Monthly Archives: July 2014

Fixation Without Representation

As I went through my belongings in preparation of moving the last two weeks I found a letter that confirmed my suspicion. It was something of an intervention letter from my best friend in high school expressing her concern (and rightly so) for my apparent fixation and total inability to focus on the present -one of the symptoms that contributed greatly to my subsequent (first) psychiatric hospitalization.

The irony was that as I read the letter, I was experiencing a mixed/depressive episode (something my psychiatrist has nicknamed the “three quarters” episode comprised of three quarters depression and one quarter mania) with very similar symptoms as that first big episode.

I can’t claim to be an expert on the human brain or the human heart, or even to know much about which of my symptoms “lend themselves” to which diagnoses… what I can say is that in the realm of what I experience, fixation has been a big problem for me and has greatly contributed to some of the most torturous episodes I’ve ever experienced.

So bipolar, OCD, anxiety… it all feels irrelevant. When my mind and my emotions are one train on one track it seems futile to try to categorize the details. All I know is that the train is headed one way; toward self annihilation.

The fixation issue seems to come about most often when I find myself under a particular amount of scrutiny or rejection. While there are times someone might say,

“You’re being irrational and fixating on things,”

I can usually gladly follow the logic around how the person arrived at that conclusion. Being able to understand where that person is coming from, I can say, “why yes, I am doing those things. Thank you.”

The trouble starts when I am being insulted (and perhaps finding out about it later) or people seem to be going out of their way to attack me (or manipulate me) and I can’t find the logic in it.

An example I can throw out is from the first time this really took place, when my ex-boyfriend was stringing me along while dating another girl. His actions and words did not match whatsoever, and all I wanted, all I longed for, was to understand why.

My mind begins to obsess over every little detail. Every contradictory or accusational thing that has been said echoes over, and over, and over again in my mind, and the only course of action I can seem to take is to argue and plea my case against them.

This month I received some extremely bizarre (and untrue) accusations about myself that left me in the same position. Why would my ex-therapist (among others) act so nice to my face, and then write such bizarre accusations about me in her files? Why would the people I am trusting (the situation involved several others I’m not at liberty to disclose at this point) go out of their way to screw with me? How does attacking someone having a decidedly hard time help anyone?

The voices of all of these people banded together in my mind and took turns bashing me. Every second of every day it was all I could think about, and it was all I could do to argue with each voice, to try to contradict it, to try to stand up for myself… knowing my efforts were truly fruitless and that the voices wouldn’t listen, and even if they did, the relinquishment of their manipulation would only take place in my head (and not in real life).

This is a big part of the reason I couldn’t blog about anything. Every time I tried to write a blog post, I could only get one or two sentences in before the pleading would spill out of my head through my fingers into the computer. I was desperate to focus on something, anything else, but this was one situation where writing only fed the beast. I tried at one point just to write a personal piece about what I was thinking, the arguments, and what was happening. I stepped away from the computer seven hours later and still felt I had barely touched the tip of the iceberg.

Through all of this obsessing, I was angry. I was depressed. I couldn’t sleep because it was all I could think about. In a matter of days I was whittled down to a sharp point, extremely reactive to everyone and everything around me.

If the topic of suicidality in our culture is taboo, the topic of homicidality is taboo to the 10th degree. I realize this, but honestly the issue of homicidality is also one that will send me straight to the hospital much more quickly than most lingering thoughts of suicide will. It is something I have to deal with, and in these sorts of situations (mixed episode, feeling like my back is up against the wall, feeling like I am being attacked from all angles -including from within my own head) I become extremely concerned for the safety of the people around me. When I have spent all of my energy talking back to these angry, accusational voices… I don’t have much energy left to funnel toward self-control.

In a sense, I got lucky. Having that “three quarters” episode meant that I only really spent 1/4 of my time in raging attack mode, and these outrageously angry moments came at me in waves book-ended by the other 3/4 of my time in severe, suicidal depression. If those rage waves would have been any closer together (or longer in duration) I would have opted for hospitalization without question. As it was, I was on the fence… and only because I was supposed to move in a matter of days.

Personally, I think the sort of rapid cycling I experience makes hospitalization a difficult prospect because my mood can change several times just in the time it takes for the intake procedures. At the same time, when it cycles and I am in an impatient unit I quickly get the boot, which doesn’t help because it can quickly cycle back into a dangerous place (within minutes, hours) of being discharged. I’ve experienced a lot of frustration around this phenomenon and because of this it isn’t unusual for me to feel more upset upon leaving than I did when I checked in.

Through all of this, my psychiatrist has really been one person I feel that I can trust. He suggested I go home and wait it out, and I spent the vast majority of my time confined to the apartment until the rage waves subsided and switched exclusively to depression (minus the insomnia).

The end result felt a little counter-intuitive, because what ultimately seemed to help me move past the fixation (and I say that but it still comes and goes) was not talking about it. Not writing about it.

I mean, I tried those things at first (talking about it and writing about it) because those are two things that have always helped me feel a sense of relief in the past about things that were making me anxious. What I experienced this time around though was that talking about the situation with my therapist (for example) only led to his voice contributing to the ones in my head. Every time I was talking about it, I was thinking about the situation more and more, which left me stuck in that “thought loop”.

Writing was equally as fruitless. I tried as hard as I could to outline an argument for myself, to make sense of the pieces I had, and it only left me with new questions to fixate upon. Every word was like a dagger, and seeing them all clumped together gave them more momentum.

Apart from my medical support team, I only told three people what actually happened. I avoided everyone else (for fear they would ask about my current state) until I felt comfortable allowing one or two people to try to draw me into their world of the present. Funny anecdotes about their jobs, or their cats, or whatever. Tiny tidbits to focus on besides me.

Those tidbits made up a gateway, and the moment I fell through the other side was the first shower I took in the new apartment. I was messing with the shower-head spray mechanism and accidentally turned the spray into a high-powered water gun that hit me in the chest and almost knocked me over. The sheer impact and surprise of the situation made me laugh out loud uncontrollably (imagining myself and Kramer with his industrial power shower head)… and for the first time in weeks I breathed a sigh of relief.

Ultimately I’m still not ready to talk about the incident that triggered this whole fiasco (I don’t want to re-start the fixating thought-loop), and though I’ve had a day or two where I’ve been able to come up for air, I’ve noticed some of the mixed symptoms returning in the last 24 hours. Luckily I have an appointment with my psychiatrist this afternoon and an entire blank canvas of an apartment full of possibilities.

When Six Hours Feels Like A Triumph

Last night was the first night in three weeks where I slept for an entire chunk of six hours straight. I’m taking this a s a sign that I am finally moving out of the danger zone (hooray!).

The mixed episode I initially experienced (something I plan to talk a little more in-depth about later this week if I can get things going) gave way to serious depression… at which point my boyfriend and I had to move everything we own to a new apartment. The move was the reason I was trying so hard to stay out of the hospital in the first place, so I generally opted to confine myself to the apartment instead. Thanks to some exceptionally wonderful people in my life we had a lot of help with the move which was a definite plus since I had become little more than a mindless walking husk at that point; beyond exhausted but unable to get any rest.

If anything, the lack of sleep has been a big indicator of how bad things had really gotten because not only am I a big time sleep fiend (I can typically sleep 12-14 hours easy not depressed), but also because my psychiatrist has been ramping up my quetiapine dose (a move notorious for groggy oversleeping) and I somehow began sleeping less and less.

I am still a little out of sorts (I just ate some eggs out of a pie pan for lack of being able to find a plate in any of the boxes in the new place) but after getting a taste of sleep (and a peek at the big blue sky out my window) I felt decidedly less wretched upon waking this morning than any of the last 20+ recent days. Though I expect things to fluctuate throughout the day (it generally does for me) having even one moment of relief is enough of a kick in the pants to keep me going.

Thanks for all the kind comments and messages I received while out of commission! Though I haven’t been able to reply to any of them individually I just want you to know that your words have meant a lot to me during a very distressing time. Receiving supportive words from people while experiencing paranoia and delusions was one of the things that really helped me discredit a lot of the negative things my mind seemed to be generating, so thank you, thank you, thank you again!

“Mixed” Up

Things have taken a bad turn via a rough mixed episode. I am unable to write very clearly, but wanted to note that if things don’t improve soon, hospitalization may be imminent and posting through next week may not be possible. I would really appreciate some good vibes… thanks for your support, hopefully things will bounce back soon.

Hyperbole and a Half – An Accessible Introduction to Depression

Hyperbole and a Half

Let me start by asking when is the last time you laughed? I mean really laughed?

A friend of mine recently passed on a book recommendation to me. She said it was both hilarious and reminded her of me, so I looked into snagging a copy at my local library. I quickly found myself eighty fifth in line to check a copy of that book out which immediately confirmed – this sheezy must be good!

Hyperbole and a Half: Unfortunate Situations, Flawed Coping Mechanisms, Mayhem, and Other Things That Happened is a book by Allie Brosh inspired by her already (rather popular) blog Hyperbole and a Half.

The book itself seems to act as something as a (very loose) memoir with several hilarious stories about her own childhood, the behavior of her eccentric dogs (something any dog owner can associate with) and her desire to learn more about herself and what makes her tick.

Let me just say, the dialogue itself is funny, but the real clincher here is the series of illustrations that go with it, creating something akin to a book with an identity crisis (am I a book or a web comic?).

While funny enough to make me cry from laughing so hard, I wouldn’t suggest this book to you for that simple reason alone.

Allie Brosh’s book takes an interesting turn when she spends a chapter describing  her experience with depression. While I find this chapter extremely relatable (knowing very well what depression feels like myself) I was both intrigued by her continued usage of funny illustrations to help her descriptions and analogies hit home and the way she actually describes depression and how the people around her reacted to her situation.

I would say this book is about 80% light and hilarious, with 20% (maybe even less) focus on serious topics (like depression). Because of this I was immediately struck by how this book makes a great introduction for people who aren’t familiar with depression, coming at the topic initially from a comedic standpoint and then really digging deep to convey what depression feels like and how difficult it can be to convey to others.

While this book is in and of itself great (I will definitely buy a copy, I loved it) I think it would make a wonderful tool for anyone who is trying to reach out to someone either with depressive symptoms who wont address them, or to help gently explain to others what living with depression is like before having a more serious conversation about the subject.

I feel like people are always asking, “how can I bring up the subject of [depression/mental illness] in a positive way with the people around me? how do I know how my [co-worker/family member/friend] will react?”

Well, one answer might be to give this book a read and share it with the people around you. After they’ve read it, you could ask what they thought about the portion about depression, and I can see this really helping to create a dialogue between people (especially young adults, teens) on the topic.

Depression can feel like a very heavy, intense topic, so being able to approach it in a smart, fun way (sandwiched between two hearty portions of comedy) makes a discussion about it more accessible to a wider audience.

As I mentioned, this book has a lot to offer and I was very impressed by how something seemingly silly could offer up something profound.

You can check out Allie Brosh’s blog Hyperbole and a Half here, and you can find her book at your local library or at (where the image in this post came from) here!


Support Needed for Mental Illness in the Workplace

Happy Monday! Today I want to share a recent article from USA Today that seems to address some issues I’ve been seeing (and living, let’s face it) about a lack of support around people with mental illness in the workplace.

I’ve been hitting a lot of big roadblocks when it comes to applying for SSDI, and I’ve honestly had some big questions about how our disability system works (or doesn’t work) here in the US. I’ve come across countless people who are against the whole idea of SSDI because it doesn’t support people who are disabled and want to work part time, and the current system seems to only support an “all” or “nothing” style of support. There have been so many situations I’ve found myself in where I know I could mentally benefit from working a few hours a week (giving my life a better sense of structure and a bigger sense of accomplishment and purpose) but the way the system is set up, trying to help myself this way is extremely frowned upon.

The article I’m sharing today addresses the idea of a “supported employment program” that potentially allows employers to do a better job of bridging the gap between the needs of their companies and realistic employment abilities of those with mental illness (which, let’s be honest, can widely vary for any given person over time). Personally, I consider this to be a stellar idea… I am just not sure how well this could realistically be executed. If companies aren’t currently willing to make the necessary accommodations for exceptionally well qualified applicants with mental illness as it is (something I have experienced several times), what would encourage them to use a program like this one?

At any rate, you can check out the article here. Give it a read and let me know what you think!

Moving; Looking at Life in Hindsight

This Friday I thought I would start by leaving you with some good news; after a very lengthy application process and some big hiccups we’ve been approved for the apartment we wanted!

Living in Seattle has involved a lot of moving for me. Since moving here in 2006 I’ve moved 8 times, and the last three years at our current place is the longest stretch I’ve gone in one place since moving away from home at age 18.

When I got to the city I was moving around so much I didn’t accumulate much (in terms of stuff) but having been staying put the last 3 years has meant diving into a much more intense packing process. Beyond the usual stuff I’ve gleaned (boxes and boxes of fabric, more rik-rak ribbon than any one person rightfully needs) I have also accumulated an extraordinary amount of paper goods.

Part of the anxiety I have involves keeping pieces of paper that I deem “important”. Apparently… this means everything. Like, a doodle I did of a dog, or our light bill from the 8th month we lived here. Looking back while packing, I can see clear periods where I attempted to clean some of this up and then slumped back into depression, leaving behind piles representing particular periods of time scattered throughout the apartment.

Most of the papers I’ve gone through in the last week have been repetitive. SSDI paperwork. DSHS paperwork. Insurance (or lack-thereof) paperwork. Yes, important at the time, but now a year or more later… useless.

Every so often I strike gold and find something useful.

“Oh good, I’m glad I really DID put a forbearance on my student loans!”

Because… who knows at this point. I can’t remember a whole lot!

In one of the piles I hit the equivalent of a gold nugget; the workbook I filled out during my last hospitalization in 2011. 

I leafed through it knowing I had scribbled crap down in there right before being released because I had found out filling out the pages was required rather late in the game. One loose page fell out though, and this one looked genuine. It said:

Positive Momentum

1.) On the left side of the page, identify which one of these areas you are struggling with the most and write it out. (Think about why you came in the door).

(I didn’t have the left side of the page, but what I wrote seemed pretty self explanatory.)

“Wearing the mask – I don’t normally express my feelings in a daily setting.”

2.) Ask yourself how you might be able to think about or do things differently to get some kind of positive momentum going for yourself?

“I would like to see a talk therapist again and continue gradually letting my boyfriend in.”


A few days ago when I read that, bells and whistles went off in my head, particularly the response to question one. Frankly, even though my symptoms have gotten noticeably worse since then (overall) I feel eons better after dropping the act, “the mask”, and allowing myself to show real emotion (even if it is out of proportion at times) instead of trying to keep it contained internally or just in journals.

I was happy to see that the response to question two is one that I have followed through on. Not only do I have a therapist (which has helped me continue to express those feelings from question one) but I have talked a lot to Corey about the things I am dealing with and he is usually the first to help me brainstorm a workable solution (even if that solution is to do nothing).

Sometimes it can be hard for me to look back, I normally don’t allow myself to read my own journals because I find them triggering and my blog posts are structured much more differently than my everyday sort of casual, emotional writing. It can be hard to know if things have really gotten any better, but this one piece of paper (found in thousands) was a nice reminder that I have moved forward and by continuing to do the things I’ve set out to do, I am continuing to help myself.

In a stressful situation, it is amazing how finding a needle in a haystack has helped bolster my confidence about getting things done and moving on to something different. After all, this single page is a real reminder of how different can be great.

When An Opt-Out Isn’t a Cop Out; Inclusivity and Event Planning

I’ve been kind of surprised lately at how many people I’ve talked to who were pissed off at a friend or relative for not attending an event they hosted.

I mean, how rude, right? Nobody likes to plan a party and have the people they believe they can count on not show up.

Frankly, I’ve been a little appalled at this attitude, because for someone like me… opting out of an event almost exclusively means avoiding a potentially ticking time-bomb (me) going off at said event. If I am not there, there is always a reason, and more often than not having bipolar disorder or severe anxiety means a reason that could potentially include avoiding hostile or aggressive social head-butting, irritable commentary, or panic attack scenes that can bring any good event to its knees.

It seems the like hosts of most events don’t understand the sort of behind-the-scenes time-bomb at work here, and try as I might to explain that having one or two ultra sensitive people take the time to discern their presence might be inappropriate as a positive thing, many people take these actions way too personally. At the same time, I think hosts could do a better job of making events more comfortable for a wider audience… but that requires a level of sensitivity and understanding that some people simply don’t seem to posses.

While I’ve gotten a little leeway the past couple years (simply for being so open about what I’m dealing with) there are many people I’ve seen with similar issues unwilling to be straightforward about them or still in denial about having any issues in the first place. It seems like these folks often get the brunt of the host-hostility anger train, which is unfortunate because they need as much support as anyone else.

For me, it has been really difficult to allow myself not to go to an event I am planning on going to. At the same time, I often have a pretty big struggle trying to get myself to go (thanks, anxiety!) so there can be a huge conflict in my mind in any given situations about whether my actions (or inaction) is justified.

Is the part of me telling me to stay home simply anxiety, or is it something more concerning? Would going out improve my depressive symptoms, or make me irritable and uncomfortable the whole night?

Beyond those internal sort of factors, there are a lot of external factors that go into making a decision to attend/not attend any given event.

->Are there going to be people there that I have had traumatic experiences with?
->Do I have an easy, straightforward way to get there and (more importantly) to get home?
->Are the other guests people I already know, or are they primarily strangers?
->Will everyone be drinking heavily except me?

and so on.

When I am facing an elevated mood, my screening process often goes out the window allowing for me to walk into some potentially dangerous situations. What I’ve found is that no matter how great I feel when I walk in the door, certain factors (like being unable to leave easily and without making a fuss) can flip a switch in me opening the door for aggressive mixed episodes or panic up the yin-yang.

One of the more recent moments where this happened left me barreling into a situation where I went to the top of the Space Needle (big mistake, I have a terrible fear of heights) and had to be escorted back down to the ground after having an earth-shattering panic attack in the revolving restaurant at the top. I was frantically waddling (yes waddling, I felt like I would fall if I stood straight up) and bumping into people’s tables while they spent an inordinate amount of money on mediocre food. My bizarre behavior was, no doubt, a precursor to at least one proposal of marriage that night… I guess that’s a fun story to tell the kids!


I’m in the process now of coming to terms with an opt-out that has been nagging me for a couple weeks. Next month is my 10 year high school reunion, and after relinquishing perceived control (I say perceived because I was the class president our senior year which means people automatically believe I would plan the reunion) over the planning portion of the event, the person who stepped in decided to have it on a boat.

This breaks one of the big Sarah commandments, and I know (especially after the Space Needle incident) I cannot allow myself to walk into a confined space without a fast, easy escape route. For me, the distinction between “fun on a boat!” and “trapped on a boat!” is very, very minute. Throw in mingling with the bullies and assholes of high school and what you have is the perfect storm.

Frankly, the whole situation is more likely to turn into the movie “Carrie” than to go well for me, so I have to face the reality; I simply can’t go.

I felt very proud of myself for stepping forward and telling people an event on a boat wasn’t appropriate for me. There were even a few people who joined in and agreed. I don’t know where my surprise came from when the response was the same it had been 10 years ago in high school; you can set something else up, we will go on the boat. 

That is the part where I’ve always swooped in to try to save things, I did it from 6th – 12th grade. Only this time I already told them I can’t. I’m not willing to sacrifice my health by simultaneously moving and planning an event on an island I don’t even live on anymore. Heck, I’ve been barely hanging on just in the moving department… I know anything more would tip the bipolar scales very quickly out of my favor.

I genuinely wish this sort of thing didn’t bother me, but it always has. This whole situation has been a nightmare where I’m re-living being deemed a second-class citizen by my peers. I guess it was silly to imagine they’d all gotten a clue and grown up (at least a little) but I guess that is something I’ll have to revisit in another ten years.


What can event hosts do to help reach a wider audience of guests? Whether it is a backyard BBQ or a movie night or even something bigger, here are a few tips to promote an inclusive, pro-mentally healthy party or event.

  • Keep the cost of attendance low. It can be easy for someone in a high-paying job to forget friends or relatives may not have the same kind of cash. Having an event with a free or low entry fee is a good way to appeal to a wider audience.
  • Offer a variety of food and beverage options or let people know if options are limited. Having a non-alcoholic beverage available can be a great way to reach out to people who can’t drink due to pregnancy or other health concerns. Another great way to take care of this is with a potluck, so people can bring food or drinks that meet their dietary needs.
  • Consider your venue carefully. With those invited with physical disabilities be able to get around easily? Are there allergens like dogs or cats that people need to know about? Is there transportation or parking around the venue? Is this a place people can leave easily in the event of an emergency (kids, mental-health, etc)?
  • Choose your time period carefully. Have you invited guests far out enough in advance that they can make arrangements to come? At the same time, has the time you’ve chosen for the event make sense for the people you are inviting? It is important to remember that some people can’t stay out late because of their work schedule, children, pets, or medications.
  • Be flexible on timing. Usually allowing guests to arrive late or leave early will mean getting a greater number of guests to attend. Likewise, guests who have health problems may need to change their attendance needs based on their health, which might mean staying only for a short period or leaving abruptly.
  • Don’t take it personally. If guests cancel at the last minute or opt-out of the event, ask if there was something you could do to make things work better next time. While some people genuinely have things come up (health, babysitter canceling, etc.) others might have issues with something unforeseen you may not have planned for. Asking if making a change might help will also let your guests see you are genuinely interested in their attendance, and implementing that change (even if just for one or two guests) can do a lot to show that you want everyone to have a great time!