Bipolar 2 From Inside and Out

Posts tagged ‘public perception’

I’m Not Brave – I’m Stubborn

Don’t forget! March 30 is World Bipolar Day!

Kopf durch die Wand

One of my friends, who is overweight, recently told me that when she was at the gym on the treadmill, a stranger came over to her and told her she was “an inspiration.”

My friend felt insulted. She was working out for herself and for her health, not to inspire anyone else or to be taken as a symbol of I-don’t-know-what – perseverance? attitude? effort? hope?

I feel sort of the same way when people say that because I am open and public with my bipolar disorder that I am “brave.”

I’m not doing this because I’m brave. I’m doing it because I’m stubborn.

I am who and what I am, and I’m willing to reveal a lot of it because, frankly, I can’t hide it and don’t want to. I’m not average or typical. Not normal, mentally or emotionally.

I’ve always had a love-hate relationship with the concept of “normal.” Desperately wanting to appear normal, but knowing viscerally that I am not. Wondering what it’s like, but knowing that I’ll never know. Wondering what it even means, or what it means that I’m not. I haven’t found answers yet, and at this point I don’t think I’m going to. It’s probably a waste of my time to try.

So, if I’m outside the “norm,” which I am, I may as well admit it. And since writing is what I do, I write about it. I’m not doing this because I’m “brave,” I’m doing this because on some level I have to. I’m stubborn.

I’m stubborn enough these days to have made a sort of peace with the concept of “normal,” even though I still don’t understand it.

I’m stubborn enough to acknowledge my difference and give it its proper name – bipolar disorder.

I’m stubborn enough not to care when I say that and some people flinch or back away.

I’m stubborn enough to reveal things that embarrass me because they are part of me and part of what I’ve lived and lived through.

I’m stubborn enough to get tattoos proclaiming my status as “mentally ill” and using them to open conversations and educate others.

I have not come to embrace my stubbornness easily. I’ve tried to fake “normal” and hide my differences. I’ve gone to my shrink and just referred to “doctor appointments.” I’ve made Prozac jokes even though I was taking it at the time. (For this I am truly sorry, as I later learned that one of those jokes made another person afraid to admit that she took Prozac too.)

I’m not trying to be an “inspiration.” I’m not trying to prove anything to anyone else. I’m doing what I have to do for me. If someone else finds some good in it, that’s fine. But that’s not why I do it.

I am bipolar.

I am a writer.

I am stubborn.

Taken together, you get this blog.

Bipolar Me.

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mental health

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What Is Sanity?

And who is sane?

Negatives Positives Computer Keys Showing Plus And Minus Alternatives Analysis And Decisions
These are questions you don’t hear much anymore, at least outside of judicial proceedings. Even there, the phrase “guilty but mentally ill” is gaining currency. “Not guilty by reason of insanity” made people think a criminal was getting away with something. And indeed, the “insanity defense” has been misused.

We’re much more comfortable talking about health and illness, concepts we all understand, than about seemingly fixed states like sanity and insanity. They sound so final. At least illness can be treated; health can improve.

Before the deluge of psychiatric labels and the DSM, how to tell if a person was sane or insane was a vital question. The insane were put away – in an asylum if they were poor or kept discreetly out of sight at home if they were wealthy.

But were all the people in asylums insane? And what kind of treatment did they receive? Investigative journalist Nellie Bly determined to find out. Her 1887 exposé Ten Days in a Madhouse was a muckraking revelation.

Bly feigned amnesia and delusional fears, was reported to the police by her landlady, and declared incurably insane.

While she was at the Women’s Lunatic Asylum on Blackwell’s Island, she experienced cold, hunger, brutality, and no diagnosis or treatment. Several of the other inmates were, like Bly, sane by any modern standard, but poor, friendless and alone. The newspaper she worked for arranged to have Bly released, but the other women remained to be beaten, choked, starved, humiliated, not treated and driven insane if they weren’t already.

Bly’s ordeal and testimony did prompt a grand jury to recommend an increase in funding of $850,000 – quite a large sum in those days – for the Department of Charities and Corrections, which oversaw asylums. (It is ironic to note that the word “asylum” originally meant a place of protection, safety, or shelter.) But it mainly went for better physical conditions – warmer clothes, edible food, more and better-trained nurses – rather than actual diagnosis and treatment of the women’s “insanity.”

The question of who is sane and how you can tell was revisited in 1973 by psychologist David Rosenhan. A professor at Stanford University, he devised a simple experiment. He sent eight volunteers, including both women and men, to psychiatric hospitals. Each person complained of hearing a voice saying three words – and no other symptoms.

All – all – were admitted and diagnosed, most of them as schizophrenic. Afterward, the “pseudopatients”  reported to their doctors and nurses that they no longer heard the voices and were sane. They remained in the psychiatric wards for an average of 19 days, beating Nellie Bly’s experience by nine days. They were required to take antipsychotic drugs as a condition of their release.

Rosenhan’s report, “On being sane in insane places,” created quite a stir. Indignant hospital administrators claimed that their staff were actually quite adept at identifying fakes and challenged Rosenhan to repeat the experiment.

This time hospital personnel were on their guard. They identified over 40 people as being “pseudopatients” who were faking mental illness. Rosenhan, however, had sent no volunteer pseudopatients this time. It was a dismal showing for the psychiatric community.

Times have changed, of course. Few people are confined in locked wards for life. Diagnosis is, if not yet a science, less of a guessing game, backed up by the DSM and assorted checklists of symptoms. And insurance companies hold the keys to psychiatric units as much as medical personnel do.

Still, the fundamental questions remain. Are neurotics sane and psychotics insane? I have bipolar 2. Am I mentally ill? I would have to say I am, since my condition will require treatment, barring any dramatic scientific advances, for the rest of my life. And my illness does affect my ability to function “normally.” Yet I think that few would consider me insane (unless I were suddenly to start shooting people in a public place, of course).

Speaking freely about mental illness and mental health is, presumably, supposed to make such disorders more understandable, less fearsome, less stigmatized. I suspect, however, that there are those who would rather we remained out of sight – if not locked away in asylums, then restrained in the virtual straitjackets of strong psychotropic medication.

And while group homes and other sorts of assisted living situations are now more available (though not nearly as accessible as the need for them would require), the general public prefers that such facilities, along with halfway houses for addicts and parolees, be constructed “NIMBY” – Not In My Back Yard.

Out of sight, out of mind.

Maybe the conversations surrounding such issues are reducing the stigma of mental illness, or insanity, or whatever you choose to call it, but I’m dubious about the level of success. There’s still a long way to go.

 

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mental health

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Is Bipolar Disorder an “Invisible Illness”?

Empty Chairs Laid Out For Meeting

Yes and no.

First, a little on the concept of invisible illnesses. These are the sorts of afflictions that are not apparent on first looking at a person – conditions such as fibromyalgia, chronic fatigue syndrome, celiac and Crohn’s diseases, diabetes, epilepsy, lupus, Lyme disease, and many others.

Disabled-world.com says, “Many people living with a hidden physical disability or mental challenge are still able to be active in their hobbies, work and be active in sports. On the other hand, some struggle just to get through their day at work and some cannot work at all.”

Most mental disorders are invisible illnesses by that definition. There isn’t a sign around our necks that proclaims “Bipolar,” “Social Anxiety Disorder,” “PTSD,” “Depression,” or even “Schizophrenia.”  The word “Crazy” isn’t tattooed on our foreheads. Our mere appearance doesn’t give away our “secret.”

We have a lot of the same problems that people with other invisible illnesses have. Spoon theory, for example. For bipolar people, simply taking a shower requires so many spoons that we seldom go out. (I count myself among that number.) People who don’t know or understand Spoon Theory often don’t understand why we don’t accept their invitations or cancel at the last minute, or simply don’t show up. You lose a fair number of friends that way.

On the other hand, a mental disorder is not always invisible. People can see us burst into tears for no apparent reason, or go into the bathroom at a party and never come out. They can see our shaking hands, confused looks, and depressed expressions. They can hear our awkward attempts to socialize “appropriately.” They may not know what is wrong, but they can often tell something is.

When we realize this is happening, there are various strategies we try. We can leave the situation – entirely or partially (my go-to is to leave the room on the pretext of needing to make a cup of tea). We can try to brush it off or laugh it off (“Sorry. My nerves are bad today” or “I don’t know why I said that. Must be a brain-fart”). We can try the half-truth/half-joke (“Oops. Guess my meds just haven’t kicked in yet”). We can ignore whatever is happening and hope everyone else does too.

Or we can own it. “I have social anxiety disorder and need to be in a less crowded space than the mall.” “I won’t be able to go to the carnival with you because my PTSD is triggered by loud noises.” “I may come to your party if my bipolar disorder will let me.”

We can also address the subject when there isn’t a situation looming. During a phone conversation or an IM chat, we can let the other person know that we have a mental disorder – an invisible illness. It doesn’t have to be dramatic and dire. Casually may be the best way to handle it. “I know you’re wondering why I didn’t go to the movies with you last week.” “When I saw my doctor yesterday we talked about my physical health and my mental health too.” “You know that character on that show that has PTSD? I have that too, but it’s not exactly like on the show.”

If that sounds risky, you’re right. It can be. There will be people who still don’t get it. People who “don’t believe in” mental illness. People who try to brush it off. People who offer the latest vitamins or super foods or Eastern philosophy as the cure-all.

But you’ll also find people who say, “Oh, my brother-in-law has that too” or “Okay. But I’m still your friend” or “What can I do to help?”

So those are the choices, basically.

Take a chance. Or stay invisible.

Neither choice is right or wrong for everyone. Mental illness is very personal.

You decide.

 

 

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Beware the Mental Health Meme

This post was specially written for BlogHer’s Social Media and Blogging section, but I thought it worth sharing here too. (Credit for the photo goes to my husband, Dan Reily.)

 

Slide1

Most Internet memes are harmless, or even amusing. They proclaim that someone has a wonderful granddaughter or that kittens are cute.

But some memes that travel the world sow unhelpful or even hurtful ideas as they go. The one above appears mild and even inspiring, but to a person with mental illness, it says a lot more than appears on the surface.

The meme that started me on this train of thought was one that invited people to embrace the crazy or enjoy the madness or some such. As a person with mental illness – bipolar disorder – I found the message troubling. The comments were even more so. One said that manic-depressives could at least enjoy the mania.

Admittedly, mania comes with feelings of soaring confidence and a whirlwind of creativity. Mania can also prompt risky behaviors – reckless driving, shoplifting, unsafe or extramarital sex – that can lead to a lifetime of problems, including failed relationships, arrest records, serious debt, and worse. Those are surely the opposite of enjoyable.

But I didn’t know if I was alone in these feelings, so I asked other bipolar bloggers how they react to popular memes. Here’s what they had to say.

Nondescript inspirational memes (of the sort that proclaim daylight follows darkness) seem relatively harmless. Reactions went from “meh” to “a waste of time.” Bipolar blogger Brad Shreve (insightsbipolarbear.com) likens them to affirmations. His research showed that evidence from reputable studies confirms that affirmations mitigate stress. Nevertheless, “I find most of them trite and condescending,” he says. “They just aren’t my thing. I choose meditation.”

Amy Balot, who blogs at madwomanacrossthewater.net, dislikes the sort of memes that tout positivity. “I do have a big problem with the way a lot of ‘motivational’ images seem to imply that all you need to do is think positive thoughts and your life will be hunky-dory,” she says. “It seems to be blaming people for things like depression or anxiety.”

Supposedly positive memes raise the hackles on a number of the bloggers. Dyane Leshin-Harwood, blogger at proudlybipolar.wordpress.com and author of the upcoming memoir Birth of a New Brain, says they range from “cool and empowering” to “[make] me feel guilty that my life isn’t as good as it could

be! It seems like it would bring anyone with bipolar depression down even
further.”

It does that to me as well.

Many such memes also promote a “bootstrap” approach to mental illness – which Jim Buchanan, who blogs at mythoughts62.wordpress.com, finds “irritating”: “I feel that this sort of thinking is harmful and it essentially blames the person reading it for their problems by implying that they ‘don’t want to allow themselves’ what is needed for a good life.”

Shreve adds, “Usually these entail [the idea that] the individual can change by doing one thing – [changing] our attitude. As if we could just snap out of depression, mania and more, if we would just put [our] mind to it. I find these guilty of mental health shaming.”

And as for the “find-your-sanity-in nature” meme that began this article? Amy Balot doesn’t care for that type. “I don’t dispute that spending time with animals or outdoors can be great and even therapeutic; but I do dispute the implication that these things are a replacement for therapy or better than therapy,” she says. “It minimizes the struggles of the mentally ill and says they’d be ok if they just took their dogs for more walks in the woods. Not all problems are solved by a little sunshine and fresh air.”

Memes intended to be humorous are a gray area, since humor is so subjective. Personally, I don’t mind being called “crazy,” but many bipolar people do. Using “crazy,” “insane,” or any of the many synonyms – “weird,” “eccentric,” “not normal” – can make people with mental disorders feel as if the meme speaks directly to them, even if that wasn’t intended.

But some people with mental disorders enjoy a gentle poke of fun at themselves. Shreve agrees: “These can be touchy because they could hurt or offend someone who is going through a difficult time, but they help me.” (Here’s one of his favorites: http://www.someecards.com/usercards/viewcard/326b0799dbae216dbe3bf6069e297ea48d).

I must admit that I can sometimes see humor in our situations. I’ve written pieces called “The Lighter Side of Insomnia” and “Confessions of a Crazy Cat Lady.” It’s not a matter of malice being intended; I don’t think people who pass along memes that we consider hurtful are “out to get” those with mental disorders. But that’s the problem: They don’t think before they click “Share.”

So I’m asking: Please think first. One of four Americans will have a mental or mood disorder at some time during their lives. You wouldn’t make fun of someone with a physical illness. Ask yourself: Would this meme still be amusing or inspiring or helpful if you substituted fibromyalgia or diabetes or paraplegia for “mental illness”?

If not, think again.

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mental health

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Bipolar Basics for the Newly Diagnosed

If you have recently been diagnosed as bipolar, there are a few basics you should know. You’ll likely find them out on your own, but it might take a while.

So, here are some tips.

    1. Being bipolar isn’t necessarily a tragedy. It’s a chronic illness. At times it’s better, at others, worse. It’s not a death sentence and it’s treatable. You can still live a reasonably full and satisfying life.
    2. You need help. To live with bipolar disorder, you need a support system. Unfortunately, your friends and family may not be all that supportive. Fortunately, there are online support groups. But the most important parts of your support system, at least at first, are your psychiatrist and your psychotherapist. I recommend having one of each – psychiatrist for medication, therapist for talk or cognitive behavioral therapy, or whatever works for you.
    3. You will most likely need medication. And the odds are good that you will need it for the rest of your life. Don’t panic. After all, diabetics need insulin, usually for life. You may hate taking pills, you may hate the idea that you are dependent on them, you may hate the fact that they remind you of your brain’s difficulty functioning. But realize that meds will make your brain’s functioning less difficult. They are worth the hassle.
    4. Everyone is different. Everyone’s symptoms are slightly different. Everyone’s medications are slightly different. Everyone’s reactions to their medications are slightly different. A support group can help you with general information, but they cannot tell you what is ultimately best for you. Your particular symptoms and your unique version of bipolar disorder may well require different medications, in different amounts, than your friends. And you may have different reactions to them. Some pills have no effect at all on one person and are life-savers for another.
    5. Getting better takes time. Once you have your diagnosis and your medication, don’t expect to feel better quickly. Most medications for bipolar disorder take a while to build up in the body. Six weeks is not unheard of. Then your doctor may assess how well the medication is working, and change the dose or even the medication itself. Then you may go through another six weeks of waiting for the new dose or drug to take effect. Each case of bipolar disorder requires a medication regimen tailored specifically to the individual, and that often takes some doing.
    6. There are several different types of bipolar disorder. The two main types are called type 1 and type 2. Type 1 is the classical bipolar disorder, which used to be called manic-depressive illness. Type 2, a more recently identified version of the disorder, often manifests as mostly depression, possibly with hypomania, a less severe version of the ups that accompany bipolar 1. Other forms of bipolar disorder are rapid cycling, in which one’s mood states alter quickly, even within a few hours. Another version of bipolar disorder is called mixed states. Mixed states occur when a person experiences both extremes of emotion at the same time – for instance, depression and irritability, or fatigue despite racing thoughts.
    7. The odds are that you already know someone with bipolar disorder, or at least some kind of mood disorder. One in four Americans will have a psychiatric or emotional illness at some time during their lives. Because we don’t talk about it, though, no one may ever know. Especially when the disorder is treated properly, a person with bipolar illness can maintain function in society and choose whether or not to share the diagnosis with friends and coworkers. Many people choose not to because of the stigma surrounding mental illness. It’s a valid choice, but it cuts the bipolar person off from possible support and understanding from others who may share the disorder.
    8. Relationships can be difficult but not impossible. Relationships are difficult for everyone. People with bipolar disorder have relationships that are difficult too. The disorder may make the relationships even more difficult, especially when the family member or loved one or even close friend does not understand the symptoms, the medication, the mood swings, the anxiety or fatigue, or all the other facets of bipolar. The best cure for this is education. However, it may not be possible for a relationship to survive bipolar disorder, just as a relationship may not survive trauma, grief, addiction, infertility, incompatibility, meddling relatives, infidelity, parenting, or a host of other conditions. It may be better to look at all the circumstances surrounding a troubled relationship rather than automatically blaming bipolar disorder for difficulties.
    9. Learn all you can. Because bipolar disorder is so little understood by the public, because it manifests differently in nearly every case, because a person can be actively suffering or in remission, because a person may have any of the different types of bipolar disorder, because everyone is different – the need to educate yourself and probably those around you is essential. The more you know, the less you’ll panic when a symptom you haven’t experienced before suddenly hits. Rely on reputable sources. Medical, psychiatric, or psychological websites are usually the best. Support groups can offer much information, but the people in a support group may not be any more well-informed than you are. And there are lots of people selling “miracle cures” that can lure a person away from needed medication and other services.
    10. Keep trying. It’s hard. It’s frustrating. It’s difficult. It’s painful. It’s confusing. But bipolar disorder is something you can live with, and even something you can rise above. The secret is to keep trying. Keep seeking out therapy and friends who support you. Keep taking your medication, even if you don’t want to. (Stopping your medication without advice from your doctor can be dangerous, so don’t try that.) Be stubborn. When you feel like giving up, tell yourself that maybe things will get a little better in the morning. Hang in there. You may not realize it, but there are people who need you in the world, who need you to be functioning and happy, who need you to keep fighting the disorder.

Do you have any other tips for the newly diagnosed? Please share them in the Comments section.

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I Chose Fat Over Misery

I was a skinny kid who grew a lot less skinny.

Do my bipolar meds have something to do with that?

Probably.

Do I care?

No.

I’ve noticed a lot of people with bipolar disorder panicking over the topic of weight gain. “I know I need meds, but I’m afraid of weight gain.” “What meds can I take that don’t cause weight gain?” “I tried X med but I quit because of the weight gain.”

It’s true that mental health and physical health are linked – what affects one may affect the other. And it’s true that medications have side effects, among which may be weight gain.

What I don’t get is why some people are so afraid of weight gain that they would sacrifice their mental health to avoid it.

Actually, I do sort of get it. There are ads everywhere that promote thinness – even to the point of illness – as the ideal for both feminine and masculine. There is a “War on Obesity” and plenty of people who will tell you that your body mass index is the most important number that identifies you. There are fat people jokes and gags that could not be told about any other group, be it race, sex, ethnicity, or religion. Plenty of comedians have made a good living making fun of fat – even their own. On TV, the fat character is never the hero.

Now back to the skinny, scrawny, bony kid I was. Undiagnosed and untreated. Aware that there was something wrong with me, but no idea what.

I had mini-meltdowns and major meltdowns. I had anxious twitches. I burst into tears when certain songs came on the radio – and not necessarily sad ones. “Take Me Home, Country Roads” tore me up. “I Am a Rock” could leave me sobbing. I took walks in the rain till I was soaked to the skin. I would laugh out loud for no reason that anyone else could see.

I was a mess. But a thin one.

It’s relatively recently that doctors and scientists have explored the connection between psychotropic medications and weight gain. Some have speculated that people who are depressed don’t eat much. Then, when their meds kick in and they feel better, their appetites return. In my case, I ate more when depressed and less when anxious. By the end of my undergraduate years, I was drinking banana milkshakes so my parents wouldn’t worry about how thin I was when they saw me at graduation.

Slowly, I got better with therapy and meds. Slowly, I gained weight. At first I didn’t notice. Then I did. I tried prescription diet pills and Lean Cuisine, which worked – for a while. But eventually, as is true of most dieters, I started piling the pounds back on. If one of my psychotropics was to blame, I couldn’t pinpoint which one, what with going on and off so many different ones and the cocktail of several I ended up with.

But as I got better and gained weight, I also started making friends, going on dates, finding lovers, and eventually meeting the man I would marry. Some of them were overweight, too. But that wasn’t what mattered most to them – or to me. Oh, I suppose there were people who were turned off by my well-padded physique. Maybe some of them were marvelous people, and maybe I would have enjoyed their company if they could have seen past the weight.

But the fact is, I now have plenty of close friends who just don’t give a damn about weight. Sometimes one of us will need to lose weight for a specific health reason like diabetes, and the rest of us will offer encouragement. But for the most part, we are who we are and love each other that way.

Given the choice – and I do have the choice – I will take the psychotropics that keep me reasonably stable and happy and productive. And yes, overweight. I remember the misery, the despair and pain, and no matter how I look, I don’t ever want to go back there. Self-esteem, for me at least, is better if it comes from the inside out, not the other way around.

The bottom line?

I’ve been skinny. I’ve been fat. Either way, I’m still me.

 

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We Are Not Amused

In the last few days the bipolar blogosphere has been in an uproar about a post from OpinionatedMan. In it he said,“I get amused by people who claim to be bi polar.” [sic]
Naturally, some people were upset.

It is hurtful to think that someone is amused by our illness. We do not have it in order to be entertainment for others. We do not expect a mild chuckle or a small, wry grin when we reveal that we have a psychiatric illness. We do not find the symptoms, the therapy, the medication, the limitations – the bipolar life – amusing. Not to ourselves and certainly not for the amusement of others.

It is also offensive that he spoke of people who “claim” to have bipolar disorder. There is some debate about whether he meant “claim” in the sense of “say they have but not necessarily truthfully” or in the sense of “own the reality of and identify with,” and, to be fair, since the post was intended as poetry, it could be both.

Although “bipolar” is popular shorthand for someone who has ordinary mood swings, making free with the term “bipolar” is like comparing someone who’s in a bad mood with someone who is clinically depressed. We wouldn’t claim it (in either sense) if it weren’t so.

That’s enough to be upset about, but I think the rest of the post was troubling as well. OM portrayed himself as “multipolar,” implying that his multipolar life is a source of his depth of feeling and writing prowess.

The author thereby denigrates others who struggle with bipolar disorder yet try to create meaning. Many of us write, blog, draw, sculpt, or otherwise avail ourselves of creative outlets. For OM to think that his supposed extreme affliction makes him more creative, a better wordsmith, a creator of higher art than anyone with ordinary bipolar disorder is insulting.

Saying that his condition is multipolar as opposed to bipolar gets us into a game of “Whose life sucks the most?” (The loser is also the winner.) We are to think that no one has suffered as he does, and that no one is a comparable artist. It’s a version of the humble-brag – I’m worse off than you and I’m also better than you.

Of course the author has the right to believe as he does and to say what he does. I would not have him stop writing. But those of us who felt his words as wounds are entitled to speak up as well. Though he has a much larger platform than most of us, his words are not automatically more powerful than ours.

This is my opinion. Others differ. Here’s the link (http://aopinionatedman.com/2015/12/02/journal-entry-4/) so you can read and decide for yourself how you feel about it. He has apologized and claimed he meant no harm, and has been bashed and trolled, which is not my intention. Think of this as literary criticism from a former English teacher. As always, YMMV.

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My New Mental Health Tattoo

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

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

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

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

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

New mental health tattoo

New mental health tattoo

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

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

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

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

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

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

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

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

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

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The Bloggess and Mental Health

I met the Bloggess (aka Jenny Lawson) recently at a book signing for Furiously Happy, her second book. (Her first book was Let’s Pretend This Never Happened.)

Back row: Rory, the Furiously Happy Raccoon; middle row: me, Jenny Lawson; front row: Erma the Armadillo

Back row: Rory, the Furiously Happy Raccoon; middle row: me, Jenny Lawson; front row: Erma the Armadillo

The space at the bookstore was full to overflowing. (People had driven for as much as five hours to see her.) Jenny read two chapters of her new book to riotous laughter and applause. There was a brief Q&A session. (I figured she got the same questions all the time and wanted to ask her something that no one else had. I imagine that writers on tour need a little variety.So I asked: If you could be any animal, what would you be and why? Her answer: A tapeworm, because I could just not move and have people feed me.)

I joined the signing line (#17). She signed my copy of her book (“Our story is not over.”) and I showed her the semicolon tattoo that goes with that saying. She also signed my armadillo purse (Erma) and a piece of glass for my husband, who wants to put it over a picture of her or of a vagina; he hasn’t decided which. She laughed. He was one of the many that ask for perhaps her most famous – or at least most quoted – phrase, “Knock knock, motherfucker.” (It comes from her story about leaving a giant metal chicken on someone’s doorstep. There were also a lot of metal chickens she was asked to sign.) The bookstore personnel made sure that everyone knew it was okay to ask for that. In fact, they announced it just before the signings, reassuring the shy or inhibited.

The title of her new book, Furiously Happy, is Lawson’s way of telling depression to fuck off: If part of her life is misery and pain, she’s going to damn well make the most of the parts that aren’t. And while she’s at it, she’ll spread the word that mental illness is not a thing to be hidden or ashamed of.

This is not to say that her mental disorders are cured or that she no longer suffers from them. She was clearly anxious when reading aloud the two chapters, and visibly relieved when that part of the evening was done. Her strategy is to laugh at mental illness, joke about her meds, and speak bluntly to those in the audience who also suffer or have a person in their life who does.

Furious Happiness is a worthy goal, and her out-there enjoyment of life leads her into some of the hysterical situations she has written about in both books. These are the stories that make you say – only you, Jenny! Then she turns around and tells you that you are just like her in the ways that count.

The readers of her books and her blog – thebloggess.com – have formed an odd mutual support community. Although we may feel alone, Jenny rallies us to be alone together. Since one of the major difficulties with being a psychiatric patient is the feeling that no one else understands or experiences the same feelings, bringing people together in the virtual world or between the covers of a book is a valuable form of networking, especially for those who can’t network any other way.

Myself, I can’t manage the Furious Happiness. Too long dealing with the black dog and relatively little experience of even the mild highs of hypomania have left me depleted. Jenny will just have to do it for both of us. This is not to say I don’t love her or her work. I do, despite the blog post that I wrote, “Seven Reasons I Hate the Bloggess” (http://wp.me/p4e9wS-56). I can see myself in her and her in me, but for the moment I’m not able to follow her exuberant example. But she gives me hope. And I’m sure that’s one of her most important goals.

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The Wrong Life

Nothing prepared me for this.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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