Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

Beautiful at the Broken Places

The Japanese have an art form or maybe a philosophy called kintsugi, which involves embracing the flawed or imperfect. Cracks or breaks in a pottery or ceramic vessel are repaired using gold dust and resin.

According to Wikipedia, “Japanese aesthetics values marks of wear by the use of an object. This can be seen as a rationale for keeping an object around even after it has broken and as a justification of kintsugi itself, highlighting the cracks and repairs as simply an event in the life of an object rather than allowing its service to end at the time of its damage or breakage.”

On December 29, I posted an essay titled “Broken” (https://wp.me/s4e9Hv-broken). In it, I described the despair and depression that finally hit me after a stressful year, one that ended with the news that my second book was not going to be published. It was an awful trigger for me, considering the amount of work and hope and myself I had already invested in the book, and how near it was to completion.

Instead, I have decided to embrace the philosophy of kintsugi. I may have been broken, but nothing says I can’t put myself back together and consider my mending an improvement. In fact, my therapist said something similar after I suffered an earlier breakdown: essentially, that I could choose what parts of myself I would restore and which I could cast aside. Recently I came across an old diary from that time. I have not yet decided whether to read it, keep it unread, or get rid of it. At any rate, I don’t think I’m strong enough to decide that now, given everything else that’s been going on. But there are other things I have decided to keep.

One of my decisions is to keep my first book, Bipolar Me, alive. It was went out of print this month, but I will be self-publishing it on Amazon. I won’t let the second book, Bipolar Us, die either. Right now I am exploring ways to make sure it will be published as a paperback as well as an ebook. It’s better than my first book, I think, and I want it to be available to people that might find help or hope in it.

To celebrate this decision, I have ordered a kintsugi-style bowl. (I can’t afford the real thing.) On the bottom will be written “My Story Isn’t Over,” which is also the motto that informs my semicolon tattoo. I will keep it near my desk, where I can see it often and let it remind me that beauty can come from the broken after all.

I also hope that the rebuild on our house, which was destroyed by a tornado, will make it more beautiful at the broken places. (The only thing that remained was the basement, so it’s really going to be all new.) At last I will have a home that I have had a hand in designing, choosing materials, and decorating. No more mismatched, hand-me-down furniture. No more rental-neutral walls and carpet. I can create my study as a place of comfort as well as work, one where my self-care items are readily available and the colors and decorations reflect a calm, steady mood. Again, it is a chance to rebuild something and make it better.

Most of all, though, I need to keep working on me. There are still cracks and breaks in my psyche that need to be repaired. It will take continued hard work and loving support rather than gold dust and resin, but I hope I can eventually convert my troubled life into a work of reclaimed art.

 

Asking for What You Need

I saw a post on a bipolar Facebook page that asked what coping mechanisms people used. There were the usual responses about self-care, which is certainly a fine coping mechanism. But it’s far from the only one.

I’ve learned any number of coping mechanisms over my years in psychotherapy. There’s “looking at how far I’ve come.” There’s “leaving the room when my anxiety gets too bad.” And there’s always one of my favorites: “petting the cat.”

But the answer I put down was “asking for what I need.”

It’s a good coping mechanism because no one can read minds. No one else knows what I need. And, short of them guessing and hoping to hit on the right thing, the only thing I can really do is ask.

I can ask my therapist whether we can work on my anxiety today. I can ask my friend to check in on me daily for a while. I can ask my husband for a hug, or alone time, or some distraction.

Of course, I don’t always know what it is that I need at any given time. At times like that, I can simply ask for things that might help or have helped in the past, like the aforementioned hug or alone time. My husband has been with me for so long and is so familiar with my bipolar disorder that he knows a number of things that are likely to help, and he can suggest them. If all else fails, he suggests I go to bed, or read, or listen to music, all things which can calm or center me. Sometimes he simply puts on my favorite movie, to help draw me out.

Closely tied to the mechanism of asking for what I need is the technique of negotiation. I may know what I want or need, but the other person may not be capable of providing it, or at least not right then. If a friend can’t take my phone call, I can suggest an alternative: Call me after 10:30 or sometime tomorrow. If I need distraction and my husband has to go to work, he can suggest that we go out to lunch the next day.

We’ve developed a shorthand for such situations. When the only thing I can do is say, “help,” he responds with, “help how?” If I can then come up with a suggestion, I do. A lot of the time he is able to provide what I need. But sometimes he just isn’t. Maybe he isn’t able to get me out of the house for lunch. So instead I say, “I need comfort food.” He usually says, “You can get that.” Or he may respond with what it is that he can do: “There’s cheese and crackers here. Will that do?”

Asking for help isn’t easy, and Lord knows negotiating for what you need isn’t either. Both take lots of practice. And there is always the possibility that another person simply cannot supply what you need. That’s where self-care comes in. I know down deep that a nap, or comfort food, or music may help me, and if no one else can provide them, I can usually do it myself.

Receiving help may not be easy, either. Asking for what you need can make you feel, well, needy. And receiving help from someone else may make you feel guilty or unworthy. But the fact is that you – all of us – need help at times and that learning how to ask for and accept help is a valuable skill. And a totally valid coping mechanism.

Dealing With Other People’s Anger

Before I was diagnosed with bipolar 2 and anxiety, I thought I was just a wimp.

Anger – anyone’s anger – frightened me, even if it was not directed at me. I spent a lot of time cringing, until it became an automatic reaction.

This was not because I was raised in an abusive home. I wasn’t. My parents expressed anger appropriately when they were angry, which wasn’t very often, and didn’t take it out on us kids. Once, my father, in a fit of frustration, kicked the locked door to a room my sister and I were squabbling in, and it shocked me. But compared to what some unfortunate kids go through, it was nothing. Once my fifth-grade teacher slapped my hand when I was holding hands with a boy, but again, my main reaction was shock.

But by the time I reached my late teens and early 20s, strong negative emotions overwhelmed me. And not just my own emotions, but other people’s. I was seldom touched by their joy or relief, but their anxiety or anger really got to me. That’s when I started cringing, literally drawing back in fear and trepidation when voices were raised. At its worst, I cringed even when the voices were in another room.

Along with this, my startle reflex was in overdrive. A sudden noise from another room caused me to jump and gasp. The sound of someone dropping a kitchen utensil was enough to set me off.

I believe that these reactions were a result of the anxiety disorder that my psychiatrist eventually diagnosed me with. I always felt that the negative emotions, the anger, and the attacks would be coming at me. I was always on edge, anticipating the raised voice, the accusation, the threatening sound. And it was exhausting. There’s a certain amount of adrenaline that goes with fear and anxiety, and it can leave you shaking.

Oddly enough, I didn’t really start to get over my fear of anger until I began to get in touch with my own anger. For years, I thought that my only feeling was anxiety, but hiding behind the fear was anger. Even in situations that should have made me angry, when I had a legitimate reason to be angry, I never felt that feeling. That part of building a wall against my feelings worked, even if anxiety and depression were walled in, not out.

Gradually, I began to see that there were times when I should have been angry about something that had happened – that I had a right to feel angry. Later, I learned that I also had a right to express my anger. And I learned that neither feeling anger nor expressing it would destroy me. At that point, other people’s anger began to have much less of an effect.

I’m not completely over it. When someone expresses not simple anger, but rage, near me, I again feel the need to rebuild the walls. But I am learning to deal with it. Sometimes I am able to help the person examine their rage and explore what to do with it. Other times I can simply remove myself physically from the situation, so the rage doesn’t come pounding in on me. I learned to do that when I was dealing with simple anger and the anxiety surrounding it. But I’ve found that it works for rage, too. If I don’t have to be around it, I don’t stay within range.

Fortunately, rage is rare in the people I choose to have around me. Anger still happens, both for me and others around me, but I have learned coping mechanisms and built up the strength to withstand it.

I no longer cringe.

 

 

Future Obsession

I used to obsess about the past. Now I obsess about the future. This is progress, I think.

A little while ago, I wrote about how our recent disaster (a tornado) had affected my obsessive thoughts and interrupted my sleep (https://wp.me/p4e9Hv-TO). At the time, my thoughts were focused backward on all the belongings we’d lost that needed to be replaced. I was losing sleep with obsessive thoughts and spending the daytime cruising the web for potential purchases. I discussed this with my psychiatrist and he prescribed an increase in one of my medications, a mood leveler, that he thought might help me turn off the insistent thoughts and allow me to get to sleep more easily. He was right. It did help.

Now, however, I am obsessing over thoughts of what will happen months from now, next spring or summer. I am anticipating the rebuilding of our house and the house-warming party that we should have. Yes, I am obsessing over what to serve at a party that is at least six months away, or perhaps even more. Two kinds of punch, obviously. Beer and wine? Cucumber sandwiches and melon with prosciutto? Cheeseboard with figs and nuts? All desserts? I’ve already changed the menu four times. I am already deciding what to wear. The red silk shirt that a friend gave me? Jeans? Message t-shirt? Butterfly dress? Something I buy specially for the occasion? And, OMG, am I channeling Martha Stewart?

This is an odd feeling. For most of my life, I have obsessed about things that had already happened. I’ve spent literally dozens of years analyzing a failed relationship and how it has affected my mental health and emotional stability. To be contemplating and obsessing about the future is unfamiliar territory.

Obsessive thoughts are one of the hazards of bipolar disorder as well as depression. I can well remember having a mental recording device that played back for me every stupid thing I ever did or social faux pas I made. I still remember when one cute guy asked me for a glass of water and I gave it to the wrong cute guy. I still remember being mortified. I know this is not just a thing that I experience because I have compared notes with others. It seems to be A Thing amongst many fellow sufferers.

This time around, I worked out the thoughts of the past with choosing what things to replace now and what to postpone to a more appropriate time, like closer to when the house is rebuilt. I know I don’t need a new desk yet (though I have bookmarked several online). Ruined books I allow myself to replace, along with my husband’s wedding ring.

I do not know how to work out the thoughts of the future. The future is strange to me. I have so much trouble living in the present instead of the past that the future rarely occurs to me. If my husband asks me to make a decision about an event that’s one week off, I reply, “I can’t think about that yet.” My husband actually lives in the future a lot and asks me to make choices that are years or even decades hence. It’s tiring on some existential level. I don’t know what to do for dinner and he wants me to discuss how we’ll spend our Golden Years.

Given what I know about myself and my disorder, it’s likely that the closer the time comes to moving into the rebuilt house, the greater my anxiety will become. You’d think it would be a time of great joy, but I am already feeling pre-overwhelmed at the thought.

Even so, I think it is perhaps a touch healthier to be obsessing forward instead of backward. It acknowledges that I do believe I have a future, that I can plan for it, and that I can take some pleasure along with the obsessions. I can learn to appease my obsessive thoughts by giving them the more sensible parts of what they seem to demand. I can, to some extent, live in my present with work to do and deadlines to meet that keep me anchored in the now.

What will happen in the future, of course, I can’t predict or control. But perhaps I can train my brain to experience anticipatory enjoyment instead of anticipatory anxiety. That’s my goal, anyway.

 

Black-and-White Thinking

 

My husband used to have only two categories when he reacted to something: It was fabulous or it was wrecked. There was nothing in between. If he cooked a dinner and I said it was “okay,” he heard “wrecked.” If I said “good,” he heard “wrecked.” Only the most superlative of adjectives would convince him that I appreciated his efforts.

Of course, this was a holdover from his childhood, one called “black-and-white thinking” or “all-or-nothing” thinking. And what that is, is a kind of cognitive distortion, a skewed way of thinking that does not represent reality,

Cogbtherapy.com has this to say about the subject:

A cognitive distortion is an automatic way of repeatedly interpreting a situation that causes us to not consider other ways of thinking about it. When we over-rely on cognitive distortions, we usually interpret events in such a way that fuels emotions such as anxiety, depression, or anger. All-or-nothing thinking is one such distortion.

All-or-nothing thinking refers to thinking in extremes. You are either a success or a failure. Your performance was totally good or totally bad. If you are not perfect, then you are a failure. This binary way of thinking does not account for shades of gray, and can be responsible for a great deal of negative evaluations of yourself and others.

http://cogbtherapy.com/cbt-blog/cognitive-distortions-all-or-nothing-thinking

Indeed, my husband was prone to depression and thinking poorly of himself. He would never be as good as his brother, as successful as his father and mother, as artistic or musical or smart as he wanted to be.

Fortunately, he eventually got over this. It’s really tiring to keep thinking of better and better ways to describe dinner. Now I can give accurate feedback, like “satisfying,” or “good enough.” Not everything has to be fantastic.

I must admit that I share in this kind of cognitive distortion. I think it may go with bipolar disorder, which, after all, includes swings from one end of the emotional spectrum to the other. But some people attribute it to my having been a Girl Scout or making straight As in school. What I remember is learning it from my parents. When a cousin, for example, screwed up, they would say with a tone of disgust, “Well, I guess some people have to learn from their mistakes.” What I heard was that some people, the good, smart people, didn’t have to learn from their mistakes because they didn’t make mistakes. It was a perfect set-up for making a little girl try to be perfect.

Later in life, I found some flaws in that line of thought. My first experience with a grade of D came in high school in Enriched Geometry. The “Enriched” part was having to do three-column proofs instead of two-column proofs, with the third column being the name or number of the theorem of corollary you were using. I thought that was stupid. You could always look up the theorem or corollary if you really needed to know it. As long as you knew how it worked, I thought, that should be enough. So I didn’t memorize them and I got a D. (Many years later, I was able to hang five pictures, four in a square and one in the middle, which proved to me that I did indeed know enough geometry to get by, theorems and corollaries or not).

I also learned that, according to my parents, perfection was only for me, not for other people. When some work friends of mine started living together, I expected my parents to freak at the sinfulness. They didn’t. But when I did the same thing, they refused even to enter the house.

I know that Cognitive Behavioral Therapy specializes in counteracting distorted ways of thinking, and maybe it would have helped me (or my husband) get over it more quickly or efficiently. But the lesson I eventually learned was that I could be not-perfect and it wouldn’t destroy me. I hung those pictures. I moved on from that relationship and my parents accepted me. I did end up in a job (editing) that requires one to be as nearly perfect as one can regarding as many details as possible, and I suppose that’s an example of turning a negative into a positive.

But if – that is, when – I make a mistake or miss perfection by however wide a margin, my thinking isn’t so disordered that I assume I’m a failure. Black-and-white has been replaced by all manner of shades of gray. That’s really where everyone lives.

Permission to Be Depressed

Depression can be so riddled with guilt. Why am I not able to fake being okay? Why do I isolate when what I need is interaction?

Sometimes what I need is to give myself permission to be depressed. I have bipolar disorder 2, with a heavy depression component. It has overwhelmed me many times. I have fought against it, given in to it, tried to make compromises with it, tried to ignore it – almost any reaction you can imagine. Then I learned how to give myself permission to be depressed.

This is not quite the same as giving in to depression. It involves acknowledging that I am depressed and allowing myself to feel the feelings that I have. Of course, I don’t give myself permission to be permanently depressed. In a way, it’s more like giving myself permission to practice self-care and not to force myself to smile and bull my way past the depression. I recognize that I am depressed and do what I need to do to get through it. That may be staying in bed. It may be crying. It may be wallowing in sad music. These are things that I’m likely to do anyway when I’m depressed, but giving myself permission to do them is surprisingly freeing.

I used this technique probably for the first time when my husband and I went on a “barefoot” cruise vacation. It was something we both enjoyed and both want to do again someday.

But I knew from the beginning that depression might overtake me – probably would, at that time in my life – even while I was doing something enjoyable. Naturally, I didn’t want the depression to ruin the whole vacation, so I decided to give myself permission to do what I needed to do to cope with those feelings.

Most often, that involved retreating to my bunk for a nap. This enabled me to get away from other people when I was feeling overwhelmed and unable to socialize. Sure, I missed some of the onboard and shore activities, but I wouldn’t have enjoyed them anyway while in the metaphorical fog and darkness. I enjoyed what I could, then let myself not do what I didn’t feel up to doing. I didn’t try to make my husband stay with me and miss all the fun. There wasn’t anything he could do for me anyway. If the other passengers thought it was odd – and they did – they barely mentioned it to me. My husband told them I was tired. Seasickness was also a believable excuse.

In a way, having bipolar depression at that level is like having the flu. I feel bogged down and logy, inclined to cocoon, rest, and stay away from other people. I realize this is not always possible, but if it is, I can allow myself to do it. Fortunately, this spell of depression wasn’t so bad that it completely incapacitated me as it has at other times in my life. I was still able to feel enjoyment at some times, though not at others.

At other times, I’ve had to give myself permission to have anxiety. If a situation makes me anxious, I acknowledge that I am nervous, and do what I need to do. I can’t “think away” my anxiety, but sometimes I can get myself out of the situation at least temporarily. I do not have to sit and be anxious while people around me argue or shout at each other, one of my anxiety triggers. When I recognize how I’m feeling (which takes practice) and give myself permission to feel the way I feel, I’m better able to come up with coping mechanisms, such as leaving the room to get some fresh air or making myself a cup of tea.

You may notice that when I give myself permission to be depressed or anxious, part of my solution involves avoiding other people. That’s sometimes a hard thing to do. Isolation can certainly make depression worse, but it can sometimes also be necessary if pushing through, trying to smile, mingle, and socialize will make the depression worse in the end. And I have learned that if I try to do that, the depression comes along with me. Once a friend told me that it was like having a separate person with me, a person called Misery. Better to give myself permission to stay home and give myself some self-care.

What I can’t do is give myself permission to stay depressed or anxious. Giving myself permission is a very limited-time offer. It doesn’t work for those really lingering, midnight-dark depressions that last for weeks or months on end. Those, I have to fight. And while I’m depressed, I don’t give up on meds or therapy. Those are necessary to alleviate the depression instead of resigning myself to feeling it.

In Remission

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

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

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

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

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

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

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

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

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

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