RealMental

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.)

By Dad Gone Mad

I’m sitting here this morning wondering when our senses of compassion and respect deteriorated to this point.

When did we become so callous and heartless that we started to view a young mother struggling with a mental illness as entertainment?

When did we stop trying to empathize?

When did we find ourselves so miserable with our own existences that we started to distract ourselves by watching someone else fall apart live on TMZ?

I hear the feeble attempts at logic.

When she decided to become an entertainer, she gave up her right to privacy.

Oh, I see. So because she’s makes her living in a spotlight, she can never leave it. Even when that light irrefutably reveals that she’s unwell, that she needs help, that the decent and humane thing to do would be to turn the light off and leave her alone, we refuse.

And let’s not stop at simply broadcasting her breakdown; let’s taunt her on her way down. Let’s call her “Unfitney” and repost pictures of her crotch and act as though we have been personally effected by someone else’s breakdown.

If it bleeds, it leads.

Better her than me.

I’m sitting here this morning wondering if anyone else sees more than one tragedy here.

Originally posted here.

I’m posting this from an airport terminal in Little Rock, where our flight to Orlando has been canceled because we’re fogged in. I can’t access the post I had prepared for today, so I thought I’d pop in and just ask for some feedback.

One of the challenges of keeping things on an even keel for us is STRESS MANAGEMENT. So, events like this can really put us into a tailspin. Alex does great during the crisis, but sometimes, after the fact, when the immediate distress is over, it kind of catches up to him and bowls him over, and we get what we just refer to as a “crash.” So right now, I’m hoping to avoid that. He’s already been pushed into what I’d consider a pre-hypomanic state by all the frenetic activity of the last 24 hours, and these new complications are just prolonging that, which is not good. The number one thing that is difficult for us but so important is the ability to remain FLEXIBLE. And my husband is a planner, so while he absolutely “takes care of business,” rolling with the punches when things get shaken up takes a lot out of him.

So, what are some stress management techniques that y’all have found to be successful, particularly as relates to managing a mental illness and preventing potentially stressful situations from throwing you all off-kilter?

(…continued from “Why I Saw My First Psychiatrist, Part One“)

I left off in Part One of this story with my arrival at my boyfriend’s house after hallucinations of dead bodies slumped over the steering wheels of cars on my way home from a friend’s house. At the time, I lied to him about why I was out of breath, and I feel that I should backtrack in order to explain why I did so.

Although such full-blown hallucinations as the bodies in the cars were new to me, the sudden excessive paranoia and scattered thoughts were not. When I sat down on my boyfriend’s couch after fleeing my nightmare of a walk home, the only thing I could think about was when I was in grades ten and eleven in high school. During those two years, I went through greater and lesser phases of paranoia that involved, at times, keeping my back to walls at all times when alone so as not to be sneaked up on, checking the houseplants for video cameras and microphones, worrying that I was being drugged through my food, hearing distant music coming through the hot-air vents at home, believing that I was waiting for a sign to take my position as the new prophet, assuming that all men were rapists in waiting, and on and on. There were periods during which I was less fearful, but for the most part, I believed that I was under surveillance at all times, and I learned to keep my anxiety to myself accordingly. I would not allow a suspicious look or word out into the public eye lest They find out what I knew: I knew that They were watching, and They knew that I was direct threat to their hegemony.

I hated being fifteen. It was far more complicated than I had bargained for.

Aside from my parents asking me if I wanted to “see someone” once and an English teacher sending me to the guidance counselor over a dark piece of poetry, I managed to keep my behaviour well enough in check to remain unnoticed, and then, with no real effort on my part and for no apparent reason, the cloud of erratic thinking began to ease up. I was no longer a future prophet, They receded into a muddy memory of fanciful thinking, and the houseplants were no longer blinds for spy technology. And yet, the reversion to my old self terrified me.

What was I now without what I had believed I was becoming? Prior to my delusions, I had always lived with depression, and that is where I found myself again. I wanted neither state. Knowing how to behave as a functioning person had saved me from what I saw as unnecessary intervention at the time, and my plan was to continue that way, even though I was deeply unhappy. I wanted no one to know where I had been, because if it came back, and I had been correct, my secret still needed to be kept. As difficult as it had been to suffer so much paranoia and anxiety, I still harboured a desire for it. The possibility of the assurance of my own universal importance was intoxicating.

And then, the next four or five years passed without much incident. I graduated from high school and I moved out on my own. I was unable to hold down a job due to depression and anxiety, but I passed that off as simply being ill-suited to customer service. I was well relative to how things had been, and I wanted to believe that I could remain that way. I saw myself as having dominion over my own mind. I would overcome, and that was that. And then, slowly and quietly, I began to slip away from myself again.

This time, though, I no longer believed that I was a burgeoning prophet or that I was being continually surveilled. The world I grew in my mind to inhabit this time was a wasteland. There were dead bodies in cars. It snowed softly all through long June evenings and nights, as though the weather did not know its own mind, either. My tastebuds went numb, but my ability to perceive colour skyrocketed. I liked to sit well back from riverside paths as a lonely, forgotten thing in the trees and watch the passersby. I had one foot in reality and the other in a place that was never quite there, and I was frightened by my secrets.

So I did not tell my boyfriend when the paranoia returned with such suddenness. I did not want to be told that I was wrong. I did not want to be locked up in an institution for seeing and thinking differently. As scary as it was to have my world shifting out of range, I wanted it to be real. If it was not real, I was lost, and if I was lost, I had nowhere to go. The other me was interminably sad. In the end, I was too scared to be able to keep up the ruse of normalcy as I had before. I knew how far my fear could go.

That June or July, I made an appointment with my doctor so that I could get a referral to a psychiatrist. Part of me worried that They might be real, that I was basically turning myself in to Them. Another part of me knew that the snow I saw falling and settling on spring’s new leaves was seen only by me. I simply wanted to stop, get off somewhere soft, and sleep.

Some time later, I found myself seated in an office building watching impossibly large, six-inch aphids grazing along Dr. Ragu’s hanging plants while I tried to decipher english through his thick, East Indian accent. He asked if they were green, and I said Of course they are. Finally, I felt I had an ally.

By coolbeans

I spent several hours today thinking about what to write. I looked for memes. I checked out writing prompts. I considered ripping off Plain Jane by pulling together my own “Go Read It Today” post.

Instead, I checked my archives to send you back to a post from 2006. But this time last year, I wasn’t writing. At least, I wasn’t writing online.

My empty blog archive sent me to my secret hiding spot for the real dirt my brain coughs up. I dug out the paper journal I’d used last year in the middle of an emotional avalanche. I tipped the notebook back and forth between my palms, feeling its weight, wondering if this wasn’t a really stupid idea. Maybe today’s the day to write bad haiku.

Deep breath
crease the spine
dive inside

There wasn’t an entry for today. In fact, there was a gap between the end of October and the end of November. The closest I came was “I haven’t journaled for almost a month.”

Open to Fall
no words for today
just a dead end

I thought that I might share some of that journal someday. I anticipated scanning pages, blurring text, biting my lip and the bullet as I hit “Publish”. But at finding nothing in the heart of the fall last year, I flipped to the beginning and read through to the end. I wonder what I had thought was worth sharing. When I read it now I’m detached, calm, and judgmental. I think it sounds a little too dramatic. A written prayer feels forced, my plea for a different history reads like melodrama, the need to get everything out of my head looks like exaggeration. I decide, “This is too much. It’s so over-the-top. Who would want to read this? It’s grim and dismal and a little ridiculous.”

But that’s what it sounds like when you want to die.

I moped around for a few minutes because I felt stupid for thinking the things I thought. I was angry for things I wrote. I was angrier for words I didn’t write and couldn’t have written because I never said them.

I didn’t stew for long, though. I don’t have to. I’m on the other side of it and I’m not still writing those things because I’m not still feeling those things. A part of me wonders if maybe it really was selfish and self-indulgent. But I remember to forgive myself. Truly, I struggle to envision how it could have been different. I worked hard to stay on top of things. I was doing everything right but I’d been running on empty and had even gotten out to push for a good long while. There’s only one other way I can imagine getting past everything that I blew the whistle on last year. And now, I can’t imagine not being here to write this today.

_______________

1-800-SUICIDE
(1-800-784-2433)

1-800-273-TALK
(1-800-273-8255)

Originally posted here.

Well, I kicked the puppy. But it wasn’t without provocation– not that it changes how I now feel about the whole thing. Before she arrived, I wondered if I’d be able to tell if she’d ever be able to have an honest conversation with me about how her behavior when I was a kid has affected me, but I’d determined to keep my mouth shut. But I just couldn’t.

Things were actually going pretty well up until after dinner Saturday night. I’d picked her up from my brother’s, and actually felt bad for her because of his reticence around her, and how she seemed starved for conversation. We had a nice day visiting one of her favorite haunts and having lunch, and she was cool with and didn’t pout about the fact that I had to do some work, unexpectedly. We went to the movies, had a good time, and came back to have dinner with a friend of mine who’d wanted to meet her.

It went downhill fast. She immediately started trotting out all her stories of how she was a hot shit thirty years ago, and the conversation inevitably turned to smack talking about my father and how he ruined all her hopes and dreams. I changed the subject several times, but she always tried to yank it right back. I just kept changing the subject. As soon as I left the room, though, she took it upon herself to tell this friend, whom she’d never met before, about how my father used to beat her.

I immediately put an end to the night, and drove the friend home after telling her that she needed to get the fuck over it. When I returned, she was apologetic for saying it to company, but not apologetic for saying it at all.

I’ve been trying to get her to understand that I don’t want to hear about what happened thirty years ago over and over again, and that my focus is on what has changed since then. I tried again to get her to understand that I blame her for not trying, because she felt entitled to blame everyone but herself for her predicament. And I tried to get her to understand that I thought that she needed to take some of the responsibility for her own failures, as well as for how we kids turned out.

It’s like I was speaking a different language, as always. Even worse, she accused me of lying, and then of being revisionist, in terms of how she used to talk about my father in front of us. I may be crazy, bu tI am clear-eyed.  My brother, who won’t ever talk about growing up with me, was good enough to say I was remembering things correctly.  She then started trying to defend herself based on stuff that happened before I was born, without ever listening to me say “I don’t care about that, I care about what you never tried to do to get over it.” Despite repeating that it wasn’t about failure after trying, but about not making the effort in the first place, she continued to harp on the same things that predated my birth, not the changing point/opportunity/watershed that my father’s drunk driving arrest presented for us all.  At a certain point the brick wall I was banging my head against became bloody, so I put an end to that conversation, but not before calling her (and defining) the terms narcissist and  psychopath, and telling her that she has rewritten history for herself because she doesn’t want to face the fact that she didn’t to a damned thing to help herself or us until after I’d left for college, even though she knew she ought.

When I woke up Sunday morning, of course there was a long letter that she’d spent all night writing.  (I once moved out on her after a week of no conversation, just stacks of 3 x 5 cards with accusatory notes at the bottom of the stairs to my room.  Obviously, I was not happy to see this letter.)  Of course, none of it was on point. It was all about things that happened before I was born. None of it dealt with what was the entire focus of the conversation– the time from when I was twelve onward, when Dad’s arrest presented us all with an opportunity to try a different tack, even though starting over isn’t an option. The letter did nothing to help, and just made me feel bloody and broken all over again– you’ve never seen passive aggressive like one of my mother’s letters.

I cried a little, emailed my brother with whom I never speak of these things (his choice, not mine) and asked him if he’d be willing to take her for the afternoon and/or the evening, too, in case I couldn’t stand to have her under my roof any longer. And then, of course, when she woke up, she was moping around and crying and feeling sorry for herself– even though I was the only one who had the ight to be mad.  But, as I said, she’s a narcissist and psychopath.  By the time she’d gotten out of bed, she’d rewritten the entire evening before in her head so that it was an unprovoked attack on her.

My brother was kind enough to confirm that I was not a liar or a revisionist, and my dad actually filled in a few things that confirmed what I’d suspected all along, i.e., that while he was not saint, he did not do the things she said he did, and that she was making things up and rewriting history– but damn, is it hard to learn, much less accept, that the worldview your mother brings to bear has nothing to do with you, or with what’s right, or with what’s true– that her perspective is so limited by her selfishness, her self-centeredness, her complete insecurity and paranoia, that she denies history that’s true, and tries to rewrite her own (and everyone else’s) past. Sorry, Mom. Just telling me I’m wrong doesn’t change things.  And even though you’re living on Planet Mom, everyone else around you knows better.

Having her out of the house let me catch my breath, and grit my teeth to get through the evening “family” birthday party, which my dad wanted to host. But honestly– it’s like I did something wrong, the way she is acting, rather than the other way around. And that’s not just limited. That’s insane– and way crazier than I’ve ever been.  I wish I’d kept my mouth shut when I got back, and just told her I wouldn’t discuss it with her, and let her stew in her own juices– but that probably wouldn’t have worked, either, because she’dve picked, picked, picked at me to forgive her until I exploded anyway.

So, now?  Now I know how limited her reality is.  And now?  Now she’ll have to learn how limited our relationship will be as a result.  Or maybe she won’t.  Since I am never going to discuss anything important or heavy with her again, maybe she’ll think everything is happiness and light.  Or at least she’ll tell herself that it’s true, until she believes it.   And me?  I’ll keep my unlimited grief and anger to myself, and limit my resolution of it to therapy, since I can’t expect it to come from the one source that might have been truly healing.

I have been meaning to write about what these last two weeks have been like for me since I upped my dosage of Celexa from 20 mg to 30 mg, but when I sit down to explain everything, all I can come up with is a hodgepodge of emotive descriptors, such as anxious and defeated and scared.

I want to have more to say than feeling words. I want to be able to tell you what I have done, realizations I have come to, behaviours I am hoping to change, but I have got bupkis. This is not at all surprising, really, because I am still making it through that first month after a dosage change, but don’t we always want to have more to show for all our hard times than orange stains on our fingers from cheez puffs and a dwindling supply of facial tissues? I know I do.

Yesterday, I was setting out cartons of asian takeout and chopsticks and whatnot for the Palinode and me, and you would have thought that I was waiting for someone to beat me by the way I was behaving. My anxiety was so high that I was fumbling with everything, and each time I dropped or bumped something, I would jump or squeak or issue an apology. I ended up reaching such a fever pitch that the Palinode took to patting my arm and saying You’re doing really well, really good, don’t worry, you’re doing fine.

Who needs this kind of support to get through setting out utensils and takeout? Apparently, I do, and it is frustrating. I always have high hopes when I change dosages or medications, so when the road to wellness is bumpy, I take that as a personal failure. I become certain that I am weak, that I am less intelligent than I thought I was, that I am inherently unlovable, that this is all there will ever be for me. I know this line of thinking is not entirely realistic, but even so, these ideas take me by the nose.

If this scenario works out the way I hope, this is just the storm before the calm. My body has to take its (sweet) time to adjust to its new chemical configuration; I have to adjust to not being the kind of anxious depressive I was when my experience of the medication (hopefully) evens out. Transitions are rarely easy, even when they do not involve psychological illnesses, so I just have to keep in mind that I am in transition and try to stay patient.

Is there a drug for patience?

(also posted on Schmutzie’s Milkmoney Or Not, Here I Come)