Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

I’m Not Brave – I’m Stubborn

Don’t forget! March 30 is World Bipolar Day!

Kopf durch die Wand

One of my friends, who is overweight, recently told me that when she was at the gym on the treadmill, a stranger came over to her and told her she was “an inspiration.”

My friend felt insulted. She was working out for herself and for her health, not to inspire anyone else or to be taken as a symbol of I-don’t-know-what – perseverance? attitude? effort? hope?

I feel sort of the same way when people say that because I am open and public with my bipolar disorder that I am “brave.”

I’m not doing this because I’m brave. I’m doing it because I’m stubborn.

I am who and what I am, and I’m willing to reveal a lot of it because, frankly, I can’t hide it and don’t want to. I’m not average or typical. Not normal, mentally or emotionally.

I’ve always had a love-hate relationship with the concept of “normal.” Desperately wanting to appear normal, but knowing viscerally that I am not. Wondering what it’s like, but knowing that I’ll never know. Wondering what it even means, or what it means that I’m not. I haven’t found answers yet, and at this point I don’t think I’m going to. It’s probably a waste of my time to try.

So, if I’m outside the “norm,” which I am, I may as well admit it. And since writing is what I do, I write about it. I’m not doing this because I’m “brave,” I’m doing this because on some level I have to. I’m stubborn.

I’m stubborn enough these days to have made a sort of peace with the concept of “normal,” even though I still don’t understand it.

I’m stubborn enough to acknowledge my difference and give it its proper name – bipolar disorder.

I’m stubborn enough not to care when I say that and some people flinch or back away.

I’m stubborn enough to reveal things that embarrass me because they are part of me and part of what I’ve lived and lived through.

I’m stubborn enough to get tattoos proclaiming my status as “mentally ill” and using them to open conversations and educate others.

I have not come to embrace my stubbornness easily. I’ve tried to fake “normal” and hide my differences. I’ve gone to my shrink and just referred to “doctor appointments.” I’ve made Prozac jokes even though I was taking it at the time. (For this I am truly sorry, as I later learned that one of those jokes made another person afraid to admit that she took Prozac too.)

I’m not trying to be an “inspiration.” I’m not trying to prove anything to anyone else. I’m doing what I have to do for me. If someone else finds some good in it, that’s fine. But that’s not why I do it.

I am bipolar.

I am a writer.

I am stubborn.

Taken together, you get this blog.

Bipolar Me.

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Mental Health

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The Pluses and Minuses of Highs and Lows

Low polygonal shape mountain background with clouds.

Bipolar disorder comes with highs and lows – mania and depression, for those who still call it manic-depressive illness. Bipolar 2 comes with plenty of depression (trust me on this), but mania that doesn’t reach the heights of regular mania. Hence the term “hypomania” – low mania. Like “hypoglycemia” – low blood sugar. (Actually, low blood sugar can affect the bipolar person’s – or anyone’s – moods, but that’s a story for another time.)

So. Mania. Mania comes with pluses – exuberance, euphoria, ambition, confidence, and other good feelings. It also comes with minuses – risk-taking behaviors that can ruin relationships, careers, finances, lives.

Hypomania, however, is usually not so extreme. Sometimes you don’t even realize that you have hypomania at all, because it comes out sideways, as anxiety. This is what happened to me, and is the reason it took me so long to get the proper diagnosis of bipolar type 2.

Recently I have been exploring the realm of hypomania, and I’m here to report that, similar to regular mania, hypomania has its attractions and its drawbacks. And they are intertwined.

On the plus side, I have more energy – more spoons to spend. I can go longer between naps. I have now gotten out of bed, dressed, and out of the house for three days in a row. I can concentrate longer on the books I’m reading and spend more time with my husband and do some actual paying work.

On the minus side, I pay for that energy. It’s like borrowing spoons – you can’t keep doing it. Sooner or later the spoons have to be replaced. Right before my most recent spurt of energy, I had a need for a nap that turned into a mega-nap – almost six hours. I woke up just in time to get ready for bed. Then I slept at least ten hours more – maybe 12. It’s impossible to schedule these things, but I have left tomorrow open just in case my body and brain decide that’s payback day for the three days of activity.

Another plus is that my creative juices are flowing. I’m working ahead on blog posts because I know at the end of the month I have a huge commitment that will keep me from writing something for that Sunday. I’ve also taken steps to spiff up my posts with visuals. And I’ve been thinking that I ought to write some fiction.

However, there’s a however. The last time I had a creative spurt I almost talked myself into starting two new blogs, for a total of four. I have plenty on my plate already, what with these blogs and paying work and trying to find an agent for my book and getting ready for a writer’s conference. This is no time to start a big new project that could easily devour my time and my ability to do the things I already need and want to do. But I do now have a computer file set aside for notes and ideas that flit through my busy brain. Call that file “Later.”

And let’s not forget anxiety. It’s hard to find the pluses there, except that anxiety, if properly harnessed, helps me prepare. I suppose it sounds better if I call it anticipation instead of anxiety. Anticipating my upcoming dental work spurred me into putting together the financing for it. Anticipating the writers’ workshop allows me to prep for all the details – wardrobe, business cards, directions, strategies to cope with exhaustion – that would make my nerves fray even more at the last minute.

I assume I needn’t discuss the minuses of anxiety. Let’s just say that for me, they include regrettable and appalling physical symptoms that no one wants to hear about.

Any way you look at it, the dental procedures are going to be a low and the workshop a high. I can already predict some of the difficulties that will accompany the workshop boost. It’s harder to think of pluses related to the dental work. Except that I really need it done, and with luck it will (eventually) improve my looks, my breath, my health, my pain level, and my self-esteem. At least that’s what I’m telling myself now.

Bipolar disorder is often compared to a seesaw (or teeter-totter, if you prefer) or a swing set or a roller coaster – for some reason, usually as a form of amusement that involves ups and downs. The amusement is debatable and fleeting. But the ups and downs are with us always. Better to learn to ride this beast rather than let it ride us.

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Mental Health

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Is Bipolar Disorder an “Invisible Illness”?

Empty Chairs Laid Out For Meeting

Yes and no.

First, a little on the concept of invisible illnesses. These are the sorts of afflictions that are not apparent on first looking at a person – conditions such as fibromyalgia, chronic fatigue syndrome, celiac and Crohn’s diseases, diabetes, epilepsy, lupus, Lyme disease, and many others.

Disabled-world.com says, “Many people living with a hidden physical disability or mental challenge are still able to be active in their hobbies, work and be active in sports. On the other hand, some struggle just to get through their day at work and some cannot work at all.”

Most mental disorders are invisible illnesses by that definition. There isn’t a sign around our necks that proclaims “Bipolar,” “Social Anxiety Disorder,” “PTSD,” “Depression,” or even “Schizophrenia.”  The word “Crazy” isn’t tattooed on our foreheads. Our mere appearance doesn’t give away our “secret.”

We have a lot of the same problems that people with other invisible illnesses have. Spoon theory, for example. For bipolar people, simply taking a shower requires so many spoons that we seldom go out. (I count myself among that number.) People who don’t know or understand Spoon Theory often don’t understand why we don’t accept their invitations or cancel at the last minute, or simply don’t show up. You lose a fair number of friends that way.

On the other hand, a mental disorder is not always invisible. People can see us burst into tears for no apparent reason, or go into the bathroom at a party and never come out. They can see our shaking hands, confused looks, and depressed expressions. They can hear our awkward attempts to socialize “appropriately.” They may not know what is wrong, but they can often tell something is.

When we realize this is happening, there are various strategies we try. We can leave the situation – entirely or partially (my go-to is to leave the room on the pretext of needing to make a cup of tea). We can try to brush it off or laugh it off (“Sorry. My nerves are bad today” or “I don’t know why I said that. Must be a brain-fart”). We can try the half-truth/half-joke (“Oops. Guess my meds just haven’t kicked in yet”). We can ignore whatever is happening and hope everyone else does too.

Or we can own it. “I have social anxiety disorder and need to be in a less crowded space than the mall.” “I won’t be able to go to the carnival with you because my PTSD is triggered by loud noises.” “I may come to your party if my bipolar disorder will let me.”

We can also address the subject when there isn’t a situation looming. During a phone conversation or an IM chat, we can let the other person know that we have a mental disorder – an invisible illness. It doesn’t have to be dramatic and dire. Casually may be the best way to handle it. “I know you’re wondering why I didn’t go to the movies with you last week.” “When I saw my doctor yesterday we talked about my physical health and my mental health too.” “You know that character on that show that has PTSD? I have that too, but it’s not exactly like on the show.”

If that sounds risky, you’re right. It can be. There will be people who still don’t get it. People who “don’t believe in” mental illness. People who try to brush it off. People who offer the latest vitamins or super foods or Eastern philosophy as the cure-all.

But you’ll also find people who say, “Oh, my brother-in-law has that too” or “Okay. But I’m still your friend” or “What can I do to help?”

So those are the choices, basically.

Take a chance. Or stay invisible.

Neither choice is right or wrong for everyone. Mental illness is very personal.

You decide.

 

 

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Mental Health

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Beware the Mental Health Meme

This post was specially written for BlogHer’s Social Media and Blogging section, but I thought it worth sharing here too. (Credit for the photo goes to my husband, Dan Reily.)

 

Slide1

Most Internet memes are harmless, or even amusing. They proclaim that someone has a wonderful granddaughter or that kittens are cute.

But some memes that travel the world sow unhelpful or even hurtful ideas as they go. The one above appears mild and even inspiring, but to a person with mental illness, it says a lot more than appears on the surface.

The meme that started me on this train of thought was one that invited people to embrace the crazy or enjoy the madness or some such. As a person with mental illness – bipolar disorder – I found the message troubling. The comments were even more so. One said that manic-depressives could at least enjoy the mania.

Admittedly, mania comes with feelings of soaring confidence and a whirlwind of creativity. Mania can also prompt risky behaviors – reckless driving, shoplifting, unsafe or extramarital sex – that can lead to a lifetime of problems, including failed relationships, arrest records, serious debt, and worse. Those are surely the opposite of enjoyable.

But I didn’t know if I was alone in these feelings, so I asked other bipolar bloggers how they react to popular memes. Here’s what they had to say.

Nondescript inspirational memes (of the sort that proclaim daylight follows darkness) seem relatively harmless. Reactions went from “meh” to “a waste of time.” Bipolar blogger Brad Shreve (insightsbipolarbear.com) likens them to affirmations. His research showed that evidence from reputable studies confirms that affirmations mitigate stress. Nevertheless, “I find most of them trite and condescending,” he says. “They just aren’t my thing. I choose meditation.”

Amy Balot, who blogs at madwomanacrossthewater.net, dislikes the sort of memes that tout positivity. “I do have a big problem with the way a lot of ‘motivational’ images seem to imply that all you need to do is think positive thoughts and your life will be hunky-dory,” she says. “It seems to be blaming people for things like depression or anxiety.”

Supposedly positive memes raise the hackles on a number of the bloggers. Dyane Leshin-Harwood, blogger at proudlybipolar.wordpress.com and author of the upcoming memoir Birth of a New Brain, says they range from “cool and empowering” to “[make] me feel guilty that my life isn’t as good as it could

be! It seems like it would bring anyone with bipolar depression down even
further.”

It does that to me as well.

Many such memes also promote a “bootstrap” approach to mental illness – which Jim Buchanan, who blogs at mythoughts62.wordpress.com, finds “irritating”: “I feel that this sort of thinking is harmful and it essentially blames the person reading it for their problems by implying that they ‘don’t want to allow themselves’ what is needed for a good life.”

Shreve adds, “Usually these entail [the idea that] the individual can change by doing one thing – [changing] our attitude. As if we could just snap out of depression, mania and more, if we would just put [our] mind to it. I find these guilty of mental health shaming.”

And as for the “find-your-sanity-in nature” meme that began this article? Amy Balot doesn’t care for that type. “I don’t dispute that spending time with animals or outdoors can be great and even therapeutic; but I do dispute the implication that these things are a replacement for therapy or better than therapy,” she says. “It minimizes the struggles of the mentally ill and says they’d be ok if they just took their dogs for more walks in the woods. Not all problems are solved by a little sunshine and fresh air.”

Memes intended to be humorous are a gray area, since humor is so subjective. Personally, I don’t mind being called “crazy,” but many bipolar people do. Using “crazy,” “insane,” or any of the many synonyms – “weird,” “eccentric,” “not normal” – can make people with mental disorders feel as if the meme speaks directly to them, even if that wasn’t intended.

But some people with mental disorders enjoy a gentle poke of fun at themselves. Shreve agrees: “These can be touchy because they could hurt or offend someone who is going through a difficult time, but they help me.” (Here’s one of his favorites: http://www.someecards.com/usercards/viewcard/326b0799dbae216dbe3bf6069e297ea48d).

I must admit that I can sometimes see humor in our situations. I’ve written pieces called “The Lighter Side of Insomnia” and “Confessions of a Crazy Cat Lady.” It’s not a matter of malice being intended; I don’t think people who pass along memes that we consider hurtful are “out to get” those with mental disorders. But that’s the problem: They don’t think before they click “Share.”

So I’m asking: Please think first. One of four Americans will have a mental or mood disorder at some time during their lives. You wouldn’t make fun of someone with a physical illness. Ask yourself: Would this meme still be amusing or inspiring or helpful if you substituted fibromyalgia or diabetes or paraplegia for “mental illness”?

If not, think again.

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Mental Health

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Support and Non-Support Groups

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

So am I.

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

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

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

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

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

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

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

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

What I found was both support and non-support.

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

So far, so good.

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

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

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

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

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

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

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

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Mental Health

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The Teen in my Head

There is someone else living inside my brain.

I don’t have Dissociative Identity Disorder (DID, formerly called Multiple Personalities). I just have another me who pipes up from time to time. And, man, can she be annoying!

She’s 14 years old, and she doesn’t have a name. I don’t know when I acquired her, but I do know when she acts up.

She’s the one who frets when a friend doesn’t answer my IM. When he does, she squees, “He noticed me! He noticed me!” She’s the one who wants to buy ridiculous, useless – but amusing – things. She makes me eat that extra chocolate cookie, then frets about getting fat and pimply. She’s the one who is hooked on all the stupid clicky Internet games.

I’ve heard the theory that everyone has a mental age that they get stuck at. No matter how old they get, they always picture themselves at that age. Mine is somewhere between 28 and 34. So how did I end up with a 14-year-old?

My theory about her existence is that she is there to try to do what I never did when I was 14 – all the regular teen-age angst and frivolous stuff: mad crushes and pouting, self-obsession and discovering her sexuality, in-jokes with BFFs and trying out fingernail polish.

When I was actually 14, I did none of that. I was in a prolonged downward mood swing, made worse by puberty and the horrors of junior high school. I wrote depressing poetry and read French existentialists. If they had had hipsters back then, I suppose I would have been one.

When I feel her popping up in the back of my skull, most of the time I have to put her in a box and sit on the lid. It’s scary to let her take over. She’s rapid-cycling, impulsive, and worst of all, unmedicated. (I don’t know why my meds don’t affect her, but there you are, they don’t.)

Once in a while I let her out of the box. I let her enjoy some mad crushes (as long as she doesn’t do anything about them). I let her buy things that cost $20 or less. I let her talk me into fake fingernails (once!). I let her have some of the fun that I never had at that age.

The thing is, I don’t know if this is just a me thing, a female thing, or a bipolar thing.

I know I’m not completely alone in having a teen ride-along. I do know a man with DID who has an alter that is a teen girl. I could tell when she was out because she giggles a lot and buys junk food. A friend of mine who has suffered from depression also has a 14-year-old in her head. She has given her teen a name – Innie Me. Hers behaves a lot like mine.

I also don’t know whether having a teen living in my head is a good thing or a bad thing. It could be good, because it does give me access to the feelings and experiences I never had as an actual teen. My teen is better than I am at having fun.

On the other hand, I know it would be a bad thing if I let her have her way all the time. She needs that box and I need to sit on the lid. The trick is knowing when and how and for how long to let her out.

On an episode of Scrubs, one character remarks that no matter how old a woman gets, she always has an insecure 14-year-old inside her. I suppose that men have similar phenomena. Most people are said to have an inner child (although I think they are usually younger than 14). I think my husband’s inner child is usually about seven.

Certainly my teen is insecure. There’s no question about that. But she’s also enthusiastic, engaged, and energetic, as well as moody, dramatic, and confused. I think she may be related to the hypomanic part of myself, although I’m also sure some of my fits of apparently reasonless weeping have been her acting up.

My therapist knows about my 14-year-old. We have discussed her and her behavior and her moods several times. Dr. B. has never expressed surprise or shock or puzzlement at the idea. She does think it’s good that I’m learning to sit on the box lid when I need to. We’ve talked less about when it’s a good time to let her out. That’s something I still need to work on.

I guess I’ll have to learn to live with my 14-year-old, because I don’t think she’s going away anytime soon. And I don’t think I really want her to.

 

 

 

 

 

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Mental Health

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I May Have Miscounted My Spoons

This week I actually got out of the house, going for lunch and a little shopping with an old friend. (Another friend of mine calls these “pants days” because they obviously require putting on pants, for going out farther than the mailbox.)

After less than three hours I went home, did some work, and promptly collapsed. All told, I think I was either active, sociable, or some combination thereof for at most five hours – most likely more like four. That for me is an exceptional day of fortitude, stamina, spoons, and hypomania.

However, I have gotten myself into a situation that will require much more than that. I am going to a writer’s conference – three days of thrill-packed seminars, lunches and dinners, and other business and social-type events. I’ve done half-day business meetings lately, but nothing so extended, crowded, or spoon-depleting. It will hit a lot of my anxiety triggers – crowds, noise, small talk, social events, and more. I know that by the time we gather for dinner in the evening, I’ll already be extra crispy.

The three days of the conference will not allow for much of any downtime – although I have fantasized about asking someone who’s staying in the hotel if I can borrow a room for an afternoon nap. (The conference is local so I don’t have a room of my own or it wouldn’t be a problem. Less of one, anyway. All I’d have to do would be pick which seminars to skip. But the idea of asking a relative stranger for the use of a room or the idea of a relative stranger letting me use a room is pretty ludicrous.) Fortunately, I have to get the car home by 10:00 so my husband can go to work. That means I can’t stay for the after-hours socializing, even though that’s said to be one of the highlights. But it does mean I get a few more hours in pjs instead of pants.

Back before I had my most recent major meltdown, I was able to attend business conventions and do at least most of the requisite functions. I could and did give little talks at power breakfasts or afternoon cocktail parties – even opened with a joke. I could meet and greet the public at our booth – “howdy and shake,” as my father would have called it. I could have lunch with potential writers. I could almost interact with our sales force.

Those days are long past. So now I ask myself, how can I build up my stamina for the writers conference? Maybe it’s time for me to try to reclaim some of those parts of myself.

It feels like I’m going to be training for a marathon – or maybe the Normandy invasion. I know that in order to get through it, I will have to prepare in advance: writing my Sunday blog posts before the conference starts, assembling my wardrobe, checking out the parking situation, stocking up on business cards, and all the other little details that make me so frantic at the last minute.

Perhaps during the next two months I can keep track of how many pants days I’m able to have and gradually increase them. Perhaps I can arrange more lunches and shoppings. Perhaps I can improve my usual record of doing only one major thing per day. Perhaps I can try to work up to three pants days in a row.

The conference itself is certainly a massive and major incentive. Plus I’ve already paid for it – yet another reason to get myself in shape to take advantage of it.

Right now the conference looks like rather an ordeal, but I hope that by the time it rolls around I’ll be in good enough shape to both enjoy it and benefit from it. At least it’ll be a group of writers, and humor writers at that. They’re known for being at least a little odd. Maybe I’ll fit right in. I’ll be the one napping on a couch in the hotel lobby in fuzzy slippers. And pants.

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Bipolar Basics for the Newly Diagnosed

If you have recently been diagnosed as bipolar, there are a few basics you should know. You’ll likely find them out on your own, but it might take a while.

So, here are some tips.

    1. Being bipolar isn’t necessarily a tragedy. It’s a chronic illness. At times it’s better, at others, worse. It’s not a death sentence and it’s treatable. You can still live a reasonably full and satisfying life.
    2. You need help. To live with bipolar disorder, you need a support system. Unfortunately, your friends and family may not be all that supportive. Fortunately, there are online support groups. But the most important parts of your support system, at least at first, are your psychiatrist and your psychotherapist. I recommend having one of each – psychiatrist for medication, therapist for talk or cognitive behavioral therapy, or whatever works for you.
    3. You will most likely need medication. And the odds are good that you will need it for the rest of your life. Don’t panic. After all, diabetics need insulin, usually for life. You may hate taking pills, you may hate the idea that you are dependent on them, you may hate the fact that they remind you of your brain’s difficulty functioning. But realize that meds will make your brain’s functioning less difficult. They are worth the hassle.
    4. Everyone is different. Everyone’s symptoms are slightly different. Everyone’s medications are slightly different. Everyone’s reactions to their medications are slightly different. A support group can help you with general information, but they cannot tell you what is ultimately best for you. Your particular symptoms and your unique version of bipolar disorder may well require different medications, in different amounts, than your friends. And you may have different reactions to them. Some pills have no effect at all on one person and are life-savers for another.
    5. Getting better takes time. Once you have your diagnosis and your medication, don’t expect to feel better quickly. Most medications for bipolar disorder take a while to build up in the body. Six weeks is not unheard of. Then your doctor may assess how well the medication is working, and change the dose or even the medication itself. Then you may go through another six weeks of waiting for the new dose or drug to take effect. Each case of bipolar disorder requires a medication regimen tailored specifically to the individual, and that often takes some doing.
    6. There are several different types of bipolar disorder. The two main types are called type 1 and type 2. Type 1 is the classical bipolar disorder, which used to be called manic-depressive illness. Type 2, a more recently identified version of the disorder, often manifests as mostly depression, possibly with hypomania, a less severe version of the ups that accompany bipolar 1. Other forms of bipolar disorder are rapid cycling, in which one’s mood states alter quickly, even within a few hours. Another version of bipolar disorder is called mixed states. Mixed states occur when a person experiences both extremes of emotion at the same time – for instance, depression and irritability, or fatigue despite racing thoughts.
    7. The odds are that you already know someone with bipolar disorder, or at least some kind of mood disorder. One in four Americans will have a psychiatric or emotional illness at some time during their lives. Because we don’t talk about it, though, no one may ever know. Especially when the disorder is treated properly, a person with bipolar illness can maintain function in society and choose whether or not to share the diagnosis with friends and coworkers. Many people choose not to because of the stigma surrounding mental illness. It’s a valid choice, but it cuts the bipolar person off from possible support and understanding from others who may share the disorder.
    8. Relationships can be difficult but not impossible. Relationships are difficult for everyone. People with bipolar disorder have relationships that are difficult too. The disorder may make the relationships even more difficult, especially when the family member or loved one or even close friend does not understand the symptoms, the medication, the mood swings, the anxiety or fatigue, or all the other facets of bipolar. The best cure for this is education. However, it may not be possible for a relationship to survive bipolar disorder, just as a relationship may not survive trauma, grief, addiction, infertility, incompatibility, meddling relatives, infidelity, parenting, or a host of other conditions. It may be better to look at all the circumstances surrounding a troubled relationship rather than automatically blaming bipolar disorder for difficulties.
    9. Learn all you can. Because bipolar disorder is so little understood by the public, because it manifests differently in nearly every case, because a person can be actively suffering or in remission, because a person may have any of the different types of bipolar disorder, because everyone is different – the need to educate yourself and probably those around you is essential. The more you know, the less you’ll panic when a symptom you haven’t experienced before suddenly hits. Rely on reputable sources. Medical, psychiatric, or psychological websites are usually the best. Support groups can offer much information, but the people in a support group may not be any more well-informed than you are. And there are lots of people selling “miracle cures” that can lure a person away from needed medication and other services.
    10. Keep trying. It’s hard. It’s frustrating. It’s difficult. It’s painful. It’s confusing. But bipolar disorder is something you can live with, and even something you can rise above. The secret is to keep trying. Keep seeking out therapy and friends who support you. Keep taking your medication, even if you don’t want to. (Stopping your medication without advice from your doctor can be dangerous, so don’t try that.) Be stubborn. When you feel like giving up, tell yourself that maybe things will get a little better in the morning. Hang in there. You may not realize it, but there are people who need you in the world, who need you to be functioning and happy, who need you to keep fighting the disorder.

Do you have any other tips for the newly diagnosed? Please share them in the Comments section.

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I Chose Fat Over Misery

I was a skinny kid who grew a lot less skinny.

Do my bipolar meds have something to do with that?

Probably.

Do I care?

No.

I’ve noticed a lot of people with bipolar disorder panicking over the topic of weight gain. “I know I need meds, but I’m afraid of weight gain.” “What meds can I take that don’t cause weight gain?” “I tried X med but I quit because of the weight gain.”

It’s true that mental health and physical health are linked – what affects one may affect the other. And it’s true that medications have side effects, among which may be weight gain.

What I don’t get is why some people are so afraid of weight gain that they would sacrifice their mental health to avoid it.

Actually, I do sort of get it. There are ads everywhere that promote thinness – even to the point of illness – as the ideal for both feminine and masculine. There is a “War on Obesity” and plenty of people who will tell you that your body mass index is the most important number that identifies you. There are fat people jokes and gags that could not be told about any other group, be it race, sex, ethnicity, or religion. Plenty of comedians have made a good living making fun of fat – even their own. On TV, the fat character is never the hero.

Now back to the skinny, scrawny, bony kid I was. Undiagnosed and untreated. Aware that there was something wrong with me, but no idea what.

I had mini-meltdowns and major meltdowns. I had anxious twitches. I burst into tears when certain songs came on the radio – and not necessarily sad ones. “Take Me Home, Country Roads” tore me up. “I Am a Rock” could leave me sobbing. I took walks in the rain till I was soaked to the skin. I would laugh out loud for no reason that anyone else could see.

I was a mess. But a thin one.

It’s relatively recently that doctors and scientists have explored the connection between psychotropic medications and weight gain. Some have speculated that people who are depressed don’t eat much. Then, when their meds kick in and they feel better, their appetites return. In my case, I ate more when depressed and less when anxious. By the end of my undergraduate years, I was drinking banana milkshakes so my parents wouldn’t worry about how thin I was when they saw me at graduation.

Slowly, I got better with therapy and meds. Slowly, I gained weight. At first I didn’t notice. Then I did. I tried prescription diet pills and Lean Cuisine, which worked – for a while. But eventually, as is true of most dieters, I started piling the pounds back on. If one of my psychotropics was to blame, I couldn’t pinpoint which one, what with going on and off so many different ones and the cocktail of several I ended up with.

But as I got better and gained weight, I also started making friends, going on dates, finding lovers, and eventually meeting the man I would marry. Some of them were overweight, too. But that wasn’t what mattered most to them – or to me. Oh, I suppose there were people who were turned off by my well-padded physique. Maybe some of them were marvelous people, and maybe I would have enjoyed their company if they could have seen past the weight.

But the fact is, I now have plenty of close friends who just don’t give a damn about weight. Sometimes one of us will need to lose weight for a specific health reason like diabetes, and the rest of us will offer encouragement. But for the most part, we are who we are and love each other that way.

Given the choice – and I do have the choice – I will take the psychotropics that keep me reasonably stable and happy and productive. And yes, overweight. I remember the misery, the despair and pain, and no matter how I look, I don’t ever want to go back there. Self-esteem, for me at least, is better if it comes from the inside out, not the other way around.

The bottom line?

I’ve been skinny. I’ve been fat. Either way, I’m still me.

 

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Am I Ready to Stop Therapy?

I got my first hint that I might be ready to stop therapy when I realized how little I was going. Over the years I have scaled down from weekly sessions to biweekly.

Then I noticed that, effectively, I’ve been going only once a month. I’ve been forgetting appointments, showing up on the wrong day, oversleeping, feeling poorly physically, or having too much freelance work to do.

Of course, those could be signs that I’m in denial, that I’m resisting therapy, that we’ve hit a bad patch of difficult issues and I just don’t want to deal with them.

But I don’t think that’s what’s happening. Here’s why.

I’m stabilized on my medications and they’re effective. When my psychiatrist moved away a few months ago, he left me with enough refills to last until this month and a list of other psychiatrists. My PCP agreed to prescribe my psychotropics if I lined up another psychiatrist for emergencies. I’ve done that, though I couldn’t get an appointment before March.

And that doesn’t alarm me. I don’t have the oh-my-god-what-if-my-brain-breaks-again panics. I don’t have the feeling that my brain is about to break again. I’ve thought about it, and I’m comfortable with letting my involvement with the psychiatric profession fade into the background of my life.

As long as I keep getting my meds.

I have more good days and I’m beginning to trust them. Oh, I still question whether I’m genuinely feeling good, happy, and productive or whether I’m merely riding the slight high of hypomania. But really? It doesn’t seem to matter very much. A few days ago I reflected on a string of particularly good days – when I accomplished things, enjoyed my hobbies, and generally felt content. And I simply allowed myself to bask in those feelings.

That’s not to say I don’t still have bad days. After a few days of hypomania, I hit the wall, look around for spoons and don’t find any, and require mega-naps to restore me. (I’m intensely grateful that I work at home and can do that. Most offices don’t appreciate finding an employee snoring underneath her desk. And my cat-filled bed is much more comfy-cozy.)

I still get low days too, but they are noticeably dysthymic rather than full-out, sobbing-for-no-reason, Pit-of-Despair-type lows that last seemingly forever. I know – really know, deep within me – that they will last a day or two at the most. And just that knowledge makes me feel a little bit better.

My creativity, concentration, and output are improving. I can work longer, read longer, write longer, take on new projects, think past today or even next week. I can trust my muse and my energy, if not immediately when I call on them, at least within a reasonable time.

I have trouble remembering how bad it used to be. Recently I’ve made connections with several on-line support groups for bipolar and mental health. I find I’m astonished at the crises, the outpourings of misery, the questioning of every feeling and circumstance, the desperate drama of even the most mundane interactions. They are overwhelming. But I realized that it’s been a long time since they’ve overwhelmed me. I recognize that I could some day be in that place again – that’s the nature of this disease. But I have a good support system that I trust to help me not fall too far without a net.

I don’t have much to talk about when I go to therapy. There are issues I need to work on – getting older, getting out of the house more, reclaiming my sexuality. But most of those I feel competent to work out on my own.  My sessions are mostly an update on what’s going on in my life at the moment, plus a recap of my recurring problems. But those problems are ones I’ve faced before and know how to cope with. I already have the tools I need and use them without needing a reminder.

So I’ve talked it over with my psychotherapist and I’m not completely quitting therapy, but I am cutting back officially to the once a month I seem to be going anyway. I know that if and when the bipolar starts giving me major trouble again, I can always call for an appointment or a telephone therapy session.

I’m not going to stop writing these posts. I still have a lot to say about where I’ve been, how I’ve got to where I am now, how things will go in the future, and all the many ways that mental illness affects society and vice versa.

You’re not getting rid of me that easily. I’m sticking around.

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