic person is like a psychic vampire who sucks all the confidence and energy and spirit from your life. He or she exhausts you emotionally and adds nothing to your life but annoyance, pain, and trouble.

Once or twice I’ve even been that toxic person when I was in the grips of the depressive phase of my bipolar disorder. Several people cut me out of their lives and I can’t say that they were wrong to do so. I gave nothing, only took. I was the psychic vampire. And I deeply regret that, even though my hurtful actions were manifestations of my disorder. It lasted so long, with no apparent signs of letting up, that it simply wasn’t worth it to them to continue to associate with me.

Once or twice I’ve been on the other side of the equation, though. I can think of two times in particular. One was when I got out of the relationship with the person who turned out to be gaslighting me, which I have written about before. I learned something from the experience (though I still maintain that the lesson wasn’t worth the price I paid).

What I discovered is that it is better to make the break definitive. If you’re going to cut a toxic person out of your life, do it cleanly. Don’t leave that door open for continued contact. In my case, I felt I owed the person some money and sent him a little every month. An acquaintance called me on this and pointed out that even if I did owe money (which he doubted), it was better just to send a single, final payment and end it there.

So that’s what I did. I scraped together some money, wrote a check, and released myself from the ties that still bound me.

It’s somehow different when the toxic person is a family member, though. I won’t write much about the actual situation because I want to leave the person their privacy. But it was a toxic relationship that sucked time and energy from me and also from another person that I loved. It was concern for this other person that led me eventually to make the break, though I was growing weary of dealing with the person’s dramas, helplessness, vindictiveness, and general mean-spirited relations with me and others in the family.

I haven’t looked back. Some people have judged me harshly for taking that step because the person was, after all, family. Many people believe that family is more important than anything. But I chose my own mental health and refused to keep forgiving the damage done to both me and others. It took a lot of years until I was able to make the break, but I am never tempted to go back on my decision.

It’s easy to say that one should cut toxic people from one’s life, but it’s often a very hard thing to do. You can end up questioning yourself and your own motives. You can be shamed by others outside of the situation. You may regret your decision and wish you could mend the relationship.

My experience has taught me that sometimes that just isn’t possible. If the person is unwilling to or incapable of seeing the harm he or she has done, it’s likely to be a mistake to let the person have another chance to inflict more damage.

I plan on reaching out one more time to a person that I have harmed. But if they don’t respond, I’ll understand. I own that I was toxic and it was perfectly understandable that they cut me loose. I’ll always have regret and shame for the way I was, and I won’t try to insert myself back into their lives. I just want it to end on a less bad note if that makes any sense.

But I note that the toxic people whom I have cut from my life show no such inclination. I have to believe that they still believe they did nothing wrong and that they have not become less toxic. I still must protect myself and my mental health by not letting them back into my life.

And if that includes family, so be it.

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When You Don’t Want to Live, but You Don’t Want to Die

“I hope I don’t wake up tomorrow morning.”

That is the classic thought of someone suffering from passive suicidal ideation. It’s not really a desire to die by suicide. It’s just a way of expressing how much it hurts to be you.

It’s not active suicidal ideation, the kind where you make an actual plan to kill yourself, even if you never put it into practice. It’s passive, meaning that you’d like to be dead but don’t intend on doing anything about it. It’s like asking the universe to take over and do it for you.

I’ve certainly had passive suicidal thoughts. Once I was very stressed and depressed while coming home from a business conference. I clearly remember thinking, “Maybe the plane will go down and keep me from having to deal with all this.” I certainly had no plan to rush the cockpit with a box cutter or anything like that. I just wanted my pain to be over. I wanted the choice taken out of my hands.

Another time I was at a business meeting in a swanky hotel that had rooms surrounding the lobby on numerous floors. I remember being on the 16th floor, looking down at the atrium beneath with what felt like idle curiosity. Would it annoy the hotel more, I wondered, if I landed on the carpeted area, necessitating a thorough cleaning or total replacement? Or would they be more upset if I landed on the marble floor portion of the lobby, making a bigger mess and potentially chipping the surface? (And was it just a coincidence that business meetings made me contemplate my mortality or did they just come packed with a lot of stressful triggers?)

At neither time was I actively suicidal. I’ve been there once too, and this was completely different. When I was suicidal, I had actual plans and plenty of means to carry out any one of them. I’m not going to discuss what those plans were. (The difficulty of choosing among them may have been what kept me from actually doing it. By then my depression had lifted just enough for me to get help.)

It was easy enough later to make jokes about the passively suicidal occasions and most people took them as exactly that – jokes. It was even plausible that they were jokes. I used to talk about jumping out a window, adding that it wouldn’t work because I lived in a basement. It was only much later that I thought about it and realized that I needed help even on those occasions. After all, isn’t pain the source of much humor and the downfall of many comedians?

Passive suicidal ideation is asking yourself “what if?” What if my troubles were over? What if my pain was gone? What if all I had to do to accomplish this was to let that bus hit me instead of stepping out of the way?

The important thing to remember is that someone passively suicidal is in great psychological pain and wants not to feel that way anymore. In that respect, it’s similar to cutting or other self-harm. And like those acts, it doesn’t end the pain at all. It may be a temporary escape valve, but it’s not a solution.

Passive suicidal ideation is certainly a bad thing and an excellent reason to see your psychiatrist or therapist as soon as possible. If you hear a friend or loved one talking this way, encourage them as strongly as possible to seek help. Let a professional decide if the person has passive suicidal ideation or active suicidal ideation. It is entirely possible that passive suicidal ideation will lead to the more active kind and even to death if it is not dealt with.

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No Resolutions – Just Memories and Hopes

I don’t make New Year’s resolutions. But since January is named after Janus, the two-faced god that can look both ways, I do look to the past and the future just to see what I can see.

Last year was a very mixed bag. It brought the heights of joy and the depths of depression, along with a little hypomania and dysthymia thrown in just because my brain does that.

The big negative this year was my husband’s heart attack in August and all the medical and financial repercussions that entailed. He’s back at work now, though he’s having difficulty managing the mental and physical stresses of it, so much so that he hasn’t made it to cardiac rehab in over a week. Rehab is not just a good thing physically; Dan said it made him feel energized, productive, and cheerful. I know, I know, exercise could do the same for me.

Still, there have been good things. My book, named after this blog, has now been published. This is a huge event in my life that lifted me temporarily out of depression and into (possibly) hypomania. And I have retired, meaning only that I will start collecting Social Security next year. It will not alter my blogging, writing, or other pursuits, since what I make from them won’t be over the “allowed-to-make-in-addition” line.

As for next year, I expect to see more of the same (minus, I hope, the heart attack). There will still be problems paying the bills, including the massive hospital one, but at least I will have a steady, fixed income. It will help me with my anxiety over potential financial collapse and my unreasonable fear of losing the house.

I’m also planning to get away for another long weekend at a bed-and-breakfast on a working farm. The last time we did it, it proved enormously soothing and relaxing. Another such mini-vacation would be ideal. We certainly won’t be able to take a full vacation, so I won’t even hope for that.

The other good news is that my second book, Bipolar Us, will be published. It may not be attended with the same level of hypomania that the first one was, but at the very least there will be real joy. Also in the coming year, I plan to finish my mystery novel and place it with an agent.

As far as my bipolar disorder, in the coming year, I will still have it. I expect that my meds will change not at all, or minimally since I’ve been relatively stable for so long. But I know it won’t go away just because I’ve crossed “publishing a book” off my bucket list. That’s not the way it works.

If this sounds like my 2019 will be more of the same, well, that’s because that is truly what I expect. Of course, my expectations will have no influence on the outcome. The year will be what it will be, as rife with unexpected events as this one was. My main hopes are that my husband’s health and my writing both improve.

I’ll try to remember the lessons learned from this year – that we are both strong and good things can happen to us. And I’ll try to plan for some positive accomplishments in 2019 and hope they’re within our reach. I won’t call them resolutions, though. Resolutions are so easily broken and I don’t like to think that my plans and hopes are.

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Men, Women, and Mental Health

My husband is no stranger to situational depression. He experienced it when his father died, when a beloved pet passed unexpectedly, and when his job turned suddenly more stressful and meaningless.

But he didn’t understand clinical, chronic depression. “What would it be like if those feelings lasted for months at a time, or even years?” I asked. He said he couldn’t even picture it. “That’s the way my life is,” I explained. Then he lost his job, and after a brief period of relief from the stress, he finally experienced depression that lasted more than two weeks – two years, in fact, during which he was unable to work.

He did not seek help for it until his best friend and I both proactively encouraged (i.e., nagged) him to do something about it. He’s been on an SSRI ever since and has occasionally seen a psychologist.

Lately, there has been a movement to educate men about mental illness and mental health. Primary among its goals is to help men understand that mental illness is a thing that can affect them and that there is no shame in asking for help.

Certainly, the statistics bear out that the majority of mental health consumers are women. Psychology Today reports: “Research suggests that women are about 40% more likely than men to develop depression. They’re twice as likely to develop PTSD, with about 10% of women developing the condition after a traumatic event, compared to just 4% of men. It’s easy to write off this epidemic of mental illness among women as the result of hormonal issues and genetic gender differences, or even to argue that women are simply more ’emotional’ than men. The truth, though, is that psychiatrists aren’t really sure why mental illness is more common among women.” Perhaps the answer is that seeking treatment for mental illness is more common in women.

Prevention magazine says that there are four mental health conditions that affect women more than men: depression, anxiety, PTSD, and eating disorders. That PTSD is twice as common in women may surprise you, though the stats about eating disorders are not likely to. The fact is that, although few women experience the traumas that soldiers do, they are much more likely to experience other sorts of trauma, such as rape, which can also lead to PTSD.

But men experience societal and psychological barriers to getting help when they need it. Among the excuses you hear are these:

  • I don’t really need help.
  • I can handle this myself.
  • I don’t want to appear weak.
  • I might lose my job if anyone finds out.

In other words, a lot of bullshit that boils down to “I’m a man and mental illness is not manly. Asking for help is not manly. Talking about emotional problems is not manly. Taking medication for a personal problem is not manly. Not being able to deal with my problems, especially emotional problems, is not manly. Therefore I have no mental problems and don’t need treatment for them because I’m a man.”

Or, looked at another way, the campaigns against stigma around mental illness have been less than effective for most men. Now the attention to that problem, which is surely needed, is beginning to be heard and, one hopes, acted upon.

Still, it’s important to remember that mental illness is not just a men’s problem or a women’s problem. It is a human problem, affecting both genders (and all ages and races) if not equally, then without discriminating.

It is important to get men the mental and emotional help they need, in a timelier and more comprehensive fashion.  I would have liked to see my husband be willing to recognize when he needed to get help and to get it without being pushed. But it would be wrong to push the needs of women aside to accomplish this. This is a societal problem, and while right now spreading the word to men is particularly important, our goal should be to make sure that all people are aware of the prevalence of mental illness, the fact that it can happen to them, and that there are places to get help. That message, at least, is not gender-specific.

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Bipolar Disorder: Mood and Food

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FDA looks to ban trans fats. Exceptions made if consumed while depressed, anxious, or without anything better to do.

The Daily Show

If that were true, I could eat all the trans fats I wanted, because my bipolar 2 often leaves me depressed and/or anxious.

In fact, my friend Leslie, who is my partner in depression, invented the perfect snack for depressive times: a ruffled potato chip dipped in cream cheese with an M&M on top. My husband starts to worry about me when I ask him to get those ingredients at the store.

But there’s a reason for our peculiar snack. Leslie and I are simply self-medicating.

“Blood sugar and carbohydrate intake are very important to the brain,” according to Everyday Health. “Your brain runs on glucose and depends on carbohydrates to supply the energy it needs. Carbohydrate intake also prompts the production and release of important neurotransmitters, such as serotonin, which creates a feeling of calm and well-being and reduces depression. So people with bipolar disorder may be indulging in a form of self-medication when they eat sugary snacks during depressive lows or manic highs.”

Not that self-medication is good for us. Bipolar people are more likely to have type 2 diabetes than the rest of the population. Three times more likely. One of the risk factors for type 2 diabetes is excessive weight and we all know and bitch about the weight gain from our assorted meds. Prescribing ourselves the Ben & Jerry’s treatment is not going to help, even though it may feel like it at the time.

So what are we supposed to be eating to help stabilize our moods? Of course, people will recommend turmeric, cider vinegar, or the latest “superfood.”  But every serious list I saw looked like this:

  • complex carbohydrates, especially fruits, vegetables, and whole grains
  • protein in the form of lean meats, poultry, fish, and low-fat dairy
  • omega-fatty acids from fatty fish (such as salmon), walnuts, and flaxseeds

In other words, exactly the kind of diet that is recommended to everyone for general good health! I think this comes under the heading of self-care, which is not always easy to do. Especially when I’m so depressed I can’t even manage a microwave cup of mac-n-cheese, or when my husband brings home a rack of ribs that he bought on sale.

But if I am stable enough to shop and cook and eat properly, those recommended foods may be good for my mood disorder as well as my body. According to bipolar.newlifeoutlook.com, eating protein “promotes serotonin and improved moods.” They also note that researchers in Italy say “increased consumption of omega fatty acids helps reduce depressive episodes and decreases the risk for suicide in patients with bipolar.” So apparently fish is brain food after all.

The other common suggestion in this realm of self-care is to keep a food journal, or I guess in this case a food and mood journal, to keep track of what you’re eating and how it affects your moods. If you’re the journalling sort, by all means, give this a try. As for me, I blog rather than journal and I know you don’t want to see a lot of “ate salmon, felt energized; ate chips with cream cheese and M&Ms, felt sad.”

The fact that food and mood are related is just one more example of how the brain and the body are intertwined, interdependent. It gives us a clue about the kinds of self-care that may do the most to help us stabilize our moods. And it gives us a chance to take more control, if we can, of our mental as well as physical health.

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The Appropriate Committee

 

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When I was a teenager, my life was spent resenting the Appropriate Committee. I always ran afoul of them.

It seemed there was some nebulous group, invisibly judging us and deciding whether what we did, or wore, or how we acted was appropriate or not.

Part of the Appropriate Committee was, of course, the adult world. Teenagers were supposed to be polite and respectful and not talk or play music too loudly. To do otherwise would be inappropriate.

The social milieu was also part of the Appropriate Committee. How we monitored one another to make sure our pants weren’t too short, or that we didn’t wear ankle socks, or that we didn’t stay in the Girl Scouts past Brownies. The punishment was derision.

Of course being bipolar didn’t help. Both adult and junior versions of the Appropriate Committee took note of my mood swings – my loud, inappropriate laughter; my extreme, inappropriate crying; my extended, inappropriate isolation.

I tried to defy the Appropriate Committee. I laughed at them, thought they were stupid, and vowed not to let them run my life. They did anyway, of course. They were all-powerful and I had not yet gained the wherewithal not to care. It was like a pervasive, invasive form of bullying: Everything I did or said was wrong. The rules changed capriciously. I was punished with disapproval, mocking, and the wrong kind of laughter.

And they broke me. At times I tried desperately to fit in, to live up to expectations, to suppress my differences. At other times, when the effort became simply too much, I let my natural weirdness float to the surface and looked for the few other like-minded individuals that could tolerate that. Depression set in and, rarely, hypomania. I still dressed “wrong.” I still laughed at the wrong things, and too loudly. I still isolated and wept.

I thought that when I grew to adulthood, I would no longer be subject to the censure of the Appropriate Committee, Of course, that was completely delusional. I learned that the Appropriate Committee for Adults was a powerful force. It is particularly insidious in the business world, where it judges not just your appearance, but even seemingly minor matters such as where and how you eat lunch (with the “cool kids,” of course) and how you spend your breaks (cigarettes OK, crossword puzzles not). There’s still the problem of being laughed at in meetings and needing to go into the restroom to cry.

I finally realized that the Appropriate Committee exists in part to perpetuate stigma. So many of the behaviors of people with mental illness defy societal norms. It’s the Committee that insists we fit in, no matter what we’re feeling. It’s the reason that neurodivergent people are so reluctant to admit their differences in public and try their best to “play through the pain,” something that isn’t good for them, or for athletes either, really.

I’ve had enough of the Appropriate Committee over the years. Now that I’m properly diagnosed and medicated and relatively stable, I could undoubtedly fit in better than at any time previously in my life. But I dress how I like, even if it’s pajamas. I play my music as loud as I want and laugh or cry along with it if I feel like it. I embrace my weirdness, my differences, and seek out like-minded weird friends who are also living in defiance of the Committee.

Maybe the Appropriate Committee is needed for some places and times and people, like theater audiences or church services. Maybe. But for the mentally ill the Committee is hurtful, and stigmatizing, and unrealistic. We can strive to overcome our differences and sometimes we need to. But sometimes it’s better just to embrace weirdness, differentness, and our membership in the group of the neurodivergent.

And when I despair, I remind myself of songwriter Steve Goodman’s lyric: “I may not be normal, but nobody is.” And I let it blast.

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The Golden Glow and the Spoons

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Hypomania is as insidious as it is enjoyable.

I remember when I quit my 9–5 office job to go freelance. I remember when I made the decision. I had gotten my first bad review, ever, shortly after disclosing my bipolar disorder to my new boss.

I remember driving around shortly thereafter, running errands in the middle of the day. I felt the warm, golden glow that goes with either happiness or hypomania. I could wake when I pleased and work when I pleased. I could run those errands when I wanted. I could take my mother to her doctor’s appointments whenever I needed to. I could make and go to my own appointments as necessary.

Best of all, I felt as though I had enough spoons to do all this. I was able to keep up with the work and the errands and the appointments and, hey, if I got tired I could take a nap in the middle of the day.

But.

Eventually the glow wore off and the spoons ran out. Hypomania dumped me back into the depression I was oh-so-familiar with. I had more work to do and less energy to do it. My mother’s problems increased and I had to take over her finances as well as my own. I was teetering on the edge of a major depression, and then I fell off that cliff.

Anymore I don’t trust hypomania. First of all, I can’t distinguish it from actual happiness, competence, or satisfaction. I always question its sincerity and watch out of the corner of my eye for the coming crash. In other words, when I’m happy I can’t even enjoy happiness without reservation.

One way I keep track of my hypomania is by being aware of the number of spoons I have. If I’m flying on a hypomanic cloud, I feel replete with spoons. It never occurs to me that I will run out. When I’m experiencing garden-variety happiness, I still suffer at some point from lack of spoons. No matter how many pleasing things are scheduled for the day, I know deep inside that I cannot simply dive into all that bounty. My joy is measured out, as the poet said, in coffee spoons or in this case metaphoric spoons which I always visualize as small white plastic ones.

Stability for me does not mean that I can ignore my supply of spoons, either. I may be on an even keel, able to do most of what I want, but inevitably the spoon depletion hits, sooner or later. There is simply no more that I can do, much as I want to. And if I force myself past that point, I will surely pay for it in exhaustion, irritability, or isolation.

Spoons, therefore, run my life. If I am too happy, I have to watch for incipient spoon depletion.  If I am level, I know that I must still keep track of the spoons I use. And if I am low, my spoons can disappear altogether, to the familiar point of not being able to get out of bed.

I think the trap of hypomania is the worst of all. On a high like that I can lose track of my spoons – even forget that they are necessary. Fortunately, I don’t get the full-blown version of mania. I fear I would squander spoons recklessly, leaving me a terrible absence of any.

Spoons are a useful way to explain the energy demands of chronic and/or mental illnesses. My husband and I speak spoonie shorthand. But I wish I could experience that golden glow, that haze of happiness, that feeling of floating, without having to keep one eye on the spoon-meter.

 

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Bipolar Sex: Drought and Abundance

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Here’s something bipolar people talk about amongst themselves but not so much with the world outside: sex.

The two poles of bipolar, depression and mania, govern a person’s appetite for sex. A lot of other factors determine whether the sex will be any good, or good for the participants.

Of course the above is true for neurotypical people as well. Moods and emotions – things in the brain – have as much or more to do with sex than stuff in the body. Thinking about sex and wanting sex, for example, start in the brain and without them, nothing else is likely to happen anywhere else.

The depression side of bipolar sex is easy enough to map out. After all, some of the hallmarks of depression are numbness, inability to enjoy things that once gave pleasure, and a tendency to isolate. It’s hard to get your motor revving with all that going on.

Still, the depressed person may want to have sex, or at least want to want to. That’s the way it’s been with me. When I’m in a thoroughly depressed state, sex doesn’t even cross my mind. When I’m not quite as depressed, I think I might like to have sex but don’t have the energy for it. And when I’m relatively stable, there’s the meds.

It’s well known that medications for bipolar disorder can kill the sex drive and in men the ability to get or maintain an erection. Some drugs supposedly have less effect on sexuality, but I’ve never found the magic combination. Or the supposed sex-friendly drug has had side effects I can’t tolerate.

So if bipolar depression is largely a big zero for bipolar sex, how about mania?

Overactive sex drive combined with a lack of impulse control can lead to sexual excess. The tendency to minimize risk-taking behaviors means that some of that sex can be detrimental to one’s health, relationships, and self-esteem. Riding that wave is exhilarating, but then, inevitably, comes the crash and the need to pick up the pieces.

Full disclosure here: Since I have bipolar 2 and my hypomania tends to turn sideways and come out as anxiety, I don’t experience that manic sex high. On the whole, I think I am grateful for this. Sex has never been such an important part of my life that I would risk everything for it.

Once, though, I did experience what you might call a hypomanic sex drive. It smoldered for a long time, requited but unconsummated, until the right set of circumstances presented themselves. It was a restlessness, an obsessive thought, a longing for connection, rather than an ungovernable rush of need. It gave me, perhaps, a glimpse of what it might be like to be manic and sexually stimulated. But I’ll never really know.

I do know that I am glad I had the experience, whatever it was. I’m glad it was safe sex.  I’m glad it didn’t destroy relationships. But just to feel that desire again, even if only for a brief time, even with the anxiety it provoked – and there was lots – it was a kind of affirmation that my body and brain are still connected in some vital way.

Most of the time I limp along with only thoughts of sex too fleeting to act upon. And maybe this is not the best way to live, but I have made my peace with it. And once in a great while, every now and then, I still am reminded that I can have a sexual existence.

Even though I have bipolar.

Of course, as always, your mileage may vary.

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What Schools Are – and Aren’t – Doing About Mental Health

I believe that mental health education belongs in schools. I’ve written about that (https://wp.me/p4e9Hv-Jw). There’s good news about the subject and there’s less-good news. I’ll let you sort out which is which.

First, two U.S. states are now required by law to include mental health in their curriculum – New York and Virginia.

New York’s law mandates teaching the subject as part of the K-12 health curriculum, which has only two other specifically required topics: alcohol, drug and tobacco abuse and the prevention and detection of certain cancers. According to the law, the new education requirements seek to “open up dialogue about mental health and combat the stigma around the topic.” Free resources for New York schools, such as teacher training, are available online. These include lesson plans, though schools and teachers are free to design their own curricula.

In Virginia, mental health education is required only in grades 9-10. Huffington Post reports that the legislation came about “after state Sen. R. Creigh Deeds (D-Charlottesville) saw that three high school students had researched, developed and presented the proposed legislation, which struck close to home for the legislator, who had lost his son to suicide in 2013.”

Indeed, those laws are good things, though one could wish that the other 48 states would take note and do likewise. They are, of course, not forbidden to teach mental health education, and many do, especially around the topics of drug and alcohol prevention and suicide prevention. Some of them even require education on those two topics, along with bullying. Many of these efforts are sincere, significant, and even life-saving, but it is worth noting that bullying and student suicide are events for which schools are at risk of legal liability. One might wonder whether that has influenced the laws, rather than supporting more comprehensive mental health education.

Contrast the U.S. experience with England, where all secondary school teachers and other school staff are being given training that will help them identify mental health issues in children, including depression and anxiety, self-harm, and eating disorders. This is thanks in part to Prince Harry’s openness about needing counseling to help him deal with the death of his mother, Princess Diana, which happened when he was 12. The Prime Minister has said that the prince’s disclosures will help “smash the stigma” regarding mental illness and the need for getting help.

“The programme is delivered by social enterprise Mental Health First Aid (MHFA) England, backed by £200,000 in Government funding,” notes the Telegraph, “and will be extended to primary schools by 2022.”

The campaigns around the mental health mandate, especially those featuring Princes William and Harry, have focused on the need for Britons to abandon their “stiff upper lip” image and to accept that men can and do need to seek help for mental difficulties. While that is indeed a vital message, one hopes that girls and women do not get left behind in the efforts.

What about U.S. states where mental health education is not a fact of life?

For schools in the U.S. that have not mandated mental health education, the National Alliance for Mental Illness (NAMI) has developed resources that can help districts, schools, teachers, and families address the problem through the NAMI Parents & Teachers as Allies program of training.

They have also developed a presentation for students called NAMI Ending the Silence, “designed for middle and high school students that includes warning signs, facts and statistics and how to get help for themselves or a friend.” These programs are offered free to schools and communities. For more information, go to https://www.nami.org/Learn-More/Public-Policy/Mental-Health-in-Schools.

For a more DIY approach, youth.gov (https://youth.gov/youth-topics/youth-mental-health/school-based) recommends that schools “partner with community mental health organizations and agencies to develop an integrated, comprehensive program of support and services.” Among the actions they recommend are for schools and partnerships to:

  • develop evidence-based programs to provide positive school climate and promote student skills in dealing with bullying and conflicts, solving problems, developing healthy peer relationships, engaging in activities to prevent suicide and substance use, and so on.
  • develop early intervention services for students in need of additional supports such as skill groups to deal with grief, anger, anxiety, sadness, and so on.

In other words, for schools to spend the time and energy to do for themselves what the state and national governments are unwilling or unlikely to do.

To me, this is one of those times when a national curriculum makes sense, or at the very least a mandate in every state. Mental health education should be comprehensive, freely available, easy to access, and scientifically accurate for all schools and schoolchildren. The education this would provide and the statement it would make would be invaluable. Drug and alcohol, bullying, and suicide prevention are just a start, but a start that many states have not made.

 

 

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