Bipolar 2 From Inside and Out

Posts tagged ‘my experiences’

The Overwhelming Problem

screaming (Uma painting)It’s been said that time is nature’s way of keeping one damn thing after another from being every damn thing all at once. I know that taking things one at a time—eating the elephant one bite at a time—is a sound idea.

However, every now and then the damn things gang up on you. The elephant is starting to go bad and you have to eat all you can right away – to use a disgusting metaphor that I will not take any further. (You’re welcome.)

Last month was one of those months. They happen every so often. But if they happen very often, I tend to get overwhelmed. And when I get overwhelmed for too long, my brain breaks. I have a meltdown, or I decompensate, or whatever the proper psychiatric term is. In practical terms, it means that I’m severely depressed and non-functional, for longer than usual. Days. Weeks. Months. Even years.

The things that overwhelm me are quite predictable – financial difficulties, health problems, relationship glitches, and free-floating anxiety of all sorts, either my own or my loved one’s. I know that these are situations that cause difficulty for everyone, but to a person with bipolar disorder, they can seem—or even be—insurmountable. Especially when they cluster and refuse to go away.

Over the years I have become good (or at least better) at recognizing when I am about to be overwhelmed. I know the symptoms—the whirling thoughts, the jumping-out-of-my-skin feeling, the insomnia, the inability to concentrate, and the feeling that doom or disaster is impending.

There is little I can do to stave off these feelings. But I know I have to. I have to keep functioning at some level, higher or lower, to maintain the things that I want to have – productive work, a loving relationship, a nice house, caring friends, and so forth. At the time of my last major breakdown, I came uncomfortably close to losing much of that.

I try my usual remedies for anxiety, of course. I distract myself. I color. I watch mindless TV. I play stupid clicky games on the computer. I turn off my phone. But if the anxiety builds up too much, if the feared disaster is real and really is impending, none of these works. The anxiety shreds my last nerve, and the depression starts to settle in. I isolate. I stay in bed. One task at a time, I stop being able to function.

I have taken one step that has helped, however. An anti-anxiety pill is one of my daily medications—one in the morning and one at night. A few years ago, as the stress was building and approaching overwhelming, I asked my psychiatrist if I could have permission to take one more a day if I needed it.

He agreed.

I have not needed to take the extra pill every day. Sometimes I take one in the mid-afternoon if I start feeling jumpy, twitchy, or panicky. Sometimes I take one at night if I haven’t gotten to sleep within 2 – 3 hours after taking my regular nighttime pills. I know it sounds strange that a depressant helps me stave off depression, but my diagnosis is actually bipolar disorder and anxiety disorder. The med catches me at the point where the one starts to turn into the other.

I’m glad my psychiatrist trusted me not to abuse what I consider a privilege as well as a necessity. By the time I made this request, of course, we had been working together for a number of years and had built up a certain trust. I think there have been only a couple of times when I have had to take two extra pills in a day—one in the afternoon and an additional one at night. And both times, I felt guilty about it and made sure I didn’t make it a habit.

I don’t want to start gobbling pills at the least sign of difficulty. All I want is to be able to eat my elephant in peace and in pieces.

Category:

Mental Health

Tagged with:

Structure in My Bipolar Days

I used to be a fly-by-the-seat-of-my-pants kind of gal. Work provided the only structure to my days, back when I was able to work in an office. It wasn’t always the same structure, depending on the job, of course. I have worked various shifts over the course of my checkered career—first, second, and third. I adjusted to them fairly well (except when I was working third shift and going to grad school in the mornings).

That all changed when I quit my last office job. I remember feeling so free. I basked in the ability to do freelance work whenever, run errands whenever, go to sleep and wake up whenever. Of course, I was hypomanic at the time, which I should have recognized because of the golden glow that seemed to envelop my days. Naturally, the crash came, along with the absence of freelance work to do. Then, when I fell into a deep depression, anything resembling a schedule fell apart. I didn’t have a specific time for going to bed or waking up, for eating, reading, errands including bill paying, and even showering. Without that structure, I had trouble finding a reason to get out of bed.

Now I’m stable on medication and therapy, and my days have fallen into more of a pattern. I still work at home, but for a company that gives me ghostwriting work. It has a built-in rhythm to it. Most of my assignments are 30,000 words long and due in 21 days. They want us writers to average 1,500 words a day. I divide that up into 750 words in the morning and 750 in the afternoon. I work weekends at this pace, too.

Fortunately, I find 1,500 words a day eminently doable. My daily schedule consists of mornings spent breakfasting, paying bills, keeping track of appointments, or making necessary phone calls (which is my usual role in running the household).

Then, mid-morning, my husband calls on his break from work. Part of the reason is to make sure I’m okay, but most of the time I’m fine and we simply talk, often about what I’ve scheduled for the rest of the week. (I keep track of his appointments and phone calls too. Sometimes I feel like I have a second job as Dan’s secretary.) After we talk, I begin my first stint of writing for the day, my first 750. I’m generally done in time to have lunch around 12:00. Dan calls again in the early afternoon, and I begin my second 750 afterward. When he gets home, we spend time together and have dinner around 7:00.

Those are my daily schedules, which I don’t really need a planner for. When it comes to weekly schedules, I do use a computer app. Our “weekend” is Sunday and Monday because of Dan’s work, but I work on my writing anyway. My calendar is filled with bills to pay by a certain date, appointments we each have to go to (which I remind Dan about), and notes indicating when my 30,000 words are due. I also make note of which weeks are for recycling. (The day before trash day, there’s frantic cleaning.) I have this and another blog that I post in on Sundays. I have a weekly internal schedule for that, too. I start writing them on Tuesdays, have them at least mostly finished on Fridays, tweak and tag them on Saturdays, and publish on Sunday mornings at 10:00.

Having these systems in place keeps me on an even keel which, after all, is my goal as a person with bipolar disorder. My days are predictable, but not boring because I don’t find writing boring, even if it’s on someone else’s topic. Does it seem too regimented? All I know is, it works for me.

This past week, I went on vacation, so for one week, my schedule was largely out the window. I looked forward to staying up late, sleeping late, having meals whenever we felt like it, spending time reading or shopping or sightseeing or watching movies whenever we wanted. Because, as much as I like my structure, I need a break from it at times. Sometimes I take a few days off between book assignments to work on other projects like organizing my jewelry armoire or my desk.

It’s a balancing act, really. Enough structure to keep me focused, but not so much that it becomes a rut. Dan’s phone calls help. Having time in the mornings and evenings before and after I write helps. And my most important routine, of course—taking my meds in the morning and at night. That’s a part of my day’s structure I never want to neglect.

Category:

Mental Health

Tagged with:

Sensory Overload

I know that sensory overload can be a problem for people on the autism spectrum. Too much noise, uncomfortable touch, and assaults on the other senses can affect them negatively.

I discovered this firsthand when my best friend, Robbin, and her ten-year-old daughter, Kelly, visited my house. My husband collects clocks, and the sound of all the ticking bothered the young lady. Then the clocks started to chime. They were not synchronized, and they sounded off one after the other, sometimes overlapping. It was noon. Kelly was visibly distressed by the sound, and they left soon after.

I’ve had some indication that, though I’m not on the spectrum, I’m sensitive to noise as well. When Kelly was six, I brought Robbin a fluffy black-and-white kitten that she had admired. The squealing noises the little girl made cut right through me. I looked over at Robbin, who just shrugged.

It turned out that I’m particularly sensitive to the high-pitched sounds of children laughing and shouting. I learned to avoid Chuck-E-Cheese and Cici’s pizza—basically, any place with a ball pit. High-pitched women’s voices like Judy Holliday’s in Born Innocent bother me. It’s one of my husband’s favorite movies, but I can’t stand to watch it with him. Loud voices are a problem, too. If I’m in a room where people are shouting at each other, I make an excuse to leave until they settle down.

Much more typical is my aversion to two or more sounds. TV and talking, for example. If my husband talks to me while the TV is on, I can’t make out either one, which is particularly difficult when what he’s saying is, “What did that guy say?” And if I’m doing something on the computer, I’m completely lost. I’d be lost at a cocktail party, too, so it’s lucky we’re never invited to them.

WebMD has this to say about sensory overload: “Sensory overload and anxiety are mental health conditions that are deeply related to one another. When a person feels anxious or already overwhelmed, they may be more prone to experiencing sensory overload in certain situations. Likewise, experiencing sensory overload can make you feel a sense of anxiety.” They also say, in addition to autism, that PTSD, ADHD, PTSD, Generalized Anxiety Disorder, and Tourette Syndrome are mental conditions associated with sensory overload. They recommend anti-anxiety or antidepressant meds, self-care, therapy, mindfulness, and meditation as ways to address the problem. Avoiding triggers is another recommendation, and that’s the one I use (see not going to Chuck-E-Cheese, above). That’s the one that seems to have the most beneficial effects.

PsychCentral lists the stimuli that can lead to sensory overload:

  • bright lights, chaotic movement, or a cluttered environment
  • rough, tight, or itchy clothes
  • loud noises, voices, or music
  • scents including chemicals and perfumes
  • foods with strong flavors
  • hot or cold temperatures

And they list the possible effects:

  • overwhelm that makes you want to either shut down or have a meltdown
  • irritation or rage
  • tension in your face, neck, shoulders, or back
  • having either too many thoughts in your mind, or none at all
  • exhaustion
  • dissociation, or being separated from yourself and your surroundings

They add: “It’s possible for sensory overload to cause a panic attack. This could be because much overlap exists between parts of the brain involved with the panic response and those responsible for sensory processing.”

Not being a neuroscientist of any stripe, I can’t speak to the truth of that, but it also seems to me that a panic attack can lead to sensory overload. My other notable experience with sensory overload was having an anxiety attack in the grocery store, where I was overwhelmed by the visual noise of the bright colors on the cereal boxes. As I recall, I took an anti-anxiety pill, went home, and lay down. I don’t remember if I bought the cereal or not.

Category:

Mental Health

Tagged with:

How I Treat My Bipolar Disorder

There are many treatments for bipolar disorder, from SSRIs to EMDR and more. I must admit that I haven’t tried all of them, but I have encountered a few over the years. Some worked well, others not so much. But I’m doing well now, so I thought I’d share what works for me—my roadmap to stability.

Note that I said, “How I Treat My Bipolar Disorder.” That’s because my treatment is up to me. My psychiatrist or therapist can recommend a certain treatment, but whether I take that drug, undergo that procedure, or engage in therapy is ultimately my choice. I look at my providers as people who recommend treatments and help me implement them. But they don’t make the decisions. I do. Most of the time, I take their suggestions—they know more than I do about medications, for example. But I feel free to make suggestions, too, if the medication isn’t working like it’s supposed to or is having side effects I can’t deal with.

Meds

My med journey started (approximately 30 years ago) with the then-ubiquitous SSRI, Prozac. It worked well for me, relieving my depressive tendencies (I hadn’t been diagnosed with bipolar yet). Until it didn’t. That’s when my doctors started throwing drugs against the wall, hoping they would stick. Over the years, I’ve been on at least three different SSRIs, two NDRIs, two SNRIs, and a sedative-hypnotic. Probably other ones, too, that I don’t remember. (One of the side effects for one of them was memory loss.)

My previous psychiatrist experimented with a variety of meds until we hit on a cocktail that worked: an SSRI, a broad-spectrum anti-seizure drug, an atypical antipsychotic, and a benzo. My current psychiatrist mostly tweaks the dosages up or down when I need it. I’ve quit the sedative-hypnotic altogether and only take the benzo as needed. Recently, when I told him that I thought I was having mixed states, he upped the dosage of the atypical antipsychotic. (I don’t like to give the names of the drugs I’m taking because what works for me doesn’t necessarily work for others.)

I see the psychiatrist four times a year for med checks, though I can call if I have any adverse reactions or increased symptoms.

(When I was looking for illustrations to go with this post, I was astounded at the number of images of mushrooms that I saw. I guess it’s trendy now, but I’ve never tried them. There were also pictures of marijuana plants. There’s a medical dispensary in my area, but I’ve never pursued getting a prescription. I have taken CBD gummies, but the only effect they had was to make me foggy and dizzy, which I didn’t like. They did nothing for my moods. They didn’t even relax me; I was too nervous about my balance and the potential of falling.)

Therapy

Individual talk therapy is my go-to form of therapy, though I recently felt I could stop. (I keep the number handy in case I ever need it again.) I guess you could say I weaned myself off therapy. When I started I was going once a week; later, once every other week. When it got to three or four weeks between appointments, I decided it was time to fly on my own. I don’t know what particular kind of therapy I had—CBT or DBT, for example. She never said and I never asked.

I went to group therapy when I was still undiagnosed, but it wasn’t helpful. Once, when my therapist was out of town, I went to a therapy group she recommended but had an adverse reaction to it. Another group just seemed to have a weird format and a book they used like a “bible,” and I didn’t get anything out of that, either. A few times, my husband and I went to couples therapy, and it seemed to help. Another time, we went to a few sessions with a different therapist and I felt shredded. She seemed to think that I was the “sick one” and my husband was the “normal one.”

Treatments

Most of the modern treatments I haven’t tried because medication and talk therapy work so well for me. I had a close brush with ECT, which frankly frightened me, when I went through multiple drugs for several years and nothing seemed to work. My psychiatrist gave me the information and gave me time to think it over and make my own decision. I was almost ready to try it when, miraculously, a different drug brought my mental function under control. But when it comes to TMS, ketamine, EMDR, et cet., I have no experience with them. I don’t believe in reflexology and won’t try herbal remedies because they might interact badly with my meds. Basically, because what I’m already doing works for me, I see no need to explore alternatives.

Self-Care

It’s hard for me to keep up with self-care. I do stick to a sleep schedule and get 8-9 hours a night, with occasional daytime naps. I don’t exercise. It’s hard enough just to walk with my arthritic knees and bad back.

My husband helps me enormously with self-care. He works at a store with a grocery section, and he makes sure I have a variety of food and beverages on hand—fruits and juices, fizzy water, bread, and cheeses, for example—and fixes meals with protein, starch, and vegetables. Left to myself, I would probably subsist mostly on peanut butter sandwiches and breakfast cereal. Back in the day, he used to drive me to my therapy appointments when I was too nervous or depressed to drive myself. Now he picks up my scripts at the pharmacy department in his store.

What’s the takeaway here? I’m not telling you that I have the answer for how you should treat your bipolar disorder. I know what’s worked for me, but you have to find a path that’s right for you. I merely offer my experiences for what they are—mine. You can create your own roadmap, too.

Category:

Mental Health

Tagged with:

Running Out of Meds

Isolated Empty Pill BottlesRunning out of your medications is scary.

I know. It’s happened to me several times.

Sometimes it was a matter of supply. My usual pharmacy ran out of a sleep aid and wasn’t going to get any more until after the weekend. Fortunately, they recommended a mom-and-pop pharmacy (yes, such things do still exist) just down the street and helped me transfer my prescription there.

Another time the problem was the prescription. I ran out of an anti-anxiety med, but when I called in for a refill, I was told that it wasn’t time for one. When I looked at the bottle more closely, I discovered that they had given me 60 pills, as if I were taking two a day, instead of the three a day actually prescribed. (I was changing doctors about that time and there was miscommunication.)

Yet another time, it was money. I ran out of an antipsychotic and was told that even with insurance, it would cost me $800 for a month’s supply because of the out-of-pocket required minimum. I spent a couple of days arguing with the insurance company, researching solutions online, and making sure a local pharmacy would take the coupon I found, which lowered the price to under $200. That was still a hefty chunk of our budget, but we managed to scrape it together until the drug went generic a couple of months later. (I also had to stand in line while the pharmacy called the coupon people and the insurance company to see how to enter it all in their system.)

And of course there are the everyday screw-ups. My husband forgot to pick up my scrips (one time he remembered to pick them up but left the bag in the car and drove 500 miles away), or he forgot which pharmacy they were at, or he didn’t hear me say that I was completely out, or the pharmacy didn’t open until 10:00, or they had my pills in two different bags and only gave us one. There are lots of ways it can happen.

Once I even took my entire supply on a weekend getaway and left them in a drawer at the bed-and-breakfast. I know. Stupid.

Most of the time running out of drugs isn’t a crisis. It just feels like one.

Of course, there are exceptions. It is a crisis if you run out of certain anti-anxiety drugs and you don’t get any for several days. You can have withdrawal – actual, physical as well as psychological withdrawal. I’ve heard that benzo withdrawal can be as bad as opiates. That’s one reason it’s important to replace your meds as soon as possible.

A lot of psychotropic medications build up to a therapeutic level in your bloodstream, so a day or two without them probably won’t even be noticeable. When you start taking them again, your levels will even out.

But even if the med you run out of is one that you can easily tolerate a day or two without, you may have some psychological effects. When I run out of a prescription, even for a short time, I become twitchy and agitated – my hypomania kicks in and comes out as anxiety, the way it usually does for me. I fear crashing back into that deadly unmedicated space where all is misery and despair. Intellectually, I know that likely won’t happen. But it sure feels like it will. This is one way my none-too-stable mind plays tricks on me.

It’s like the opposite of the placebo effect – believing that a sugar pill will help you and experiencing gains until you learn that the pill is fake. In my version, I believe that not taking the pill will cause relapse, even though it actually won’t.

Whatever else you feel or do, DO NOT use missing a couple of pills as an opportunity to go off your meds entirely. This is another lie your brain can tell you: “You’re doing fine without it. Why keep taking it?” It may not in the short term, but you will feel the effects of not taking your meds, and then there you are, back in the Pit of Despair or rocketing to the skies. It won’t be pretty.

For me and a lot of others like me, the key to effective medication is consistency. Once you find the right “cocktail,” stick with it. But if you run out, don’t panic. Keep Calm & Get a Refill.

Category:

Mental Health

Tagged with:

Christmas, Bipolar Style

This post will go live on Christmas Eve, and the holiday has been much on my mind of late. My reactions to the holiday aren’t necessarily what you will experience, but as a bipolar person, I wanted to share what depression and hypomania do to me during the holiday season.

Hypomania

I’ve tried the traditional giving of gifts on Christmas Day, but this year our gifts are all either pre- or post-holiday. Last year, I was hypomanic and overspent. I was disappointed, though, when my selections for my husband didn’t garner the response I thought they would. He still hasn’t used the camera I got him last year on the grounds that he didn’t have the time to figure it how to use it. (I’m going to suggest that one of his gifts to me will be to learn its workings.)

This year, I’m slightly less hypomanic. We got a present for both of us, a little early. We got matching heart, lock, and key tattoos. Since the tattoo shop is closed on Christmas and the tattoo artist is much in demand, we booked the appointment early and have already had these done. I’ve bought Dan another item or two on sale—oven mitts and a bathrobe—that I’m telling myself aren’t really presents, just things he needs, so he doesn’t have to get more presents for me. I honestly don’t mind if he doesn’t get me anything else. He gives me little gifts all year long—just things he finds at the store he works at that he thinks I’ll like.

This year I’m working at home, and I plan to work on Christmas Day, at least for a few hours. Realistically, I could take the day off and not risk missing my deadline, but the routine of working helps keep me centered. I have been exploring what local restaurants are open on Christmas Day so we don’t have to cook. For New Year’s Eve and Day, we actually have a tradition—champagne and appetizers on the Eve and Chinese Buffet on the Day. We often ask friends to join us for that.

Depression

I don’t think I’ll be too depressed to go out New Year’s Day, but then again, who knows? Dan has invited friends from work, so there will be people there I don’t know, as well as two that I do. I don’t really feel up to small talk these days, so Dan can handle that with his work friends.

I’ve given up trying to get into the “Christmas spirit” by dressing for the occasion. It never works for me. I’ve had Christmas earrings. One year I had a Grinch t-shirt. I once worked at a place where everyone wore holiday sweaters and sweatshirts. I didn’t have any and felt left out, but I didn’t want to pay the prices for the sweaters. After the holiday, I bought a couple on sale for the next year’s festivities, but I lost the job before I had an opportunity to use them. Oh, well.

My Lack of Advice

I know there are a lot of articles this time of year giving advice on how to deal with the holidays while in a shaky mental state. I’m not going to do that, because you already know all the standard advice—self-care—and I have nothing really insightful to add to it.

Except that it’s okay to have your own traditions or to ignore the holidays altogether if they’re just too much for you. If you’re alone, you could be subject to depression or just feeling numb, but that’s a natural reaction if you’re like me. Scale down your celebrations to suit yourself. If you’re experiencing anxiety, you can skip big celebrations and have your own small—or private—one. If you’re hypomanic, you may be up to some festivities, but you don’t have to be the life of the party at every one. And keep track of your spending. Most people prefer to get only one or two thoughtful presents rather than a flood of random ones.

I don’t wish you Happy Holidays, just survivable ones.

Category:

Mental Health

Tagged with:

Control/No Control

When I was a kid, my family used to go to visit relatives in Campton and Beattyville, Kentucky. It was always a good time. There were barns to play in and fishing, berrying, eggs to gather, and so forth. To get there, we took what was then a toll road called the Mountain Parkway. I loved dropping change in the bucket as we passed through the toll stations.

The road wound and twisted up into the mountains. There were steep dropoffs along the sides. I don’t remember railings, though I suppose there were some. We visited there about once a year during summer vacation. My Dad drove.

I have a number of things on my List of Things I’ll Never Be Able to Do Again, and going to Campton is one of them. For one thing, I have no relatives left there anymore—most were quite aged back then and their children have scattered. But the more important reason is that I could not handle the drive.

When I was in Ireland with my husband, we rented a car and drove around the country. The GPS that came with the car was sketchy at best. It took us on one-lane roads that meandered through the hills. On the larger roads, there were many rotaries, which we hadn’t driven before. Eventually, we started relying on my phone and Google Maps, which didn’t get us lost as often or run us off into ditches. We still ended up going on twisty back roads.

But I was terrified the entire time we were driving. Dan had to drive since I couldn’t adjust to driving on the left (I tried once and gave up). My nerves couldn’t handle it. The entire time we were driving, I had my hand braced against the roof of the car. When it was particularly frightening, I made a peculiar humming noise that Dan had to learn to ignore. He’d remind me that I had anti-anxiety meds I could take, too. I did, but they didn’t stop my symptoms.

Fast forward a couple of years. We were in Gatlinburg, Tennessee, driving around looking for where we stayed and where we were going. Again, we used Google Maps on my phone. Again, we were traveling on twisty back roads with sudden hills and no shoulders to speak of. Again I clung to the Oh Shit handle and made the weird humming noise as we navigated the convoluted routes. Again I took anti-anxiety meds.

Then I had a revelation: I could never go to Campton again, even if Dan was driving. The bends in the road and the steep drop-offs would prove too daunting. I don’t want to put myself through that again if I don’t have to. And I don’t want to have to.

I don’t have trouble driving on surface streets or highways, even alone. Those I can handle—even for four- or five-hour drives.

When I’m driving, I feel in control of the vehicle and don’t have the massive anxiety. That is, unless the circumstances involve something that makes me feel out of control, like left-side driving or narrow roads with switchbacks and doglegs. Even if Dan drives and I navigate, I still do the clutching and humming thing. It’s exhausting. If I were driving, I would have to go 20 mph and mightily piss off the cars behind me.

The bottom line? I can drive myself places, but only under certain conditions when I feel in control. If there’s a factor—or more than one—that makes me feel out of control, I can’t do it.

I like to think that I’m not a control freak under other circumstances. There’s just something about a machine that weighs that much going at a speed that feels unsafe in terrain that strikes me as difficult. This still leaves me a lot of places I can go, even without Dan. But not everywhere. And that makes me feel sad and incompetent, two feelings that I don’t like and that there’s no medication for.

Category:

Mental Health

Tagged with:

Pill-Shaming

When I first started taking Prozac, when it was just becoming ubiquitous, my mother said, “I hear it’s a ticking time bomb!”

“Oh, dear!” I thought. “Mom’s been listening to Phil Donahue again.” (She had been, but that’s not the point.)

Back in the day, Prozac was hailed as a miracle drug and condemned as a killer drug. On the one hand, it was said to be a “magic bullet” for depression. On the other, it was supposed to result in addiction and suicide.

It’s probably true that it was prescribed too often to too many people who may not really have needed it. And it may have led to suicides—not because Prozac prompted such an action, but either because it was improperly prescribed or because it activated people who were already passively suicidal and pushed them into action.

At any rate, Prozac was not an unmixed blessing.

For me, it was closer to a miracle drug. It was the first medication that had any significant effect on my depression. I noticed no side effects.

But Prozac is no longer the psychiatric drug of choice. Since that time, hundreds—maybe thousands—of psychotropic drugs have been introduced and widely prescribed. Many have proved just as controversial as Prozac. Indeed, the whole concept of psychiatric drugs is now controversial.

I belong to a lot of Facebook groups that encourage discussion on psychological matters and have a lot of Facebook friends with opinions on them, sometimes very strong ones. Some of the people with the strongest opinions are those who condemn certain classes of psychiatric drugs or that category of drugs altogether. They share horror stories of addiction, atrocious side effects, zombie-like behavior, and even death from the use of these drugs.

Benzos are the drugs that are most often condemned. And it’s true that they can be addictive if they’re misused. Whether that’s because a doctor overprescribes them or a patient takes more than prescribed I couldn’t say. But I maintain that benzos aren’t inherently harmful when prescribed appropriately and supervised professionally.

I have personal experience with benzos. They were the first psychiatric drug I ever took, meant to relieve a rather severe nervous tic that affected my neck and head during junior high school. I do remember walking off a short stepstool while shelving books in the library, but I was not injured and the misstep could be attributable to ordinary clumsiness, which was something I was known for (and still am). The benzos were discontinued when I got better. I also took benzos in college because of pain due to temporomandibular joint problems.

Now I have benzos that my psychiatrist prescribed “as needed” for anxiety and sleep disturbances. After all the years I’ve seen him and my history of compliance with prescribed medication, plus the very low doses, he had no hesitation prescribing, and I have no objection to taking them.

But some of the people I see online object to any psychiatric drugs whatsoever. Again, the most common complaints are addiction, side effects, and zombie-like behavior. Of course, I can’t—won’t—deny that they have suffered these effects. Psychotropics are known to affect different people differently. I’ve had side effects from many of the ones I’ve taken that were too unpleasant for me to continue taking the drugs. But after all the different meds I’ve tried during my journey to a combination of drugs that work for me, it would be a surprise if I objected to them altogether.

But I don’t. I’ve had cautious, responsible psychiatrists who’ve prescribed cautiously and monitored rigorously, listening to me when I reported side effects.

So, my personal experiences have been good. I know not everyone’s experiences have been, for a variety of reasons.

What I object to is the drumbeat of “all psychotropic medications are bad and ruin lives.” And the memes that show pictures of forests and puppies that say “These are antidepressants” and pictures of pills with the caption “These are shit.”

I hope those messages don’t steer people who need them away from psychotropic medications. And I hope that people who do need them find prescribers who are conscientious, cautious, and responsible in prescribing them. On balance, I think they’re a good thing.

Category:

Mental Health

Tagged with:

I’m Sorry

The other day, my husband was putting together a magnifying lamp that I had bought to help me repair some jewelry. I was trying to adjust the lamp to a height where it would be usable and comfortable. The lamp was a cheap piece of shit and it broke.

Instantly, I apologized. The clamp broke. I apologized again. It turned out that the pin holding the clamp together broke. I apologized again. My husband determined that it was not fixable as it was. Guess what I did? That’s right — said, “I’m sorry.” I said I was sorry for ordering the cheap thing. I said I was sorry for wasting money. I was sorry for wasting my husband’s time. I was sorry for everything.

The week before, I wanted to go to an art house in a nearby town to see the documentary about Joan Baez. The whole way there, I was nervous — about the route we were taking, whether we would find parking near enough to the theater, whether we should eat dinner before or after the movie. And especially whether Dan would like the film. On the way home, I kept asking him, “Was that okay? Did you like it? Is it okay that I chose the movie? Is it okay that I chose that movie?”

On the way home, he reassured me. He liked the movie. He learned things he hadn’t known about Joan Baez. We were lucky to find the parking place so near the theater. It was a nice evening for a drive.

Then he said, “Where’s all this coming from?”

“I chose the movie and the time and bought the tickets and decided which theater to see it at. If anything went wrong, it was all my fault.”

“Ah. Old tapes.”

In these recent cases, things went right. Dan figured out a way to fix the magnifying lamp by cannibalizing another lamp. We got to the movie on time and got good seats. We found a handicapped parking spot open right across from the theater. The movie was great. I felt better after we got home.

Dan was right, though. The excessive apologies started in my past — not with Dan — further back in time than that. If something was my choice, and it didn’t turn out great, it was wrecked. I realize this is all-or-nothing thinking, which is counterproductive.

Even before the old tapes, though, I had a habit of feeling sorry for everything and saying so. I apologized for everything. And I punished myself. If I said something “wrong” or even a tiny bit off-color, I tapped my cheek with an open hand, symbolically slapping myself for doing something bad. (I think it’s important to note that my parents never slapped me as a child, so I don’t know where that came from.)

And I apologized endlessly. For everything. My friends noticed. They asked why I did it. They let me know that it was annoying. I tried consciously to stop. And after a while, after having friends who stuck with me, after practice, I did stop. For a while.

Then I got in a relationship with a gaslighter and again felt guilty for everything. He blamed me for things I did and things I didn’t do. Once, he even claimed that when I did something wrong in front of company, I had offended his honor. And of course, if I selected anything — where we went, what we ate, what music we listened to, I was at fault. I was at fault for liking mayo on my sandwiches and for not offering him a bite of my sandwich. I was seriously wrong not to wait for him even though he was past the time for a meet-up with friends. Wrong to hook up with a friend while he was hooking up with one of mine in the next room. Eventually, I shut down, afraid to do anything.

Years later, I got past the apologizing, for the most part. The past two weeks, I’ve been backsliding. I think it may be because money has been extra tight, which makes me extremely nervous, and I’ve had to tell Dan he can’t make some purchases now. That feels treacherous, even though he doesn’t complain or blame or shame me. But it puts me back into the mindset of blaming myself before someone else can. It’s not comfortable for either of us. It’s all I can do not to apologize for feeling this way, for my disorder having this effect.

I’m hoping that writing about it will help me work out how I feel. And maybe make the apologies back off. At least for a while.

Category:

Mental Health

Tagged with:

Am I Neurodivergent?

Last week I wrote about language that has been lost from technical meaning to become popular usage. This week I want to explore a term that may or may not apply to me—neurodivergent.

The dictionary definition I looked up said that neurodivergent means “differing in mental or neurological function from what is considered typical or normal.” It added that the term is “frequently used with reference to autistic spectrum disorders.” The alternate definition given is “not neurotypical,” which is no help at all.

I’m not on the autism spectrum, so I don’t “qualify” as neurodivergent that way. And I don’t have any of the other disorders, like ADHD, that typically are associated with neurodiversity. So where does that leave me?

Another definition: “Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.”

I like that better. It leaves room for a lot of varieties of neurodivergence.

A medical website explained it this way: “Neurodivergent is a nonmedical term that describes people whose brains develop or work differently for some reason. This means the person has different strengths and struggles from people whose brains develop or work more typically. While some people who are neurodivergent have medical conditions, it also happens to people where a medical condition or diagnosis hasn’t been identified.”

Wikipedia also notes, “Some neurodiversity advocates and researchers argue that the neurodiversity paradigm is the middle ground between strong medical model and strong social model.”

It’s true that my bipolar disorder means my brain and my behavior are not typical. I feel neurodivergent, even though I know that’s hardly a criterion. I’ve accepted that my bipolar is somewhere in the middle ground between the medical model and the social model. For a long time, I believed in the medical model absolutely. To me, my bipolar disorder was brought on by bad brain chemistry. I couldn’t see any glaring social problems such as abuse in my family. Mine was very much the traditional social model—working father, stay-at-home mother, one sister. I never suffered domestic violence or sexual abuse.

What I didn’t see was that there are other kinds of traumatic events, some of which I did experience as a child. Some of them were so painful that I remember having meltdowns because of them. Young adulthood brought more trauma. Since then, a combination of medication and therapy has helped. Perhaps the medication helped with the part of my disorder that was caused by my brain, while therapy helped the social trauma part.

Lately, I’ve been thinking about the idea of a spectrum. Although autism is often considered using the convenient concept of a spectrum, I know that “being on the autism spectrum” is not accepted by all. High-functioning or low-functioning, people are at base autistic or non-autistic, not “a little bit autistic,” as the spectrum seems to imply. Other people find the spectrum idea useful.

I’ve also thought about the introvert/extrovert spectrum. It makes sense to me that no one is truly at either end of that spectrum—all introvert or all extrovert. Nor is anyone pure ambivert, evenly poised between the two ends of the spectrum. We’re all various degrees of ambivert, leaning toward one side or the other, but sharing some of the characteristics of each.

My brain has developed differently or works differently for some reason. But according to the spectrum philosophy, no one is totally neurotypical or totally neurodivergent. We’re all jumbled somewhere in the middle. A little to one side and we’re considered one or the other. So, I see myself as on the neurodiversity spectrum—neither one nor the other and not evenly balanced between the two. Somewhere in the relative middle, to one side or the other. Part neurodivergent and part neurotypical.

Whatever I am, I’m not 100% neurotypical or 100% neurodivergent. But I’m at least partly neurodivergent. And I’m comfortable with that.

Category:

Mental Health

Tagged with: