Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

The Journey to Proper Meds

By areeya_ann / adobestock.com

This week when I went to my four-times-a-year med check, I told my psychiatrist that I thought I needed a change in medication. The previous time I saw him I had expressed concerns over assorted Life Stuff that was making me extremely anxious. Given what was going on in my life at the time, the anxiety was understandable.

Since then my anxiety has lessened somewhat, now coming out mostly as irritability and difficulty sleeping. And my depression now makes me feel like I have a low-grade fever – logy, listless, exhausted (which is not helped by the sleep problems) – plus the usual depressive numbness, lack of holiday cheer, and all the rest.

My psychiatrist listened to my symptoms, then discussed my meds with me. There were only two, both mood levelers, that he would recommend increasing. I chose the one that had had the most dramatic effect on me when I started taking it. So he increased the dosage from 200 mg. to 300 mg. We’ll see how that works out. I’m to call him before my next med check if I need to.

I’m used to changes in medications. It took a long, trying – even painful – time for my previous psychiatrist and me to work out the cocktail of drugs that would alleviate my seemingly treatment-resistant bipolar disorder. We tried various antidepressants, anti-anxiety agents, anti-seizure meds, antipsychotics, mood levelers, and I-don’t-remember-what-else. At last, when we were about to give up and try ECT, one of the drugs worked. It took some more tinkering before we got the dosages right, but for years now, I’ve been on basically the same “cocktail” of drugs.

Psychiatric Times, in an article on switching antidepressant medications (most of the literature seems to focus on antidepressants), reports that approximately half of all patients fail to achieve an adequate response from their first antidepressant medication trial. High treatment failure rates make it critical for prescribers to know how to safely and effectively switch antidepressants to ensure patient-treatment targets are met.” Other publications put the figure at nine percent, one-third or two-thirds. Whichever is correct, it’s a substantial number.

One method of switching medication is simply called “the switch.” The patient goes off one drug and onto the other. But there are problems with that, including drug interactions between the old medication and the new one.

The technique most recommended is the one that my previous psychiatrist used with me, which is known as “cross-tapering” – tapering down on the first drug and then ramping up on the second. A “wash-out period” when no drug is given allows time for the first med to clear the body before the second is given. This is promoted as the safest method.

I can testify that it is also the slowest and most miserable. Going off one drug, being basically unmedicated while you wait for the second drug to ramp up, and then possibly going through the whole process again when the second drug doesn’t work either (or has side effects you can’t tolerate) is brutal. I went through the process more than once, and it was hell. Basically, it took me back to full-strength depression during the wash-out period and minimal to no effect as the new drug being tried ramped up.

However, eventually, we found a drug that made a huge difference and that, in conjunction with my other medications, allowed me to function almost normally. Close enough for jazz, as they say. The recent adjustment in dosage does not appear to be having much of an effect yet, but I didn’t expect it to. Pretty soon, relatively, I’ll know. And if it doesn’t help – or if it induces side effects – I still have my psychiatrist’s phone number.

References

https://www.psychiatrictimes.com/view/strategies-and-solutions-switching-antidepressant-medications 

https://www.uptodate.com/contents/switching-antidepressant-medications-in-adults

https://www.healthline.com/health/mdd/switching-antidepressants

Workplace Adjustments I Would Like to Have Had

by Chinnapong / adobestock.com

I missed out on the heyday of the ADA. People didn’t become as conscious of accommodating people with disabilities until much later. And even then, the most common accommodation was wheelchair ramps. But there are some workplace adjustments or accommodations I wish I had available to me, back when I worked in an office.

According to the Americans with Disabilities Act (ADA), persons with disabilities are entitled to accommodations to make it possible for them to work. Most of us think about certain kinds of lighting, closed captions, or specialized chairs. But what about when you have an invisible disability?

The ADA definition of a disability is one that impairs an individual’s ability to – among other “major life activities” – learn, read, concentrate, think, communicate, and work. Certainly, a number of psychological or psychiatric conditions qualify as producing trouble in these areas. In my case, my bipolar disorder made it difficult to do many of those in your standard office work environment.

But would the ADA have made accommodations available to me? The ADA does include some mental illnesses in its list of disabilities. Examples of mental disabilities commonly considered under the ADA are:

  • Major depressive disorder
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Obsessive-compulsive disorder
  • Schizophrenia

Examples of accommodations or work adjustments for those with psychological disabilities include, among others:

  • Flexible Workplace – Telecommuting and/or working from home.
  • Scheduling – Part-time work hours, job sharing, adjustments in the start or end of work hours, compensation time and/or “make up” of missed time.
  • Leave – Sick leave for reasons related to mental health, flexible use of vacation time, additional unpaid or administrative leave for treatment or recovery, leaves of absence and/or use of occasional leave (a few hours at a time) for therapy and other related appointments.
  • Breaks – Breaks according to individual needs rather than a fixed schedule, more frequent breaks and/or greater flexibility in scheduling breaks, provision of backup coverage during breaks, and telephone breaks during work hours to call professionals and others needed for support.

Of course, in order to receive accommodations or adjustments, it’s necessary to reveal to someone – at least your boss or maybe the HR department – that you have a psychological or psychiatric disorder.

My own experience of needing accommodations at work was not great. In the job I held the longest, I only mentioned my depression (as it was then diagnosed), to my immediate supervisor. He was sympathetic, but the work environment was not exactly conducive to my needs.

One of the things that I could have used in dealing with the anxiety that went along with my depression was privacy. At first, that was not even possible, since my entire department was located in a cube farm, where no one had any real privacy. Even the fact that I was an editor and needed to concentrate on my work did not win me a private space.

Later, when we moved to an office that had actual offices, I snagged one with a door. The only problem was that I was not allowed to close the door, or at least looked askance at when I did.

An ideal situation for me (aside from being allowed to close my door) would have been permission to work from home. There was one person at this office who had this privilege, but it was never considered for me. Admittedly, this was very much pre-pandemic, but most of my work was done on a computer, and I had one at home that was compatible with the office computers. It wouldn’t even have been necessary for the company to supply me with one.

Another accommodation that would have helped lots would have been a hotel room to myself at business conventions, which would have allowed me time and space to decompress after a long day of being “on,” meeting and greeting, and being sociable and respectable. Unfortunately, that was a privilege reserved for the men. (As I understood it, the salesmen were booked into double rooms as well, but winked at when they rebooked them into singles.) This may have nominally been due to my sex rather than my mental condition, but not having a solitary retreat from the clamor of a convention definitely had a deleterious effect.

After 17 years at that job, I was let go, most likely because I was considered “unreliable.” At the next office where I landed, I had a boss who understood bipolar disorder (as I was then diagnosed) and who was satisfied with my work.  Never a bad evaluation – until that boss left. “I’m going to miss you,” I said. “I know you will,” she replied.

I realized what she meant when I revealed to my new boss that  I had bipolar disorder. “What does that mean?” she asked. Taken aback, the only reply I could think of was, “Sometimes I have good days and sometimes I have bad days.”  It wasn’t a great description of my condition and set me up for problems. After one year of my mother’s health and my psychiatrist appointments requiring me to miss work, and my missing work in winter owing to living at the bottom of a snowy, icy hill, I received my first bad evaluation. Nothing about my performance had actually changed since my work with the first boss. I could have easily worked from home and occasionally was permitted to, but my work was dubbed sub-par once I did.

(Not that it’s a big thing, but I would also have appreciated being able to take a “brain break” such as doing a crossword puzzle, instead of a cigarette break, since I don’t smoke. And not being asked work questions when I was on the toilet.)

After that, I went freelance, worked at home nearly all the time, and was only required to attend a meeting at an office once or twice a year. I have worked that way since and it suits me. It’s only now that I’ve become my own boss that I’ve been able to get what I really need when it comes to work.

 

References

https://www.eeoc.gov/statutes/americans-disabilities-act-amendments-act-2008#:~:text=The%20Act%20emphasizes%20that%20the,shall%20not%20require%20extensive%20analysis.

https://www.sfglife.com/blog/top-10-causes-disabilities-us-and-why-you-need-disability-insurance/

https://adata.org/factsheet/health

https://www.dol.gov/agencies/odep/program-areas/mental-health/maximizing-productivity-accommodations-for-employees-with-psychiatric-disabilities

https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/cms_011495.aspx

https://www.ada.gov/pubs/adastatute08.htm#12102

Take a Hike: Nature and Mental Health

photo from the author’s collection

 As a child and as a teenager, I was a Girl Scout. We hiked. We camped. We did all sorts of nature-related crafts. We ate wild plants. Well into my 20s, I was an outdoorsy-type person, hiking on the Appalachian Trail, walking to all my classes through the leafy green environs of my college campus, even trudging contentedly through the copious snowfall. One year I lived in a log cabin on a hilltop so far from civilization that you had to go to town to pick up your mail.

All the while, I had bipolar disorder, and it was relentless, I experienced the inevitable mood swings, the crashing lows, the tempestuous highs, the confusing mixed states. 

Now, everywhere you turn, there are articles and memes touting how time spent in nature is good for various psychiatric conditions. When you look more closely, though, the studies often refer to simply alleviating bad moods or improving cardiovascular health. Very few of them seem to apply to actual mental illnesses. Perhaps this is to be expected, since improvements in emotions or mental health are largely self-reported or tracked by means of a survey. It’s hard to quantify mental health. But let’s take a look at some of the studies anyway.

Harvard Men’s Health Watch published an article called “Sour Mood Getting You Down? Get Back to Nature.” The subtitle on the piece read, “Research suggests that mood disorders can be lifted by spending more time outdoors.” Then the article went on to suggest that “ecotherapy” shows “a strong connection between time spent in nature and reduced stress, anxiety, and depression.” 

The subtitle suggests that the outdoors has an effect on alleviating mood disorders. The body of the article, though, stresses alleviating unpleasant moods in general, not primarily what psychiatrists would class as mood disorders. The article cited a 2014 study saying that “people who had recently experienced stressful life events like a serious illness, death of a loved one, or unemployment had the greatest mental boost from a group nature outing.” Stressful and sad events, certainly, but not mood disorders such as PTSD, clinical depression, or bipolar disorder.

The article also cites a report published online March 27, 2017, by Scientific Reports, which suggests that “listening to natural sounds caused the listeners’ brain connectivity to reflect an outward-directed focus of attention, a process that occurs during wakeful rest periods like daydreaming. Listening to artificial sounds created an inward-directed focus, which occurs during states of anxiety, post-traumatic stress disorder, and depression.” It does mention psychiatric disorders, but it says only that inward-directed focus occurs during these states, not that inward-directed focus causes them.

Greater Good published an article that claims, among other things, that “scientists are beginning to find evidence that being in nature has a profound impact on our brains and our behavior, helping us to reduce anxiety, brooding, and stress, and increase our attention capacity, creativity, and our ability to connect with other people.” Again, this says nothing about actual psychiatric disorders.

The article also cited a Japanese study: “Results showed that those who walked in forests had significantly lower heart rates and higher heart rate variability (indicating more relaxation and less stress), and reported better moods and less anxiety, than those who walked in urban settings.” The researchers concluded that there’s something about being in nature that had a beneficial effect on stress reduction, above and beyond what exercise alone might have produced.

This, of course, does not apply to those in urban settings who do not have much access to forests or sometimes even parks. And the abstract of the Japanese study says, “Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity.” It doesn’t really deliver what the headline offers: “How nature makes you kinder, happier, more creative.” Good heart health is, of course, a good thing, but to extrapolate that to mental health benefits is quite a stretch.

The UK’s Mind.org does offer a link between ecotherapy and mental health in one instance, at least: “Being outside in natural light can … be helpful if you experience seasonal affective disorder (SAD), a type of depression that affects people during particular seasons or times of year.” This article also acknowledges that there are “other options for treatment and support – different things work for different people….You might do an ecotherapy programme on its own, or alongside other treatments such as talking therapies, arts and creative therapies and/or medication. Some ecotherapy sessions follow a set structure, and incorporate types of talking therapy, such as cognitive behavioural therapy (CBT). People in the group may or may not have experience of mental health problems, but the main focus is usually working together on the shared activity.” This at least sounds both more scientific and more likely to produce results.

If a walk in a natural setting does you good and alleviates your symptoms of mental illness, then by all means, make it part of your routine (or do it as often as you can manage). My bipolar depressions, however, are so debilitating that I am unable to plan, much less embark on, a walk in nature, even as far as the mailbox. Bringing nature indoors is, of course, an alternative. But the little plant pictured here, which needs two ounces of water once a month, is all I can really handle.

Resources

https://www.health.harvard.edu/mind-and-mood/sour-mood-getting-you-down-get-back-to-nature

https://greatergood.berkeley.edu/article/item/how_nature_makes_you_kinder_happier_more_creative

https://www.hindawi.com/journals/ecam/2014/834360/

https://www.mind.org.uk/information-support/tips-for-everyday-living/nature-and-mental-health/how-nature-benefits-mental-health/

A Letter From the Future to Bipolar Me

by sosiukin via adobestock.com

Dear Me:

You’re 13 years old now, and there are a few things you should know.

You have bipolar disorder. No one knows this, not even you. But a lot of people notice that you act “weird” at times. You have decided to embrace your weirdness, which is fine, but what you really need is psychological help. And medication.

Don’t pass up any chance to get that help. Your high school will recommend to your parents that you get counseling. When your parents leave the choice up to you, take it. It will not go on your permanent record, and you will still get into a college. A very good college, in fact.

I know that at times you sit alone and cry. Other times you laugh at things no one else finds funny. This is not just “weirdness.” This is a mood disorder, called bipolar disorder, type 2. Your mood swings will make it difficult for you to make and keep friends. Keep trying. The friends you will find are worth it and will stand by you when you really need them. You will not be alone in dealing with this.

Your choice to go to college out of state will be a good one. There you will have a variety of experiences that will make you grow in unexpected ways. Your mood disorder will go to college with you, though. Leaving Ohio will not mean you will leave bipolar disorder behind. You will still feel the mood swings, and most of them will be depression.

It’s a good idea to take that year off between freshman and sophomore year. I know it will feel scary, but at that point you will be in no shape to carry on with academics. Instead, you will get a job which, while not great, will introduce you to more new people and new ways of life. At least one of those people will stick with you till you are old and gray.

Returning to school will be a good decision. Your parents will support you in that decision. They won’t object to your year off, because they know you will go back. It still won’t be easy, but you will have a core group of friends that accept you, even though you are different from them.

Your bipolar disorder will follow you back to college. It will make you miss some opportunities and choose others that will not be good for your mental health. You will be unhappy most of the time, but you will find that music helps you through it.

Try not to self-harm. I know you will feel numb and want to feel something else, but cutting yourself is a bad decision and will not help. You will carry those scars forever.

When you meet Rex, though, you will be encountering a problem too big for you to handle, and the relationship will leave you scarred as well. It would be best if you were to steer clear of him altogether. But then again, you will find some true friends in his circle, and it would be a shame to miss them. Try your best to hold yourself together, remember what I said about self-harm, and don’t give up on who you are. You are not your disorder, and you will get through this, despite everything.

I know you never gave a thought to marrying, but you will meet a man and in a few years you will marry him. This, I assure you, is a good decision. He will stick by you no matter what and help you find help.

Going into the building that says “South Community Mental Health” will be a good decision. Whatever you will be feeling at this point – most likely misery – it’s not mentally healthy. This will be the place where you will start to climb out of the hole you have found yourself in.

At last, a doctor will tell you that you have bipolar disorder – most often depression, but also anxiety. He will work with you to find a combination of medications that will help you. When that happens, you will become reacquainted with your brain and relearn how to function in the world at large. Your brain will function in a new way, one with fewer out-of-control feelings. You will experience life more fully and be glad of your new outlook.

It won’t be quick, and it won’t be easy, but you will have therapists, and friends, and work, and love, all of which will help see you through. You will have bipolar disorder all your life, but it will not be your life, though it seems that way now.

Reach out for help whenever and wherever you find it. Cherish your friends. Keep trying, even when you want to give up. Better times are on the way.

I promise.

Love, me (older and maybe wiser)

Psychological Tactics of Abusers, Gaslighters, and Cults

Image by Vadim Gushva via adobestock.com

Once upon a time, I lived with a man who, I later realized, was a gaslighter. (This was in the time before gaslighting became trendy and well-known.) For a while after I left, I had no notion that I had any harsh feelings towards him. It was only later, after I had been away for a while, that I realized what my buried feelings were and what damage he had done. The experience was responsible for parts of who I am today, including my strength and resilience.

For a time, though, right after my deeper feelings began surfacing, I realized that I had been psychologically controlled. I began to read up on the phenomenon. Some of the subjects I devoured were accounts of and theory of domestic physical and psychological abuse, mind control, and cults. They fascinated me – how the human mind and spirit could be so affected by another person or persons that they acted in irrational ways, defended their abusers, changed their personalities, and gave up their lives, either figuratively or literally. I don’t mean to compare my experience to the suffering that the people I read about have gone through, or to the suffering that still exists. All that I knew was that I had been manipulated, and was desperate to find out how, if not why.

I started with the easiest subject to find information about – domestic abuse. I will say that my gaslighter never harmed me physically and only once said something that could be taken as a violent thought towards me. But I learned, particularly, about intermittent reinforcement. This happens when the abuser switches between telling the victim that he loves her and she is wonderful, and that she is stupid or ugly or otherwise worthy of abuse. These mixed signals keep the victim coming back, on the theory that sometimes the person is so nice and loving. “It must be that I make him mad without meaning to,” she thinks.  Thus, she is hooked and less likely to leave.

My gaslighter also used intermittent reinforcement and mixed signals to keep me hooked. I stayed much longer than was good for my mental health.

Learning about mind control – “brainwashing,” kidnapping, and so forth, gave me little insight into my own situation, except that some of the principles were to isolate the person being controlled, to control the environment such as when the person slept or ate, and to be that person’s only source of information or reality. I had been relatively isolated physically, had little control over schedules, and, while TV news was available, it was always filtered through the gaslighter’s sensibilities and opinions. Again, I am not comparing my suffering to that of other people. I don’t believe, really, that suffering can or should be compared.

Learning about cults took me even farther from my own experience, but I was fascinated by it nonetheless. I soaked up information about Jim Jones and Jonestown, Heaven’s Gate, Scientology, and others. Especially interesting to me were stories of people who had escaped from cults. (One of my Facebook friends escaped from a religious cult, which took advantage of her PTSD and bipolar disorder to ensnare her. She supports others who have been victimized by cults and spreads information on cults and the tactics they use.) All I can say is that leaders of cults are usually charismatic, often reject societal sexual norms, and mentally coerce their followers to isolate from family and to finance the cult leader’s lifestyle.

Gaslighting, which I have written about many times (https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-C2, https://wp.me/p4e9Hv-Ir, https://wp.me/p4e9Hv-Cu) most resembles domestic abuse, though usually without the physical violence. It uses the tactics of intermittent reinforcement, isolation, verbal abuse, cults, and mixed signals to convince the victim that her perceptions of reality are invalid – in extreme cases, that she is going insane.

All of these forms of abuse do harm to their victims, in varying degrees. I was lucky to be able to leave my gaslighter when and how I did, and I will forever be grateful to the people who have helped me heal from the experience.

If you are in any of these situations – domestic violence, emotional abuse such as gaslighting, or being victimized by a cult, the best advice is: Get out now. Leave while you still can, before something worse happens. And get help, both from your friends and family, if possible, and from a professional counselor who has experience with these issues. It could save your happiness, your sanity, or even your life.

 

Resources

https://www.goodreads.com/list/show/72664.Nonfiction_resources_on_abuse_and_domestic_violence

National Domestic Abuse Hotline https://www.thehotline.org/

https://nymag.com/strategist/article/best-books-on-cults-reviewed-by-experts.html

https://www.women.com/sophiematthews/lists/books-on-gaslighting-101718

A Sensory Self-Soothing Room

Photo from the author’s collection

Not long ago, I read in the Creativity in Therapy blog (http://creativityintherapy.com/2016/05/create-a-sensory-self-soothing-kit/) an article by Carolyn Mehlomakulu, art therapist, called “Create a Sensory Self-Soothing Kit.” The idea was that a box filled with items that engage your five senses is an excellent tool for being grounded when you need centering or self-care. The recommendations were for any five things that appeal to the senses of touch, sight, hearing, taste, and smell. I tried the exercise and came up with the following:

Touch – plush animal

Sight – amber necklace

Hearing – iPod playlist

Taste – caramel

Smell – Oolong tea

I never actually made myself such a self-comfort box, but I remember the exercise as a way to think about my senses and how nourishing them can nourish me.

Lately, though, I have acquired a room of my own and have been decorating it to suit myself. Recently, I realized that it has all the requisites of a comfort kit toolbox.

Touch – I have quite a collection of stuffed animals stashed around the room. A great many of them were gifts from my husband, who knows my history with stuffed animals (as we used to call them). Every Easter there was a new stuffed rabbit in our Easter baskets, along with the chocolate bunny and the jelly beans.

Perhaps the most important plushie in my room is named “Trauma Bunny.” My husband found her in the store he works at, squashed behind two huge bags of dog food in the pet aisle, rather than in toys where she belonged. Of course, he bought her and brought her home to me. Now she sits on my desk, guarding my headphones and cellphone, close enough for me to reach out and pat her on the head or fondle her ears.

Sight – I have furnished my room with many things I like to look at, from travel souvenirs to prints and paintings that have significance for me. Even the walls are a toasty rusty-brickish color that makes me feel warm just to look at. I also have a television, where I can watch shows that comfort me, such as ones on the Food Network. I have two windows, and the blinds are always up on at least one of them. The view isn’t terrific, but the sunshine is welcome.

Hearing – I do have iTunes on my computer, with more music than I could listen to in a week. Among the tunes are ones recorded by some of my singer/songwriter friends, as well as the well-known artists I like best, ones you don’t hear on the radio anymore. There is also instrumental music, from Vince Guaraldi to Béla Fleck, if I want something less distracting than voices and lyrics.

I also have a cat tree by the window, where my two cats love to sit or sleep. Both cats purr nicely and loudly. One of them even snores when she sleeps – daintily, but she definitely snores. (Of course, petting the cats also qualifies as touch, and watching them bathe themselves, which I find soothing, counts for sight as well.)

Taste – My husband keeps my room stocked with things he knows I like such as Cocoa Puffs. There’s always diet cola in the bottom drawer on the lefthand side of my desk. Right now there are honey-roasted peanuts in case I need a more proteinaceous snack.

I generally eat only one meal a day, and when I’m really depressed sometimes skip eating altogether. It’s good to know that there’s something here that is easy to access, requires no cooking, and meets some of my basic needs and likes.

Smell – Since I’ve transferred most of my library to an ereader, there are fewer books in my room, but most of the ones I still have are old and retain that almost-indefinable book smell – dust, paper, and some other distinctive aroma that I remember from trips to the used book store as a kid.

I also have a candle that smells like snickerdoodle cookies. I’ve never lit it, but sometimes I just pick it up for a deep sniff. Then there’s my tiny Mr. Coffee, which I use for tea, including oolong, herb tea, and possibly my favorite, the spicy smell of Constant Comment tea.

I practically live here, even though the house is fairly large and there are sensory delights in the other spaces as well. But what I have here, I recently realized, is a comfort box that’s just the size of a room.

Bipolar Conversation

This morning a podcast called Bi-Polar Girl was uploaded, and I was the interviewee. (You can find it on Apple, Amazon, and other podcast sources.) Here’s a look at what was like.

  • Prepping. Before we recorded the podcast, my anxiety kicked in, and I tried to overprepare. I bombarded the hosts with emails asking what I should be prepared to talk about or what questions they were going to ask me. Basically, they told me we were going to “wing it” and have me tell my story.
  • History. The thing we talked about most was when I started showing signs of bipolar and when I was diagnosed. I explained that I was showing signs of it as early as my high school years, how I decided to seek treatment after college, and how I was mistakenly diagnosed with major depression for years before receiving the proper diagnosis and medication.
  • Meds. We discussed medication in some detail – pill-shaming, how every person reacts to meds differently (so it’s useless to “recommend” a particular drug to friends or support group members). We talked about the side effects of various medications, including the fact that the most-feared one seems to be weight gain. One particular point of discussion was how many people are afraid that taking medications to treat their disorder will stunt their creativity or turn them into “zombies.” Snowflake (one of the hosts) and I agreed that our creativity and ability to work were actually improved while on medication, because it enabled us to focus and do more creative work.
  • Family. We also talked about the fact that I have no children and my reasons for that. (We also introduced some of our pets during the Zoom call, or they introduced themselves. Just try to keep an animal out of a Zoom call.) I shared that I felt it would be unfair to a child to have a nonfunctional mother, that I was afraid of going off antidepressants while pregnant, and postpartum depression afterward. Snowflake shared her story of medications, potential side effects, pregnancy, and postpartum depression.
  • My publications. I talked about my blog and my books, Bipolar Me and Bipolar Us. In particular, we discussed gaslighting, which features in my second book, and how people with bipolar are more susceptible to it. Both Snowflake and I shared how we had encountered gaslighters in our own lives.
  • Groups. Chacoman, the other host, questioned me about whether I was involved in any local or regional support groups, and I had to admit that I’m not. Now, during the pandemic, group meetings are problematic at best, but I don’t react well to groups at any time, due to my anxiety (which is how my hypomania manifests). In my case, outreach is limited to my blogs and books, and membership in online support groups.
  • Miscellaneous. We got off topic a number of times. I don’t want to make it sound like the interview was all serious or grim. We also talked about our pets, positive relationships, college memories, and even politics.
  • Plans. I talked about how my next book will be a mystery, with a bipolar main character, and received positive feedback on the idea.

All in all, it was a good experience, worth overcoming my anxiety for. I had only participated in a podcast once before, a not-altogether-successful interview about my first book with an interviewer who had obviously not read it and was more interested in whether any of my family members were also creative. (It was supposed to be a podcast about first-time authors.)

This was not the same sort of thing at all. I told my story, as the hosts had recommended, and we had a genuine, far-ranging conversation about not just my own experiences with bipolar disorder, but with how others cope with it as well. Actually, I learned a lot about myself, from how much my anxiety – and especially social anxiety – still affect me, to how much my teen years illustrated my journey into depression.

So, here’s a big thank you to Snowflake and Chacoman for the opportunity to share with them and their audience. I would absolutely do it again. It helped me step out of my comfort zone and, I hope, will help the listeners as well. It’s a form of outreach that I had never considered, but one that I found valuable – and just plain fun!

 

 

The Demise of a Bipolar Support Group

By Artur / adobestock.com

Funny, but I thought support groups were supposed to be supportive. Recently, though, I ran into one that was anything but.

I won’t name the group, since some people may still get something out of it, but as far as I could see, it was a group of over 5,000 people out of control. Many posts were off-topic, sexually-oriented, political, and even abusive. Of course, many people never contributed at all, so I don’t know whether they approved, ignored, or simply watched from the sidelines.

I have my own opinions about bipolar support groups – they should be focused on bipolar disorder, its symptoms, treatments, and lifestyles. Within that large umbrella, there are lots of topics to be covered.

To me, it is legitimate to have “getting to know you” posts – Where are you from? What is your favorite comfort food? What kind of music do you like? Such posts and responses enable people to reach out and make connections, to realize that there are people in the world who experience life in the same way that they do – or in different, equally valid ways.

Similarly, it is understandable that people post about their symptoms – Do you ever wake up angry? Do you often get hypersexuality as a symptom? What do you do about it? Is there anything that alleviates your feelings of being alone? These posts encourage people to share commonalities and suggest ways to deal with them.

I can even see some good in comparing medications, though I don’t much like them. Has anyone tried Vraylar? Do you have much weight gain with Abilify? As far as I can see, the only answers to such questions are: Ask your physician or pharmacist. Medications affect everyone differently. Yes, I have, but your mileage may vary. The only truly useful things I can think of to say are: Don’t stop taking your medication without a doctor’s help, and If you get a rash, especially around your mouth and nose, see your doctor immediately. But if it gives comfort to know that someone else has the same reactions you do, that may indeed be helpful.

What this particular support group got into, however, was way off-topic remarks, sexual solicitations, stalker-like behavior, politics, name-calling, and general nastiness. It seemed like some of the participants went out of their way to be offensive. One poster asked, “Do you know what ‘tea-bagging’ is?” A few others got into a, shall we say, heated discussion about Black Lives Matter and Blue Lives Matter that involved calling each other not just racist, but “cunt” and “fucking POS.” Yet another complained about the cursing appearing in such posts and was met with a long list of responses, all of which said, “Fuck you.”

Part of the problem seemed to be inexperienced or overwhelmed moderators. They did not take down the most offensive posts. They did not try to steer the discussion in productive directions. Admittedly, moderating a support group is not an easy thing to do, and dealing with a group that experiences symptoms such as anger, despair, hypersexuality, sensitivity, and irrational thinking, as well as the normal responses of outrage, insult, offense, anger, retribution, and hurt, is that much more complicated.

Perhaps the majority of the 5,000 group members don’t mind such interactions, but there were more than a few who did, and said so. Some quit the group or went off to start their own. Others decided to stay around for a while to see if things got better.

I am torn. I hate the group the way some members are currently behaving. I hope that more administrators/moderators can get the group back on track to something that is truly a support group. But my time, attention, and patience are limited. Unless I see some changes – and soon – I’m outa there. I may not be missed, but neither will I miss them.

When My Carer Needs Care

By Farknot Architect / adobestock.com

My husband is the mainstay of my support system and, in large part, my caregiver. I cannot count the things he has done for me and does for me every day. We’ve been married for over 35 years and during that time he has helped me through daily life, major depression, anxiety attacks, loneliness, irrational thoughts, school, therapy. He makes sure I practice self-care and cares for me as needed.

Recently, though, he needed my help and care. The other day he experienced distressing eye-related symptoms – a large “floater” (dark spot) in his vision and unexpected flashes of light. What could I do about it? First, I answered his request to get a flashlight and look in his eye, but I saw nothing.

Next I arranged an appointment for him at our eye doctor. Dan used to be terrible at admitting when he needed medical treatment, but since a heart scare he’s been much more amenable to seeing a doctor. That particular evening, he was scared and cranky, and made up excuses. He left his phone in the car. That’s okay. I had mine right there. He didn’t know the number. That’s okay. I have it programmed into my phone. I waited on hold. “Forget it,” he said. “Never mind,” I replied. “I’ve got nothing else to do.” He said he didn’t see the floater any more. I pointed out that his eyes were closed. I got through to the doctor and made him an appointment for the next day.

Naturally, I drove him to the appointment, as they would have to dilate his eyes. Then, afterward, I drove him on several other errands (including an appointment with a different doctor) and made sure he ate lunch. I canceled one of the errands and put off others when I saw how tired and nervous he was getting. I took him home and tucked him in bed. (The floater turned out to be nothing truly alarming, just an effect of his aging eyes. He named it “Freddie the Free-Floater.”)

Dan has done almost exactly the same for me, many times. I could usually make my own appointments, but he encouraged me to do so. He has driven me to appointments countless times. He makes sure I eat. When I run out of spoons, he cancels or postpones errands, or even runs them for me. He reminds me when I need to have a lie-down or to sleep or to shower.

It was unusual for me to be the caregiver in this situation, and at times difficult, but I didn’t begrudge it. How could I possibly?

Of course, later in the day, I had a crisis and a mini-meltdown of my own, and there was Dan, ready to be with me, talk me through it, and make sure I didn’t skip a meal.

I know this is what marriage is supposed to be – partners helping each other through their individual and mutual times of difficulty. I also know that mental illness can put a terrible strain on a relationship. I admit that I am very needy at times, and was even more so at other times in my life.

But this time I got to be the strong one and take care of his needs before my own. And I was pleased and proud to be able to do that. Often there’s little enough that I can do for him, except offer him encouragement and remind him that I love him and appreciate him and all he does for me. If he asks for something he needs, I try to make sure he gets it (except for the $900 woodchipper, I mean). And I do what I can that benefits both of us – working to bring in money, paying the bills, doing computer research, handling phone calls, reminding him of appointments when I can – mostly stuff that involves computers and phones and recordkeeping and occasionally knowing where missing stuff is. And reassuring him when he gets trapped in the depression that he also suffers from that I love him and that he is strong and good and that he needs to take care of himself, and that if he can’t, I will try and do my best.

My Hypothetical Baby

By pololia / adobestock.com

Having bipolar disorder was one of the reasons I decided not to have children. Really, it was having major depression, which was what I was diagnosed with at the time.

I wasn’t so much concerned with passing my condition on to any potential offspring, since, at the time when I was contemplating motherhood, the genetic links were not yet that firmly established. Now that I know more about it, I think that might have been another deterrent. My parents had no idea what to do with me when bipolar symptoms started happening, and there’s no guarantee that I would have done any better. I’d like to think I would, but there’s no telling, really.

No, what I feared was having to go off my medication while pregnant (and breastfeeding, should it come to that). I was terrified of being unmedicated and I knew that psychotropic drugs were not good for pregnant women or their developing babies. Once I had discovered the benefits of Prozac and other mood-regulating meds, I knew I never wanted to be without them again. I never wanted to again fall into the pit that I had clawed my way out of. (In truth, that pit was waiting for me anyway, when I experienced a major depressive episode many years later.) 

Postpartum depression scared me too. I had heard the horror stories of women killing their children and/or themselves while suffering from the illness. I knew how out of control I could get with just plain ol’ garden-variety depression and anxiety. Adding postpartum hormones to the mix could be a really bad thing.

But the main reason that I decided my bipolar disorder made it unwise to have a child was that it would be unfair to the child. How to explain to a toddler that mama couldn’t get out of bed today or that she burst into tears for no apparent reason? How to explain weeks or months like that? How to deal with a child jazzed up on mama’s sudden hypomanic jag, who would then be let down when she crashed? How to soothe a child’s anxieties when mine were making me jump out of my skin? How to take care of a child’s essential needs, when I suck at taking care of my own?

Is that selfish? I know there are people who would say it is. That when the time came, I would suck it up and do the best I could. And I might. But would that “best I could” be good enough? I’ve heard it phrased that I was too involved with giving birth to myself – a relatively stable, reasonably happy, mostly functioning self – to give birth to someone else. And I think there’s some truth in that. It’s been a struggle, filled with despair, misery, hard work, setbacks, immobilization, dangerous thoughts, and living too much in my own head. To do the work of bringing myself to some baseline of functioning while trying to nurture and bring up another person daunts me.

I do understand that there are women with bipolar disorder and even postpartum depression who have children and that those children can be happy, healthy, and as well-adjusted as any modern child ever is. I don’t know how they do it, though. I was fortunate that I had a choice of whether or not to have children. I know that not all women do, and that many are delighted with their choice – whichever way they decide. I know that there are those who desperately want children and are unable to have them. I was fortunate that my husband didn’t push the issue, despite the fact that he would have welcomed a child.

I also had irrational thoughts about that potential child. I imagined that if the child were a boy (which run in my husband’s family), Dan (whose inner child is, shall we say, close to the surface) and the little boy would be natural allies and I the odd one out. He would be the fun dad and I the not-fun mama. And while that’s somewhat irrational, it also might be partly true. It took a long time for me to learn how to relax and have fun and share it with another person.

The one time I was open to having a child was when my father was dying a slow death. I thought that if he was going to see his grandchild, I’d better produce one promptly. Fortunately, it didn’t happen. I later realized that that was a really poor reason to bring a new life into the world.

What I’m saying is that the decision is not – was not – an easy one. Having a mental disorder makes it even more difficult.

 

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