Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

Self-Harm Revisited

If that title isn’t enough of a TRIGGER WARNING for you, I don’t know what is.

Not long ago I saw on the web a video with the title “Is scratching self-harm?” Well, of course it is, I thought. The video agreed with me.

It seems like the low end of the spectrum, not as extreme as as what most people think of as self-harm, but a form of it nonetheless. Scratching, pinching, hair pulling, and the like are probably considered subclinical next to cutting and burning. But they are still problems. They can escalate into worse self-harm.

In another article (http://www.upworthy.com/this-researcher-who-studies-self-injury-explains-why-people-do-it-and-why-he-did-it?c=ufb1) I saw this definition for self-harm:

“Self-injury is intentional damage to body tissue (that doesn’t include body modifications like piercings, tattoos, and scarification) without suicidal intent.”

So, yes, scratching is self-harm. It is intentional. It is damage to body tissue. and it does not indicate suicidal intent.

Scratching sounds so minor. We scratch ourselves all the time when we have an itch or an insect bite. We scratch ourselves accidentally on protruding nails. Occasionally we draw blood. We wash it off, slap on a band-aid, and that’s that.

But when scratching escalates to self-harm, it can indeed be serious. For one thing, scratches have a tendency to become infected, infection of the sort can lead to further tissue damage – and if untreated, to more serious complications.

There is also the potential for further harm because the scratching will scab over. Then the desire to scratch off the scabs kicks in. When this happens, the scratches never heal. And yes, that’s both a fact and a metaphor.

My own experience with scratching came when I was working at a job that required me to monitor burglar alarms. The alarms tended to go off – whether there was a burglary or not – during thunderstorms. When a storm hit, a dozen or more alarms could go off simultaneously, or at least in rapid succession. I had to call the owners of the businesses, or emergency services as required.

One night during a particularly bad storm, I missed one of the alarms. I did not call the owners until I looked back at the record. When I called, it was 45 minutes since the alarm. I knew I had made a mistake, and a bad one. The owners of the business would not be happy. My boss would not be happy. I was not happy.

I sat alone by the monitors and imagined the trouble I was in. I started scratching my right arm – long slow strokes from nearly the wrist to nearly the elbow. Repetitively. Obsessively. Painfully. I believe I was punishing myself for making a bad mistake. Perhaps there was some thought that if I inflicted the pain, I would escape further consequences of my mistake.

Of course that makes no sense. It’s an example of the irrational thinking that goes with self-harm.

I don’t cut anymore, as I discussed in a previous post (http://wp.me/s4e9Hv-cutters). I also don’t scratch the way I did that night. I still have a tendency to pick scabs. Occasionally if I have an insect bite, I will scratch it to blood and then pick the scabs on that. I try not to. My husband helps me by reminding me not to pick at scabs or to put band-aids on them. I try to rub instead of scratch, or use lotion.

Jenny Lawson (aka the Bloggess) has admitted in her most recent book, Furiously Happy, that she scratches past the point of bleeding and pulls her hair enough to create bald spots. It’s clear that she considers this self-harm. Her husband tries to help her with it too.

But self-harm is basically a private thing – something we do and hide from the world. Some people are able to hide it even from their most intimate family and loved ones. I know I wore long sleeves to cover the dreadful scratch on my right arm. It healed from a scratch to a pink scar and then to a white scar. Now I can’t even see it anymore through the freckles.

But I don’t need the visible reminder. I remember how it felt to do it, how it felt after I did it, and how I felt as I watch the scars slowly fade. its nothing I’m proud of, except for the fact that I survived it and no longer do it.

As most cutters and other people who self-harm do, I feel shame in recalling the act, and almost never speak of it. The reason I’m sharing the story in such a public forum is to let people know that not all self-harm consists of big dramatic gestures. It can start with a tiny scratch. But it is not something to be ignored. We need to talk about self-harm, educate about it, bring it out in the open, and let others know that it doesn’t have to continue.

And that it can start with something as small as a scratch.

Does “Natural” Treatment Work for Depression?

Not for everyone. Not all of the time.

Angel Chang recently posted on LittleThings.com “The 10 best natural ways to treat depression.” (See http://www.aol.com/article/2015/11/06/the-10-best-natural-ways-to-treat-depression/21260290/?ncid=txtlnkusaolp00001357) While she does acknowledge that “clinical depression is triggered from within, and very often need[s] medical attention” and “it’s imperative to consult your physician if you notice an abrupt change in your mood, feelings, or sense of well-being,” her article is about “easy” ways to treat depression yourself.

Unfortunately, her tips are not very helpful for me and many others who suffer from clinical bipolar or unipolar depression. Here’s how I respond to them.

Meditate. This is both nearly impossible when you have racing thoughts and a way to sink even lower if you can’t clear your mind of negative thoughts, which is one of the hallmarks of depression. And if you’re manic, even sitting still in one place for any length of time can be a challenge. After you’re stabilized on medication – go for it.

Eat Foods With Vitamin B. It may be true that vitamin B has been linked to neurotransmitters that we need more of, but preparing them is not realistic when I’m in the Pit of Despair. I try to imagine myself preparing a meal of fish, Swiss cheese, spinach, and eggs, and I just can’t. Or shopping for them, for that matter. I might be able to scramble an egg in the microwave, but that’s about it. (I wrote about food and depression recently: http://wp.me/p4e9Hv-db.) I do take a multivitamin along with my bedtime psychotropics, so I guess I can follow this advice a bit.

Set goals. Chang recommends starting with “small, daily goals.” When in full-blown depression, mine are about as small as you can get. Get out of bed. Make it through the day without crying. Take my meds. Poof! Out of spoons! The expert Chang quotes gives an example of a goal to work up to as washing the dishes every other day. To me, that implies a series of goals: Gather up dishes. Find soap. Fill sink. Wash a dish. Put in drainer. Repeat. My tip: Wash the spoons first!

Sleep on a schedule. Going to bed at the same time every night may be do-able, but getting up at the same time isn’t possible for me, which is one of the reasons I can’t hold a regular job. An alarm clock awakening me before my body is ready leaves me groggy and unfit to work. And there’s no guarantee that I’ll actually sleep during those scheduled hours, even with Ambien. Chang advises not taking naps, but I seldom make it through the day without one, even if I have slept eight (or nine or ten) hours. In fact, I love naps and consider them therapeutic, for me at least. Naps are my friends.

Get out of your rut. Structure is the only thing that keeps some of us going. And if we could find joy in a painting class, a museum, or making a new friend, as Chang suggests, we probably wouldn’t be depressed in the first place. J. K. Rowling described the Dementors in the Harry Potter books: “Get too near a Dementor and every good feeling, every happy memory will be sucked out of you. … You will be left with nothing but the worst experiences of your life.” She has stated that they are metaphors for depression. With every good feeling sucked out of you, you can’t see anything but the rut. I am told that for some people, Cognitive Behavioral Therapy (CBT) lessens the tendency to keep traveling in the rut. But “easy” and “natural”? I don’t know.

Talk. Chang is advocating talking with trusted loved ones, which is good as far as it goes. What it ignores is that friends and loved ones are not universally understanding of depression or supportive in dealing with it. She never suggests talking with a therapist or doctor. I don’t know why that’s less “natural” than talking with someone who has no training. Except you have to pay them (or your insurance does), but painting or language classes or art supplies aren’t free either.

Exercise. This is a classic antidote for depression, and I understand that it works for many people some of the time. But I would put this under the same heading as setting goals. I know it would be good for me, but motivation is hard to come by and immobilization thwarts me. But I wish I could take this advice. I looked into water aerobics, but there’s not a feasible program in my area.

Responsibilities. “Because you might feel down,” the article states, “you may also want to withdraw from your daily activities in life and your responsibilities at home or at work.” Yepper. “Try staying involved as much as possible in the causes you care deeply about, and take on new daily responsibilities. These can be as simple as volunteering at your local food pantry, or going back to work part-time.” Big nope. See getting out of your rut, above. For the clinically depressed, working even part-time is unimaginable, with responsibilities of the crushing sort.

Unwind and relax. If your depression comes with anxiety like mine, this idea is a non-starter. Unless you count drinking as relaxation, though it isn’t the best idea if you’re on meds.

Stay off caffeine. Okay, I can pretty much do this one, except for one cup of coffee or a caffeinated soda to get me started in the morning.

“Did you learn something new about how to naturally treat symptoms of depression?” the article ends. Not really. Well, except for the B vitamins. We’ve all heard these kinds of advice before. They’re good tips for situational or reactive depression, but largely not feasible for the chronically, clinically, biochemically depressed. In a way they add up to the much-hated “Just stop it. You must want to be depressed or else you’d be doing all these great things.”

But try them if you can, perhaps in addition to medical treatments. Maybe some of the ones that won’t work for me will for you. In the meantime, get help. See your therapist and/or psychiatrist. Keep taking those meds. Those may not be “easy, natural” ways to treat depression, but if they work, isn’t that the larger point?

P.S. Do NOT Google “CBT.” Spell out “Cognitive Behavioral Therapy.” Trust me on this one.

My New Mental Health Tattoo

Once again I have gotten a tattoo, supporting the cause of mental health.

A few months ago, I became a part of what’s called the semicolon project and wrote about it in this post: http://wp.me/p4e9Hv-9G. For those of you who aren’t up on the terminology, a semicolon tattoo represents mental health awareness, especially erasing the stigma, and suicide prevention.

The semicolon was chosen as the symbol because in writing, a semicolon indicates a place where a writer could have completed – or stopped – a sentence, but chose to go on. The semicolon says, in effect, “My story isn’t over.” The idea is to have the tattoo someplace visible – in my case, on my left wrist – and use it as a conversation starter.

Most people will assume that since I am a huge grammar nerd, my semicolon tattoo is some weird manifestation of love for punctuation. Then I can tell them that it’s a whole lot more. You can find out more about the semicolon project at http://www.projectsemicolon.org/.

My new tattoo represents bipolar disorder. Again it’s made up of punctuation: two colons and a paren. These symbols, unlike the semicolon, have no special meaning in writing and are never seen together in that order. Instead they make up a double emoticon: looked at one way, the colon and paren make up a smiley face. Looked at the other way, a frowny face.

New mental health tattoo

New mental health tattoo

This symbolism is easier for anyone seeing the tattoo to grasp. In a way, it’s a minimalist version of the comedy and tragedy masks you often see in theaters.

Again, it’s a conversation starter. Bipolar disorder is not well understood by the general public. This is particularly true of bipolar disorder type 2 – the kind I have – which many people have never even heard of.

Since I have gone public with having a mental illness, it seems only appropriate to introduce people to the disorder in a way that’s creative, nonthreatening, and understandable.  It’s a lot less abrupt than blurting out, “Hey, I have a mental illness!” Even my mother-in-law recognizes that these tattoos are not just a whim, but for a good cause.

The second tattoo is on my right wrist, so no matter which hand I extend, I can open up new understanding about a very real problem that many people live with daily.

A number of articles have come out lately questioning whether a person who gets a tattoo will regret it when they grow older. I think I can say with complete confidence that I will never regret these tattoos. They say something about who I am, something that will not change as I grow older. The disorder will always be with me and so will these symbols. For the rest of my life I can use them to educate, identify with other bipolar people, and remind myself that wrists are not for cutting.

I will say, however, that whoever thinks of these things had better put the brakes on new mental health-related tattoo designs – especially those made of punctuation – or I will soon become the illustrated editor/blogger. At the moment I have no plans for any further ink. My friends, however, tell me that tattoos are addictive. So we’ll see.

A few notes, since everyone asks: These simple tattoos take 10 minutes or less to apply. They hurt a little bit, but not much – a stinging sensation. They may fade a bit at first and need a touch-up. Because they are so quick and simple, you will not pay a lot to have them done. After you get the tattoo you have to take care of it while it heals, moisturizing it regularly for the first 3-6 weeks or so.

If you decide to get a tattoo, check out the studio before you have it done. It should be a professional operation, with high standards of cleanliness and concern for health. Tattoo artists should wear surgical gloves and change them frequently. There may be a consent form to fill out, indicating that you know what you are getting into, and even indicating whether you have various medical conditions or allergies, or have drunk alcohol within the previous eight hours. A reputable tattoo studio will not work on a drunken client.

Do you have a tattoo related to mental health? I’d love to hear about it. But don’t tell me if it’s more punctuation. I only have two wrists.

The Spike

It was The Year of Living With Rex, and for me that meant dangerously. I was undiagnosed and unmedicated, except for wine. I had already been through an episode of cutting. I was clueless and stubborn, isolated and emotionally abused. Tired to my soul and trying to claw my way through my last year of college and a relationship that has affected me to this day.

Then the pain started. Without warning, I would feel a railroad spike being driven through my right temple. It was blinding, all-consuming, and lasted for as much as 30 minutes straight, sometimes. If I was lucky, it was only a few seconds, but I was seldom lucky.

I didn’t know anything that would make it better. All I could do was lie down and weep until it went away.

As this continued, the fear grew in me that I had something dire, like a brain tumor. In addition to my major depressive episode, I was living with massive anxiety.

I don’t know how I made it through my senior year. I don’t know how I made it through the train wreck I was living.

But here’s how I made it through the railroad spike.

Actually, it was kind of amusing, if you weren’t me and it wasn’t happening to you. I went to a doctor, a neurologist, who took one look at me and said,”I can give you any test you want, but I’ll tell you what it is right now. Your jaw is crooked.”

It was Temporomandibular Joint (TMJ) syndrome. And this was before it got trendy and over-diagnosed, the way way gluten sensitivity is now.

My jaw was indeed as crooked as could be. When the doctor put his fingertips on my jaw and asked me to open my mouth, we could both feel it slipping sideways. I’ve been told it feels like my jaw is going to fall off in the doctor’s hands. It made clicking and cracking noises that I had somehow never noticed, and occasionally seemed to get stuck briefly.

How did this explain the railroad spike? When I was anxious, my jaw muscles would clench – and since my jaw was crooked, they would tighten up unevenly. Causing much pain.

“What can you do for it?” I asked.

“We could break your jaw and put it back together, but there’s no guarantee that would work,” he said. (This was in the ’70s. I believe treatments have improved since then.)

While I contemplated whether I really wanted to have a surgically broken jaw (I did not), he gave me a prescription to calm my anxiety so the muscles wouldn’t tighten up and trigger the pain spasms.

Good ol’ Valium.

Now I was officially medicated with benzos and self-medicated with wine. It did take down the anxiety, but plunged me even further into the depression. And I was still living with academic pressure, isolation, no psychiatric diagnosis. And Rex.

I finished up the year, grabbed my diploma, and lit out for my home state as fast as I possibly could. Rex threatened to send the police after me if I took my things while he wasn’t home to supervise and prevent theft of any of his goods. Fine, I thought. Just let him try. I was across two state lines before he got home from work. No, geographic cures don’t work, but sometimes retreating to a safer place can help.

So, all in all, a truly rotten experience. But did I have a psychiatric problem? After all, a crooked jaw is a decidedly, visibly, diagnosably physical ailment.

Of course I did. The crooked jaw was just one component of my condition. The anxiety was another –  a big, huge, whopping one. After all, I’d had a crooked jaw my entire life, and it never sent me railroad spikes until that year. And the depression made it all harder to see and to get away from.

If you ever needed proof the mind and the body are so intertwined that you can hardly tell one from the other, there it is. Physical problem + psychological problem = pain, of both sorts. Good luck trying to sort the two out. And medicating one without making the other worse.

Things That Work – Sometimes

Right now I am in the middle of a fairly deep depression. It has gone on for days, which is unusual now that I am more or less stabilized on medication. But there is no let-up in sight.

This time is one of those I-have-nothing-to-look-forward-to moments; plus the holidays; plus the need-to-see-my-therapist thing; plus the have-an-appointment-with-new psychiatrist-but-it’s-not-till-March thing; plus the whole no-spoons-to-get-out-but-really-need to-get-out-of-the-house feeling; plus the various catastrophizing-about-finances-and-the-IRS problem; plus the there’s-something-I-really-want-to-happen-but-if-it does-it-won’t-be-soon-and-may-not-happen-at-all.

Let’s see. Is there anything else?

Oh, probably, but that will do for starters. Of course to a lot of people, those would be everyday annoyances and I would be having your standard pity party. But for a bipolar person, with my brain chemistry, it’s an invitation to a deep, dark pit.

So what are the things that help pull me through, or out, or up? And what are the things I can do while I just ride it out?

Well, there’s music. I’ve written about that before (http://wp.me/p4e9Hv-42). There are two long-form musical bits that have been known to lure me out: The Mikado and The Pirates of Penzance. Occasionally when I haven’t gotten out of bed in a while, my husband will put on a DVD of one or the other and wait for me to appear in the door of his study. There is usually beer or snacks, and I can sing along (badly but loudly) to my heart’s content. Heart’s content – now there’s a good thing. Going to see live productions of Gilbert & Sullivan was an activity my sorority used to do, and one of my best memories of otherwise-difficult sorority life. (I mean, really, can you picture me in a sorority?)

Then there are distractions. These don’t actually improve my mood, but they can help me avoid dwelling on the above list of what’s-wrongs. If I have the concentration needed to read, that’s my go-to choice. (I’ve also written about “comfort reading”: http://wp.me/p4e9wS-3n.) I usually try to keep one fiction and one nonfiction going, so I can switch back and forth.

Sometimes, though, I don’t have the concentration to make it through a chapter. Then it’s time to try TV. Something familiar, non-challenging, not too fast-paced. Cooking shows work, or something like Pawn Stars. True crime or true medicine. Shows where I already know the characters and the back-stories: Castle, Bones.

When I don’t even have enough concentration for that, I go for stupid clicky games. One round of Candy Crush Soda Saga is about as mindless as you can get and still be breathing. Even playing out all five lives takes about 15 minutes. Or I can turn off my brain entirely, play obsessively, and get lost for hours of not-worrying about anything more important than making six-letter words in AlphaBetty.

Occasionally I can do light-as-popcorn forms of social interaction. Phone calls with a depressed friend or one who always has a silly joke ready or one who reads the same sorts of things that I do. Instant messaging. Facebook.

Sometimes, though not often in this state, I can force myself to work a little. Or work on my blogs. It’s difficult and not really satisfying and sometimes even painful, but if I can do it, it’s probably the best thing for me. Accomplishing something – anything – helps build a step out of the pit.

As for the usual advice – rest, exercise, nutrition, meditation – I usually can’t manage those. Except for sleeping. I’m a world-class napper. Also a world-class insomniac. Don’t ask me how I manage that. It’s a gift. I have a new exercise regimen that involves walking up and down the stairs more times than I really have to. My husband makes sure I eat at least one good meal a day. For meditation I pet a cat.

Then I wait.

I know that this will not last for weeks or months or years the way it used to. I’m just going to be miserable until I’m not anymore.

The Depression Diet

It seems that Target (and other stores) can now send, well, targeted ads based on previous purchases. The example usually given is that someone who buys a home pregnancy test will start receiving coupons and discount offers on diapers and strollers.

I maintain that one way to spot depressives is through their grocery-buying habits. Just as psychologists say that odds are that the last three people in any long line are likely to be clinically depressed, I say that someone who purchases an entire chocolate chip cheesecake and a bottle of Jose Cuervo is going to be in the back of that check-out line too.

Which brings me to my point. There are certain foods that depressed people tend to eat. These foods don’t cure depression, of course, but they do seem to provide some comfort.

The first category of depression food is, of course, comfort food. We all have our own definitions of comfort food, but a lot of them seem to be high-carb, high-fat, no-nutrition sorts of food. They bring back memories of childhood, maternal nurturing, and a simpler time when calories didn’t count. Some of my comfort foods include club sandwiches, grilled cheese sandwiches with tomato soup, mashed potatoes, and macaroni and cheese.

My husband knows enough to make me comfort food when I’m stressed out. He does add tuna fish and peas to the mac and cheese to make it somewhat more nutritious. He knows my needs and does well at meeting them, though his grilled cheese will never rival my mother’s. He does pretty well on the tomato soup.

The next category of depression food is weird food. I suppose this category includes the chocolate chip cheesecake and tequila. One of my depressed friends introduced me to her particular specialty: wavy potato chips dipped in cream cheese with an M&M stuck on top. My husband starts to worry about me if I ask him to pick these up for me at the store. But it does contain all four food groups: salty, sticky, sweet, and crunchy.

When I was a kid, my favorite was a block of cream cheese with that odd, unnaturally orange French dressing poured over it, mashed with a fork, and with pickle relish if I we had any. This was my own chip dip creation. It resembled my friend’s in the cream cheese and wavy chips department, but French dressing is no substitute for M&Ms. Let’s just say my tastes have grown. (Not necessarily up.)

Another category of depression food is useless food. These are edibles that one can make with very little effort, as even small efforts can be overwhelming at this point in depression. Frozen dinners are good for this. I recommend Marie Callender pot pies if you go this route, because they have both a top and bottom crust and so feel more like a meal. Foods that come in small cups with pop-open tops are good too: Beefaroni, mac and cheese, soups.

Sometimes, however, the depression is so severe that even these simple efforts are beyond you. For those occasions, there are truly useless foods. It’s a mistake to call them meals at all. Here I’m talking peanut butter straight out of the jar (spoon optional), and dry cereal straight out of the box. During my worst days I used to keep a box of Cocoa Puffs by my bedside, just in case. As I slowly improved, I replaced that with a box of Life cereal. (The name was a coincidence, I assure you.)

I know that eating a well-balanced, nutritious diet is one of the most common suggestions for keeping depression at bay (along with exercise, sleep, and all that other good advice). I also remember that when a person is talking about suicide, one of the questions you’re supposed to ask is, “When’s the last time you ate?” Supposedly it’s harder to take your own life if you’ve recently done something as life-affirming as eating. (I don’t know if that’s actually true, but I did try it once and the person is still alive, so maybe.)

I also know that sometimes irrational thinking extends to food choices as well. I worry about my husband when he starts eating peanut butter sandwiches dipped in cold chunky soup (still in the can). I’ve been told that’s a guy thing, not a depressive thing, but still sometimes I wonder. Even at my most depressed, I’ve never been tempted to do that. Ew. Just ew.

The Wrong Life

Nothing prepared me for this.

This is not the life my upbringing prepared me for. I don’t just mean the special guest speakers we had in home economics class who tried to introduce us to the subtleties of silver, china, and stemware. No, I was also misled by the books I read.

If Life Is a Bowl of Cherries, What Am I Doing in the Pits? and Please Don’t Eat the Daisies led me astray. Don’t get me wrong, I’m a total fan of Erma Bombeck’s writing style, but the quirky suburban life she loved and lamented was not what I got. Bombeck and Kerr both made light – and fortunes – of portraying the petty foibles and cute misunderstandings of women and their husbands, women and their children, women and their neighbors, women and other women.

Daily disasters with dishwashers, sticky-fingered children, and clueless husbands were an endless source of amazement and amusement for them. They soldiered on, supported by an innate buoyancy, faith in the divinity, and the occasional glass of wine.

My glasses of wine have been more than occasional. My disasters have not been humorous. I do not have children, and the cats are somewhat deficient in making adorable conversation in high-pitched, lisping voices. Sometimes all I can get out of them is “meh,” which is pretty much how I feel too.

As for the trappings of the genteel life, we eat off paper plates more often then not. I did once have a set of Limoges, but only because I was acting as a pawnbroker for a friend who needed ready cash. I fed one of the cats on the Limoges saucer, just to say that I had.

My parents used to say that their house was decorated in early married junk and I have followed in that fine tradition. Most of our furnishings are a demonstration of the maxim: If it’s not from Kmart or Goodwill you won’t find it here.

No one’s life prepares them for clinical depression, hypomania, bipolar disorder, or any other mental illnesses. I’ll wager that even psychologists’ kids don’t have a clue when they escalate from picking scabs to experimenting with lit cigarettes. Maybe their parents don’t either.

Either the mental disorder has been going on so long that you don’t know what it’s like without it, or it comes on so suddenly that you desperately hope that it goes away just as suddenly. Or it comes in a way that you can just convince yourself is no big deal. “I overspend? That’s just because I love shopping, not because I have mania or need to validate myself with expensive things.”

Perhaps people who grow up with a mentally disturbed loved one have a chance of understanding the underlying mechanisms. But with the number of families who don’t discuss the “elephant in the room,” or pass it off as, “Your sister is just high-strung” or say, “Uncle Ted is a little odd. Just ignore him,” not even that exposure may help.

How do young people learn about mental illness? Or even – gasp! – get help for one? If not at home, maybe at school? The National Association of Secondary School Principals cites the U.S. Surgeon General’s report saying that “one in five children and adolescents will face a significant mental health condition during their school years” and that the ratio of school counselors to students is 471:1. Add to that the fact that most school counselors have been shifted away from offering personal and emotional support to offering academics-only services. (http://www.nassp.org/Content.aspx?topic=57948)

Most of us struggle alone. Some never find a proper diagnosis and treatment. We have to be our own resources and our own advocates much of the time, even if our illnesses do not allow us to get out of bed. If we have one family member – or even a close friend – who understands, we are lucky beyond measure.

I wish that I had been even slightly prepared for the life I now lead, instead of the one I was “supposed” to have. No one can predict the future, but why can’t we at least have a bit of mental health education in school? I suppose that’s a lot to ask, when even sexuality education varies from the merely adequate to the appalling, when schools are barely able to stay abreast of the teach-to-the-test curriculum, and when Texas’s governor vetoes a bipartisan bill allocating resources for mental health, based on lobbying by Scientologists.

Do I sound bitter because I didn’t get to live the genteel suburban life? Probably. But there are aspects of that life that likely would have actively impeded my search for mental health. So I’ve had to do it on my own, or nearly so, at least until recently. A lot of us go DIY for mental health.

But a lot of us are accomplishing it. Living the life we have and not some fictitious pie-in-the-sky one. We may not have been prepared for it, but we muddle through anyway – and sometimes even realize that imperfect real life is better than a perfect lie.

Confessions of a Crazy Cat Lady

One can be a crazy cat lady without living alone in a cavernous house with a dozen or more cats. I should know. I am one, and I don’t.

First let’s start with definitions. I’m crazy. I think we all know that by now and I don’t mind saying so. (See “Yes, I Am Crazy. Thanks for Asking” http://wp.me/p4e9Hv-4h.) I’m also a cat lady. We had dogs growing up, but I never got very close with them. I did have a rabbit that I was awfully fond of, but this was in the days before lop-eared rabbits became house pets. She lived in a cage in the garage, or in the back yard when the weather was nice.

To me a crazy cat lady is someone who has eight or more cats, lives alone with them, usually in a large house, but one not quite big enough for all the inhabitants. Often you hear news stories about crazy cat ladies who die alone and are eaten by their cats, or crazy cat ladies whose pets are taken away from them because of inadequate care – especially sanitation.

I have a friend who was had more than eight cats at once, and is just as crazy as I am. She does not, however, believe that she is a crazy cat lady because another lady down the street has more cats. And truthfully, she doesn’t meet the other requirements of crazy-cat-lady-hood. She has a family, and keeps up with the care and feeding of her menagerie.

Do crazy cat ladies have an actual mental disorder? If so, do they all have the same kind? Maybe not. The crazy cat lady on The Simpsons (Eleanor Abernathy) is pretty clearly schizophrenic, though I doubt that many are in real life. Real-life cat ladies may demonstrate obsessive-compulsive tendencies, or their isolation may be due to depression. Or something else entirely.

Psychology Today tells us there is no real basis for the stereotype.

The stereotypic term “crazy cat lady” is used in a pejorative sense to classify an older, female animal hoarder and there is no research to support such correlation. Research on animal hoarding is lacking and there is not one plausible theory that suggests why older females tend to hoard animals more than men.

https://www.psychologytoday.com/blog/when-more-isnt-enough/201106/animal-hoarding-is-there-such-thing-the-crazy-cat-lady

Still, crazy cat lady behavior may be psychologically classified as a “hoarding disorder.” Mother Nature Network reports that the condition…

…is only now getting the recognition that will prove helpful to sufferers. Recent research has revealed abnormal brain activity in people with hoarding disorder. And both experts and hoarders hope and believe that the new DSM classification will help bring about better treatment.

Read more: http://www.mnn.com/health/fitness-well-being/stories/crazy-cat-ladies-to-get-a-new-clinical-definition#ixzz3nG9WWESM

I would make the case that crazy-cat-lady-hood is actually a defense against mental disorders. Carried to an extreme, perhaps, but beneficial nonetheless.

Caring for cats – even multiple ones – gives a person another living being to care about. Patients in geriatric facilities are often brought into contact with small domesticated farm animals or cats and dogs (therapy animals), which pretty clearly help them deal with isolation and depression.

For an isolated person, cats provide someone to talk to. Not that the cats necessarily listen or respond, of course, except in the most perverse ways possible. They are cats, after all.

I got my first cat when I was living alone and recovering from several years of psychological trauma. My future husband went with me to the shelter, but was studiously unhelpful in selecting a cat, thereby proving that he had some sense and a grasp of how important it was for me to find a kitty I could bond with.

“Which one should I get?” I asked.

“Gee,” he replied, “I dunno, honey. They all look like nice cats to me.” The one I chose was Bijou, a tortoiseshell.

We as a couple have since had up to five cats at one time, and through the years a total of well over a dozen.

When my bipolar disorder was at its worst, after I had suffered a major meltdown (nervous breakdown, decompensation, or whatever you call it), I was certainly crazy, but hardly a cat lady. I was unable to take care of my own daily needs, much less those of anyone else, human or feline. My husband, who was taking up enormous amounts of slack, took over pet care as well. Now that I’m back on a fairly even keel, I can do my part with feeding, litter box tending, grooming, and so forth.

Fortunately, even when I was immobilized, my cats, in addition to my husband, gave me emotional sustenance. The therapeutic effects of a purr, a gentle kneading, and a nice snuggle are not to be underestimated. The antics of a kitten may be exhausting to watch, but they provide more than a little distraction, if that’s what you need.

Do dogs have the same therapeutic effect? I don’t know. For some people I suppose they do, but I have never bonded with a dog as I have with my cats.

In psychological terms, my cats are “comfort objects,” like furry, living security blankets, or teddy bears that shit and meow. I hope never to be without a cat again. I need them for my mental health.

Stress Plus

Mental stress plus physical stress = Stress Plus.

The mind and the body are part of the same system. What affects the one affects the other as well. When the body is stressed, the mind suffers. When the mind is stressed, the body suffers.

When both are stressed, you get Stress Plus.

Here’s how it works for people with mental disorders. You feel depressed or immobilized and you don’t get up and move around. Your body responds by becoming lethargic and flabby. Your mind responds to that by becoming discouraged and self-blaming. What you have there is a feedback loop.

My body and brain have been going different directions of late. My mood disorder has lessened and my brain doesn’t seem to be trying to kill me at the moment. This is good.

However, my body is experiencing all kinds of unpleasant disorders and sensations. Some – the thinning hair, the jowls, the weakened eyesight – are simply functions of aging. This does not make them any easier to deal with. They are wrapped up in my self-confidence, my sexuality, my identity, how others perceive me, and how congruent my self-image is with reality.

Stress symptoms have affected me at least since junior high. I developed a tic in which my chin would jerk up and to the left, making it hard for me (or anyone sitting behind me) to study. My doctor put me on Valium, which stopped the tic, but did no good, I’m sure, for my then-undiagnosed bipolar disorder.

Other physical ailments and disorders are the result of specific events or diseases. I have a bad back, which required two operations, the second because I irrationally thought it would be a good idea to ride an Arabian horse bareback. The experience has left me with nerve damage in my left toes – idiopathic radiculopathy, they call it – and an unsteady gait that sometimes necessitates the use of a cane for balance. It does not make me look or feel any younger.

Also, my hands shake. My neurologist called this an “essential tremor,” which means it’s caused by nothing in particular. He noticed that I often sit with my hands folded in my lap to call less attention to it. Between this and my balance issues, sometimes I stagger and shake like an old street rummy. A friend, God bless him, once told me I had a long way to go before looking like a street rummy. It was nice to hear, no matter what my brain tells me.

When my brain was acting up the worst, it also gave me the worst physical symptoms. My reflexes were hypersensitive and that included the reflex that empties my bowels. Just imagine the literal shitstorm I created in the bathroom of a bookstore one day. Then imagine how much of my self-esteem got flushed along with the rolls of toilet paper I used to try to clean it up. Imagine the humiliation of telling a store clerk, “Someone’s been very sick in the bathroom and you probably need to send a janitor.” I’m sure she knew it was me, because of how embarrassed and sickly I must have looked, but we both pretended that I was simply informing them that an accident had occurred.

Needless to say, all these conditions make me not want to go out amongst people, which adds to the isolation that my bipolar disorder already exacerbates. And when I don’t get out, my body doesn’t get moving, and I become even more immobilized – both physically and mentally.

Like I said, Stress Plus – a vicious circle.

Social But Spoonless

In the past week I have been out of the house more and seen more people than I have in years. It’s almost like having a social life.

In the past week I have also slept more than I usually do in my sloth-like, torpid existence.

I think the two are not unrelated.

If you follow Spoon Theory (http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/) you know that each spoon represents an amount of coping that you can do.

Every day you get a certain number of spoons – not the same number every day.  You use them to perform everyday tasks that most people think nothing of – things like getting out of bed (some days you don’t even have that spoon), taking a shower (1/2 spoon for Janet’s patented “super-fast smelly-bits sink wash-up”), getting dressed, finding something to eat, fixing that something (keep a box of Cheerios by the bed in case you run out of spoons at this point), and all that is without even leaving the house. Some days that’s all the spoons you have and when you’ve used up your spoons, that’s it.

Other days you can manage to do all that and leave the house, go to work, run errands, and assorted other normal activities. But for those of us who have mental disorders, such days are few and far between.

You hear depressed people talk of not being able to get out of bed, and for the most part that’s caused by lack of spoons. I am usually notoriously low on spoons. My husband now understands Spoon Theory and we use it as common shorthand for “I’m too tired” or “That’s all I can handle right now.”

Dan, however, is an over-scheduler and I often have to rein him in by pointing out that his proposed slate of activities will not be possible because I, for one, will run out of spoons, and he may too.

The dry run for my recent spurt of socializing began last week. After I went for my final session with Dr R., I managed a trip to the bank, a trip to the place where I could pay my power bill, and since it was right next door, a stop at Kmart to buy underwear. It was a good thing that was a hypomanic day, but it floored me for the rest of that day and the next. And it started a cycle of bipolar up-and-down oscillations that were clearly related to spoon usage.

My spate of social endeavors started with a double-header. On Saturday I had lunch with a friend at a favorite restaurant I almost never get to go to. We talked about politics, social issues, and book proposals. Then I went home and had a little nap.

That evening Dan and I went to Monkey Bones for Zombie Dogz. I know that takes a little explaining. Monkey Bones is the tattoo studio where I got my semicolon tattoo (http://wp.me/p4e9Hv-9G). Zombie Dogz is a local food truck. (Also, it’s fun to say “We went to Monkey Bones for Zombie Dogz.”)

Notice that in a single day I had to get up, out of bed, and get dressed twice. That’s a lot of spoons. Sunday I was not able to get out of bed at all.

Monday did not involve socializing, but it was another hellacious spoon-eater. Dan and I spent the day scrounging for documents and information that the IRS wanted. It was taxing. (See what I did there?)

Tuesday was an extra-special social event, though it did not involve getting dressed and going out, or even interacting with other people. It was Jenny Lawson’s online book launch party. Better known as the Bloggess, Jenny has severe social anxiety. At this stage in my life, I certainly would not be able to dress up, mingle, and make polite conversation with both friends and complete strangers. The online party was a genius idea.

I sat at home in my pajamas with some red wine while the Bloggess read chapters from her new book, Furiously Happy. (You should get it, by the way. It’s about mental illness, but funny.) As low-key a social situation as that was, it still used up spoons because it was something I had never done before. Making sure I had the right URL, converting Central Time to Eastern, not being able to ask questions because I don’t Tweet, worrying that Dan was getting bored – not a lot a lot of spoons, but still some.

The effects were getting cumulative. Again I was unable to get out of bed the next day. In fact, Dan and I both slept away most of the daylight hours. For him it’s understandable because he works third shift, but I have no such excuse. Except that if you borrow from the next day’s spoons, or try to keep going without them, you will pay.

Thursday, I was determined, with or without spoons, I was going to meet a friend for coffee. I’ve seen her only once, briefly, in several years. In a way, it was a test of my ability to maintain anything approaching a real social life.

I put forth the extra effort because a mutual friend cut her ties with me because I canceled so often on social engagements. I suppose I really have nothing to prove to anyone but myself but it seems important that I do so. It’s not like coffee with a friend is an ordeal or anything. It’s just that I know I’ll be using a spoon for more than stirring my coffee.

And I hope I have enough spoons left over to work on my other blog.