RealMental

Dear Friend-

We spoke on the phone the other day, it’s been a very long time since I’ve spoken with you and it was great to hear your voice.

You reached out for some help and I was honored that you chose me, and that I was available to speak to you. There were a lot of things that I wasn’t able to tell you, as our call was cut short unexpectedly. The things we discussed are things that I have experience with, things that I’ve tried very hard to make better in my own life.

More than anything, I hope you will be able to muster up the strength it will take to remove yourself from your situation and begin rebuilding your life. It is very important for you to know that it IS possible for you to move on and rebuild your life. It won’t be easy, it will be really really hard. You’ll have to process through a lot of bullshit, there are layers that you cannot even see right now.

The emotional pain will be unbearable, you may even think that dying is a viable option. It isn’t. You will grieve your situation as you would grieve a loved one dying. In a way, a part of you will die. A chapter in your life will die, and grieving is something you’ll have to do in order to walk through this whole terrible thing.

Prepare yourself for the fact that you will consider staying with your current situation, because it will be so very hard to make the change. Your life will be a living nightmare.

The positive side to this will be that it will pass, you can walk through it. Once you get past the initial pain, you WILL begin to feel good again. You will begin to see your worth, you will begin to heal, you will rediscover the person you were before this situation consumed you.

I know that you are unable to be objective about yourself and your situation right now. Please try to believe that you are a good person, you are worthy, you are smart, you are beautiful, you are a fantastic mother, you are capable of making your dreams come true and miracles are possible. If I had not seen this happen to many people over the years, I would not believe it to be true. Honestly, I’ve seen people rebuild their lives having lost everything they had.

Right now, these compliments probably don’t mean a lot to you or you may even have a hard time believing they are true. Believe that I believe. Not just me, but your family and friends that you’ve reached out to over the years. You have done nothing to deserve such a painful life. None of us “deserve” to be mistreated. Look at yourself through the eyes of your children, treat yourself with the same love and respect that you look at your children.

No matter what action you take (or don’t take), I want you to know that asking for help is not a character flaw, it is an act of courage.

With love,

Moonflower

I’m on my way up. And there are signs—if I look for them, listen to them, use all my senses to detect them—if I don’t, then it’s the lurch in the stomach on the down curve of the rollercoaster that’s often the first sign.

If I’m really paying attention, then I hear it when my assistant says “Aren’t you Miss Polly Productive” when I leave him an enormous pile of dictation tapes, written motion and discovery work, and all the other legal detritus. If I look at my time sheet, I can see that I’ve billed a week’s worth of work in three days, though there’s no need to—I’m just blowing through everything, double time. It’s good work, too. Productive, concise, and necessary. The air’s clearer, the brain’s faster, and I feel more creative—am more creative. I write really well, and a lot, because I sure as hell only need about three hours of sleep.

If I miss that sign, then the next one is this. I’m still Polly Productive—except I’m now Misanthrope Polly Productive. I hate everyone—they’re all out to get in my way, talk with their whiny, annoying voices, bother me with inconsequentials. Every Little Thing They Do Is Enraging. I have road rage. I hate every cashier in every store everywhere who doesn’t blow through the things on the belt with superhuman speed. My critical voice snarks on each person’s shoes, haircuts, grocery selections, each one more worthy of hate than the last. My family and my husband bug the crap out of me, and I can’t understand Why Won’t They Leave Me Alone. There’s no objective perspective on why I’m so irritated.

The physical sensations start as I’m just about to crest from Misanthropic Polly Productive to Downward Spiraling Deirdre Depressed. The strange crown-like feeling on my forehead. That pushing sensation under my sternum. And the sweat. This is weird—but after three or four of these post-diagnosis, post medication episodes, I’ve realized something. When I’m in a high mixed state, and just about to start the long, long slide to the bottom? I sweat. Profusely. And it smells strongly. And my feet stink to high heaven.

Yes, that’s more about me than you want to know, really. But it’s a sensory sign—one that’s so weird that I notice it, even as I’m in the process of that catatonic withdrawal into my head, when the extreme productivity, the crazy irritability, slide by. Crazy has a smell for me, a clear, last-ditch signal. I might not be able to follow my mind all the time, but I can follow my nose. I wouldn’t have noticed it, maybe, if I hadn’t been serious about writing EVERYTHING down in my symptom notebook, but after talking it over with my shrink when I had my lithium toxicity episode, she said… tell me more about the sweating thing. Would I recognize that as a physical sign, even if I’m ignoring the emotional and mental ones? Turns out, I can.

Animals can smell fear. I suppose it’s not as weird as it could be that crazy has a smell that can wake up my animal brain, can trigger that self-preservation instinct that crazy makes it so easy to otherwise ignore. That smell says hey, put the brakes on this thing, slow this roller coaster car down– right now. I should be looking and listening and feeling for signs—but I’ll take the smell if that’s what it takes.

Mental Illness Awareness Week in Canada was this week. I received an email from Sarah who writes:

What Can You Do To Help?

We invite you to visit the website – letsfacethis.ca – and post a photo and message on the “Tree of Support”. With each new photo added, the “tree” will grow, symbolizing growing awareness, education, fundraising and hope for those suffering from mental illness.

Let’s Face This reminds us that mental illnesses, like depression and anxiety, are not the result of personality flaws or character weakness, but, like other illnesses, are biological in nature. And like other
medical conditions, respond to treatment and care.

I invite you to join me and countless others confront the stigma of mental illness.

Let’s Face This together and confront the stigma of mental illness.

Also, take a look at the Canadian Mental Heath Association’s website.

My post about my first appointment with my (psycho) psychiatrist made a couple of waves in the mental health blogging world. Phil from Furious Seasons did a huge post on it, and told me it was one of the “worst stories I’ve ever heard,” which, coming from a dude who blogs exclusively on mental health injustices, is pretty bad. Liz Spikol from The Trouble with Spikol also picked it up, with the title, “This is why people don’t trust doctors,” calling the experience “bizarre” and stating, “I have heard of similar experiences, but only with cults.”

It was nice to have others recognize how horrible this situation was. Unfortunately, it didn’t really change my situation.

After that first appointment, I vowed I would never go back to psycho psychiatrist again. I went to my family doctor and told her what happened, (she was horrified and said, “Maybe she was hypomanic that day!”) and she agreed to refer me to another psychiatrist.

The problem is this is a small city with a limited number of psychiatrists, and the majority of them work in the same clinic downtown. I made sure that she referred me to a psychiatrist who had a private clinic so there wouldn’t be any problems.

A few weeks later, I got a call back from my doctor’s office saying that the psychiatrist’s office had rejected my referral, stating that it’s his policy not to accept any patients who have already been seen by another psychiatrist in the city.

My doctor tried to refer me to another psychiatrist, again in a private clinic, and his office also rejected my referral, based on a “conflict of interest” because I had already seen another psychiatrist.

[And may I also mention that before I even went to psycho psychiatrist, I tried to get in with my mom’s psychiatrist, and he also refused to see me because he felt it was a “conflict of interest” to see two members of the same family.]

So, not only is it really difficult to get in with a psychiatrist in the first place, once you get in, you’re stuck with her no matter what, because everyone else will refuse to see you because they don’t want to get involved in any drama that may be going on between other psychiatrists and their patients.

Aaaaaaaaaaghhhh!

I didn’t feel like I had much of a choice, because I strongly felt I needed a psychiatrist to monitor me because of my family history. Unless I wanted to try and get referred to a psychiatrist in one of the neighbouring cities, wait another six months to get in with him/her and then take time off work to drive a few hours to my appointments, I was stuck.

So, I did what any semi-sane person would do: I went back.

But I went back armed with six months of mood charts, a list of supplements and drugs I’m taking and a very guarded attitude.

It was six months after the first appointment. And the weirdest thing happened.

She was nice.

She smiled, she laughed, she was friendly and helpful.

It was like she had switched personalities since the last time I saw her. This was the woman my doctor had described when she first referred me to a psychiatrist. This is the woman I wish I had had during my first psych appointment when I was scared and vulnerable.

Maybe she has some kind of personality disorder?

I think I’ve also learned how to deal with her. One of the first things I did was hand her a piece of paper with all my supplements and drugs listed, along with the doses. She exclaimed, “Oh, I wish all my patients did this. This is so helpful!”

I then said things like, “I took your advice and started taking fish oil supplements, and I noticed a real difference.”

“I took your advice and went off the Wellbutrin, and I’m really glad I did because I don’t think it was a good drug for me. I feel much better now just on the Celexa, as you suggested.”

“I took your advice and kept a daily mood log, and I’ve brought a graph of all my moods for the past six months here with me for you to look at.”

She was really pleased. “You’re doing everything right! You’re doing so well!”

Of course I was: I had followed all her advice and made sure she knew it.

We looked at my mood graph together and she agreed that there was no hypomania there. I reminded her that the only time in my life that I’ve ever felt hypomanic was when the Effexor made me wonky and again with a high dose of Wellbutrin.

She hasn’t deviated from the initial diagnosis as far as I can tell, but she was much better to deal with this time, and didn’t push any additional drugs on me. She just said we’d monitor it and only respond if something changes. She didn’t try to get me to go off the Celexa either.

So, while the situation isn’t ideal, I think I can work with this woman, particularly if I only have to see her once every six months.

I don’t think I can ever fully trust her, though, because I will never forget the things she said/did during the first appointment and the horrible way she made me feel.

The main problem with this psychiatrist, as far as I can tell, is that she needs to be the authority figure. She doesn’t know what to do with an educated, intelligent women who has done her research and who knows her mind/body/mood well.

During my first appointment, my psychiatrist was very defensive and aggressive, and it seemed as though she was threatened by me asserting myself and not agreeing with everything she said. If I had to guess, it was that dynamic that led to the weird behaviour/accusations on her part.

I was able to diffuse that dynamic by appeasing her in the second appointment, but I did notice that anytime I spoke too much, inserted my opinion, or let my guard down and tried to crack a joke, she would cut me off and dismiss me.

So, it’s all about walking that fine line with her. Acting the part of the patient and choosing my battles in order to get the care that I need in the very weird system we’ve got going on here.

My next appointment is in December. Hopefully, I’ll get her nice personality again. Wish me luck.

I mean, not to draw deep meaning from the G.I. Joe cartoons, but really, it is.  Paying attention to my illness, as annoying as it is to have to be that self-aware, is the only way to ensure that I keep myself out of trouble.  And I’m pretty good at that part.  But.  But?

Did you know that taking a B-vitamin complex supplement has been clinically found to elevate mood in people suffering depression, as has exercise?  

Did you know that Omega-3 fatty acids have been shown to increase time between depressive episodes, among people suffering from unipolar and bipolar depression?  I did, but I’d never read the studies.

Did you know that clinical research is tending to show that antidepressants do not affect the recurrence or severity of depressive episodes in people with bipolar disorder ?  I didn’t, and when it came up during a medication discussion with my psychiatrist a few weeks ago, I was surprised.  I don’t know why– we already knew that antidepressants alone can actually trigger a manic episode, leading to an even worse depressive crash thereafter.

I’m not a doctor.  I am a lawyer who has worked with doctors, extensively.  I am also a civil litigation attorney, used to defending cases where people’s medical records are at issue.  I consider myself well-versed in the news, and I thought I’d done my reading about bipolar, by keeping up with the science and health sections of the Boston Globe (hooray for proximity to one of the top medical areas in the world) and the New York Times, my “paper of record.”  But I still missed things, and I’m embarrassed.  I’m not doing my work, doing the reading that I need to do to be aware of developments in the science.  Especially since brain chemistry is affected by hormones from all over the body, and is “hideously complex,” as my psychiatrist says.  I tend to think of it as playing darts, blindfolded, while balancing on one leg– there’s still so much to be learned.

I’m lucky to have a wonderful set of doctors caring for me.  But they can’t help me with symptoms and behaviors I don’t know are important, and so haven’t reported to them.  Too, doing my reading may give me a new perspective on something I’d never thought about, opening up a new avenue for treatment.  Doing you bipolar homework needn’t be a hypochondriac thing, nor need it be a distrust of your doctors’ advice or ability to keep up with the reading.  It’s simply this:  it takes two to tango, one to lead, and one to follow.  But the one who follows isn’t the patient– it’s the doctor.  My doctors can only treat what they’re aware of.  If I don’t stay abreast of the research, and combine that with my work to mood chart, med chart, symptom chart, then I am not leading, and we’re going to step on each other’s toes or crash into a wall eventually, having steered them in the wrong direction. 

So here’s what I’ve done in my battle to know better.  I’m using my gmail account more efficiently.  I set up a Google Calendar on which to record when I took my meds– since I check my email a lot, switching over to the calendar for a few minutes isn’t too time-consuming.  I take my meds three times a day– it’s hard to keep track of, even with my pill counter– but I’ve set up alarms in my calendar to go to my cell phone, to remind me.  I also enter symptoms– diahrrhea?  Worth tracking, in case I’m having a toxicity episode.  More clumsiness than usual?  A headache that’s different from my regular headaches?  Bad sleep, without the pleasantly weird dreams my medications usually give me?  Irritability?  Anything, and I do mean ANYTHING, that seems interesting or out of the ordinary goes in there.  I then did a brave thing– I emailed an invitation to share the calendars to my psychiatrist, my therapist, and my primary care doctor.  I’m a pretty reliable patient, luckily I’ve never gotten too manic… but knowing they can read the calendar whenever they want, and see how I’m doing, is comforting.  It also gives them a way to hold me accountable if I am NOT reporting things accurately, and if I’m not updating the calendar.  That all keeps them in the know.

To keep me in the know?  Google Alerts.  I set up alerts to come to me once a week about “bipolar research,” “lithium research,” and “depression research.”  I may have to tweak the search descriptions after I start getting my reports, but at this point I figure over-inclusiveness is better– I can use the “Advanced Search” options to refine the queries after I see what I get.  I’m also in the process of setting up better bookmarks to mental health sites such as NAMI and DBSA, as well as NIMH, and a Google Calendar reminder to spend an hour, once a week, checking up on their science alerts.  After all, an hour’s not too much time, since I can’t know too much– especially when I think of the hours that might be lost if I know too little.

(You can ask Google for an invitation to a Gmail account from the Gmail front page.)

I am a control freak, a perfectionist.  I am sure that some of it is the “nurture” effect of being an ACOA, but that’s not all it.  I am, by nature, a Type A as well, and the need to achieve, to prove, to surmount, to perfect is at the firm core of my personality, like the cookie center of a Twix candy bar. 

The ACOA part of the control freak includes the irrational belief that if things go the way I plan, then everything will be Fine.  But I am not Ganesha, remover of obstacles, equipped with the many arms needed to remove roadblocks and keep all those balls in the air. 

The Type A control freak is a little milder than the adult child—the urge to control comes from self-confidence in my intelligence and skills, coupled with just wanting to win.  Of course, the Type A control freak can be just as dangerous—the insistence on doing it my way is not conducive to cooperative working and family relationships.

And buried beneath all of that it my inner child.  She is all to willing to shed the outer adult skin, ill-fitting, stifling, too hot and too cold all at once.  The inside me wants to cede control, yield responsibility.  I want someone to take care of me.  To take care of it.  To take care of everything, always.  Because I’m 33, and feel 80 sometimes, I’ve been working so hard.  I’m tired of being Right, being Responsible. 

Learning to share control is the hardest.  My Type A is convinced that My Way is Right.  Therefore, everyone else is wrong—why would I do it any way but mine?  My Adult Child is afraid—if I don’t do it, I am pathologically certain that no one else will.  I took up those burdens because no one else was, or could—whatever the reason, the fact remains that I am Eldest, Responsible.  Perhaps I was unconsciously self-appointed at first, but in being reliable, others allowed me to remain responsible, ceded their obligations to keep things going. 

In my friendships and loves, I’ve carried Control on my shoulders—until the sheer weight of it caused me to collapse.  Sprawled on the ground, gasping for emotional breathing room, grasping for a sense of self that had nothing to do with solving other people’s problems all the time, I would disappoint the expectations of miracle work I had encouraged others to believe.  When I let them down, they were, in some ways, right to be angry, disappointed, to never speak to me again.  Some of these friends I’m glad are gone from my life, since now I know they were emotional black holes, never reflecting any light or warmth.  But others I miss dearly, and I regret my failures, whether it sprung from something healthy or not.

I’m slowly, creepingly, glacially, trying to not say yes to everything.  I’m slowly trying to let others volunteer first, and to do it their way.  The world won’t end because I wouldn’t have done it that way.  Often enough, my pride is mere vanity.  I’m painfully learning discernment—what requires my real skills and abilities, and what can be done by others, without harm to anyone.  Most frighteningly, I am trying to listen to my inner child, and hear her when she says “I can’t do this alone,” and ask for help.  But yielding control is at least different from losing control, and since so much of my control comes from wanting to please those I love, yielding, ceding, sharing control, asking for help avoids failing those I love.

The self-control, to not take control, is exhausting, exhilarating, illuminating.  Eliminating the knee-jerk assumption of control?  It will be a long journey.  But after many years, I finally think I have an atlas, and a map light.

There is something in my belly, and I finally know what it is. My belly is the storage for very intense emotions, ones that were stuffed far away not to ever be seen, or heard by anyone.

I’ve figured out that when the belly is disrupted in any way, I break out into a serious panic attack. I am certain that it’s been this way for years but I am only now becoming aware of it.

This particular panic attack from the belly region tells me to run very quickly. It begs for a sinkhole to open up on the very ground in which I stand, and to take me away this time. It begs to take me anywhere but here where the pain threatens to swallow me whole.

The lost girl stores her pain in my belly.

If I put on an article of clothing that is too tight, the belly signals the brain to run away as fast as possible because it hurts in there and we must not be reminded of that hurt.

After eating too much of a good meal, the pain signals the brain to crawl into a cave and hide where no one can see us. She is scared; she doesn’t want you to see her. If you see her, it will make it all real and she cannot possibly process everything if it is in fact, real.

My massage therapist, that I used to see on a regular basis told me that I always hold my left side closely, not letting go.

Louise L. Hay writes that problems with the left side of the body “represent receptivity, taking in, feminine energy, women, and the mother.” The stomach “holds nourishment and digests ideas.”

Not only do we store everything in our brains, but also in our bodies. Physical abuse is stored in your body, your body remembers it. This is why I get a certain type of headache around certain people, and why my shoulders lock up in my neck with certain stressful situations.

It is exactly why I used to bite my nails until they bled when I was at her house.

A frightened child who is not letting go of the pain even though it weighs her down is living in my belly. She didn’t have anywhere else to go, and doesn’t know what to do with the pain because it’s all she has.

I am grateful to have finally found her hiding place.

Now, I can invite her to come out so that I can nourish her with the kind and loving energy of a mother who soothes her frightened child.