Bipolar 2 From Inside and Out

Posts tagged ‘public perception’

Wounded People, Invisible Scars

Let me tell you about the time I got stoned in third grade. I was a weird kid – smart, scrawny, emotionally out-of-step, lonely. I dressed funny. I was no good at sports. In short, I was bully-bait. One day I was waiting at the bus stop with some other kids. They decided it would be a fun game to throw rocks – broken pieces of macadam – at my feet. I jumped over them easily, laughing along.

Then one of them threw a rock and hit me in the head. As I was sobbing and bleeding, a passing teacher rescued me and called my mother. The kids ran off, yelling, “We didn’t mean to hurt her!”

I was wounded, nonetheless. Three stitches later, I was, if not as good as new, at least able to carry on. The scar on the outside has since faded to invisibility. The scar on the inside is invisible, too, but very much still with me.

A lot of us have invisible wounds and not all of them come with physical scars. There’s a whole category of conditions called “invisible illnesses.” They’re the ones that don’t come with wheelchairs or crutches or seeing-eye dogs. People who look “normal” on the outside but are fighting like hell on the inside. Some of these conditions are autoimmune disorders. Others are caused by developmental difficulties, uncommon viruses, and even hormonal disruptions.

Then there are the ones that live in the brain. In memories. In scars no one can see. In mental illnesses. What was wrong with me was mental and emotional, inside my brain. Maybe the other kids could sense that and that was what made me a target.

There are a lot of the walking wounded among us, along with non-ambulatory people who are also wounded in other ways. People with brain injuries or PTSD. These disorders can strike anyone and you can’t tell who those people are simply by looking at them.

In cases of serious mental illness, in particular, the wounds and scars, while internal, can be deadly. At least once, my own brain has tried to kill me. Bipolar depression, combined with irrational thinking and problems in the world outside my brain, left me with seemingly only one choice. Fortunately, I didn’t act on the pain. I lived through it.

Too many of us have invisible, internal wounds. Too many of us spend enormous amounts of time and energy pretending that we don’t. For some reason, internal wounds seem more shameful, less understandable, than external ones. A broken leg elicits sympathy. A broken brain, not so much.

I know that the rock that hit my head wasn’t what broke my brain. Bipolar disorder is much more subtle than that. Whatever its causes – and the jury seems to be still debating that – a minor physical impact is not considered to be one. The seeds of my bipolar disorder were likely already there, lurking in my differentness, my emotional oddities, my uncooperative but active brain.

But the incident sure didn’t help. It made me more vulnerable to the shocks and disappointments of life as a weird kid. It took a pothole-sized chunk out of what should have been my developing self-esteem. It opened up crevices in my brain where the doubts, fears, insecurities, and excesses of bipolar disorder could lodge.

Wounded people surround us every day. Sometimes the pain leaks out around their eyes. Other sufferers are more adept at hiding it. The important thing to know is that anybody – anybody – you see on the street or meet at work or at church or at the gym could have one of those invisible scars.

Not all the broken look broken. Not all wounds are visible. Not all scars are external.

Be gentle with other people. You never know who’s hurt inside.

What Does “Normal” Mean?

When I was young, I wanted like anything to be normal. I didn’t know what normal meant, but I knew I wasn’t it.

I had a lot of the trappings of what passed for normal in that day and age: parents still married, one sister, suburban house in a town with good schools, church down the street, same-age children living within a block, working father, stay-at-home mom, abundant books and toys, and vacations to visit the relatives.

But I knew. There was something different about me. Everyone else knew it too. I wasn’t normal. I was too sensitive, whatever that meant. I was precocious. I didn’t fit in and I didn’t know how to.

As I reached my tween and teen years, I encountered a dilemma. I desperately wanted to be normal. Normal kids had friends, got to hang out with each other, laughed and smiled a lot, wore what was in fashion. They gave off an aura of being normal. I longed for that. I was in love with the idea of normalcy.

But every time I tried, I failed. I was always too weird, too emotional, too smart, too something.

So I began to hate the idea of normalcy. If I didn’t fit in, then by God, I would scorn the idea of fitting in. I would embrace non-normalcy. I would hang with the few other misfits I could find. I would eschew the latest fashions and trends. I didn’t rebel, exactly. I was too timid for that (yet another too).

And I blamed the suburb and the Midwestern state where I lived. Maybe this kind of normal was bland, spiritless, and hum-drum. Maybe I was right not to want to be of it.

So, of course, I tried the geographical cure, going away to college, where I thought the people would be more like me, where there would be enough diversity that I could find others like me and finally fit in. Be normal within a different definition of normal.

And it worked, at least partially. But by that time it was too late for me to ever be normal.

What happened was that bipolar disorder caught up with me. I had probably been struggling with it all the time I was a weird kid who didn’t fit in. Other kids threw rocks at me. My moods were extreme. I cried and laughed at things that were neither sad nor funny. Being betrayed by a friend sent me into a severe meltdown.

By the time I was in college, there was no doubt that I was struggling with a mood disorder, although we didn’t have that term for it at the time. At the time it seemed like major depression and for the most part, it was, or at least that was the only mood I could identify.

Years later, when I got a proper diagnosis and the right medication, it was easier to look back and see my bipolar tendencies slowly building over the years. But I’ll admit something – I still both love and hate the idea of normalcy. I still want to fit in and I’ve found a few groups where I seem to. But I also want to embrace my oddness, celebrate my differences, glory in my assorted varieties of geekiness.

I never want to go back to that lost, lonely, spinning-out-of-control kid who was always too much or not enough. My lifestyle helps since I don’t have to try to fit in at a nine-to-five office job. My husband helps, as I was at least normal enough to find one. And my writing helps, so I can work out some of my conflicting emotions and bipolar moods through this blog and other venues.

Here’s another reason to hope: Matt Norris, a blogger at The Thinking Orc, recently wrote:

Disapproving of people who aren’t “Normal” went from a virtue to vice within my lifetime. The shift in public morals changed the rules on what it took to be seen as a good person. It used to be about not doing anything weird, and looking down on anybody who did. Now it’s about not doing anything cruel, and looking down on anyone who does.

Besides, to quote songwriter Steve Goodman, “I may not be normal, but nobody is.” I know that now. So in that sense, I do at last fit in.

Good Enough

I know a man who used to be caught in all-or-nothing thinking. Anything at all – a dinner, a gift – had to be “fantastic” or it was “wrecked.” “Okay” wasn’t good enough. “Fine” wasn’t good enough. “Nice” wasn’t good enough. “Good enough” wasn’t good enough. He heard them all as “wrecked.”

Fortunately, over the years, he learned to accept compliments that were lesser than “fantastic.” He could even understand “needs work” or “meh” without feeling that those meant “wrecked.”

There was I time when I thought my life was wrecked. Irretrievably, permanently wrecked. All I had to look forward to was someone recognizing my wretched wreckedness and having me committed. Fantastic was never even an option.

Later I learned that my life wasn’t wrecked, though it surely hit some rough patches and there were a few things that were wrecked along the way – friendships, my self-esteem. But gradually I learned that the problem was not wreckage, it was bipolar disorder.

And now my life is not wretched and wrecked. Bipolar disorder has backed off.

I don’t think I’ve been cured of bipolar disorder, because I don’t think that’s possible. I think that the most that you can say is that I’m in remission.

And that’s okay.

I’m content with the idea that I’ll have to take medications for the rest of my life. They’re what got me here and they’re what keep me here, in the land of Good Enough.

I don’t ever expect to be normal – whatever that means – but I do expect to remain reasonably functional. I have a good marriage. I can do paying work. I have a comfortable home. I’m stable most of the time. I go to a psychiatrist only for med checks.

I have just enough symptoms to remind me how I used to be (that is, dreadful, miserable, and sometimes numb). I still don’t like to go out of the house, but I can if I need to. I still have to lean on my husband for support. I still get free-floating anxiety at times. But those are symptoms I can live with.

Of course, the road to remission has been very (very) long. I’ve fought my way through meltdowns. I’ve had to learn coping skills and some degree of self-care. I’ve tried nearly every combination of medications on the market, except for the newest ones – I’m not switching from what works now in hopes of getting a little bit better. Because that might not happen.

And because I’m good enough.

I’m good enough to write blogs. I’m good enough to write a book (I wrote a book!). I’m good enough to have lots of friends, both online and off. I’m good enough to help other people who are going through the same things I did.

I’ll never be perfect, but let’s be honest, that was never a goal of mine or even a possibility, really.

But I feel I have beaten this bipolar disorder; it hasn’t beaten me.

And that’s good enough for me.

Children’s Bodies, Children’s Minds

I read recently that the Duchess of Cambridge was visiting a series of schools to mark Children’s Mental Health Week. The duchess is the royal patron of Place2Be, a children’s mental health charity. The article said that this year’s theme for Mental Health Week would be “Healthy: Inside and Out, focusing on the connection between physical and mental health.”

The article explained, “The charity works with more than 280 primary and secondary schools across England, Scotland and Wales, providing support and expert training to improve the emotional wellbeing of pupils, families, teachers and school staff.” 

The duchess, it says, would be meeting with members of the school community to discuss students’ school readiness, teacher welfare, the wellbeing of the school community, and the importance of being active; and also talk with parents about good routines and habits around sleep, screen time, healthy eating, and exercise.

All of which sounds fine and worthy. But does anyone else see something missing from this public relations tour? Maybe it’s just me, but there doesn’t seem to be much actual emphasis on children’s mental health.

Yes, we know that the body and the mind are intimately connected. Yes, we know that children need a sense of wellbeing. Yes, we know that being active and eating healthy are important for kids. And we know that parents, teachers, and school communities have important roles to play in students’ healthy development. We also know that sleep, healthy eating, and exercise are good for people with mental illnesses. Hell, they’re good for everyone.

But there’s a lot more to mental health than physical fitness and a sense of wellbeing. If that was all it took, we could just eat kale and kiwis, meditate, and send the therapists home.

Of course, the article was short and seemed to focus on the duchess’s meetings with the youngest kids, who after all the most photogenic. Maybe the charity and the duchess also educate about the thornier aspects of mental health. Maybe they promote dialogue about self-harm, suicide prevention, childhood depression, and other conditions. I would like to think that they do.

But the article and many others like it focus on the physical and feel-good aspects of mental health and not the mental and emotional. Bubble baths for self-care! Pets as the best therapists! Super foods for regulating moods!

Memes are not the answer. And the physical aspects of mental health are certainly important. But we’re talking about mental illness and mood disorders here. Can’t we at least spend time talking about the mind and the emotions?  Maybe even have a dialogue about what happens when something goes wrong with them? Stress the importance of seeking help when one is confused, overwhelmed, and despairing?

I think society at large is still uncomfortable talking about mental illness and twice as uncomfortable talking about mental illness in children. Many of us are still laboring under the illusion that childhood is a uniformly happy time. In fact, many kids suffer from serious mental illnesses. If the statistics give any indication, 20% to 25% of them will experience a mental health problem at some time in their lives.

We should talk about this and ultimately do something about it. Something more than emphasizing good physical health and getting celebrities to do 30-second spots about how they too experience depression, though these are indeed good things.

I’ve written before about what I think a mental health curriculum in schools should look like (https://wp.me/p4e9Hv-Jw, https://wp.me/p4e9Hv-Hl). I suppose that first we need to be aware that children can and do have mental health problems – that it may not be “just a phase they’re going through” or something they’ll “just get over.” It’s a serious problem and requires serious attention, not to mention serious actions.

Whatever else we do, let’s put the mental back into mental health.

 

 

Ridding Your Life of Toxic People to Save Your Mental Health

It’s hard to cut toxic people from your life, even if the person is a gaslighter or other abuser. There’s always the temptation to give the person one more chance, believe his or her protestations of love or change, or to feel it is up to you to change the situation or the other person.

But sometimes it’s necessary to end the relationship.

A toxic person is like a psychic vampire who sucks all the confidence and energy and spirit from your life. He or she exhausts you emotionally and adds nothing to your life but annoyance, pain, and trouble.

Once or twice I’ve even been that toxic person when I was in the grips of the depressive phase of my bipolar disorder. Several people cut me out of their lives and I can’t say that they were wrong to do so. I gave nothing, only took. I was the psychic vampire. And I deeply regret that, even though my hurtful actions were manifestations of my disorder. It lasted so long, with no apparent signs of letting up, that it simply wasn’t worth it to them to continue to associate with me.

Once or twice I’ve been on the other side of the equation, though. I can think of two times in particular. One was when I got out of the relationship with the person who turned out to be gaslighting me, which I have written about before. I learned something from the experience (though I still maintain that the lesson wasn’t worth the price I paid).

What I discovered is that it is better to make the break definitive. If you’re going to cut a toxic person out of your life, do it cleanly. Don’t leave that door open for continued contact. In my case, I felt I owed the person some money and sent him a little every month. An acquaintance called me on this and pointed out that even if I did owe money (which he doubted), it was better just to send a single, final payment and end it there.

So that’s what I did. I scraped together some money, wrote a check, and released myself from the ties that still bound me.

It’s somehow different when the toxic person is a family member, though. I won’t write much about the actual situation because I want to leave the person their privacy. But it was a toxic relationship that sucked time and energy from me and also from another person that I loved. It was concern for this other person that led me eventually to make the break, though I was growing weary of dealing with the person’s dramas, helplessness, vindictiveness, and general mean-spirited relations with me and others in the family.

I haven’t looked back. Some people have judged me harshly for taking that step because the person was, after all, family. Many people believe that family is more important than anything. But I chose my own mental health and refused to keep forgiving the damage done to both me and others. It took a lot of years until I was able to make the break, but I am never tempted to go back on my decision.

It’s easy to say that one should cut toxic people from one’s life, but it’s often a very hard thing to do. You can end up questioning yourself and your own motives. You can be shamed by others outside of the situation. You may regret your decision and wish you could mend the relationship.

My experience has taught me that sometimes that just isn’t possible. If the person is unwilling to or incapable of seeing the harm he or she has done, it’s likely to be a mistake to let the person have another chance to inflict more damage.

I plan on reaching out one more time to a person that I have harmed. But if they don’t respond, I’ll understand. I own that I was toxic and it was perfectly understandable that they cut me loose. I’ll always have regret and shame for the way I was, and I won’t try to insert myself back into their lives. I just want it to end on a less bad note if that makes any sense.

But I note that the toxic people whom I have cut from my life show no such inclination. I have to believe that they still believe they did nothing wrong and that they have not become less toxic. I still must protect myself and my mental health by not letting them back into my life.

And if that includes family, so be it.

Men, Women, and Mental Health

My husband is no stranger to situational depression. He experienced it when his father died, when a beloved pet passed unexpectedly, and when his job turned suddenly more stressful and meaningless.

But he didn’t understand clinical, chronic depression. “What would it be like if those feelings lasted for months at a time, or even years?” I asked. He said he couldn’t even picture it. “That’s the way my life is,” I explained. Then he lost his job, and after a brief period of relief from the stress, he finally experienced depression that lasted more than two weeks – two years, in fact, during which he was unable to work.

He did not seek help for it until his best friend and I both proactively encouraged (i.e., nagged) him to do something about it. He’s been on an SSRI ever since and has occasionally seen a psychologist.

Lately, there has been a movement to educate men about mental illness and mental health. Primary among its goals is to help men understand that mental illness is a thing that can affect them and that there is no shame in asking for help.

Certainly, the statistics bear out that the majority of mental health consumers are women. Psychology Today reports: “Research suggests that women are about 40% more likely than men to develop depression. They’re twice as likely to develop PTSD, with about 10% of women developing the condition after a traumatic event, compared to just 4% of men. It’s easy to write off this epidemic of mental illness among women as the result of hormonal issues and genetic gender differences, or even to argue that women are simply more ’emotional’ than men. The truth, though, is that psychiatrists aren’t really sure why mental illness is more common among women.” Perhaps the answer is that seeking treatment for mental illness is more common in women.

Prevention magazine says that there are four mental health conditions that affect women more than men: depression, anxiety, PTSD, and eating disorders. That PTSD is twice as common in women may surprise you, though the stats about eating disorders are not likely to. The fact is that, although few women experience the traumas that soldiers do, they are much more likely to experience other sorts of trauma, such as rape, which can also lead to PTSD.

But men experience societal and psychological barriers to getting help when they need it. Among the excuses you hear are these:

  • I don’t really need help.
  • I can handle this myself.
  • I don’t want to appear weak.
  • I might lose my job if anyone finds out.

In other words, a lot of bullshit that boils down to “I’m a man and mental illness is not manly. Asking for help is not manly. Talking about emotional problems is not manly. Taking medication for a personal problem is not manly. Not being able to deal with my problems, especially emotional problems, is not manly. Therefore I have no mental problems and don’t need treatment for them because I’m a man.”

Or, looked at another way, the campaigns against stigma around mental illness have been less than effective for most men. Now the attention to that problem, which is surely needed, is beginning to be heard and, one hopes, acted upon.

Still, it’s important to remember that mental illness is not just a men’s problem or a women’s problem. It is a human problem, affecting both genders (and all ages and races) if not equally, then without discriminating.

It is important to get men the mental and emotional help they need, in a timelier and more comprehensive fashion.  I would have liked to see my husband be willing to recognize when he needed to get help and to get it without being pushed. But it would be wrong to push the needs of women aside to accomplish this. This is a societal problem, and while right now spreading the word to men is particularly important, our goal should be to make sure that all people are aware of the prevalence of mental illness, the fact that it can happen to them, and that there are places to get help. That message, at least, is not gender-specific.

Big Box Mental Health

photo by rawpixel.com from Pexels

According to an article published on the blogsite She Knows, “a Boston-based company that manages mental health care for 40 million people, has opened a small clinic in a Walmart location in Carrollton, Texas, and has plans to expand the program in other retail locations throughout the country.”

And I don’t know whether to vomit or applaud.

Walmart’s ubiquity is one point in its favor. They’re everywhere. And for some people, whether they love or despise Walmart, it’s the only choice they have for groceries, household goods, or much of anything else. Those areas are also likely to be underserved by the mental health system, such as it is.

And sparse as the options offered by the Walmart walk-in clinics is – treatment for anxiety, depression, grief, relationship issues, and stress management – it’s more than a lot of people have access to now. The trial site is said to be staffed with one licensed clinical social worker, has a sliding fee scale for those with no insurance, and will soon be approved for Medicaid reimbursement (it is hoped). There will even be remote Skype therapy services if necessary.

All that is good, as far as it goes. But does it go far enough? Will people be able to get more than a pat on the head and a pep talk as they do their weekly or monthly shopping? How will the walk-in clinic handle referrals for people with serious mental illness or a need for psychotropic medication, something that clinical social workers can’t provide? How many people can get help from a single professional? How good is internet therapy? And what percentage of Walmart shoppers have access to the internet?

The walk-in clinics are touted as reducing stigma around mental health issues. After all, the thought is, getting your mental health services at Walmart will become as natural as getting a haircut or an eye exam there. Well, maybe. On the other hand, how many people are willing to have their friends and neighbors see them publically, sitting in the waiting room or ducking surreptitiously through the door? It seems to me it might perpetuate stigma, rather than lessening it.

Besides, Walmart is hardly a bastion of high-quality goods and services. Will the mental health services be second-rate as well? It could be that even second-rate care is better than no care at all. But it’s surely not enough to deal with issues that require long-term therapy with actual treatment plans; scheduled repeat visits; building a relationship with a particular therapist; access to medications; and all the other aspects of more effective treatment, especially considering complicated disorders like bipolar, OCD, or anorexia.

I fully admit that I hate Walmart – the way they have driven out local Mom and Pop stores, for example, and the way they treat their employees. But I have many choices of where to shop near where I live, and access to both therapists and psychiatrists, and insurance that covers my appointments and medications. If I weren’t looking through the lens of privilege, I might see things a lot differently.

So for now, I guess my attitude is to wait and see. One test location does not a Walmart Psych Empire make. Perhaps it will succeed; perhaps not. Perhaps it will become the Great Clips of the psychotherapy world.

But while I’m waiting, I’m hot holding my breath.

 

Tag Cloud

%d bloggers like this: