The Difficult Relationship of the Empath

I read an article today I thought I would share called The Toxic Attraction Between an Empath and a Narcissist. While I find the article to be a little rough (and I certainly don’t agree with all of the generalizations) it did make me look at the relationships I have had with people a little differently… and therefore was worth the read.

Every bipolar support group I have gone to that has brought up personality categories or alternative views on bipolar symptoms as a “mental illness” has typically led to one word: empath.

An empath is someone who can easily find themselves feeling the emotions of others, and generally has little trouble imagining themselves in someone else’s shoes.

Needless to say, when I sat in a room of people with a bipolar diagnosis and found that every single one scored the same result (empath) I wasn’t surprised. I have known for a long time that the emotional state of those around me have a huge effect on my own emotions and that I have always had a genuine desire to help others (being able to feel and see situations from their perspective), but it took me many years to learn that there were people who were interested in manipulating these traits and that I needed to protect myself by being selective of the relationships I have with others.

One of the best things I have done for myself is to keep the relationships I have with open, genuine people and discard the rest.

At any rate, an interesting read… and if you’ve found yourself drawn to people who tend to hurt you (romantically or otherwise) check it out!

Keaton Ferris; Mistreatment Bringing a Town Together

*Trigger warning; contains some detail about the mistreatment and death of a man with mental illness*

It seems like every day I hear of a new situation where someone with mental illness has been taken advantage of, abused, or killed with little repercussion. It isn’t every day, however, that I hear about this happening in the small town of Coupeville I grew up in on Whidbey Island in Washington State.

That isn’t to say it doesn’t happen there. I definitely received some spotty (at best) mental healthcare when I lived there 15 years ago, but reports from my family, friends, the community, and the local news have detailed a story much more disturbing than I could have imagined happening in my tiny, sleepy town on my own.

Keaton Ferris, a 25 year old local man who was diagnosed with bipolar disorder was in the Island County jail after not showing up for a hearing. Two weeks later, he was found dead in his cell, with the autopsy report showing he had been denied enough food and water to survive; he died of dehydration.

His parents had been asking to visit him but staff denied all of their attempts to see their son, and they were never told that he was physically unwell.

Allegedly Keaton was denied his medication in jail and quickly became psychotic, at which point the staff was unwilling to treat him properly because they were afraid of his violent behavior.

(Keep in mind, there is a hospital three blocks from the jail, and though there are hospitals in Washington state designed to house and treat people in the criminal justice system with extreme mental illness, they are often too full to take on new patients, leaving them at local hospitals or jails that are completely unequipped to manage in a professional way.)

While the staff neglected to properly feed and hydrate Keaton, they also did not check on him regularly (as policy dictates). By the time he was found deceased, the coroner has reported that he had been dead several hours without notice.

I guess this situation is hitting pretty close to home for me because I spent the first 18 years of my life in that town. Well, that and I know what being on the receiving end of discrimination because of mental illness feels like, even to the point of having staff withhold my medications and becoming very ill. I feel lucky that I have made it to this point, but as a young woman with mental illness, the writing is on the wall.

If this could happen to Keaton Ferris it could happen to me, and that is a truly terrifying notion.

My goal is not to instill fear in anyone, but just to tell stories of my experiences and the experiences of those around me who can’t speak for themselves. Equal rights, proper treatment, and the acknowledgement of our medical needs in times of mental crisis seem like the basic human rights anyone deserves, right?

So where are they?

There was recently a rally in front of the jail where community members gathered to protest the treatment Keaton received, and while I wouldn’t ever suggest that one young man’s torture and death is a positive thing, I am certain that this situation will touch the lives of every person in that town, and I expect people will begin to think differently about mental illness… begin to act differently about it… and that is how the change begins.

You probably aren’t part of this small community, but that doesn’t mean this story wont touch you, or infuriate you, or inspire you to change even one or two small things in your life that will make a difference when we put them all together.

I would encourage anyone who is interested in learning more or helping support our community’s cause of demanding equal rights and treatment for those with mental illness in the criminal justice system can find all news articles, videos, and up to date information at Keatonh2o.com

The Many Faces of Psychosis

My attempts at writing lately have not been particularly fruitful, but I have finally gotten some sleep. Unfortunately, the sleep was also accompanied by several intense conversations with my health care team pointing to ongoing psychosis the past few weeks (at least).

When it comes to psychosis I find myself in something of a pickle. I have not been able to tolerate taking an antipsychotic on a daily basis (because of intense side effects like ultra-rapid weight gain and feeling so fatigued and exhausted I can barely move) so my psychiatrist allows me to take it only in times I am experiencing psychosis. It definitely isn’t the sort of thing I would generally expect is a good idea, however my rapid cycling paired with my inability to tolerate the drugs for more than a few days at a time make it more useful than, say, nothing at all. Many times it seems like one or two days are enough to kick the legs out from under the psychosis before my mood cycles away from it.

The biggest hurdle in this method for me has been being able to identify when the psychosis is present on my own. With a good team looking out for me (my boyfriend included) it becomes easier… but even after meeting this “character” (psychosis) on and off for at least the last 50% of my life I have a hard time picking it out of a crowd.

Meeting psychosis when physically ill or on various medications has left memories that were already too fuzzy around the edges to be able to account for an accurate depiction.

Meeting psychosis when manic has been like stumbling upon a huge party where the music and lights are easily drowning out the words and the intentions of the faces I see around me.

Meeting psychosis when in a mixed episode has been like crawling into a crime novel where I don’t know who I can trust, and psychosis might look just as innocent or guilty as anyone else I stumble upon… leaving me with no distinguishing features.

Finally, meeting psychosis when I feel (or think I feel) stable has been the most confusing thing of all. The encounter is totally unexpected, and I find myself quickly trying to write the ensuing conversations and situations off as simple irrational fear or rapid mood swings happening too fast for me to put a defining stamp on them.

The best indicator I have of psychosis is when pieces of my life, pieces of stories don’t line up the way they ought to. When the memories I have don’t correspond with the half dozen other people who were there at the time. When my boyfriend seems to have me caught in a “lie” but as far as I know, I’ve only spoken the truth.

At any rate, I expect to spend the rest of the day on the couch due to the exhaustion I feel from the rispiridone today, but if that is what is necessary to aid in alleviating the confusion, I am ready to do it.

the mania/insomnia symbiosis

I am no stranger to insomnia. I’ve experienced the overactive brain induced insomnia, the straight up fear and adrenaline based kind (airplanes are notorious for producing that for me), even insomnia formed by a series of horrible nightmares and my body and mind developing a fear of sleeping.

Typically, though, the type of insomnia that tends to really sneak up on me (and especially in the summer) is the kind where I’ve missed my sleep window and can’t reclaim it.

My energy level is very rarely a straight line, it is more often a series of peaks and valleys, and their intensity seems to be associated with my mood swings, diet, and anxiety or excitement, among other things. I have found that for my situation, going to sleep in the evening at the first sign of tiredness has typically been the only way for me to ensure I get to sleep. The problem is that this energy trough might occur at 6 pm (right after I’ve eaten dinner) and the best case scenario would put me in a position to wake up the next morning at 6 am. Once that energy lull passes, I can find myself wide awake again -thus unable to sleep.

I’ve always needed a lot of sleep. More than most people. 12 hours tends to leave me in the best emotional position the next morning, but 10 hours can be manageable.

Missing my sleep window because of anxiety or outside forces (loud neighbors, hot apartment, unfavorable reactions to medications, etc.) might mean I only get 7 hours, sometimes less. That might be sustainable for a day or two, but the longer I go without sleep, the more symptoms of mania I begin to acquire. The more symptoms of mania (even hypomania) I acquire, the less likely I am to be able to sleep the next night.

This fuel might be racing thoughts, or a huge spike in energy, or euphoria (where feeling good seems to counteract the idea of sleeping) among others. Regardless, these traits begin to mix with an increasing fog that sets in from insomnia. My actions start to feel like they matter less, since the fog distorts any of the negative consequences that might be on the horizon… leading to impulsive and relatively irrational decision making. That poor decision making might include missing my next sleep window, when one (rarely, with hypo/mania) occurs.

Keeping my mood under control begins to feel less important, as my sudden frequent crying spells also begin to alternate with fits of hysterical laughter can’t contain… and though there is an audience at the grocery store as I have a laughing fit so severe I am crying and sitting on the floor, it just makes me laugh harder because their concerned faces look increasingly hilarious to me.

Insomnia makes me feel like I am doing a better job of managing my mood swings even though I have had several outside opinions that this idea is not true. While I definitely become more reactive and my swings can land in rapid succession (as they do normally for me, many in a day) my perspective on this situation varies largely from an outside opinion. An outsider might argue I am more difficult to manage (since my brain seems too tiered to bother with trying to negate my impulses triggered by mood swings… well, and the fact that I begin to express everything that crosses my mind, even to strangers) but the euphoria I experience makes me feel that I am doing a great job of taking care of myself, and the fog that has come from not sleeping makes every moment that isn’t the present seem long gone. Out of sight, out of mind.

Ultimately, I find that insomnia may not be the primary trigger of mania on all of the occasions that I experience it, but it does typically perpetuate manic and hypomanic symptoms for me in a symbiotic way.

The less I sleep, the more manic I become.

The more manic I become, the less I sleep.

 

Like a Fish Out of Water; Surgery and the Hospital Outside the Psych Ward

Well, it’s happened. I’ve made it through my hysterectomy slash bowel-resection surgery and in hindsight it appears that having an exploratory surgery a month previous to this one gave both my doctors and myself the opportunity to work all the kinks out before tackling the more serious subject of my bowel being invaded by endometrial tissue.

The two weeks leading up to surgery were torturous and the overwhelming amount of anxiety I was feeling about the aftermath led me to skirt around the fringes of paranoia when it began to escalate.

Generally for me, paranoia tends to take the form of the belief that someone is trying to kill and/or undermine me in some way. My paranoia stemmed not from the surgery itself but from the 5-7 days I was expected to spend in the hospital recovering after surgery.

I had never spent time in a hospital –that is to say, I have never spent time in the hospital, save the psychiatric ward. Trying to fend for myself in a psychiatric ward (and by that I mean communicate properly with my doctors and nurses about my particular medication sensitivities and the odd tendencies of some of my psychiatric symptoms) has often led to both a communication breakdown and further exacerbation of whatever unfortunate mental state that landed me there in the first place. This is an issue I’ve had with many regular doctors as well, so the idea of being drugged (or asleep) in a hospital bed and at the mercy of whoever was on duty that shift frankly scared the hell out of me.

To offset my crippling fear of facing (another) abusive nurse or another medication slip up (as happened with my last surgery) I spent the week leading up to surgery generally huddled in my apartment making list after list of instructions, drugs to avoid, people to contact in the event of psychosis or mania induced by medications, etc. followed by lists about each of the lists, color coded and copied several times over to be available on my bedside table.

Though I found this slightly soothing, there was still an extraordinary amount of fear. What would happen if I had to share a hospital room with a stranger? Would my PTSD land me in a situation where I became manic or psychotic -as it has several times in the past? And what about if I did become manic or psychotic, how would the hospital staff respond to that? The hospital I was to have surgery at doesn’t have a psychiatric unit, so I was baffled at what might take place if I needed one.

A touchy subject for me, given my history of difficult hospitalizations and abuse in hospitals. Thankfully it was not one I needed to explore, because after speaking at length with my surgeons and anesthesia team on surgery day we made a quick decision that allowed me to bypass the use of narcotic pain killers almost entirely. I opted instead to receive an epidural, which numbed my body from my waist to my knees, rendering the use of the narcotics (that have proven to be big time triggers for me in the past) unnecessary.

So not only was I not triggered by the narcotics, I did not require much medication for nausea (also a trigger for me) since I was without the narcotics. I was able to be put in a private room (given my mental health history and luck regarding room availability) and since I only had to take a small fraction of the drugs I would have otherwise, I was generally alert and able to communicate with the staff more easily regarding my drug allergies and (psych) medication needs. My alertness definitely helped ease my concerns in the area of paranoia… though I did wake up once or twice in the middle of the night certain that the balloons next to my bed were up to no good.

Actually, the bigger problem (in terms of my mental health) in the hospital was the fact that my vitals were being taken every hour over night, so I was not able to get more than 45-50 minutes of sleep at a time. Sleep disruption can also be a trigger for me (both in terms of mania and depression) so I opted to get home from the hospital as soon as humanly possible.

Generally speaking, the staff in the regular part of the hospital were much more kind and eager to listen than those I have met in the psych wards in the hospitals I have been to. I feel very lucky that they treated me respectfully and did not discount my concerns merely because I have a mental illness, something that unfortunately is a serious issue in many psychiatric units today.

I definitely can’t say that I went the four days in the hospital without any mood swings at all, but they were generally depressive waves… much more easily managed laying around in a bed all day than mania. In the last week I’ve been home they have definitely been increasing in frequency and severity, but I am hopeful that being able to finally diversify my meals a little bit and spending more time without intense pain (rather than with it) will help tip the emotional scales back in my favor.

All in all, I would say that the surgery and hospital time went better than I expected. There were no incidences with bad medication reactions, or particularly volatile interactions with the staff (ok, maybe one), and it felt like a totally different experience when my doctors made everyone else adhere to my psychiatric and physical particulars.

The difference this time around surely came from one of my surgeons having had a foster daughter with bipolar disorder. He has a first hand experience seeing the sorts of episodes and behavior that can be triggered (for me at least) by many medications, among other things, and there is no doubt in my mind that this led to him directly telling the staff to take my concerns very seriously. Frankly, he seemed just as concerned about triggering me as I was, which is how I imagine (in a perfect world) healthcare professionals should act!

Anyway, I am glad to be home.

Brain and Body – One Unit

With my next surgery only three weeks away, any sort of mental stability has been… skittish, at best. The nice weather has helped instill some good hypomanic moments, but I have been randomly transforming into a raging hose-beast from anywhere to 5 minutes to several hours at a time. Highlights include when my lawyer told me to “call him back when I felt more emotionally stable,” (good luck there buddy), or my explosion at my boyfriend for [me] not being able to find a reasonable anniversary gift for him. Whoops.

Overall, pain and eating issues/the fact that my body isn’t interested in going more than 15-45 minutes without requiring a restroom has been a large stressful addition to an already jacked up mental state. Not being able to eat the food I want (that would normally comfort me in times of stress) has been pretty difficult, and the embarrassment of having to ask the deli clerk to watch my basket at the grocery store while I use the bathroom three times in one 15 minute visit doesn’t feel so nice either.

Ultimately, the issue that my surgeon found during the last surgery is that my uterus (having grown diseased endometrial tissue) has become connected to my colon. While this seemed weird (and the doctors expressed that feeling too) I imagined the two bound by a small, maybe quarter size area that could be sliced apart… case closed right?

Uterus vs. Colon

Unfortunately that isn’t the situation. My uterus is now holding my colon hostage and is connected for a long stretch of both. I am happy that this explains the pain, nausea, and inability to eat… as well as some other, less pretty problems I’ve been having, but the fix isn’t quite so quick as I might have imagined.

Why even write about that here? I mean, I thought about that, and I thought about not going so in-depth about a health problem that isn’t mental health related.

Oh wait! But it IS!

The biggest issue my doctors and surgeons have had to wrap their head around is that I have a pretty severe case of bipolar disorder. Because of this, many aspects of my symptoms, my treatments, and my recovery are different from most people.

My symptoms include physical pain, but this is a big purveyor of emotional stress for me, which means triggers for emotional outbursts and episodes . At the same time, my symptoms of being unable to eat a long list of yummy things (dairy, beef, spices that aren’t salt, fatty or fried foods, seafood, acidic foods, the list goes on…) disrupts my typical “self-care” routine when it comes to finding joy in what I am eating. Having less options to draw on in maintaining my mental stability means less stability!

My treatment of this health problem is atypical because all typical treatments (using hormone therapy) trigger severe emotional reactions for me. That means the best option I have is a procedure (hysterectomy) that is normally reserved for women much older than me. Granted, I have never been interested in having children (so I dodged a bullet there) but upcoming surgery is, again, stressful, and despite my disinterest in having children my subconscious is still grappling with the idea and I’ve had nightmares every night.

My recovery will also be different than the norm because I have the added risk of post-surgery medications triggering episodes (like last surgery). Once again, the pool of self-care resources I will have will diminish as I will be immobile, and feeling “trapped” has always been a big trigger for me. The physical pain will continue to be an issue for a while and there is the possibility I will need to be on a liquid diet for a while as well (depending on how much surgery is done on my colon). So, um… stress much?

All in all, there is no separating my mental and physical health from one another. Even though my brain isn’t down in my abdomen having tug-of-war party with my uterus and colon, they are connected. It’s called a body! It is generally considered one unit.

At any rate, this is a situation that I know will require physical work. It will require mental work. It will require emotional work. If that is the price it takes at a chance of feeling better, as usual, I will take it.

 

There and Back Again; A Bipolar Surgery Patient’s Tale

While I’m not in a position to either calmly nor collectively express myself right now, I thought it important to pop in and let everyone know that at the very least, I survived surgery last month.

Healing from the surgery itself seemed to bring me no more pain than I was experiencing prior to the surgery, however I hit a number of speed bumps that have made it exceptionally difficult to write.

The first was a nerve in my abnormal cavity being pinched by my diaphragm post-surgery, and while this was very painful it was the fact that the doctors couldn’t rule it out as a blood clot that made things very intense for a short period right after surgery.

After that I had a really bad reaction to some of the medication I was given (not a new experience for me, given the reactions I’ve had to most psych drugs… I have the same problem with drugs in all categories). After being unable to consume anything but water for three days (including my normal medications) I slipped into a very interesting delirious state that quickly escalated into mania.

So the third hurdle was a bipolar one and frankly one I was rather expecting -though I can’t say I was expecting mania, more of an expectation for depression (given the pain). Things started out energetic and euphoric and after a couple of days without sleeping my boyfriend confronted me about his concern that I wasn’t resting properly. This was enough of a red flag for me to prepare myself for taking my as-needed I’m-kicking-mania-to-the-curb antipsychotic that evening, but even if it hadn’t been the paranoia and conversations I began having with people who were not present later that day were enough to get the job done.

After taking the emergency rispiridone I spent 48 hours in a zombified, half unconscious state. It wasn’t until the emotional void wore off that I found myself plummeting down the depressive rabbit hole.

I’ve gone back up and back down a couple times since, had probably twice as many panic attacks as usual, and I am honestly really struggling to find a balance between taking care of myself and resting. I expect that this is difficult in a normal situation, but resting when I can’t sit still and going to my follow up appointments when I am feeling exhausted has been doubly difficult. The emotional roller coaster isn’t fun, but not being able to rely on my body for information on how it is feeling at any given time (since my energy level fluctuates with my mood, not my level of health) is confusing, at best.

It is important to me to try and take a positive spin on this, and even though this has been difficult I am generally managing to claw my way through (with a LOT of outside help). Despite how overwhelmed I feel, finding out this week that I will need a second larger surgery in a month or two to address the issues found during the first surgery has left me with a loss for words. When it is hard for me to identify how I feel about something, it is even more difficult for me to write about it.

I have many thoughts and experiences I want to write about, and while they are things I plan to share I have no foreseeable timeline. In the meantime just know that I will be posting whenever I find myself in a place somewhat less tumultuous.

Thanks for reading!