RealMental

That you are more irritable, more angry, every day.

That I am not The Enemy.

That I am here because I choose to be.

That there are so many landmines around currently, I can’t take a step in any direction without setting one off.

That I have made, and continue to make, sacrifices of myself in order to be with you.

That I make these sacrifices because I love you.

That I do not feel like a martyr.

That  following a burst of anger just before bedtime, while you go to sleep with the aid of sedatives and sleeping pills, I am left awake, crying, hurt.

That I don’t have anyone to confide in–not really–partly because I want to protect the way you are perceived by others, and “this” is not “you.”

That I feel very, very alone.

That I temper every single decision I make, no matter how seemingly insignificant, with what possible effect it may have on you.

That I resent not only not being able to look forward to Springtime, but having to dread its coming.

That I feel like I’m being “used up” faster than I should be.

That when I am sick, like I am now, I try to somehow “schedule” my illness and treatments around what I think you can handle.

That I sometimes feel trapped, even though intellectually I know that I’m not.

That I have learned more than you’d believe about detachment.

That I refuse to be manipulated by The Bipolar Beast.

That a great deal of my strength in dealing with these bad times comes from knowing that I am only here by choice, and that the power to stay or leave is all mine.   I can say “I don’t have to take this,” and mean it.

That the fact that, so far, I have chosen to, and have been able to “take this,” does not mean that I always will be able to.

That you do keep getting better.  Even the worst times now are better than the best times “then.”

That I appreciate when you try.

That I understand that it is hard.

That I KNOW it’s not fair.

That I am your single most loyal ally on all of God’s earth.

That if I don’t figure out how to get some of myself back, there won’t be anything left to give to you.

That by the time you could read these words with understanding and empathy, they will no longer be relevant, because you’ll be “yourself” again.

That I’m not sure how long I can hold out waiting for that time to come this year.

Sticks and stones may break my bones, but names can never hurt me.

Is that true?  Do names have meaning, power, or can they be shrugged off?  I’d suggest that it depends on who hears it, and what state the hearer is in.

Crazy as a loon/crazy as a fox/crazy as a shithouse rat/Loony/Gaga/Off her rocker/Off the deep end/around the bend/Batshit/Batty/Bonkers/Bugged out/wacked out/wigged out/Psycho/mental/demented/Drank the Kool-Aid/One can short of a six-pack/Not right in the head.

If the hearer of the name-calling is feeling vulnerable, misunderstood, and worthless?  Those terms have wounding power indeed, and only serve to feed the feelings of worthlessness the sufferer is feeling.  If they’re in a better place, mentally, there’s less harm to be done, because they know that the name-caller has no perspective on what it means to actually be crazy.  But when you’re in the midst of it?  You hear it differently.  That name-calling is shorthand for the following internal monologue:  “You’re crazy, you’re worthless, no one loves you.  No one could love you.  You’re not worthy of it, because your crazy.”  Round and round that thinking goes, until your own brand of crazy breaks out into suicide or violence. “But I didn’t mean it,” “You knew I was kidding,” “you taking things too seriously!”  It doesn’t matter if you say these things.  The harm is already done– the name-caller has jump-started the cycle, the circle, that results in black hole suicide or blood red rage.

I have used these words to refer to myself, and to refer to my mother, especially when she’s aggravating me.  I need to make light of my illness, of her illness, for a moment, because things are sometimes too serious to face them full on.  But I would never use these names to her face, and I never describe her as anything but “mentally ill” or “bipolar” or “having some problems” when I’m in public.  When I’m disclosing my illness for the first time, I talk about it in precise medical terms.  Informal comments that “I’m feeling crazy today” are reserved only for those who have proven their understanding, who get it, who would never call me crazy when I really was.  Because then, unlike other times, the words have power, and hurt, and get me going in a bad spiral, down, down, down.  It feels bottomless inside my own head– why would you try to make it worse once I’ve told you how it is?  When I am in my bad space, I’ll thank you kindly to refer to me and my illness clinically.  And while I can only speak for myself, it’s my feeling that other fellow sufferers feel the same way.

The mentally ill/Depressed/Anxious/Bipolar/Manic-Depressive/Schizophrenic/ Disassociative/ personality disorder/mental trauma/biochemical disorder/ hormonal disorder/Survivor of rape/child abuse/sexual abuse/verbal abuse/war/ civil strife/ Functional/Disabled.

Those who don’t know better must be made to medicalize mental illness and mental trauma– to be forced to use the clinically correct terms in discussing someone’s mental state.  Those terms have meaning, that can be ascertained by looking it up.  By doing a little research.  By taking care.  Clinical terminology can provoke scientific curiousity– “what does that mean?” “how does that work?” and “how do you treat it?” Make the discussion serious again, eliminate the “joking” terms that can wound at the right-wrong time.  Those without the experience of a sufferer or a caregiver must learn, must be forced to confront the truth– that names, deployed at precisely the wrong time, can be sticks and stones.

It’s been on me now for months now. It sits in the middle of my head, buzzing like some sort of damned demented tsetse fly.  I am defeated for no reason whatsoever. I can’t smile, at least not for myself, and my eyes are always heavy.
I know that part of the solution is to move around among the living but every time I try panic sets in and suddenly the lights are too bright, the rooms too small, my breathing too shallow and I can’t find my way back to safety. More often than not, I make the decision to avoid movement.

My loved ones want me to get better. They are sure that there is action I can take to get better. I know that they are right. It scares me that they can see it- I am a world class actress after all.  It must be really bad.

I’ve curled up into myself because I know how to take care of me, to keep from falling over that precipice that looms on all sides of my psyche, craving a misstep. It’s hard to explain how withdrawing helps- it just does.

I think that sometimes depression causes so much pain the sufferer’s only recourse is to anesthetise themselves. I used to do that by using drugs and alcohol. Now I do it by drawing myself up into a ball, so that my insides aren’t exposed.

I am starting therapy again and I know that it will help. There’s no magic pill for this, it is something I have to tread through. That may be the hardest part about living with depression and anxiety. When every fiber in your being is screaming at you to keep quiet, keep still, keep yourself safe- to take those steps towards recovery- I am jumping off of a god damned cliff.

Dear Mom:

Brother and I owe you an apology– we have been indulging in a months-long fantasy that you’ve been OK, ever since you left here in November. We should have known that two breaks in two months was too much, and come out to visit earlier. But we’ve been hoping and wishing that you’d be compliant, and take your meds, and go to your shrink, and behave like a rational adult. Why we engaged in this mutual delusion, when you never took responsibility before you were diagnosed, I don’t know. But I’m sorry we let you slide for so long.

Instead, when you stopped answering your phone this week and disconnected the answering machine “because God told you to,” I had a sense of dread that This Was It. And then I got the call from Shrink that you’d missed a second appointment in a row. When Aunt got over there to check on you at Brother’s request, it wasn’t pretty. You answered the door stark naked. The toilet had overflowed, and there was a more than dubious puddle out into the hallway and into your bedroom. The management company had to tear it up.

To be fair to us, even after we discovered that your mania had allowed you to lie about med compliance in a calm and even tone, there were long periods where you seemed really lucid. You had normal conversations, recalled things from past calls, had no trouble recalling words or nouns, and didn’t drift off, mid-sentence. Your intelligence masked how far off the deep end you were—it was only seeing you in person that would allow the observer to see all the things you’d thrown away, and read all the stacks of gibberish God had told you to write.

When Brother got there, he was able to observe those things. He was also able to see how suggestible you were. We’re both worried for what this means to your bank account. And you refused to go for inpatient treatment. Well, your shrink doesn’t want you back as a patient, so if Brother can’t find you a new one next week with the help of the county social services agency I’ll be calling, we may be committing you anyway.

You see, we need you stable enough so that you don’t act up on the plane ride home. Because you can’t stay out there anymore. You can’t be trusted to take your medications or attend your appointments, and we can’t fly out to the West Coast to frog march you into every appointment. Once we get you qualified for Disability, there’ll be a supplement to your income, too, and hopefully we can get you into a nice Assisted Living facility where you can take some of your stuff.

We’re not looking forward to the fight in getting you home. We’re hoping that physically watching you take your meds every day for two weeks will get you stabilized enough that you won’t fight about it. But if we have to have you declared incompetent over your objections, so be it. It might almost be better if you stayed as you are, docile and agreeable, while we pack your things, change all your financial papers, and deal with your current landlord.

If you do regain some lucidity, I know you’re going to think we’re just trying to take over your life, but that’s the furthest thing from the truth. See, I can’t speak for Brother, but I really want very little to do with you. I want you to be happy and safe—I don’t hate you—but I don’t want you in my life, really, except at the outskirts. Bringing you back means weekly visits and caretaking and tolerance of your narcissistic bullshit, when all the while I really want to slap you for being so selfish.

At the same time, Brother and I are happy for you, if not us, inasmuch as your separation from reality seems to have stabilized at a happy point. You’re not paranoid or angry or violent, and you know who and where you are. While a nice scary psychotic break would have at least landed you in the hospital, giving us some leeway in getting them to keep you longer to try out a better medication regimen, I don’t wish you the scary visions and voices that would have required.

We don’t know what’s going to happen—we’ve been worried you were undermedicated anyway, and on the wrong mood stabilizer to boot, so we’re hoping we can get you something back to normal. But it’s been a while now that you’ve been fluctuating in this narrow band of crazy, and that does real damage to your brain, even though you didn’t believe me when I tried to talk to you about the need to take your meds, back when this whole thing started. So, if you remain the precocious and delusional three year old that you are right now, well, it could be worse.

You may never read this letter. Even if you do, your bipolar and your narcissism may prevent you from appreciating the best intentions that Brother and I have in setting you up someplace where you can have some independence, and yet still be taken care of. Despite all your faults, despite all the damage you did, you did instill in us a sense of responsibility, of caring for those not capable. I’m sorry, too, that I can’t end this letter by saying that I forgive you. I don’t, and I may not be able to. But I won’t hold it against you, either, and that’s to your credit, no matter everything else.

By JB

This week, I had a very hard decision to make. Faced with a meeting about my less-than-stellar academic performance, I had two choices. One, I could continue keeping my bipolar disorder a secret, continue pretending like I have no extra-ordinary challenges to medical school. Two, I could tell the truth I’ve been aching to tell all along. I’m bipolar. I’m treated. It presents unique challenges to my medical school education, and I am still figuring out all the intricate twists and turns of what it means to be a functioning bipolar person, a functioning bipolar medical student.

I’m only 10 months in, here. I am still figuring out who to tell, how to tell them, when to tell them. When is that magical moment? I told Joe in the line at Subway, I told Thomas while we were floating in kayaks on a river. I told Sahar while we were eating lunch; I told my lab group during one of our first lab meetings. All of these times, I felt, were the right times. These were people who needed–or deserved–to know. These were people I would feel fake around if I didn’t tell.

For all the grief it causes me in deciding, actually telling someone I am bipolar is truly a freeing event. Being bipolar is part of every moment of every day. It is inextricably tied up in my being. There is no point where I am not bipolar. I am medicated, which means I don’t act bipolar, but there is always the chance that my medicine will slip and become less effective, that I will need people in my life who know so that we can catch it early. So we can catch it before anything bad happens. So we can catch it before I ruin my life.

So I decided yes, which is something out of the norm. All materials I’ve read on the subject–and there are not many–by bipolar medical students reveal that they did not disclose. Above that, they refuse to disclose. They say it is the worst thing they could possibly do. Unfortunately, these medical students worry that the doctors who surround them, who decide about residencies, will discriminate against them. And I’m sure the concern is valid, which is a sad state in itself. How can we tell our patients that it is possible to be a whole functioning human being if we don’t believe it ourselves?

The truth is, I want to disclose my mental illness to everyone at my school. I want them to probe and pick my brain, to learn from my mistakes. This is something that my friends who know do sometimes. They get this look on their face, and it inevitably leads to a question. “Why did you seek treatment?”
“What was the worst part of being bipolar?” We talk about the symptoms and signs; we talk about what they should do if they suspect that something wrong is happening, which ranges from the practical [“Get me to a therapist.”] to the absurd [I’ll just run across the horseshoe and tackle you.”] We talk, which is good for me. It’s good for our friendships. It’s good for their future patients. It’s just good.

So, facing the dean of the graduate school, the director of my program, the words tumbled out like an avalanche. “In March, I was diagnosed with bipolar disorder. I am treated, and I have made a lot of lifestyle changes in the last year. The first semester of medical school was a difficult transition for me, because in college, I did a lot of manic studying. I’m still trying to figure out how normal people study.” He was very supportive and inquired about treatment. I assured him that I take my medication, but told him I was currently without a therapist or psychiatrist because of some insurance
problems. He was, thankfully, understanding, and referred me to the school psychologist. I have already made an appointment.

I hope that I–and my generation of doctors–can change minds, opinions, and attitudes about mental illness, especially as it pertains to medical school. People with mental illnesses can perform well in medical school, and they can [and deserve] to be doctors. Although I would gladly trade my mental illness for a clear bill of health, I can do good with it. I can advocate for other mentally ill people, and I will share a true empathetic bond with my patients. It is well-noted that doctors make poor patients, but I hope the opposite is true well. I hope that patients make good doctors.

So I disclosed. So I will continue to disclose, to trusted colleagues and administrators, to anyone who will hear and listen, to anyone who is interested and can offer support. I will continue to disclose, because I owe it to myself. I owe it to future generations of medical students, who I hope will have an easier time of disclosing. And I owe it to all of the patients of all the future doctors I know now, the ones who may have an easier diagnosis because of me.

Originally posted here.

As my handle states, I’m a lawyer. Even worse, I’m a litigator– I go to court a lot, file lawsuits, get high on the charge of arguing my case before a judge or a jury. I handle a blend of straightforward and more complex cases, and it’s the complicated ones that I really love. It’s how I get to show my smarts, prove my abilities, and feel recognized, acknowledged for my talents. I aspire to be a well-known, scary smart litigator on the cover of SuperLawyers and reported in the Top Verdicts and Settlements report every year. I want to be queen of my corner of the legal world.Actually, that’s not true. Or more accurately, I should say that this whole paragraph should have been written in the past tense, except for the “I’m a lawyer” part. And maybe not even that. Because I am realizing that the way I chose my online handle, BipolarLawyerCook, has more meaning in the order of the words than I could have thought.

See, Bipolar comes first. It’s taken me a while to realize this, despite the fact that I type my online handle nearly every day. Let me repeat that. Bipolar comes first. It doesn’t mean that I walk around with a big scarlet B attached to my coat. What it does mean is that I need to take my bipolar into consideration when I am making decisions about what will keep me healthy, and therefore happy. If I ignore my hard-acquired self-knowledge about my triggers, my mental knee-jerk habits, if I fail to avoid people, places, and situations that back me into a corner where I curl up into a little ball, and just give up, then all I am is bipolar, and worse, a crazy bipolar. If I remember, and adapt, then there is plenty of room for any other descriptors I want to tag on after bipolar– so long as the terms can all coexist with bipolar, and take turns as need be.

When I was first diagnosed, eons ago in 2005, I was relieved– finally, an explanation, and one that did not implicate some moral weakness on my part. I started taking my meds, went religiously to therapy, worked on my triggers, was a model patient. But not really– because I made the mistake of believing that I would now be able to do all the things I’d wanted to, but couldn’t. Despite knowing better, I assumed that the meds and the therapy would cure me, and that I could do whatever I set my now-stable mind to.

Not so– the meds control, don’t cure. If I overtax myself, then all my crazy predispositions come roaring back. But more importantly, and fortunately without quite the same variety of mental ups and downs, I am finally coming to realize that litigation as a practice is mostly insane. Whether or not you’re officially crazy, the pace, the hours, the adversarial climate and lack of civility are all enough to drive the sanest person nuts. And I’m realizing that it does drive everyone crazy, eventually. Maybe you become a screamer, or a drunk, or you cheat on your spouse, or your kids hate you because you were never home, or your colleagues and opponents will never give you a break because you never give them one– there are a thousand different ways to fail as a person, if not so obviously as a litigator.

I recently took some time off, since I needed to switch mood stabilizers, was exhausted and depressed, and was therefore on the brink of messing something up again at work. The time off has been a revelation in more than one way. First, I’ve had even more ideas to write, and took the leap to start pitching ideas for freelance assignments. Second, I realized that the charge that I get from the ritualized combat of litigation comes with a price, and that I was ignoring the law of mental gravity: what comes up must come down. Add to that the slow dawning acceptance that my energy reserves are shallow, and I’ve come to accept that my flame burns bright, but burns out quickly. I need to find work that is more sustainable, less full press– and to do that, I need to give up my Queen Litigator dreams. This became less difficult when I had my third realization, while lunching with a coworker, who was stressed beyond belief. I didn’t want to go back– and not just to that office. Worries about the future aside, I was happy.

I was sharing this with my therapist, and she asked me who I was proving myself to with my SuperLawyer fantasy. When I realized that I was trying to get approval from those who will never give it, it because so much easier to step to the side, and understand that my dreams of worldly success would not make me happy, even if I had the mental resources to achieve them. I also realized that setting aside the fantasy isn’t failure, no matter what other litigators might think.

Having realized this, it becomes easier to think about walking away from the practice of litigation, or to at least think in a more clear-eyed manner about what will make me happy, and how I can best sustain that happiness. In compiling my list of things that make me happy, I’ve come up with: cooking, taking pictures, being with friends, writing for writing’s sake, having quiet time to myself, blogging for sharing’s sake, having quiet time with my husband, reading everything in sight, learning new things, and helping other people learn new things. I’m looking forward to adding more things to that list– and maybe more and different things to my handle.

Republished from BipolarLawyerCook.

I’ve wanted to write about this for months now, but felt compelled to stay as far away from the media’s scary-unremorseful-rabid-stalker coverage of the story as possible. Now I feel like it’s okay to write about it because something positive has happened- Britney Spears may very well get the help she needs.

You can always tell that a person’s life has taken a turn for the better when the media starts compiling montages of past tragedies and airing them over and over and over again.

I’m not in a position to speculate about or diagnose the nature of Britney’s condition but it is obvious that, for what ever reason, her mental health has deteriorated dramatically over the past year. It’s horrifying to watch a person go through that, as a fellow human being and as a fellow mental patient. The greatest fear I’ve had is that she would not survive the ordeal. So many of us don’t.

It’s been doubly horrifying to watch the reaction of the media and general public. People have laughed at Britney Spears, called her names, shamed her- all but spit on her as she walked down the street. Every day I am thankful that I have, with the abundant support of others, been able to treat my illness. I can say with certainty that had I been judged and ridiculed to the degree that Britney Spears has, I would not be alive right now. Let’s be frank shall we? I’d have blown my fucking brains out.

I’ve read a few good articles this morning calling for responsible action on the part of the media and public:

“In the case of Britney Spears, professional ethics also are involved which the media must confront. Roy Peter Clark, vice-president of the Poynter Institute, a leading center of journalism training and ethics, recently wrote. “There is clearly a danger zone, when life and health are at stake, when the best thing the press can do is back off. That time for Spears is probably now.” – Michael J. Fitzpatrick, executive director of the National Alliance on Mental Illness (NAMI )

“The paparazzi are not known for their scruples when it comes to hounding their celebrity quarry. So the resignation of a British photographer from his LA agency in protest at the “aggressive” treatment of Britney Spears is a signal that media harassment of the unravelling celebrity has reached a new and troubling level.

Nick Stern predicted that the pursuit of Ms Spears would end in tragedy as he quit his job at Splash, a Los Angeles-based, British-owned celebrity picture agency, over the tactics employed to feed the media obsession with the troubled pop star.”- Times Online

Sadly, the majority of the coverage seems to have been dictated from a conversation between two terribly insecure 13 year olds. There seems to be so little actual knowledge or understanding about mental illness. There seems to be even less compassion. As a person who periodically finds herself in the midst of her own mental disintegration, I have to say how afraid it makes me that we seem to find the psychological torture of our fellow humans highly entertaining.

I sincerely hope that Britney Spears gets help- voluntary or otherwise. I hope she is able to be healthy again, to care for her little boys, to live a happy and productive life. I hope that we as a society will allow her to do so. I hope that we will learn to treat mental illness as a potentially deadly disease and not a platform upon which we can stand, looking down with vicious judgment and self-gratifying amusement on it’s sufferers.