Bipolar 2 From Inside and Out

Posts tagged ‘support systems’

The Comfort That Remains

Here I am, caught between reactive depression and clinical depression.

If you’ve been reading my last several posts, you know that I’ve been having a rough month. Several months. It’s been a real challenge to my hard-won quasi-stability.

3ff82b43-7ccd-4bde-8219-be5598c73452Last week, my 20+ year old cat, Louise died. The week before that, my husband’s 17+ year old cat died. So now I am trying to deal with those reactive feelings of grief and loss, without losing myself in the eternally waiting Pit of Despair that is clinical depression.

In doing that, I am trying to find things that remain to take comfort in.

I take comfort that my husband was here with me, to help me through.

That Louise had a good, long life spent in our loving care since she was a tiny kitten.

That she died peacefully, at home, in my lap, with me petting her.

That I had a chance to say goodbye to her.

That I know she loved me as much as I loved her.

That her presence and her purr helped calm me and helped me when nothing else could.

That she gave me a constant presence through a third of my life, and all of hers.

We have two cats now – Dushenka and Toby. They are young and healthy, but of course our time with them is not guaranteed. I know that, just by having them and loving them, we are inviting future grief into our lives, along with the joy. That’s just how it is.

I’ve been reflecting a lot lately on animals, humans, and what we share with each other. I know this is likely to happen again, and soon, for our dog is also aged and nearly ready to go. It’s hard. Is it harder when your brain doesn’t work right and tries to tell you that sorrow doesn’t end?

I don’t know.There’s no scale by which to compare pain, and loss, and despair, and grief. We each go through it the only way we can.

I hope that soon, at least a few of the clouds will part and I can feel something besides sorrow, express something other than pain. Maybe next week’s blog will be about healing, or coping, or sharing strengths.

Those are all things I need to be doing – that we all need to be doing.

Someone remarked this week that a recent post (http://wp.me/p4e9Hv-k8) was not about healing. It reflected, the commenter said, all the privileges I have – money (or those who can lend it to me), drugs I can take to help me through a crisis (too many, according to the commenter), a supportive husband. And that’s all true. I have these privileges and more besides – a home, work that I can do without leaving the house, insurance, a psychiatrist and a psychotherapist. Some of these come to me because of circumstances I don’t control, and some I have had to work very hard for, as I have worked hard for the ability to heal, a little bit at a time.

There are still things I cannot do – leave the house more than twice a month or so, shop for groceries, see the dentist without massive panic, stop taking the psychotropic meds that allow me to think, have a healthy sexual relationship. I expect that some of these will get better and others won’t.

But, no matter our symptoms or their severity, we as people with bipolar disorder are all in this together – or as the Bloggess would say, alone together. Maybe I have an easier time of it, but that’s far from saying it’s easy for me.

I still experience grief and sorrow, depression and anxiety, irrationality and immobilization, pain and despair, relief and help, struggle and hard work, love and loneliness.

And always, I look for the comfort that comes when I need it most, or expect it least, or believe I’ll never feel again. We all do.

Category:

Mental Health

Tagged with:

Managing My Anger

Many people need to control their anger by learning not to let it out. They can take anger management courses.

My anger problem is keeping it all in. I never know when it’s safe to let some of it out. And I don’t think they have courses for that.

Why do I need to let my anger out? Wouldn’t I be happier and life be easier if I were pleasant and agreeable all the time?

No. There are reasons I need my anger, and need to express it.A LOADING Illustration with Black Background - Anger

I need to vent. I was at the office once and a coworker had done some crazy thing or other. I went to my boss and spouted off. Wisely, he just tsk-tsked about it and didn’t try to fix anything. He knew that it was just a frustrating situation and I needed to express my feelings.

Stuffing your feelings is unhealthy. It’s especially bad if you push the feelings of anger down and then try to smother them with food or alcohol. A character on Dharma and Greg once said, “If you’re going to bottle up your feelings, you might as well pickle them first.” Taking advice from sitcoms is usually not the best idea.

Swallowed feelings don’t go away. They stay inside you and fester. Sooner or later you may explode and cause real damage – the kind you can’t fix. Better to let off a little anger at times than to save it all for later.

Sometimes, anger is justified. Anger at injustice or when you’ve been wronged is appropriate. If you don’t express it, the injustice or wrongful behavior will simply continue.

Having bipolar disorder makes dealing with my feelings of anger even trickier. I’ve spent too many years not recognizing that I even have anger and that it’s sometimes an appropriate feeling. That leads to being a doormat, which I also have years of experience with.

Dealing with my bipolar issues has meant dealing with anger as well. Here are a few things I’ve learned.

There are people I can vent to. One of them is my therapist; some of my male and female friends provide good outlets too. These are not people I am angry at, at least not at the time I vent. As with my former boss, I just need someone to hear and acknowledge my feelings of anger. I have separate categories – a friend to discuss my husband with, another one for work issues, and so forth – so no one has to listen to too much of my anger spillover.

I need to pick my battles. Living with anyone causes friction, which can lead to anger. Just this week I was mad at my husband. I wanted to shout at him, “If you had done your errands yesterday instead of watching movies, you wouldn’t be jammed up today and laying them off on me!” But really, how would that have helped? Could he go back to yesterday and do the errands himself? Would it have helped to refuse to do the errands and then sulked all day? Was there any real reason I couldn’t help out? Best to let this one go.

I have to measure my words. Perhaps I do this too much, but some amount is necessary. What was helpful this week was to say to my husband (after I had run the errands), “I need to tell you that I’m frustrated that you left all these errands until today and I had to take over some of them. There were other things I needed to be doing today.” (My things could be postponed; his couldn’t.) By that time I had cooled off enough that “frustrated” was more accurate than “angry,” and less likely to trigger a major shouting match. (Also notice the “I” statements that psychologists recommend.)

If I am angry and I do express it, it’s survivable. My husband and I have gotten through some very bad spells when both of us have been extremely angry. Some of them have required couples therapy, while others have been solved through time and negotiation. Other parts of my life have not turned out as well. I had to cut ties with a toxic relative for whom I had an unhealthy level of anger, with no hope of either of us changing.But I survived – and was the better for it, mentally and emotionally. Sometimes that’s necessary, for either your own or the other person’s mental health and safety.

It helps to have a good emotional vocabulary. Seriously. I don’t have to jump straight to anger when something upsets me. Maybe I really am just frustrated. Or disturbed. Or annoyed. Inconvenienced. Irritated. Miffed. Insulted. Disappointed. Cranky. Those feelings are easy to mistake for anger. It may be better for me to step back and ask, “Do I really feel angry?”

It helps to have a repertoire of behaviors. Not all anger has to be dealt with the same way. I could lash out and say something hurtful. But I could also walk away until I calm down, or have a good cry. I could say, “I’m too angry to discuss this now.” I could release my anger in a physical activity (actually, my husband is much more likely to do this). I could write a “never-send” letter (or a “to-be-sent” one).

But the first step to all of these is recognizing that I do indeed feel anger, and have a right to own my anger and express it. Anger may be harmful, but denying it is harmful too.

Category:

Mental Health

Tagged with:

Forced to Face My Fear

A little while ago, I posted about my severe dental phobia (http://wp.me/p4e9Hv-cG). So of course fate pushed me to the wall and left me no choice but to confront it.

tooth fairy illustrationHere’s the backstory. My teeth are awful, and my dental phobia has a lot to do with it. Realizing this, we borrowed some money and put it aside for my dental work. The reason that we had to borrow that much money was not just because we’re broke (we are) or that our dental insurance is so crappy as to be nonexistent (it is), but the fact that the last time I got any dental work done (years ago), I was so terrified that I had to have a traveling anesthesiologist brought in to put me completely under. And that approximately doubles the cost of already-pricey, though necessary, procedures.

Then another disaster ate the money we had put aside. There was no choice in the matter. The dental money had to be sacrificed.

Then fate stepped in. Last Saturday I got a toothache. Of epic proportions. Not realizing that the dentist had a 24/7 emergency number, I toughed it out till Monday, when my face was hideously swollen and the combined powers of Anbesol and Tylenol were insufficient to let me sleep. I got in to see the dentist on Tuesday.

That one tooth was definitely going to have to come out and the abscess drained (did I mention there was an abscess?). And there were a few other highly recommended procedures that needed doing as well. None of which the crappy insurance would pay for.

But that wasn’t the real problem, or at least not the only problem. The traveling anesthesiologist was out. The dental slush fund no longer existed. Normally (that is, for normal patients) the dentist offers “oral sedation,” which turns out to be triazolam (Halcion). But since I already take lorazepam (Ativan), that wasn’t considered safe.Apparently the two don’t work and play nicely together.

“You’re going to do this without anesthesia AND without oral sedation?” the dentist said.

“I have no choice,” I replied. He had given me Vicodin for the pain (as well as an antibiotic for the abscess), but I couldn’t really take that long-term. And so I was cornered. I had to have the procedure, no matter what. (My husband offered to get a rubber mallet and knock me out, or knock the tooth out, or something. I politely declined.)

The plan we worked out was this: On Thursday, when they were to do the procedure, I would take two Vicodin and increase my lorazepam from .5 mg to 1.0 mg. (with my pcp’s permission). Then I would have nitrous oxide, which had never worked for me before, but hey, worth another try, right?

And I would have my husband there in the procedure room, as my comfort animal. He had to stay out of the way, but was able to reach over and pat me on the ankle. Which was comforting, actually.

Double Vicodin (I was permitted two but had been taking only one) and double Ativan (plus one prophylactic Immodium) left me suitably stoned. I was totally confused when the hygienist asked me, “Bubble gum or orange creamsicle?” I was stoned, but that made no sense. Turns out nowadays they have scented nose cones for the nitrous. (I chose mint.) I could barely feel the numbing shots, and the extraction went smoothly. I didn’t hear/feel the terrifying, sickening crunch that went from my jaw directly through my brain when I had my wisdom teeth out. My husband said I didn’t even flinch. He patted my ankle anyway.

Then we paid about the same as we recently had for two vet visits for our ancient cat, but nowhere near what we had borrowed, put aside, then spent.

I didn’t even disgrace myself, though I had spare underwear in my purse, just in case.

All in all, it went way better than I expected. Have I conquered my fear? I don’t honestly know, and probably won’t until the next time. (And there will be a next time.)

But at least I’ve proved that I can do it. I can have a dental procedure done without anesthesia and without oral sedation, if it’s really, really necessary. Pain is surely a great motivator. I am no longer a huge wuss, I guess – just a regular wuss. I do hope, however, that when the clot heals and the infection clears up, and the swelling has gone away, that I do not have to go through this again for a very, very long time.

(At least this time I did better than when I faced my apiphobia (http://wp.me/p4e9wS-7H).)

 

Category:

Mental Health

Tagged with:

How a Cat Helped Me Stay Sane

Queen LouiseAny pet can help with mental health, really. But in my case, it was a cat.

I was living alone after a bad breakup that had shattered me, mind and spirit. After moving twice, once from another state and once from an apartment complex after I lost the job that paid for it.

I was damaged, and I was alone, in the upstairs of a small house in a small town. I asked my landlady if I could have a cat. She was dubious, but said yes.

I found a cat at a shelter. She was an adult tortoiseshell calico named Bijou. She was small and shy and quiet. The first night I took her home, she slept across my throat.

We needed each other. I needed someone to care about, to focus my attention outward on. She needed someone  to draw her out of her shell, to care for and about her.

We took it slowly. At first she didn’t like to be held. When I got home from work she would meet me at the door. I would pick her up, give her a quick kiss on the head, and set her right back down. Soon she learned that being held wasn’t such a bad thing.

Since then I have never been without a cat.

And they have improved my mental health. Pets do.

Pets entertain when we need distraction.  They can make us smile and even laugh.

Petting them brings tactile comfort and purring offers a soothing sound.

Caring for a pet makes us feel – be – needed. Even when we have a hard time caring for ourselves, a pet becomes a responsibility bigger than we are.

Losing a pet teaches us about the process of necessary grieving. Then getting another pet teaches us about the process of loving someone new, opening our hearts again.

Pets listen. They don’t judge.

Pets communicate with us, and teach us their personal language.

Pets are now being used as therapy animals and comfort animals for the anxious, the aged, prisoners – and psychiatric patients. The laws and policies regarding “assistance animals” are only just beginning to be enacted. They are far from catching up with the need.

Even visits with farm animals – lambs and chickens and ponies – are fulfilling vital roles in people’s lives.

I’ve written about “crazy cat ladies” before and even identified myself as one (http://wp.me/p4e9Hv-bI). There is a stigma that goes along with the label – yet another kind of stigma that we would be better off without. Admittedly, we can become obsessed with our companion animals, even to an extent that is unhealthy. They can be burdens, and annoyances, and expenses.

There are some people – perhaps people with rage issues, for example – who should not own pets. Having pets is a choice that should only be made if they and you fit together well. We’ve all read the stories and seen the pictures online of people who abuse pets horribly. Now those are the ones that I consider crazy.

Pets may not me be the right choice for other reasons. A person who travels a lot, or has extended hospital stays, may not be able to make the commitment. Germophobes and emetophobes may not be able to handle the inevitable messes that come with pets. Even pet fish need their bowls cleaned.

Personally, I would avoid fish, unless the care of, say, tropical fish fascinates you. And their placid swimming can be calming. But for most of us, a pet that interacts with us is preferable. Birds aren’t very cuddly, but they make agreeable (to some) sounds. Reptiles have their own fascination and aficionados. Me, I want something I can pet.

The picture that accompanies this post is of Louise (aka The Queen of Everything). She is 20 years old and, although she is hanging in there, I will be devastated when she goes. My husband’s 17-year-old cat, Garcia, has some health problems, though again, not terrible ones considering his age. Then there are our youngsters, Dushenka and Toby.

I don’t think it’s too much of a stretch to say that they are as much a part of my support system as I am theirs.

 

 

 

Category:

Mental Health

Tagged with:

How I Learned a Few Social Skills

I thought my social skills were bad until I encountered a woman who asked me, “Do you have mental problems?” (She recognized me from our mutual psychiatrist’s waiting room, but still….)

expression

With practice, however, I have been able to improve my casual conversation skills, at least enough to get by in some situations, as long as they don’t last more than an hour. Here are my secrets. They do take practice. I have been fortunate to have had people to practice with – friends, coworkers, and of course my husband.

Introductions. Actually, I taught this one to my husband. Often when we met someone that he knew, he would fail to introduce me, leaving me standing there like the proverbial bump on a log. He claimed that the problem was that usually he couldn’t remember the person’s name. “Just point to me and say, ‘This is my wife, Janet.'” Then I will stick out my hand to shake and say, “And you are?” That way we both learn the person’s name. It works like a charm, every time.

Very Brief Conversations. Conversation with strangers – just a sentence or two – is also relatively easy to learn. The trick is the innocuous comment and there are two ways to go about it. The first is to make the comment yourself – “Those are great shoes! They make your feet look really small.” “What a lovely handbag. My mother had one that was similar.” Make an observation and then a related remark, usually complimentary. They don’t even have to be true technically. If you can’t think of anything else to say, a comment on the color of an outfit is usually good. There’s hardly any way someone can take offense at “That’s a great shade of blue on you.”

The other side of the equation is to get someone else to make a comment to you. This requires a prop most of the time. I used to carry a purse shaped like an armadillo, and that proved a great conversation starter. I memorized several responses that I could use when the other person said, “Oh, what an unusual purse!” I could say, “My mother gave it to me for Christmas one year” or “A friend found it in some catalog.” The purse went over  big, especially if there were children present.

Longer Conversations. These require more practice. Luckily at one of the jobs I had, there were a couple of people that I could invite out to lunch and practice conversation with. (I suspect that they knew what I was doing, but they never mentioned it. In effect, they played along.) Mary, for example, had two adopted children, and questions about them we’re always good for a few minutes of interesting listening. They also had a cat and a snake. Pets and children make good topics.

Sometimes it’s best to steer clear of work-related subjects, but if the person is really understanding, you may be able to vent. You should also be able to listen to the other person too. The secret to that is not to try to fix the problem. Simply listen and validate the person’s feelings. “That sounds awful! Does she do that all the time?”

Formal Settings. Mary also provided me with the opportunity to learn about a sometimes-necessary but difficult situation – funerals. Mary and a few other people invited me to go with them to the viewing of a person that I knew only slightly in a work context, so the stakes were low. From watching Mary and her friends, I learned that the proper procedure is to stand briefly at the coffin looking solemn, then go to the bereaved, shake hands or hug (depending on whether they proffer a hand or two arms), and say, “I’m sorry for your loss” or “My deepest sympathy” and at least one remark about the departed. It can be as simple as “He was a pleasure to work with” or “Everyone at work is going to miss her.”

Not Melting Down. Another important social skill is not having a major meltdown in front of other people. When I first visited my husband’s family, I became very uncomfortable quite often because everyone seemed to be yelling at each other. Loud, angry voices tend to upset me, especially if they continue for any length of time. The technique I developed was to go into the other room and make a cup of tea. Making tea is socially acceptable. (If you’re in the kitchen, go to the bathroom or step outside for fresh air.)

Much later I learned that my husband didn’t realize that his family reacted to even minor questions with argumentative responses in loud voices. To him, and to them, this was simply the normal style of conversation. It wasn’t what was normal in my family, and it triggered my aversion to confrontation. I guess whatever you grow with grow up with seems normal to you.

One other piece of advice: Don’t attempt flirting unless you have a coach. It’s really tricky and possibly dangerous. Not for the novice (especially not the kind of novice who wears a habit).

 

Category:

Mental Health, Uncategorized

Tagged with:

The Week of Living Alone

Sometimes, when I get tired of my complicated life, I imagine what it would be like to start over someplace new, or what it might have been like if I had made different choices. I envision myself, living alone (well, with one cat), in a small town like Benson, AZ. I would have a small used book store or secondhand shop and live in a small apartment over it or behind it. I would have a couple of friends I met in my shop and go out to lunch or dinner once in a while, but mostly spend my free time listening to music, watching TV, or on the Internet.

Sounds simple and peaceful, doesn’t it?

Portrait of a young woman drowning, shark fin on the backgroundThis past week has convinced me that even such a stripped-down existence would not be possible for me. My husband was out of town for nine days, and I could barely manage.

Those of you who follow this blog know that my husband is my rock and my support. I often say I could not get through without him, and my recent experiences only reinforce that.

I didn’t begrudge his leaving, though I wish he had not been gone quite that long. His mother needed him to help her get ready to sell her house and move, and nine days was barely enough time to start on all that needed to be done. There are times she needs him as much as I do.

But coping on my own was difficult. I have paid work I have to do. It matches perfectly with my skill-set and I’m grateful to have it, but sometimes it’s just plain hard to do and hard to make myself do. And I have two blogs (the other is at janetcobur.wordpress.com) that I have made a commitment to posting in once a week, each. Plus, I have started writing a novel.

We have four cats, two of them ancient, and one dog, also ancient. I was afraid that one of them might die while my husband was away. (None did.)

As scary as the idea of coping with a dying or dead animal on my own was, just caring for them was difficult. They keep demanding food several times a day, you see, and they have no thumbs to open cans with. Then there’s the water bowls and the litter boxes. I used to live alone with one cat and manage okay, but that was many years and many meltdowns ago.

Then there was feeding me. Dan had stocked up on things I like before he left, but after the French bread pizzas were gone, I lived largely on salami sandwiches, cheese and crackers, and cereal. (I did eat vegetables. I had a small tray of sliced veggies and dip.) Once I made a couple of baked (frozen) fish sandwiches early in the week, but later I had devolved to the extent that my evening meal was peanut butter on a bagel. Another night I had mashed potatoes and a glass of red wine. Other meals I simply skipped.

Then there was Dealing With Stuff. Life Stuff. You know. The Stuff that happens to everyone sometimes piled up on me. I had to talk to (argue with) the utility company and the IRS. I had to pay bills. Life stuff leaves me exhausted.

Plus, I kept having to Go Out. Deposit my check. See the doctor. Pick up prescriptions. Buy cat food when I ran out. I wore pants more days last week than I had in the previous month. (Dan wanted me to water his butterfly garden daily, but it rained every day or night, so I didn’t have to put on pants and go out for that.) I treated myself to lunch twice when I had to go out to do those errands, but it was nearly impossible to decide where to eat.

Now Dan is back. I had to put on pants again so we could return his rental car.

But you see what I’m getting at here.

My fantasy of retreating to a simpler life is not feasible. It simply wouldn’t work. The everyday tasks and trials of managing a shop, caring for myself and a pet, negotiating all the stuff of life would overwhelm me. Oh, when I’m hypomanic and can sometimes focus, I might do all right for a while, but life – even a very basic one – would eventually overwhelm me. There are so many things I can no longer do, at least not without serious amounts of help and support.

I can muddle through for a while mostly on my own. I am getting better. But not better enough to live independently, at least not right now.

 

Category:

Mental Health

Tagged with:

Support and Non-Support Groups

My family has never been big on support groups. When my father had multiple myeloma (which killed him after 15 years), he turned down any opportunities he was given to join cancer support groups with names like Make Today Count. He preferred to go it alone. He was stubborn.

So am I.

I have actually been to support groups for mental illness once or twice, but they were never a success or, I guess, just never right for me.

The first one was when I was in college. That one was a bust because I wasn’t really ready to address my problems and because I had the ability to appear “normal” for an hour at a time while sitting cross-legged on the floor. I couldn’t do that now. (The floor-sitting part.)

The second time was after I saw a brochure for a group called High Flyers and Low Landers, which met in the church I was going to at the time. (I don’t think the organization still exists. The church is still there.)

It was a very odd experience. Everyone had a book, many with needlepoint covers. It was their bible, though not the Bible, which I know many people needlepoint covers for, or at least did back then.

The meetings consisted of a little ritual. One person read a passage from the book. Then each person in the circle had to tell an event that happened to them in the past week. The recital had to be in a specific format: what happened, what symptoms the person experienced (dry mouth, racing thoughts – there was a list), how the person would have handled it before reading the book, and how the person did handle it. There was much quoting of the book and certain specific phrases that everyone had to use.

Some of the quotations were helpful, or at least true. (People do things that annoy us, not to annoy us.) But as I recall, those were the only sorts of comments the people in the circle were allowed to make. Not “How did that work out?” or “What did your mother do next?” or “I hate when people get passive-aggressive.”

It was just too weird and formulaic for me, so I never went back. (As I was leaving, I offered someone a mint. Everyone laughed and said, “Dry mouth!”)

Since I don’t seem to do so well in actual support groups, I recently thought I would check out some virtual ones. I’m not going to name the groups I joined or where I found them, because all of them stressed privacy and confidentiality.

What I found was both support and non-support.

Some of the groups were associated with national organizations or publications, and they pretty much stuck to sharing articles about scientific research or political news about mental illness, along with lists of resources, hotlines, and the like.

So far, so good.

Other groups were more like traditional support groups, with members asking questions or relating accounts of what had happened or how they felt. There were administrators who tried to keep the members to more or less stick to the topic and rules of the group (give trigger warnings, no suicide threats, or whatever).

Some of the groups were peaceful. People asked standard questions (Who’s on this med? Should I take something else too?) and received fairly standard answers (Worked for me. Didn’t work for me. Ask your doctor.) People related similar events and how they handled them, or asked for more specifics so they could understand the situation better. People posted assorted uplifting memes and affirmations.

Then there was the other sort. People did not know how to use trigger warnings or simply didn’t bother. Others shared people’s posts without removing identifying information. Some posted truly vulgar jokes that had nothing whatsoever to do with bipolar disorder. Negativity overflowed. Arguments raged. (Some of the topics were “Bipolar is not an excuse for bad behavior” and “Don’t buy into the drug companies’ propaganda by taking meds.”) There was the online equivalent of name-calling and shouting. People reported other people to the admins. People accused people of reporting people to the admins.

The administrators did try to keep a handle on these groups, but couldn’t always, most likely because they were busy with their own lives and issues and difficulties.

It got so bad that I took to lurking instead of participating. Every week or so I would go back to take a peek and check on the drama llamas. Mostly they were still running around spitting. I think I had helpful things to add to the discussions and times when I needed help with feelings, but I just couldn’t trust enough to jump back in. I know other people left these groups for similar reasons, and some were blocked or banned or given warnings about their behavior.

In general, I have this to say about online support groups. You’d do well to sit back and watch their interactions before you try participating on anything but a “Congratulations! You got a job!” level. If the group seems truly helpful – supportive – then dive in. You may be able to give and receive help.

But non-support is exhausting. And I’m too stubborn to put up with it.

Category:

Mental Health

Tagged with:

I May Have Miscounted My Spoons

This week I actually got out of the house, going for lunch and a little shopping with an old friend. (Another friend of mine calls these “pants days” because they obviously require putting on pants, for going out farther than the mailbox.)

After less than three hours I went home, did some work, and promptly collapsed. All told, I think I was either active, sociable, or some combination thereof for at most five hours – most likely more like four. That for me is an exceptional day of fortitude, stamina, spoons, and hypomania.

However, I have gotten myself into a situation that will require much more than that. I am going to a writer’s conference – three days of thrill-packed seminars, lunches and dinners, and other business and social-type events. I’ve done half-day business meetings lately, but nothing so extended, crowded, or spoon-depleting. It will hit a lot of my anxiety triggers – crowds, noise, small talk, social events, and more. I know that by the time we gather for dinner in the evening, I’ll already be extra crispy.

The three days of the conference will not allow for much of any downtime – although I have fantasized about asking someone who’s staying in the hotel if I can borrow a room for an afternoon nap. (The conference is local so I don’t have a room of my own or it wouldn’t be a problem. Less of one, anyway. All I’d have to do would be pick which seminars to skip. But the idea of asking a relative stranger for the use of a room or the idea of a relative stranger letting me use a room is pretty ludicrous.) Fortunately, I have to get the car home by 10:00 so my husband can go to work. That means I can’t stay for the after-hours socializing, even though that’s said to be one of the highlights. But it does mean I get a few more hours in pjs instead of pants.

Back before I had my most recent major meltdown, I was able to attend business conventions and do at least most of the requisite functions. I could and did give little talks at power breakfasts or afternoon cocktail parties – even opened with a joke. I could meet and greet the public at our booth – “howdy and shake,” as my father would have called it. I could have lunch with potential writers. I could almost interact with our sales force.

Those days are long past. So now I ask myself, how can I build up my stamina for the writers conference? Maybe it’s time for me to try to reclaim some of those parts of myself.

It feels like I’m going to be training for a marathon – or maybe the Normandy invasion. I know that in order to get through it, I will have to prepare in advance: writing my Sunday blog posts before the conference starts, assembling my wardrobe, checking out the parking situation, stocking up on business cards, and all the other little details that make me so frantic at the last minute.

Perhaps during the next two months I can keep track of how many pants days I’m able to have and gradually increase them. Perhaps I can arrange more lunches and shoppings. Perhaps I can improve my usual record of doing only one major thing per day. Perhaps I can try to work up to three pants days in a row.

The conference itself is certainly a massive and major incentive. Plus I’ve already paid for it – yet another reason to get myself in shape to take advantage of it.

Right now the conference looks like rather an ordeal, but I hope that by the time it rolls around I’ll be in good enough shape to both enjoy it and benefit from it. At least it’ll be a group of writers, and humor writers at that. They’re known for being at least a little odd. Maybe I’ll fit right in. I’ll be the one napping on a couch in the hotel lobby in fuzzy slippers. And pants.

Category:

Mental Health

Tagged with:

Trigger Warning: Trigger Warnings

What is a trigger warning?

Let’s start with a more basic question. What is a trigger?

Just as a literal trigger activates a gun, a figurative trigger activates your mental disorder. It’s a stimulus that sets off either a manic or depressive phase, or a bout of PTSD.

Triggers are usually unique to the individual. What sets you off may not affect me at all.

Over the years I’ve learned what my triggers are, and so do most bipolar or PTSD sufferers. Loud noises and large crowds trigger my anxiety, which is why I could never work at a Chuck E. Cheese. My depressive phases don’t often have triggers except for bad dreams about an ex-boyfriend. Most of my depressive episodes just happen without a trigger.

Generally, one avoids triggers, because who needs more manic or depressive phases in addition to those that occur naturally, with no prompting?

A trigger warning is something else. It is a notice that someone puts at the beginning of a piece of writing to warn readers that the subject matter may be intense. Ordinarily, trigger warnings are given for major life events that have caused trauma and may cause flashbacks, severe stress  or other extreme reactions.

Some of the most common trigger warnings are for graphic depictions of rape, suicide, self harm, or physical or sexual abuse. The trigger warning says to a potential reader: If you don’t want to encounter this material, if you think it will make your illness worse, or cause you undue stress, don’t read any further.

Although we call relatively minor stimuli triggers, they usually do not require trigger warnings. If you’re going to write about having a fight with your mother, you probably don’t need to put a trigger warning on it. If your mother hit you in the face with a frying pan and sent you to the ER, you might need to place a trigger warning on your post about it.

Online, the standard form for trigger warnings is first to state, often in all caps, TRIGGER WARNING and state the type of trigger it is – TRIGGER WARNING: SELF-HARM, TRIGGER WARNING: SUICIDAL THOUGHTS, etc. To be extra sensitive, the writer leaves a number of blank spaces or a few dots before beginning to write the difficult material. This gives the reader the choice of whether to scroll down and read it or not.

Trigger warnings have become controversial, particularly in schools and colleges. Many pieces of literature and even textbooks on history or sociology discuss difficult topics that may be triggering. For example, a novel might feature a rape as a plot point, or a history text might discuss slavery.

Some people believe that a trigger warning will help a prospective reader know whether reading further will provoke a strong reaction. Other people believe that trigger warnings are a way of coddling the weak and letting students avoid challenging material that is necessary for the class.

My own opinion is that a trigger warning is like chicken soup: It won’t hurt and might help. It may mean that a student asks for an alternative reading or assignment, but it also may mean that the student simply wants to be in a safe space – not surrounded by strangers, for example – before reading the material.

People that believe trigger warnings should not be given have usually not experienced the kind of emotional breakdown that can result from unexpectedly confronting a traumatic topic. Very likely they have never even been in the presence of someone who has had such an extreme reaction.

I suppose that ideally, we could all read any material and simply brush it off if we found it troubling. Unfortunately, for those of us with mental disorders such as bipolar illness, PTSD, and anxiety disorders, this is simply not possible. A trigger warning may prevent someone from having a public meltdown and others from having to witness one.

I don’t know why that should be controversial. It seems like simple courtesy to me.

Category:

Mental Health

Tagged with:

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.

Category:

Mental Health

Tagged with: