Bipolar 2 From Inside and Out

Posts tagged ‘physical pain’

Depression Hurts

You’ve probably seen those commercials where the announcer and the actress playing the part of a depressed person try to answer the question: Does depression hurt?

Once when we saw this commercial, my mother turned to me and asked whether my depression hurt me physically.

I had to say yes. I don’t think I ever took Cymbalta, the medication that the commercial was touting, but I was clear on the fact that physical pain is involved along with the psychological suffering of depression.

My head and eyes hurt from all the crying spells. My back hurt from lying in bed all day. I had painful knotted muscles from the anxiety that went with the depression. I had intestinal cramps because my overactive nerves led to irritable bowel syndrome. I had headaches and eye strain from the over sensitivity to light and noise. And I had the general flu-like malaise that is practically the hallmark of depression. You know the one. Every bone and muscle aches, but you can’t think why.

Were these aches and pains psychogenic? Undoubtedly some of them were. But others, like the irritable bowel, were all too demonstrably physical phenomena.

The mind and body and soul are inextricably intertwined. We know this to be true. Depression affects them all.

And it does hurt.

Cutters

If that title wasn’t enough of a trigger warning, well, here goes:

TRIGGER WARNING: Self-Harm

Recently a small discount store a couple of miles from my house was caught up in a furor because a “Princess Wand” toy they were selling (ominously named an “EvilStick”) would reveal a hidden image of a teenage girl cutting her arm with a knife. Here’s a link to a local news story about it, and the snopes.com report verifying it. If you want to, you can easily search out a copy of the image, but I don’t recommend it.

Self-Injury

http://www.snopes.com/photos/odd/evilstick.asp

The “toy” is in horrifically bad taste (so, for that matter, is the snopes article’s headline, “Wristcutters – A Toy Story”). But items that adults consider dreadful can attract kids (remember the Garbage Pail Kids trading cards?). The image of the teenage cutter looks like a macabre Halloween costume rather than anything realistic (I’ve seen it), but we don’t really know whether a mistake, an error in judgment, a misunderstanding, or a prank at the factory that went way over the line resulted in the image on the toy. I kind of hope so, because if it was intentional, that’s way worse.

But bad taste is the least of the problem. The toy and the reaction to it have introduced the subject of cutting to a wider audience, if they choose to look beyond the squick factor and think about what the image really means. Cutting is a reality that’s mostly hidden from view.

Of course, it’s not always cutting. Burning is popular too. But cutting is perhaps the most common name. There are websites devoted to it, some offering help, facts, and information on quitting (see below) – but others glorifying it as, I don’t know, a creative expression of teen angst or something.

The name does keep changing. The last I heard, the “approved” psychiatric term was “Non-Suicidal Self-Injury” (NSSI). Self-mutilation, deliberate self-harm, non-fatal self-harm, self-destructive acts, self-inflicted violence, parasuicide, and self-wounding are all names for the dangerous practice performed by desperate people. The subject still isn’t talked about much and carries a huge stigma. As if the mental and physical scars were not enough.

Some facts: Self-harm is not attempted suicide, though with some miscalculation it can lead to serious permanent injury or death. Most people associate it with teenage girls, but I’ve know at least one man in his 50s who cut himself fairly regularly. It is not a matter of attention-seeking, since most cutters hide their physical wounds.

As I understand it, the practice results from one of two phenomena: the build-up of painful pressure such as perfectionism, or a feeling of severe alienation to the point of numbness. Cutting is a coping mechanism, though a dangerous, dysfunctional, and unsuccessful one, to deal with pain.

In my case, it was probably the numbness. I was feeling a lot of psychological pain at the time (college age) and irrationally wondered if physical pain would lessen that, or increase it, or feel any different. Like I said, irrational. All this was before I was diagnosed bipolar, had a therapist, or was medicated.

I made a few small cuts on my wrist to watch the blood well up. (Ironically, they became mildly infected; I neglected to sterilize the knife.)

I wasn’t suicidal. They weren’t that kind of cuts. I do know the difference. (I didn’t realize that I could have damaged tendons or nerves in my hand or arm, perhaps permanently.) It was more like when you stand on a bridge or balcony and look over the edge. You walk away. But you know the bridge is always there.

All told, I cut myself maybe three or four times. The scars are very faint now, white against my pale inner wrist, almost invisible. The memories are vivid. A friend who’s a psychologist once asked me why I stopped. “Because I didn’t need to any more,” was the only answer I could give. I’ve only felt the urge once since, and it was easy enough to push aside. But I recognized it.

I hesitated to write and post this, though I knew I would have to sooner or later, if I meant this blog to share my experiences truthfully. One of my dearest friends once said that if he ever found out I was a cutter, I would never hear from him again. Except for his publicly mocking me for being so stupid.

Naturally, this sort of reaction, though common, is not helpful. I didn’t tell him (or practically anyone else). And I didn’t tell him that at least two other people he knew – one fairly intimately – were also cutters.

Anyway, Tom, if you’re reading this and still feel the same, I guess this is goodbye – just not the long goodbye. I would rather skip the public mocking, though. I’ll just assume you’ve done it while I wasn’t there, mm-kay?

Cutting isn’t going away if we ignore it. It won’t go away even if we do talk about it. (Or mock it, or gasp in horror.) But understanding self-injury is a big step.

If you’re a cutter, or know someone who is, here are some places you can go for information, hope, and help:

Suffering and Train Wrecks

What doesn’t kill you makes you stronger.

Right.

This is one of the world’s biggest falsehoods, right up there with “Sticks and stones may break my bones, but words will never hurt me.”

But it’s a platitude we hear all the time, particularly those of us with mental illnesses.

And it’s about time to call bs on the saying. Here’s why people say it:

Suffering hurts. It grinds you down. It makes you less able to function. It keeps you from being the person you want to be.

Except in literature. There, suffering ennobles one – makes one a finer person, a more worthy person, and, yes, stronger.

Once in a graduate-level literature class, I objected to this. I said the thing about suffering hurting and grinding you down.

I got called a sociologist, which apparently is a terrible insult in literary circles. But they were talking about literature and I was talking about real life, so maybe we both had a point.

But back to the saying. There are lots of things that don’t kill you, but also don’t make you stronger. Train wrecks, for example. If they don’t kill you, they can leave you on the brink of death or physically maimed or with PTSD. You may recover some, with help, but your back will still hurt and your leg won’t regrow and you can suffer from memories and dreams.

I’ve compared some relationships with train wrecks – probably most of us have. They simply cause you to suffer and the memories of them may always pain you like a damaged joint in bad weather. One can come through ordinary bad relationships and be stronger for it. But train wreck relationships, the toxic ones that erode your soul, do not ennoble or strengthen you.

Mental disorders can be like that. Yes, you may improve. Yes, you may become stronger in some ways. You may become more compassionate, more aware of others’ pain, better able to avoid situations that will cause you harm, capable of rebuilding a different life with the parts you want to keep. But it’s just as likely that when your brain breaks, it will never be good as new again. There will be cracks in your emotions or reasoning or moods that will be weaker, not stronger, and more likely to rupture again in the future.

We sufferers need strength, but it won’t come from platitudes and bumperstickers.

And you can’t explain this to people who haven’t been there.

Also, don’t get me started on that thing about God not giving you more than you can handle. We’ll be here all week.

As always, these are my experiences only. Your mileage may vary.

Taking Turns

For the past several days, I have been dealing with a husband in severe pain from osteoarthritis, plantar fasciitis, and back spasms.

I have driven him to Urgent Care, picked up prescriptions, provided him with a walking stick and a cane, set up a heating pad, researched his conditions on the computer, talked him through his exercises, and more. I wish I could do all this without getting cranky. I wish he would follow my advice more, especially when I tell him to see a doctor. But sometimes he’s such a guy.

What I have been doing for him is nothing – at all – compared to what he did for me and how he supported me when I had my last breakdown, which lasted several years. He did everything. Shopping, pet care, cooking, paying bills, earning a paycheck. Not to mention loving me through the despair, irrational thinking, sobbing uncontrollably, immobilization, and all the rest.

He really took that whole “in sickness and in health” thing to heart. Now it’s my turn to do likewise.

I am completely out of spoons. I will carry on anyway. He deserves it.

Posting Weakly

Today I don’t feel like writing at all. It’s been a tough week.

Although I usually try to say something about mental health in general, bipolar disorder specifically, something relevant that caught my eye in the news, or a piece of my past that might be interesting or informative, today I can’t.

I’m very depressed. Or feeling sorry for myself. Sometimes I can’t tell the difference.

There’s a convention in July that I would really, REALLY like to go to. I could see many friends, including one I haven’t seen in literally years and have been fearing I may not have the chance to again (maybe irrational thinking, maybe not). I would have intellectual stimulation, friend, parties, laughs, all sorts of fun available to me.

And I can’t go.

Some of the reasons are practical. We can’t afford it. My husband has to work. Driving that far and carrying luggage would trigger back pain and the walking required would rapidly exhaust me. If I went, I might well spend much of my time flat on my back in a hotel room, wiped out or communing with Vicodin.

The other reasons I can’t go have to do with my mental disorders. I barely leave the house as it is, except for doctor and therapist appointments. A day with a few simple errands uses up every spoon I have and sometimes the next day’s as well.

But mostly, it’s my over-sensitivity to the crowds and the noise. I can’t tolerate either one for more than a few minutes without a panic attack or a meltdown. Neither of which is pretty and neither of which would add to my enjoyment of the convention, or anyone else’s, for that matter.

I’m now thinking about all the things I can no longer do for physical or mental reasons. My therapist would tell me to look at how far I’ve come – all the things I can do now that I couldn’t do a few years ago, like write a blog and maintain a goal of posting weekly.

She’s right, of course, but for now I just need to go back to bed, and try again to accomplish something after a nap.

Drugs vs. Drugs

I’ve been vastly depressed lately – Pit of Despair depressed. And let’s not forget anxiety; there’s plenty of that too.

I’m sure that the Vicodin I’m taking for my bulging disk/pinched nerve isn’t helping any with my moods.

So, physical misery or emotional misery? Which do I choose?

Either way, it’s hard to get any work done.

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By the way, the combo that the Vicodin is fighting is Zoloft, Ativan, Ambien, Inderal, and Lamictal. But more on that later.

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