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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.

Self-Compassion

My compassion reserves are running low. In my last relationship I took the words of Jesus and Buddha literally about how we should be able to love everyone. It was practically a 3 year exercise in compassion. But by the end I wondered if perhaps I had misunderstood what they meant about loving others. It was a lot of work to have to channel Buddha and Christ just to tolerate being in his presence. I feel like I’m experiencing a backlash now. All those feelings I tried to deny are coming out with a vengeance. I guess I was supposed to have compassion for myself, too.

I’m not very good at self-compassion. Every time I try, the Inner Critic berates me for whining about my problems when I have a good life. I don’t know what pain is. I’m not living in a war-torn country. My life hasn’t been devastated by natural disasters or school shootings. All of the people I love are still alive. Who am I to complain?But surely I must have the right to honor my feelings. My suffering must count, too, if God cares about all of us. So I’m going to write about what’s upsetting me, without apologizing for it or justifying it or willing myself to be positive.

This week I will be moving closer to divorce. Filing forms. Getting documents notarized. More tears. More snot. You would think there would be a limit to how much it’s possible to cry over something. That 4 years would be more than enough time. I used to pray to God–plead, even–to tell me what I could do that would allow both of us to be happy. Leaving seemed like it would just make us both miserable. And it has. And I don’t see an end in sight for me, at least. I’m trying not to blame God or myself. But in this moment, my faith in a happy future is wavering and I feel like I deserve the pain.

I have 2 family members who are currently on the opposite ends of the bipolar spectrum. My brother is trying so hard but still feels terrible.  It hurts me that he’s hurting. My dad is manic. Mania feels great for the person experiencing it, but it’s hell for the rest of us. But what power do I have to make him see?  If he were my client, I could make him see our psychiatrist, get him on meds. But as a daughter, I am practically useless.

I’m afraid to answer the phone when my parents call. Which makes me feel horribly guilty, because I know their time on earth is limited and I will regret not talking to them more when they’re gone. But the call is almost always about something bad. Something I’m expected to fix. Or something I don’t want to do. At minimum, I’m supposed to be a receptacle for the stress, but I can’t take it. It’s too much. I’m not able to function afterwards.

So I have to be strategic about when I call or when I answer. It has to be a time when it will be OK if I fall apart. But since it’s hard to choose something where there’s a good chance you’ll fall apart, I often forget to call altogether. Which makes me feel even guiltier and reactivates the vicious cycle. I wish it could be easier. I wish there were some way I could be a good daughter but also protect myself.

It takes a lot of work to maintain my health. Since I have GERD, allergies, and exercise-induced asthma, I have to take shots, nasal sprays, pills, steroid inhalers, rescue inhalers. I’m not supposed to have coffee and chocolate. I can’t eat or drink 3 hours before exercise or bed time. If I drink too much during a match, I’ll even throw up water. It’s frustrating to have to worry about throwing up every time I play. Or brush my teeth, even. But giving up dental hygiene and tennis are not options.

My mental health is always hanging in the balance. It’s work to maintain my sleep cycle because of my night owlness. I can’t miss any of my drugs. I can’t miss Ativan for even one night. I meditate, pray, journal, exercise, and all of the other self-care strategies. But despite my best efforts, I can never make it to the end of the term without burning out before I cross the finish line. I can’t handle the stress of my life. I can’t get out of bed right now. It makes me feel weak. Inadequate. Unable to do the basic tasks of life.

Just got a call from my lawyer friend that my paperwork looks good to go, so I guess I’ll be filing for divorce this week for sure. If you believe in God, feel free to say a prayer for me. If you don’t, send positive vibes my way.

2014 Blog for Mental Health Project

“I pledge my commitment to the Blog for Mental Health 2014 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”  
A Canvas of the Minds

Sometimes we make the most important decisions in our lives without consciously knowing why we made them at the time.I knew that I wanted to become a psychologist since I was in high school. At the time I wasn’t fully aware of being depressed in the clinical sense. Being anxious was so much a part of my personality that I didn’t think I had an anxiety disorder. And I definitely wasn’t aware of any mental illness in my family. I had no idea at the time that depression, bipolar disorder, and anxiety would impact every aspect of my life–in both positive and negative ways.

It’s probably not surprising that I have been negatively affected by mental illness. But as I write this post, I realize that there have been positive things about it, too. I have learned the most important lessons in life through suffering and loss.

Even as a therapist, when I heard clients make comments about how they had a bad week, it didn’t fully register how horrible that week was for them. In part because clients don’t elaborate unless you ask them to. Unless they are certain that you really want to know. And because they are embarrassed about it. Ashamed, even. But after going through my worst depression 5 years ago, I have much more compassion when clients make these offhanded comments.

I admit, during that period there were times when suicide would cross my mind. But there were two things that kept me from seriously entertaining it. One is that my dad would be devastated, and I feared he would never recover if I went through with it.

The other reason is that if I took my own life, it would undermine everything I ever said to my clients about how pain passes. That one day when they look back they will realize how strong they were at the time. That they will learn lessons from their suffering that it takes some people a lifetime to learn. How can you believe anything your therapist said if she committed suicide? That would be the ultimate betrayal.

So I spent months willing myself to get better. I went back to therapy, started meds again, meditated and prayed, and forced myself to play tennis and spend time with friends. And I did get better. And everything I said about realizing my strength, becoming more compassionate, and acquiring wisdom were all true. I would have never chosen depression, but we usually don’t choose the experiences that teach us the most about life.

People often ask me how I can listen to client’s problems all day long. In all honesty, I can’t imagine what else I would do for a living. It feels more like psychology chose me. And when I hear a client’s story, I always have hope that together we can change the plot for the better. After all, I always root for the underdog. I am the eternal optimist. And I never back down from a challenge.

There was a time when I would never have told this story about my struggles with depression and anxiety to my students or clients. Or even friends and family. But now I want to share it with the world, because every act of courage benefits someone else. My blog is proof of that.

Bipolar and Brilliant

I just finished Haldol and Hyacinths, by Melody Moezzi, and it is one of the best memoirs on bipolar disorder that I have ever read. A lawyer and human rights activist, Moezzi talks about how her passion and aspirations come from the same place that her mania and psychosis come from, and sometimes it is difficult to separate the two.  

In An Unquiet Mind, the gold standard of bipolar memoirs, psychologist Kay Redfield Jamison says the same thing: that she was the most productive and most brilliant on the way to mania–until she became psychotic.

From personal experience I would argue that it’s true that for some people, it’s a thin line between brilliance and mania. I have never reached the heights of brilliance and mania that Moezzi and Jamison describe, but I know what it’s like to walk that line between sanity and insanity. Most of the time I stay on the side where I know the rules and try to follow them as obsessively as possible.

But there have been periods where I have had one foot in this world and one foot in the other. A world where the lines between black and white, good and bad, and reality and fantasy are blurred. I have had some of my best insights at those times, but I was also the most reckless during those periods. It is both freeing and dangerous.

At those times, I pay close attention to where I’m standing and do my best to maintain my balance.

Four of the six people in my family are bipolar. The kind of people who light up a room when they walk in. But when they are manic their light is blinding, and they can no longer see how they are hurting themselves and other people with their actions.

Sometimes people with bipolar disorder don’t want to take their meds because they don’t want to dull their creative side, kill their buzz. And it’s true that when you’ve reached the peak of mania the drugs you take are meant to put out the fire, so they dampen everything for awhile.

But there’s a lot you can do to keep from crossing that line. There are a lot of things that are in your control. You can be honest about your diagnosis. You can be compliant with treatment. You can pay attention to the warning signs and intervene right away.

It often takes a person with bipolar disorder many years before they can reach this place of self-acceptance, as these authors demonstrate. But they also demonstrate that you can still be brilliant when you’re stable.