RealMental

By Kay

One of the hardest things for me to do is to say that I can’t. It goes against the very positive message that I’ve had engrained into me my whole life, that I can do anything. Saying otherwise feels like giving up, and I hate that.

The psychologist I was seeing last summer never suggested that I couldn’t do things. The issue at the time was the same as it always is, that I was going between unemployed and underemployed, and my parents weren’t pleased by it. My psychologist suggested that instead of letting my depression drag me down to the point where I was sleeping instead of working, I should see working as a step in treating my depression, and most of our sessions were spent discussing ways to become employed, her encouraging me to take on more work, even suggesting places for me to apply. When I did start working full-time, my 9-5 schedule kept me from staying in bed all day, and both my psychologist and my parents declared that it was therefore helping me to get better. I didn’t tell them that I was struggling to keep my eyes open at my desk, and spent every lunch hour napping, and that I was still miserable.

Then I went back to school, and was no longer working, and was struggling with my classes, and my parents were on my case to get a part-time job during the school year. After a few months of going lower and lower, I found myself trying to explain why I hadn’t gotten a job to my new psychologist at student counselling.

“So, you’re having trouble keeping up academically, and you’re sleeping through classes. And you’re exhausted all the time. And you were hit by a car, and you’re still recovering from that. Well, it sounds to me like you’re not in any position to be looking for employment on top of all that, not if you’re not going to be thrown out for not paying the rent any time soon.”

“But my parents-”

“Your parents are right, you’ll have to work at some point in the future. But maybe right now you can’t, and that’s okay.”

A few months later I was referred to a psychiatrist, who diagnosed me with ADHD. I tried to articulate to her how exactly I managed to lose things and forget things so much.

“It’s not as if I want to, it’s just that when I need to remember something, I don’t know how to make that information be in my head at that moment. I’m always thinking about something else, and I’m not even thinking that I should be trying to think of what I need to remember.”

“Of course. You don’t forget thing because you’re trying to. It’s not even because you’re overly indifferent. You would remember if you could, but you just can’t.”

Both times it made me feel a lot better to think that I couldn’t, because if something is truly beyond my limitations, then it means that it’s not really my fault. It’s difficult to explain it to a lot of people though. I have a lot of conversations, especially with my parents, along the lines of “what do you mean, you just can’t? Is there something physically stopping you? Have you been tied down or something?”

The idea still bothers me a lot. I hate to think that I have limitations, and I hate even more to admit it to others. And I never want to use my problems as an excuse for not trying hard enough. But a mental illness by definition means that sometimes I can’t. If it didn’t limit me, it wouldn’t be a mental illness, because there would be nothing wrong. So I’m trying to learn to acknowledge those limits, and work from there.

Originally published here.

By Jb

Being an Art Star is about struggling to remember.
[Rev Jen]

Bipolar disorder gives me colors, hues that “normal” people can’t understand. My mania is the color behind your eyelids when you look at the sun with your eyes closed. It burns brightly and strongly, and it is hard [so hard] to turn away. You can’t move–it’s just there.

My depression is the black-blue in the center of bruises, the color that sits dully, the one that makes you cringe when you press it. It reminds you of pain. It is tender to the slightest touch.

The other day, I told my friend that I wanted to stop feeling the feelings, and most of that is true. But a small part of me, the smallest part per billionth aches for the feelings. It’s the part that relished their return, the part that wanted to get out of bed and drive around the city, the part that wanted to drape itself down a staircase and cry. It’s the part that feels most alive when it feels sick, the part that wants to smile at the cars that drive by. The part that wants to break itself into pieces, the part that wants to fuck and fight and talk shit and sleep and cut. It is self-destructive and can be [was once] all-consuming.

So we talk about why I want to take more medicine. Yesterday, I had some depressed moments. I thought of driving to the lab, stealing one of the razor blades. The fantasies expanded, more than they ever have [I’ve never cut]. I thought of which one I would chose, the one least likely to have chemicals on it. I would boil a pot of water and drop the razor in. I would wait, slowly, patiently. When it was done, I would lift it up. When it cooled down, enough to use but still warm with the memory of water, I would press it in. Where? Somewhere less noticeable. Not the flashy, needy, begging wrists, no matter how much that vein shines and pulsates out. No. The ankle, perhaps. The upper shoulder.

The upper shoulder–when I first started treatment, I would write on my left shoulder in brown thin line Sharpie. I would remind myself that there were four things that were important, that I wanted, that I needed: prayer, honesty, fidelity, love. The things you turn to when razors cut across your mind, the
things you turn to when you are stuck.

So I remember that the only thing that can fight a broken mind is that same mind, wanting to be fixed. That same mind, that same ache for things to be ok. It’s the aching yearning mind that reaches out for help. That mind compels you to talk when you don’t want to. That mind helps you remember that the palette you have in your mind is beautiful but poisonous. Bright things usually are.

So, with one part relishing the darkness, wanting desperately to succumb to the heaviness of depressed eyelids, the other parts push back, open the mouth, and say–to whoever is listening, but mostly to that one rogue part–“I want to stop feeling that being human is an irrevocable injustice.”

This is why you keep living. This is why you keep shaking the pills into your hand. This is why you torture yourself with therapy, why you eventually give up all of the bad thoughts you’ve been hoarding. For true happiness and true sadness, for human emotion that your human peers can relate to and comfort. For this, you give up being a superhuman. For this, you finally become what you’re meant to be. Yourself.

Originally posted here.

At the end of September, when the antidepressant I was on made me go wonky, I asked my doctor to refer me to a psychiatrist.

 And then I waited.

 And waited.

 And waited some more.

 Because, while I usually have nothing but praises to sing about the Canadian health care system, when it comes to mental health care, if you don’t have a knife to your throat, you’re shit out of luck. If you want to get in with a psychiatrist for the first time, you have to wait three to six months, no matter how bad you are doing. As long as you’re not actively suicidal or homicidal, you wait.

 I waited five months. By the time my appointment came up, I was feeling fine. My drugs were working and I wondered if I even needed a psychiatrist after all. But, given my family history, I decided to go anyway. It couldn’t hurt, right?

 Wrong. Oh, so very wrong.

 The psychiatrist, whom I shall call Dr. R, came very highly recommended from my family doctor. I had told her, “I want someone who will allow me to be an active participant in my own care, who will listen to me.” She said this woman is fantastic and very compassionate. I adore my family doctor and we get along quite well, so I trusted her opinion.

 My appointment was three weeks after I had major jaw surgery, and only one week after I had my jaw unwired, so I was still on some painkillers and having problems getting enough calories into my body. That didn’t really help my emotional state going into the appointment.

 However, I was determined to have a positive attitude and to be open-minded. Sitting in that waiting room, I tried not to be nervous and instead psyched myself up (hah), telling myself: this is something I’m doing to make my life better and ensure I am going to be healthy long into the future.

 I quickly figured out that this appointment wasn’t what I was hoping it would be, no matter how much positive energy I tried to throw at it. The moment I told Dr. R my family history and the adverse reactions I had to the Effexor and Wellbutrin, she decided I was Bipolar II and tried to fit everything I said into that diagnosis.

 I’m not disputing the diagnosis itself; it’s a fair hypothesis, and one that I have considered myself. However, I have a huge problem with a doctor diagnosing a patient within five minutes and then “accusing” her of all kinds of behaviour that doesn’t exist.

As the “interview” (or interrogation, as it became) went on, the two of us got more and more frustrated, and the conversation grew heated. She was frustrated because I refused to just accept what she was telling me about myself, and I was frustrated because she wasn’t listening to me or considering my explanations for my decisions or behaviours.

 And then it just got plain weird.

 Dr. R: Do you ever spend large amounts of money?

Savia: Sure. I have a house. I’m doing home renovations right now.

Dr. R: How are you paying for that?

Savia: A line of credit.

Dr. R: That’s hypomanic, irresponsible financial behaviour.

Savia: But I’m making an investment in my home, and my house value has quadrupled in the past seven years.

Dr. R: Going into debt for any reason is hypomanic.

Savia: What? But it’s not just any debt. It’s good debt.

Dr. R: There is no such thing as good debt.

Savia: But… [about to explain how her sewer blew up and also how the energy efficient renovations were eligible for a $3,000 government grant, which would pretty much pay for them, not to mention the savings on the monthly energy bills.]

Dr. R: [Cuts me off] The only way it would be acceptable for you to go into debt for home renovations is if you were selling your house and would get the money back right away.

Savia: [looks at her like she’s on smack] I guess we’ll have to agree to disagree on that one.

 Note how she didn’t even ask how much money I make or how much the home renovations cost or any other details that would have explained why I was going into debt for this project? It was all about absolutes. And let me just say, if going into debt for any reason makes a person bipolar, I guess the majority of North Americans have this disorder. Maybe that’s why it’s so hard to get in with a psychiatrist?

 After that, it quickly went downhill. She snapped her questions at me and cut off my answers. Any time I tried to explain or elaborate on one of my answers, she said, “You’re rationalizing your behaviour.”

Um…no…I’m just trying to give context – the grey answer to a question that she tried to make black and white. Because life isn’t like that – it’s all about the shades of grey.

 At the beginning of the appointment, I was quite succinct in my answers. But then, she would jump in and fire several more at me, obviously looking for more context. So, I started giving more thorough answers. She never smiled and she cut me off a lot, which made me really nervous and uncomfortable. I started talking faster and being less concise. At one point, she stopped, tilted her head, smirked at me and said:

 Dr. R: You’re talking fast and circumventing the question. That’s hypomanic.

Savia: I’m nervous!

Dr. R: [cutting me off] There you go, rationalizing your behaviour again.

 I’ve lost count of how many arguments we got into in that hour and a half. Our personalities clearly do not mesh, and I could tell that she didn’t appreciate me challenging some of the things she was saying or asking questions to help me understand where she was coming from. We both ended the session thoroughly pissed off.

I was so angry and upset, not about the diagnosis (though that did scare me quite a bit, because I don’t want to have this disorder and I don’t want to have to take mood stabilizers, ever), but about the way she treated me. Her cruelty to someone so vulnerable cut very deep.

 I didn’t sleep at all that night, and then I cried for two days straight and fell into a depression. What if she was right, and all of these things that I consider as part of my personality are just a disease? I thought I knew myself really well, but if this is the case, who the hell am I, then?

 I talked to a few friends who’ve known me through all of the ups and downs, and they said the same thing, “You’re always Savia. No matter if you’re depressed or anxious, there’s still something about you that’s always there and doesn’t change.”

 And they were right. I tried to put Dr. R’s harsh words behind me and take the good out of the appointment. A few things that she said did ring true.

 For instance, when I told her that I don’t have hypomanic or manic episodes, she said that for me, hypomania may manifest itself as anxiety. I found that interesting, and it would fit with what’s been happening to me. She also gave me the signs of hypomania and told me to keep a mood chart for the next three months so I would have a record of my patterns.

 Dr. R said that the current drug mix I was on (Celexa and Wellbutrin together, in low doses) could put me at a higher risk for hypomania and that it would be better for me to be on just one of those drugs, or off them entirely and on a mood stabilizer, my reaction to which would serve as a diagnostic tool.

 She also told me to take Omega 3 fatty acids, which she said is the one thing that has been clinically proven to help with depression and mood disorders.

 So, I did take the good advice she had and used it to my advantage. I went off the Wellbutrin at the end of April and found that just being on the Celexa was much better for me. I started taking Omega 3s, along with a daily arsenal of B complex and Vitamin C, and am amazed at what a difference that makes in stabilizing my mood.

And last, but certainly not least, I am keeping a daily mood blog where I quickly jot my mood, appetite, sleep, spending, menstrual cycle, drugs and sexual interest levels. It takes me two minutes a day, but it has made me aware of some of the factors that affect my mood, which gives me the opportunity to deal with things before they get out of hand.

 And the best thing about the mood chart is that the next time I go to a psychiatrist (in six months, if I can get in with someone else, that is), I will have that record to show him/her. And, hopefully, I can avoid any further nastiness.

Because going to the psychiatrist is stressful enough without having to prepare yourself for a knock-down, drag-out fight with the person who is supposed to be helping you.

Migraines?  Excedrin alone will sometimes work, but I’ve got other pills in my arsenal if I need them.  Arthritis bugging me?  Allergies? Same thing.  There’s almost a pill for each everyday physical ill, or something that works in a matter of days.  Non-medicinal remedies too– more water, less sugar, more walking, less gluten.  The lag time between applying the cure and the end of what ails me is short, and the resolution is tangible.  Hour by hour, I can feel myself getting better– and if it’s not a cure, then at least there are palliatives that can be repeatedly applied to assuage the feelings of not-rightness.

Not so with mood.  Taking your meds, getting enough sleep, watching my carb intake, trying to get out in the sun and to move around some more only help so much.  Positive self-talk, journaling, talk therapy, too.  The distance between what I know and what I feel?  Sometimes it’s a short reach across a small crack, and I can grab hold, strongly, to join the brain and the heart for days, weeks, months.  Other times, that crack is a chasm, miles wide and deeper than imagining, and there’s nothing to be done but hunker down with my darkened heart, and hope that in the meantime, the brain on the other side of the chasm will kick in and figure out how to bridge the crossing.  Right now, the gap is narrowing, something my brain side knows and something my heart side hopes, and my heart side is reaching out, but my heart and my brain are still fingertips away, swiping at each other– I know it’s close, but any contact now is tentative, fleeting, too weak to get me across without making a lunge that I know, from experience, may not get me across.  There’s no quick fix– just a waiting game.

It’s been a rough spring around our house. But at the same time, it’s been better than each one before it. So I feel like I should be grateful, and I feel guilty for feeling emotionally exhausted all the time, but there you have it. I feel what I feel, and it is what it is.

I belong to some support groups for “significant others” of people with bipolar disorder, and I can tell you from years of observation and experience that, among our ranks, May is a rough, rough month. In a bit of black humor, someone somewhere began referring to this month as “May-NIA,” and that stuck. Even my own spouse, who is faithful and dedicated to his mental wellness, and takes his meds and tries to stick to healthy routines, has periods of “breakthrough” hypomania in the spring. Do what we will, the force of springtime will not be denied. Every year I’m struck with jealousy over other people’s rejoicing in the coming of spring…they’re planning their flowerbeds, washing their windows, de-winterizing their mowers, while I’m monitoring the bank account, trying to keep things quiet, and generally just scattering a fresh layer of eggshells across the floor for us to walk on. I dread spring. And to be honest, I resent having to feel that way.

In the beginning of our journey with this illness, post-diagnosis, I lived in a state of wary watchfulness. In the first year, there was a significant relapse, so after that I was pretty much in constant readiness, watching for that sign that would indicate that everything was about to go south again. If he was 5 minutes late, or didn’t answer his cell phone one time, I just knew that “it was happening again;” that he’d disappeared, he’d “run,” and that, since that was the line I drew in the sand when we decided to stick this thing out together, that our marriage would, consequently, be over. I literally went through this entire thought process on a regular basis. It was a long, long time before I could make myself continue to breathe normally in the face of even a small unknown. But I learned, as time went on, how to focus on myself, to trust myself, and to breathe.

As more time went by with no full-blown episodes, something odd happened. I did manage to stop living mentally perched on the precipice of disaster. I remembered who I was before I ever tangled with bipolar disorder. I realized that I’m smart (enough), capable (enough), and tough (enough) to handle whatever it could throw at me. And with that knowledge, I relaxed. A lot. But I didn’t anticipate what came next–what has been happening for the last couple of years.

My husband has expressed to me, often, the irony of managing a mental illness well–that is, that since he stays on top of his medication regimen, sees his doctor regularly, performs well at a regular job, etc., that people tend to “forget” that he has bipolar disorder. Then, when there is an episode of breakthrough depression or hypomania, the reaction is one of disappointment, like, “I thought you had this thing beat.” No one understands that it’s an ongoing, daily battle, and that there is no magic pill that’s going to work all the time. We “tweak” his med cocktail once or twice a year, at the very minimum.

I have caught myself falling victim to this same phenomenon, in a way, and I’m not sure it’s any better than the way I used to live. Instead of being constantly on edge, expecting things to fall apart any second, I now let even a couple of weeks of good times lull me into near-total complacency, so that, when there is a bump in the road, as there most assuredly always will be, I’m left gobsmacked, the rug pulled entirely out from under my happy little world. Every time this happens, I feel so stupid, because, of course, I knew better. But it is so altogether soul-wearying to live in that watchtower, that sometimes I just desperately want to come down for a while. To stay up there, watching, watching, watching, is to admit defeat, in a way…but more than that, that sort of life is really no life to have. It’s not just emotionally tiring; I can feel it chipping away at my physical health, with all sorts of symptoms I never knew before I met bipolar disorder, like anxiety, panic, depression, irritable bowel, nausea…this disease that I don’t even have is shortening my life.

But the alternative–life without my husband? No, that’s no life for me, either. Somewhere, somehow, there must be a way to find balance. I wish this post were more about answers.

A story from my local paper about a teenaged girl suffering from bipolar and the push in Massachusetts for better funding for youth mental illness treatment.

By Fiddley Gomme

Tuesday, April 15, 2008

The past few weeks have found me struggling, and mostly failing, to stay out from under a fairly heavy malaise. Simply functioning has been painful at times. At work, I’ve been hard-pressed to perform at the level for which I’m generously compensated. At home, I’m not even coasting. At night, I drag myself through the motions but fail to follow through.

Falling short in my personal and professional performance leads to feelings of failure and shame. The failure and shame inevitably leads to more feelings of remorse and defeat. And thus the cycle turns. What it doesn’t bring are those manic, desperate artistic outbreaks like you see in movies.

So I finally got my sorry ass back into my therapist and took his advice to get myself some crazy pills. And by took his advice I mean that I told him I was doing it and that I needed some advice on staying conscious during a trip to my physician’s office. He told me to stop being such a pussy and make the appointment.

So I did. I risked the threat of public unconsciousness and did nothing more than sit there and sweat and shake and effortlessly convinced my doctor that I needed something to alter my serotonin uptake thingies. Very brave of me, I know.

Seriously though. The doctor was very understanding and probably waited until my check cleared before sharing a laugh with the girls in the office about the full-grown man who can’t get his blood pressure checked without very-nearly blacking out. And he gave me Zoloft. And Xanax.

Xanax is a palindrome. I know this because I’m not wired right.

What? How did the first day go, you ask?

Well, I spent today quivering like a bundt-pan-shaped jello ring. So, really, about the same as every day. Not surprising as Zoloft takes some time to take the desired effect. That’s sad but the good news about The Big Z is that the side-effects are available immediately.

The first twelve hours were fine. Mostly because I spent most of that time asleep. By lunchtime today and right up to this very second however, I’ve pretty much wanted to throw up nearly constantly. And in the middle of the afternoon I got simultaneously lethargic and totally disconnected. Oh, and did I mention? This is on half a dose? After just one day?

I’m saving the Xanax for a special occasion. Like maybe tax day.

Originally posted here.