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Tag Archives: bipolar disorder

Just An Ordinary Day

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Sometimes I think God tries to help me wake up with text messages. And by having to pee every hour after 6 a.m.

Even though I keep my phone on vibrate at night, I still wake up when I get a text. Am I that light of a sleeper that I can hear the buzz? Am I so happy to get a message that I can sense it in my sleep?

Whatever the reason, for me, the typical pattern in the morning is to wake up, check my phone, go to the bathroom, and go back to sleep. Repeat every hour until I finally get out of bed. Which is usually several hours later.

Even in this state between sleep and wakefulness, my inner critic is hard at work. Right before I look at my phone, it says no one gives a crap about you. Which kind of hurts my feelings. I guess it’s trying to be helpful by mentally preparing me for the disappointment of not seeing a message. As I have mentioned in several blog posts, not having anyone to check in with in the morning is one of the hardest parts of being single.

Yesterday, however, I woke up to several texts. (Take that, inner critic!) One of them was from a friend who asked me if I had gotten the paper. For people who keep up with the news on a daily basis, their first association would probably be to the newspaper. But since I am not one of those people, I had no idea what she was talking about.

Like my inner critic, my anxiety was also wide awake and coming up with catastrophic situations that this mysterious paper might be referring to. Did I mess something up? Was there a 9/11 type attack going on? Was there some kind of tennis emergency?

Luckily, she was referring to an editorial about a former NFL player who struggled with bipolar disorder but did not know it until much later in life. Whew! I mean, I felt bad that the guy had to suffer, and I was glad that he was making the public aware of the importance of funding for mental health issues, but I was also glad that the world wasn’t coming to an end.

Even in this half-asleep/half-awake state, it made me think about how much we take for granted that ordinariness can be a good thing. When something bad happens, we are acutely aware of how in a moment’s notice, our lives can be turned upside down. An illness. An accident. An affair.

I’m not trying to be morbid or anything. In fact, I was genuinely happy that, in that moment, my life was exactly the same as it had been when I had gone to bed. Ordinarily I would have felt bad about waking up at noon, but in the grand scheme of things, it’s really not that big of a deal. It was par for the course. Just an ordinary day.

Thank God for ordinary days.

On Death and Dying

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I’m going to warn you up front that this post is morbid and depressing. I’m reluctant to write it, but this is what’s been on my mind, and I’m committed to writing what’s true. So here goes.

My friend’s father died last week, and I have been obsessing about death and illness since then. I am terrified of getting older and of dying. And I’m terrified of watching someone I love die.

If I could have, I would have asked my friend if his father was in pain. If he gave any indication that he was ready to let go. His doctor thought he would only live 9 more months, and it occurred to me the night before he died that perhaps he didn’t want to live that long. I imagined being in his father’s place, lying in bed, in pain, not being able to do anything. Not feeling like myself. Perhaps 9 months felt like too much.

When my dad was depressed, he looked like the walking dead. A shell of his former, manic self. It was painful to see him in that state for four years. But he got better, and every day I say a prayer of thanks for this. He is in full form now, reckless in his pursuit of happiness.

It’s disconcerting, all the crazy stuff he’s doing. But if he has to go, I guess he wants to do it on his terms, being fully alive when it happens. And to be honest, that’s how I want him to go, too. I don’t want to have to go through that again–watching him become less and less like himself until he is gone.

I also had the morbid realization that if I were diagnosed with a terminal illness, I would not have anyone to take care of me. No one to take me to my appointments, to make sure I got my meds, to bear witness to my suffering. I guess that’s why people get married. In sickness and in health, ’til death do us part.

Perhaps it doesn’t matter, because I don’t have any one who I need to live for, anyway. No children or spouse who relies on me. And I wouldn’t want to ask anyone in my family to put their life on hold to take care of me. I can barely ask for help as it is.

Maybe I wouldn’t even tell anyone. Maybe I’d just keep going to work and playing tennis and blogging until I couldn’t do it anymore. I don’t want to be known as the person who is dying during what little time I would have left to live.

That might be a problem with my commitment to honesty and vulnerability in my blog, though.

This is the most depressing line of thinking I’ve had about being single.

When clients are obsessing about things to come, I tell them that they don’t know what the will future bring. That when they get there, they can worry about it then. So I guess for now, I’ll take my own advice.

I Prefer Moths to Zombies

I was having dinner with a friend last night, catching up on how the holidays went. I told her that this Christmas was not as stressful as it usually is. But as I related the details, I broke down crying. Because even when things are going pretty well, there are still always crises when you have this much mental illness in your family.

In a previous post I talked about the stress of dealing with a family member who is currently manic. But in all honesty, I prefer the mania to the depression. I’m sure I would feel differently if I had to live with someone who is manic, but luckily I don’t. And regardless of what pole they are in, I still have to keep a safe distance, lest I trigger my own depression and anxiety. Still, when I’m with my brothers or my dad when they are at one of the extremes, I prefer the over-the-top version of their best self than a shell of the person they normally are.

I understand why people with bipolar disorder don’t want to take their meds. I didn’t want to take my meds, even though they made me feel much better. People use drugs to create the feeling of mania. So it’s understandable why someone would not want to take a drug that keeps them from experiencing the highs.

I’ve had hypomanic episodes, and they were great. I had energy, despite my lack of sleep. I was productive and creative. And I didn’t do any of the destructive things that my family members do when they’re manic, like spend all their life’s savings. Or quit their job, move to another city, and become a dance instructor. Or get kicked out of a bar for starting a fight with someone because they’re certain that guy was making fun of him.

The most extreme thing I can recall is that I made mixed tapes for each of my brothers, and they all had different songs on them. That’s like, over 100 songs. For those of you who are too young to have made a mixed tape, it is way more time-consuming than burning a CD from iTunes.

Plus, there was no crashing and burning after my hypomanic episodes. If anything, the hypomania was a reprieve from the depression. Still, I have no problem giving them up in order to have stability in exchange.

I do have one brother who consistently takes his meds and has been stable for years now. He could be the poster child for bipolar disorder, illustrating how it’s possible to live a normal life if you’re compliant with treatment. The other two, however, live most of their lives at one extreme or the other.

I was looking for a picture of my niece the other day and ran across a picture of my dad while he was depressed. I had to turn away. Any of the pictures taken from that 4 year period make me want to cry, because he looked like someone who was barely alive. Ordinarily he is larger than life. Unforgettable. But when he’s manic, he is a moth to a flame and believes he’s fireproof. But when he’s depressed, he is a zombie, sleepwalking through life.

If stability is not an option, I prefer the moth.

Crisis

Why I Blog About Mental Illness

Yesterday someone asked me to write a 1,000 word essay on my personal experience with mental illness. After I wrote it, I realized that I have never told my story to anyone. I have now added it to the menu on my blog, but I thought I’d include it in a post, too. Here it is:

I come from a family with a history of depression and anxiety. My dad and two of my brothers have bipolar disorder. My mom has an undiagnosed anxiety disorder. And I struggle with both mood and anxiety disorders. Because of this familiarity with mental illness, I played the helping role in my family for many years before I chose my profession. So becoming a clinical psychologist almost felt like a calling rather than a choice.

I first became depressed in high school. It’s hard to separate the angst of adolescence from clinical depression, but I had thoughts of suicide by the age of 15, so I’ll say that it started then. At that time, my diagnosis would have been dysthymic disorder—a more chronic, lower grade version of depression.

When I left for college at 18, I crossed over to major depression. However, I didn’t do anything about it for a year. At 19, I had my first therapy session with a psychiatrist who confirmed my diagnosis of depression. At the time, that was enough to make me feel better—to have someone tell me that what I was going through was real.

So I didn’t follow up with therapy until after I graduated from college, when I was 22. I can’t say I thought that therapist was particularly helpful. He never told me his opinion on anything, never gave me homework, never offered me another way to look at things.

The 3rd time I went to therapy was with my boyfriend right before we got engaged. I was 25 at the time. It was clear that she thought that our relationship problems were because of my depression and suggested that I go on meds, which really pissed me off. We didn’t see her for very long.

Still, she planted the seed of meds in my mind, and I started a trial of antidepressants about 6 years after she suggested it. And it did help. But after a year and half, I stopped taking them because I didn’t want to have to rely on meds to feel “normal.” Then I started them again a few years later when my husband and I started talking about separation.

I also went back to therapy. And she is the therapist who I have seen on and off for 13 years now. Her unconditional acceptance and belief in me, over time, has allowed me to accept and believe in myself. Still, I would see her for as little as I could get away with until I became functional, because I didn’t think I deserved to take up more of her time.

My 2nd major depressive episode happened almost 6 years ago when I was 40. I had stopped taking my meds again, and about 3 months later, I got depressed again. And it was even worse than the first time. It probably took me about 9 months to recover completely.

This time I was not able to just restart my meds and return to normal, so I saw a psychiatrist for the second time. Surprisingly, he was more concerned about things like light therapy, sleep hygiene, and supplements (Omega-3, NAC, Folic Acid) than he was about antidepressants. But I had to take those, too. He also added Ativan, because my anxiety had worsened, and lamotrigine for bipolar depression, because of my family history and my hypomanic episodes.

It was difficult to accept that for the rest of my life I would be on a regimen that requires an AM and PM pill box. But I had suffered so much through this last depressive episode that I got over it and was thankful to pharmaceutical companies for coming up with drugs that could make me feel like myself again.

Since that last depressive episode, I have gotten much better at taking care of myself. Mental health professionals have a tendency to put other people’s needs first, usually to their own detriment. I guess it’s sort of like how physicians make terrible patients. However, my determination to avoid a 3rd major depressive episode has motivated me to make my well-being a priority.

I have never shared this detailed of an account of my mental health history with anyone because I was ashamed of my depression. I felt like a failure. I was supposed to have everything under control, but sometimes I was struggling more than my clients were. But then a few years ago I decided to write a book about self-acceptance where I make use of both my personal and professional experience.

I decided to start with a mental health blog where I would be open and honest about all of the things that I ordinarily try to hide as a way to demonstrate how to practice self-acceptance. Because it’s that hard to do. Even when you know what you’re supposed to do.

Surprisingly, readers are more interested in my personal experience than my expertise. Although I think it helps them to know that I am a psychologist, because it’s further proof that everyone struggles. Being an expert doesn’t make you exempt from suffering. From avoiding help. From resisting treatment. It is all a process that slowly improves with time. And as I blog and get feedback from readers, I become increasingly more comfortable with being me.

So even though I started this blog to help other people, it has turned out to be the best gift I have ever given to myself.

Happiness vs. Mania

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In my family, sometimes mania can look like anger, irritability, and paranoia, but most of the time it looks like happiness. It looks like the life of the party. The person who lights up the room. The person who leaves a lasting impression because his energy is so infectious.

I admit, I’ve had hypomanic episodes, and they did feel good. I become a more extreme version of the way people already see me: happy, loud, and energetic. But there are things that I do that are uncharacteristic. I will compulsively shop rather than obsess about money. I don’t need much sleep. I attract a lot of attention from guys.

Often mania is followed by depression, but that isn’t the case for me. In fact, sometimes I would intentionally will on a hypomanic episode to pull me out of a depressive episode–to get me out of bed, make me be productive. And it worked, too. Often it was the first step toward getting out of that dark hole. Still, with my family history, I am hypervigilant of any signs that I may be heading in that direction.

That is definitely one of the things that distinguishes me from the rest of my bipolar family. Because they never think they are manic. Once my brother wanted to scale the wall outside of a restaurant, but he knew this seemed crazy. So he preemptively reassured us that he was not manic; he just really wanted to climb that wall.

One of my family members is manic right now. This summer I finally worked up the courage to tell him this, and of course he disagreed. But it wasn’t completely pointless, because he did agree to see a psychiatrist. But since you can’t force someone to take meds, he assumed that the psychiatrist confirmed that he wasn’t manic, since he didn’t prescribe lithium or an antipsychotic. At least he started taking the meds that prevent bipolar depression, which is what I was the most concerned about. But then again, I don’t have to live with him.

And thank God for that. Because it’s unbearable to be around him for more than a few minutes at a time. What may seem entertaining to other people is absolute torture for me. It’s a terrible feeling to love someone but to not want to be in their presence. It fills me with guilt and makes me feel like a bad person. But I have my own sanity to protect, so I do my best to keep my distance.

I wish I could end this post on a positive note and say that things are looking up. But that would be lying, and this blog is about honesty. He’s still manic. Things are getting worse. And I am powerless to do anything about it.

So I just pray and hope for divine intervention. And if you believe in the power of prayer, then perhaps you can say one for my family, too.

Declaration of Independence

I am working with a client who was sexually assaulted and is thinking about taking her case to our judicial board. We talked about the levels of awareness that she went through before she could be ready to take this step. How at first she didn’t want to acknowledge what happened. Then she opened up to a few people who felt safe. Now she wants to make sure he understands that what he did was not OK. To force him to think about it the next time. She hopes to eventually share her story at Take Back the Night so that other people can benefit from it.

She knows that there will be people who won’t believe her. Who will blame her for what happened. She prepares herself by reminding herself that as long as she knows what happened, that’s all that counts. But that’s a hard thing to do–to face the judgment within us and around us. It takes a lot of courage to face that kind of scrutiny.

I like to think of this process as a kind of declaration of independence–from our demons, from judgment, from fear. It happens every time someone goes to AA and admits they’re an alcoholic. Every time someone finds the courage to say I have an eating disorder. I struggle with depression. I live in fear. In making this declaration, they take away the power that their condition has to make them feel weak. Defective. Crazy.

To a lesser extent, I think of my blog as a kind of declaration of independence. I’ve tried to hide these things about myself all my life. I don’t want to be held hostage by them anymore. I want to be able to embrace everything that makes me who I am–especially the things that I am ashamed of.

The president of the student organization I advise, Active Minds, told me that he reads my blog, which kind of freaked me out at first. But he thought it was the most powerful way to fight stigma and to let other students know that they are not alone in their struggles with mental illness, which is the primary goal of Active Minds. So he is finding ways to give students the opportunity to make their own public declarations. It is a wonderful feeling to know that this has come out of my willingness to share my vulnerabilities.

I’ve always liked the expression that freedom isn’t free. You have to fight for it. Although blogging has been a surprisingly supportive and positive experience, I am well aware that there will be times when someone will judge me for what I say. I try to prepare myself for it by doing what my client is doing–to remind myself that ultimately, the only person who counts is me. Then I take a deep breath and hit Publish.

Declaration of Independence

Imagination

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Once when my brother was manic he thought he was the smartest person in the world. I don’t think he did anything with this newfound knowledge; I think it probably just felt good to believe he was intellectually superior. He also did stuff like show up at people’s houses unexpectedly to collect long overdue debts and convince telemarketers to go out on dates with him. This is one of the reasons why people who are bipolar don’t want to take their meds; who wouldn’t want to feel invincible?

While I haven’t reached the heights of mania that he has, I have what could be considered delusions of grandeur. For example, ever since high school I have been convinced that I am going to be a famous writer some day. I would ask whoever I was with how they felt about the fact I was going to be famous–whether they minded that they would be in the limelight and whether they would feel threatened by my success.

I still believe this. I’ve read all the stuff that says that the J.K. Rowlings and Elizabeth Gilberts of the world are the exception rather than the rule, but I’m not really deterred by  it. I don’t usually admit this to people because it does sound a bit delusional, but it’s a nice reprieve from feeling like I suck.

And it’s a helpful delusion. Anyone who aspires to do something great has to believe the odds are in their favor. Otherwise, why try? It’s hard to walk that line between believing that you are destined for greatness and being manic, but people do it all the time. So why not me? I have decent balance.

In The Secret Life of Bees, Zach is a black kid who wants to be a successful lawyer in the South during the Civil Rights era. Lily tells him she’s never heard of a Negro lawyer. That you have to hear of these things before you can imagine them. He counters that you have to be able to imagine what’s never been.

I would take this a step further. Our imaginations are actually fairly limited; we can’t envision all of the possible outcomes. Perhaps I  won’t write some best seller, like I have always imagined. Perhaps success will happen in a completely different way. Someone could decide to make tennis skirts out of my patterns, for example. Or maybe it will be something else that I can’t conceive of from my limited viewpoint of the present.

I try to bring myself back to reality. Don’t get your hopes up. Maybe all you will accomplish is to help a few more people than you do through therapy–which would be worth it, too.

But I’ve said it before and I’ll say it again: you can’t fail if you never stop trying.