Bipolar 2 From Inside and Out

Posts tagged ‘psychological pain’

Growing May Take a While

I saw a meme the other day that said, “Grow through what you go through.” I thought to myself, “This is going to take a while.”

Now, I’m not saying that the meme promotes a bad idea. I just mean that it’s not as easy as the meme makes it sound. Memes are like that. They encapsulate a difficult and painful process into a succinct platitude that never captures the reality of what it purports to express.

It is certainly possible to grow because of bad experiences that you have gone through, and I have surely done this. But it hasn’t been quick or easy. Not that it is for anyone, but especially not for people with serious mental illnesses.

Bipolar disorder, and bipolar depression in particular, often leads one to recall and obsess about the very things one would most like to forget. (Of course, this happens with unipolar depression, too.) It’s like having a recorder in your head that replays the most painful, embarrassing, humiliating, or devastating events in your life. And there is no “off” button or even a “pause.”

Getting through something is not the same as getting over something. And growing through something is something else again. It takes as long as it takes. There is no way to rush it or to speed it up.

Take grief, to choose an example that most people with and without mental disorders are familiar with. I saw a TV show once in which various characters were concerned that the hero had not “gotten over” the death of a friend as quickly as they thought he should. I remember thinking, “That’s stupid. There’s no arbitrary limit on how long a person should grieve.” I know that in days past, a mourning period of a year was customary, with restrictions on dress and activities. That’s stupid too. It may take a few months or a year or the rest of your life, depending on how close you were to the deceased and the circumstances of her or his death.

Deaths don’t have to be physical, either. The death of a relationship can be just as soul-searing, as traumatic, as a literal death. It’s still a loss and one that you may have put your whole heart and soul into.

Of course, it’s great if you can grow through the experience. It’s possible to acquire a new depth of spirit when you go through something traumatic. You can emerge stronger and more resilient and more compassionate because of the experience. I think that’s what the meme was talking about.

But if the trauma – the death or separation or other experience – is fraught with pain as well as grief, then growing through it can be even harder and take even longer. A son whose abusive mother dies has feelings that can hardly be expressed, a jumble of emotions that’s almost impossible to articulate, much less grow through. The end of a relationship with a gaslighter may evoke relief as well as grief, conflicting emotions that can impede growth. These and other situations can call up memories and feelings that one wants to escape, not dwell on. But processing them seems perhaps the only way of growing through them.

That process cannot be rushed. It may take years of bad dreams and flashbacks – at least it did for me – as well, perhaps, as a period of therapy that, like grief, takes as long as it takes to make progress in growing through whatever happened. From outside the situation, it may seem like the person is wallowing in the pain or grief. But on the inside, the process of growing may be occurring at a rate that you can’t see or understand.

In other words, if a person has been through a trauma, don’t expect him or her to “get over it” on what you think is a proper timescale. Some plants, like dandelions, grow incredibly rapidly. Others, like oaks, grow incredibly slowly. For each, it takes as long as it takes.

 

The Stressor I Didn’t Realize I Had

You’ve seen those lists of life stressors, the ones where they assign you so many points for each stressful life event that occurred during the past year and use the total to calculate the likelihood of your becoming physically ill. Death of a spouse or child is at the top of the list, for 100 points. Marriage, divorce, taking out a mortgage (or losing your home), and even retirement are on the list.

The lists you find in various places differ in the details. Some list only ten major stressors, while others list 20 or more. (Nowhere in any of the lists does being diagnosed with, or living with, a serious mental illness appear. Apparently, only physical illnesses are considered stressful.)

I’ve managed to avoid a lot of the major stressors this year, though I can count retirement, my husband’s heart attack, and losing our home in my total. But there was one life event on one of the lists that I hadn’t even considered: changing one’s residence.

When I thought about it I could understand it, though. Moving is a major disruption of your life. It entails endless details, physical effort, and a need for psychological stamina. Packing up your life in boxes is itself a stressful process. (Hell, I get stressed just packing for a vacation.)

In the past month and a half, we’ve moved a total of four times, if you count the night we were evacuated from our tornado-damaged house to the Red Cross shelter. (Not that we did any packing for that. The rescue squad just yelled, “Grab your medications and come with us!”) We then moved to a hotel, then a pet-friendly hotel, and finally to a rental house where we can stay for up to a year while our house is rebuilt. (We had good insurance.)

It was the last move that was possibly most traumatic, though it was the one that brought us closest to a “normal” situation. A whole house. A full kitchen. A backyard. A mailing address. Like the hotels, it came with various rented amenities such as linens and dishes that made the transition easier, but it was still foreign to us.  We’ve been here for a couple of weeks now and are adjusting, but it’s undeniable that the whole process has stressed us very badly.

I know that we are fortunate in so many ways. The closest we came to true homelessness was the day spent in the Red Cross shelter. We both survived the tornado physically intact, and so did our cats. We know we still had a lot to be thankful for, and we were, and are.

The tornado was the really big stressor, but I only recently realized how much stress the constant moving added to the toll. As a person with bipolar disorder, I find all these moves jarring as well as stressful. I like to cocoon, rarely leaving the house. I want my comfort objects around me. The series of moves tapped into my fear of abandonment, my anxiety around packing, and my feeling of being overwhelmed by life. My husband, who is given to depression, feels the loss of all the things that embodied his memories very keenly. Our local paper observed that many of the tornado victims were suffering PTSD. I may be among them, as I have had tornado dreams and other sorts of upsetting ones.

Will we succumb to stress-induced physical illness? Who knows? Have we been suffering from the psychological effects of stress? Definitely. If you had asked me two months ago whether moving was a stressor, I would most likely have said yes.  But I had no idea of the reality. We had intended to stay in our home for the rest of our lives. When suddenly that became not an option, we came unmoored both physically and psychologically.

Stability has always been a problem for me, but now my husband and I have even less of it than usual. When we finally get a chance to settle in, take a deep breath and a day off, perhaps the stress will lift a little. But until then, we’ll keep slogging through it.

 

When Trauma and Mental Illness Happen Together

Couples who experience serious trauma may go through the experience together, but they do not always stay together afterward. The death of a loved one, infidelity, the onset of a disease – many things can test a couple’s ability to cope with the event and with each other.

Serious mental illness can also be a relationship killer. Dealing with symptoms, treatments, medications, setbacks, hospitalization, mood swings, and just generally going off the rails is more of a task than many couples can handle.

Combine serious trauma and serious mental illness, though, and what you’ve got is a recipe for a new level of disaster.

One of the potential pitfalls is two people who grieve in different manners or on different timescales. One partner may feel it necessary to process events aloud and at length, while the other may prefer to process feelings internally, without conversation. One person may take a year to get over a death, while the other is still grieving after three or more.

Then there’s couple who have different agendas when it comes to whatever is troubling them both. One may feel that moving on is the best response to a traumatic event, while the other person can’t let go of the past.

Many relationships crack and break apart under the strain. And those are just for couples who don’t have mental disorders.

Now take an example (not completely at random) of a couple who have lost their home in a natural disaster. He suffers from depression. She has bipolar disorder. He grieves the loss of their home and all their belongings to a point that she considers excessive. She kicks into hypomania and focuses on the small details of their situation. He thinks she doesn’t grieve. She thinks he needs to help her address the future.

It will be easier for this couple to stay on track and stay together if they can talk about what has happened and what is happening. That may well involve talking with other people – a trusted friend, a professional counselor, even each other. But it’s important that both people feel that they are being listened to and, more importantly, being heard. And that’s not always something that the other partner can provide.

If the couple can talk to each other, their communication skills will be severely tested. Depressed people and those with bipolar disorder both tend to isolate in times of stress. Processing feelings may not be either person’s greatest strength. And those different timescales and differing agendas are likely to throw up roadblocks should they try to talk about it all.

Being aware that trauma and mental illness both have detrimental effects on a relationship may help. Although even previously strong relationships can be stressed to the breaking point, stepping outside oneself to try to understand the other person can be enlightening. Feelings that seem callous or stubborn or flippant or shallow can just be different ways of dealing with trauma. Thinking the way you feel is the only way to feel will severely impede healing.

If it sounds like I am trying to remind myself of all these things, well, I am. We lost our home in a tornado, and my husband and I were dealing with mental difficulties before that happened. I feel that I must be on alert now for any signs that our relationship is cracking. But it’s not just my problem. The disaster, and the mental disorders, and the relationship are things that we share. They have led to a tangle of emotions and reactions that aren’t predictable or rational or even helpful.

We know the basic things we need to do – take our meds, practice self-care (and help each other do so as well), talk when necessary and be alone when that is what’s needed. We have to keep our eyes on what’s important: our mental health and getting through these difficult times intact both personally and as a couple. And we need to see the humor where there is any. But this isn’t the ordinary sort of disagreement that lasts a day or a week. It’s something we’ll be working on long-term.

Wish us luck.

When You Don’t Want to Live, but You Don’t Want to Die

“I hope I don’t wake up tomorrow morning.”

That is the classic thought of someone suffering from passive suicidal ideation. It’s not really a desire to die by suicide. It’s just a way of expressing how much it hurts to be you.

It’s not active suicidal ideation, the kind where you make an actual plan to kill yourself, even if you never put it into practice. It’s passive, meaning that you’d like to be dead but don’t intend on doing anything about it. It’s like asking the universe to take over and do it for you.

I’ve certainly had passive suicidal thoughts. Once I was very stressed and depressed while coming home from a business conference. I clearly remember thinking, “Maybe the plane will go down and keep me from having to deal with all this.” I certainly had no plan to rush the cockpit with a box cutter or anything like that. I just wanted my pain to be over. I wanted the choice taken out of my hands.

Another time I was at a business meeting in a swanky hotel that had rooms surrounding the lobby on numerous floors. I remember being on the 16th floor, looking down at the atrium beneath with what felt like idle curiosity. Would it annoy the hotel more, I wondered, if I landed on the carpeted area, necessitating a thorough cleaning or total replacement? Or would they be more upset if I landed on the marble floor portion of the lobby, making a bigger mess and potentially chipping the surface? (And was it just a coincidence that business meetings made me contemplate my mortality or did they just come packed with a lot of stressful triggers?)

At neither time was I actively suicidal. I’ve been there once too, and this was completely different. When I was suicidal, I had actual plans and plenty of means to carry out any one of them. I’m not going to discuss what those plans were. (The difficulty of choosing among them may have been what kept me from actually doing it. By then my depression had lifted just enough for me to get help.)

It was easy enough later to make jokes about the passively suicidal occasions and most people took them as exactly that – jokes. It was even plausible that they were jokes. I used to talk about jumping out a window, adding that it wouldn’t work because I lived in a basement. It was only much later that I thought about it and realized that I needed help even on those occasions. After all, isn’t pain the source of much humor and the downfall of many comedians?

Passive suicidal ideation is asking yourself “what if?” What if my troubles were over? What if my pain was gone? What if all I had to do to accomplish this was to let that bus hit me instead of stepping out of the way?

The important thing to remember is that someone passively suicidal is in great psychological pain and wants not to feel that way anymore. In that respect, it’s similar to cutting or other self-harm. And like those acts, it doesn’t end the pain at all. It may be a temporary escape valve, but it’s not a solution.

Passive suicidal ideation is certainly a bad thing and an excellent reason to see your psychiatrist or therapist as soon as possible. If you hear a friend or loved one talking this way, encourage them as strongly as possible to seek help. Let a professional decide if the person has passive suicidal ideation or active suicidal ideation. It is entirely possible that passive suicidal ideation will lead to the more active kind and even to death if it is not dealt with.

The Fire and the Window

fire orange emergency burning

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When Anthony Bourdain died by suicide and I told someone the news, he asked me, “Why?”

I was taken aback. “What do you mean, ‘why’?” I replied.

“You know,” he said. “Did he have money trouble? Break up with his girlfriend? Have some disease?”

That’s a common reaction to suicide and it’s uninformed. Real-life stressors can contribute to suicide, but they are almost never the whole story. People die by suicide when the pain of living seems greater than the pain of dying.

Gregory House, the misanthropic, genius title character of House, M.D., once said, “Living in misery sucks marginally less than dying in it.” People who kill themselves don’t believe that. They believe the opposite.

The best metaphor I ever heard for suicide was the plight of people in the World Trade Center’s upper floors on 9/11. There were the flames. There was the window. And that was the choice. Suicide happens when a person sees only two alternatives and both are equally horrible, or nearly so.

The bullied child does not take her own life because she was bullied. She was in pain, for a variety of reasons that included bullying. It was a factor, but it wasn’t the reason. She was hurt. She was isolated. She was depressed. She couldn’t believe that things would improve. She wanted the pain to stop. She believed she faced the choice between the fire and the window.

The politician who dies by suicide in the face of a major scandal does not kill himself because of the potential scandal. He dies because he sees his choices limited to shame, humiliation, despair, and ridicule. He believes that what happens to him will be as bad as dying. He is caught between what he sees as the fire and the window.

Mental illness can make it difficult to see that there are other choices. The distortions of thinking associated with serious mental illness can make us see only the fire and the window.

The one time that suicidal ideation got the better of me and I was close to making the choice, my thinking was just that twisted. I was faced with a choice that seemed to me would ruin someone I loved. I thought that I could not live with either choice. One was the fire and the other the window.

My thinking, of course, was severely distorted by my mental disorder. The thing that I thought might rain destruction on the other person was much smaller than I believed. There were ways out of the dilemma other than dropping a dime or killing myself. If we continue the metaphor, the fire was not that big, or that implacable, or that inevitable, but I couldn’t see that. In the end, I hung on long enough for my thinking to clear and for me to see other options.

I don’t actually know what was going on in the minds of the souls who were trapped in the Twin Towers. I don’t mean to lessen the horror of their deaths or wound their families by speaking of suicide this way. The reality of their choice is so far distant from the choices that other people who consider suicide face.

But that’s kind of the point. People who die by suicide don’t see any other way out. If they seem to be responding to what most people see as survivable hurts or solvable problems, people say they can’t understand how someone that rich, that successful, that beloved, that full of potential could have not seen that help was only a reach away.

The person who dies by suicide doesn’t see the hand reaching out. Only the fire and the window.

 

If you are considering suicide, call the National Suicide Hotline: 1-800-273-8255.

Forgiving and Forgetting

man standing on riverbank

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Forgive and forget. That’s the saying.

To err is human; to forgive, divine. That’s another saying.

But what about when you can’t forget and can’t forgive? When you’re human, not divine?

Forgiveness is a tough subject for me, because there are things I can’t forget, despite the fact that either my bipolar disorder or my meds have made my memory spotty at best. But there are things I remember too well. And some of those I can’t forgive.

I can’t forgive the person who called my mother a murderer because she had her sick, ancient little dog euthanized. And then kept rubbing her face in it by saying she did not support my mother’s actions. This person caused my mother unnecessary pain when what she needed were understanding and comfort. By those criteria, I am a murderer too. A person that toxic is someone I don’t need in my life.

And maybe that’s wrong of me, but it was my decision.

Another person I can’t forget or forgive is my gaslighter, Rex, about whom I’ve written before (see https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-dR, https://wp.me/p4e9Hv-4t). In one of those posts I said, of forgiving and forgetting:

I can’t do either. The memories have faded over time and seldom give me flashbacks anymore. (The dreams still come.) As for forgiving? He’s never asked for it and never would. I’m sure he doesn’t think he did anything that needed forgiving….

That emotional abuse happened, and I can’t forget it. It was my first serious relationship and I left chunks of my soul and most of my barely existent self-esteem in that house on the hilltop. I had failed – at the relationship, at meeting my parents’ expectations, at so many things. I felt I was the one who needed forgiveness and spent much of the following years repeating incessantly, “I’m sorry.”

I once encountered a Christian who said that the essence of forgiveness was to “fore-give,” to give someone something before they ask for it, as in Jesus, fore-giving his life for His followers. Or giving a homeless person your coat before they ask for it.

I’ve since been told that that’s an inaccurate reading of the word “forgive.” But at the time it stuck with me and influenced my thinking. If that was forgiveness, I didn’t understand it and couldn’t accomplish it. Something to do with that “to forgive, divine” thing.

I couldn’t fore-give my mother’s pain. I surely wouldn’t have given it to her myself and I couldn’t fore-give that other person the right or the opportunity to do so.

I couldn’t fore-give Rex my pain. I gave him enough of my life – over a year – as well as some of my hopes and dreams and aspirations. And yes, at the time, my love.

I’ve thought about writing him a letter, the kind that therapists often suggest you write as an exercise in exploring your feelings, explaining what went on from my point of view. But I haven’t – not even the kind that you don’t mail.

It would be futile. I’ve written about the person and the pain here in these posts and it hasn’t done a thing toward making me forget or forgive. Far from forgetting, I sometimes need to remind myself of the pain – to affirm to myself that yes, it really was that awful and to warn myself never to get caught in a situation like that again.

I don’t go through my life holding grudges against everyone who has ever wronged me (or my mother). Everyday hurts – unless they come every day – are possible to let go of. I’ve mostly forgotten the kids who bullied me in school. And I’ve forgiven them. They were kids and didn’t know any better. I’ve forgiven friends who have cut me out of their lives because they couldn’t handle my bipolar symptoms. Sometimes I can’t handle the symptoms either. If I get fed up with my disorder, it’s easy to see how someone else could too.

I’m not going to give you any advice on forgiveness and whether you should forgive or not. The topic is too complex and I don’t know how or why you’ve been wronged.

All I’m going to say is to be a little easy on yourself if you find you can’t forgive what you can’t forget. Those sayings about forgiveness are guidelines, not laws, and your situation may not fit into those guidelines. Just know that I do understand.

Reaching Out and Reaching In

A lot has been said in recent days about reaching out when you’re in trouble psychologically. And that’s always a good idea. Reach out to your friends, your family, your therapist, your psychiatrist, your church or synagogue or temple.

hands people friends communication

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Unfortunately, not everyone has those resources. And sometimes when you reach out to them, they do not reach back to you or even respond in hurtful ways.

Sometimes – many times – you’re just not able to reach out. That’s true of me, anyway. When major depression hits me like a truck, I get immobilized. Uncommunicative. Isolated. I usually have the wherewithal to get to my therapist, if my husband drives me, but not much more.

My family and friends can tell when I’m in trouble. And they do reach out, even when I don’t reach back.

My mother always knew when I hit a particularly bad spot because she could recognize it in my voice – it lacked animation, even if I was talking about something I loved. Not that I talked much or felt much. Depression can damp down all your feelings sometimes. You don’t cry, you don’t feel sad. You feel nothing. And it shows to someone who knows how to look and listen.

This is called “flat affect” by psychiatrists. The person’s face, voice, mannerisms do not reflect emotions, sometimes not even anxiety or despair. And sometimes people adopt a flat affect so as not to betray their inner turmoil. (It can still leak out around the eyes, even to relative strangers. And I don’t mean crying.)

My husband knows I’m depressed when I turn monosyllabic. Ordinarily, I enjoy talking to my husband about anything and nothing – things we’ve read or heard, what’s happening at work (his, mostly), funny things the cats did, and so forth. But when I stop responding and communicating, or respond only with “yeah,” “nah,” and “meh” sorts of answers, or don’t laugh or at least groan at his jokes, he knows I’m headed downward.

I stop communicating other ways, too. I don’t post on Facebook or only pass along the occasional pass-along. I skip commenting on posts regarding things I usually care about. I spend hours alone reading, if my sometimes-dubious powers of concentration let me. Or I sleep, and nap, then sleep some more. I certainly don’t leave the house or even make plans to go out. I don’t call friends. I isolate. I don’t reach out, like the memes say I’m supposed to.

I am fortunate to have friends that do reach out to me. John would lend me books, talk about them with me, and listen if I needed to vent. Peggy would call and invite me to visit, even when she knew I wasn’t leaving the house. Pete sometimes IM’s every day just to check in and JB assures me that when he IM’s and I don’t feel like chatting that’s still okay. Robbin calls me and tells me all about her life even when I can’t talk about mine, then says, “Let me know when you surface.” If she doesn’t hear from me for awhile, she calls again and reminds me that I can call her too. (She can also “read” my voice and knows when there’s some topic I’m avoiding.) My husband offers a hug or kisses me on the head. My mother prayed for me. I am fortunate indeed to have had people like these around me when I really need them.

Reaching out to others is good. So is reaching in to the suffering. Best is a combination of both. But that takes work and not everyone is able to do it.

If you can reach out, reach out.

If you can reach in, reach in.

If you’re lucky, you’ll meet in the middle, where hope lives.

 

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