Monthly Archives: February 2016

The Trustworthy or Untrustworthy Self

I have always tended to operate under a series of hard rules. Hard Rules; you know, like “oh crap, I just touched that burner and it was hot!”

New rule: don’t touch hot burners!

This is a rule that is always true. If I see a hot burner, I don’t touch it (at least, never on purpose but I’m a bit of a klutz). Having said that, many of these sorts of rules that I’ve gathered up over the years have been helpful, some even life-saving. Don’t throw temper tantrums at your boss. Don’t swim out into Puget Sound where the undertow can drown you. Don’t get in a car with a random stranger. Don’t ever wear black and brown together.

Sounds useful right? Well, for the most part it is, but I have always had a tendency of somehow shuffling all rules into the “hard rule” category. Inflexible. Rigid. Once it is there, it is there forever.

Even though that is a concept that seems useful when it comes to ideas like “don’t touch a hot stove burner,” it is useful because a hot stove burner is always hot.

On the flipside, there are aspects of my life and of having bipolar disorder that might be true sometimes and not true others. Of course, in my life having a mental illness is true, but to say that I am always manic or depressed or agitated or homicidal or suicidal is not true.

These sorts of facts lead me to strange places somewhat reminiscent of math class where these rules become much more complex.

“My suicidality warrants hospitalization if and only if it is a level three on my suicidality scale, requiring x, y, and z… (you get it).”

Despite all the nit-picking and tweaking that has gone into these rules, these ways in which I keep myself alive and relatively healthy, there is one that somehow slipped under the radar. It managed to sneak into the hard rule category without any real revisions over a period of years:

Because of my bipolar symptoms, I am not trustworthy.

These days I can see the difference between a generalization and a rule, but the truth of the matter is that despite how my understanding of myself and my symptoms have improved, there has been a wall of fear that has kept me from being able to edit this statement.

I don’t know exactly where it came from, I don’t know if it was something external that I was told or that people suggested or if it was purely created out of the fear I had of myself and my inability to control myself sometimes. Yes, there have been some incidences that have scared people, but I expect this rule is probably more about how much I scared myself.

For me there was always a big fog around my symptoms or any number of the unhealthy urges swirling around inside me at any given time. I mean, what if something happened? What if they just slipped out before I could realize it?

For many years I allowed myself to defer back to this rule. When people would ask me,

“Oh, do you want to hold my baby?”

or

“Can you watch the cash register for me for a minute?”

or

“Mind unwrapping this new kitchen knife set with me real quick?”

The answer was always no. No, sorry, I might punt your baby. Or steal all the money. Or suddenly believe I can juggle knives.

A few years ago I had a friend who had a baby and she insisted I hold him. As it turned out, I held him and he didn’t burst into flames. Or turn into a squealing pig. In fact, nothing weird or inappropriate happened. After returning the baby to her I considered two things that really shook the foundation of the untrustworthy rule I had created.

  1. My friend trusted me so much she practically forced me to hold the baby.
  2. In that moment with that baby, I was trustworthy.

This friend did not know much about my past, but she knew my diagnosis. While part of me clung to the notion that she trusted me because she didn’t know about the bulk of my untrustworthy behavior, it felt meaningful that in that moment on that day, she considered me trustworthy enough to hold the most precious thing in her life.

On top of that, the fact that nothing went wrong was kind of like a slap in the face to the rule that had been created. I could be trustworthy. Er… maybe not all the time, but sometimes, yes.

Even though this one moment was the key to begin revising this rule I had created for myself, it has taken thousands of situations and the knowledge I gain about myself and my symptoms every single day to keep reshaping it into something more true.

After all, when my symptoms first started I was really just a kid. I had no idea what they meant or why they were happening, and I had no skills or knowledge to help me keep them from exploding out from me whenever they felt like having a party. When my mind wove a terror filled tapestry for me, I didn’t know I shouldn’t believe it.

Really, getting to know how my different mental states work have been like working out any other part of my body. I couldn’t walk into a weight room and bench press 300 lbs on the first day because I had to build strength first, I needed to learn my own limits in order to push myself to my goal, and be able to take care of myself and heal up if I pushed myself too hard.

Even though having mental illness is a constant for me, my understanding of myself and my symptoms have changed over time. Living with it means adapting as my understanding and knowledge grows, and affording myself more trust over time because that unknown I have been so afraid of? Well it is shrinking every day.

 

Stepping Stones; Stepping out of PTSD

Trigger Warning – my brand of PTSD came from situations involving sexual assault, and this post may contain loose details about that situation or other sexual topics regarding my recovery. Nothing super graphic though, don’t be gross.

Post traumatic stress disorder seemed to come into my life like a flood. One minute life seemed totally normal, and the next it began to deteriorate rapidly.

It was sort of like, if you could imagine, every time you bought a smoothy someone would walk up and take that smoothy away from you after a couple sips. After a while, you sort of just know to either avoid buying smoothies or, if you do buy one, only expect two sips. This is just the way things are, and because you haven’t known much else there are no real expectations otherwise.

Now imagine someone sits down with you and tells you that we live in a world where you could have (and you deserve) that entire effing smoothy. I mean, more than two sips. And that these people who have been taking this delicious fruity beverage away from you are a-holes who have done something profoundly inappropriate.

Well there’s shock. And anger. And definitely some horror associated with the fact that people can be so awful to one another, and that you’ve let this smoothy-snatching business go on for so long. There is guilt for not knowing things could have been different, and fear that this cycle is something that will never end.

But, maybe you feel a little empowered too. Like maybe now that you know this business about the smoothies you can buy one and enjoy the entire thing. You can break the cycle! So you go out, you buy a smoothy, and after two sips someone walks up, takes it, and walks away.

This time it feels different though, doesn’t it? This time you know you’ve been violated, that the other person is in the wrong, but maybe you just froze and didn’t know what else you could do to stop it. The anger is much bigger, much more difficult to contain. The fear becomes profound, because now you know that people seem cavalier about hurting you and that it can happen anywhere at any time. The shock leaves you frozen, bringing guilt because, somehow, you knew this would happen, didn’t you? Maybe the horror is so overwhelming you decide to pretend the whole thing never happened, just to put it all out of your mind, and ultimately blame yourself. After all, you really just can’t be trusted with a smoothy.

For me there was a series of moments like these that were like seeds being planted. I pushed the memories and my reactions down into the dirt as far as they would go, and once they were there I didn’t feel a need to address them because I thought I won. I thought I put them somewhere that was somehow equivalent to them not-existing, and if they didn’t exist I couldn’t be upset, right?

I admit, it is easy for me to look over this whole process when it is about a deliciously fruity blended beverage or something as seemingly harmless as seeds and connect the dots, but even now, years later, thinking about this process in terms of sexual assault there is a whole host of emotions that come up making it difficult for me to see through the fog that they create.

For several years I did a great job of putting the whole thing out of my mind and ignoring it. Then, after enough time had passed, those seeds that had been planted began to grow.

They broke through the soil and I suddenly began having panic attacks in crowded places. I became physically ill when someone, anyone, would touch me. I couldn’t leave the house without getting into arguments with people, so I didn’t leave the house. I felt powerless and depressed, but also angry and very afraid. Every time I closed my eyes I could sense someone standing next to me waiting for me to be vulnerable, like any moment I was happily unaware or in the shower or asleep.

The most infuriating part of this process for me was not being able to see how one person could get from the situation I was in to something better. My PTSD symptoms (mostly the anxiety and panic) were just as treatment resistant as my bipolar symptoms so I couldn’t rely on any anti-anxiety medications to help with the panic attacks and fear I was having. My doctors suggested deep breathing and reading boring case studies about PTSD, and while the deep breathing only really helped keep me from constantly screaming the reading seemed to trigger my symptoms over and over again.

Having said that, (spoiler alert) I am sitting here today really feeling like I have finally made a big dent in untangling myself from those awful PTSD plants and I found myself wondering just what I did to make it here. I thought that perhaps sharing what helped create a makeshift ladder for me might be useful to others in a similar situation, and while I am not suggesting you go out and do any of the things I am about to share I can honestly say they helped me, and all of these things were done with the consent of my healthcare team (including my therapist and psychiatrist).

For Anxiety and Panic Attacks

Basically I needed to desensitize myself to being around people and sort of re-learn that people (in general) aren’t trying to hurt me. The real trouble was that any time I was in a more crowded place (the bus, downtown, the grocery store) it would just trigger the panic attacks over and over again. Even at house parties of people I knew and loved I felt overwhelmed and would panic, so I entered into the realm of medical marijuana.

I realize this might not be a popular idea, but totally legal here in Washington State. Also, like many of the medications I have tried, it turned out there are some forms of cannabis that actually made my anxiety and panic symptoms worse, so the process of narrowing things down was a little frustrating. Thankfully, as someone with treatment resistant symptoms I have a lot of experience trying treatments that either aren’t effective or have some rough side effects so I already had a system for taking detailed notes on the effects I was experiencing.

I wont lie, I felt pretty weird about this idea at first. Growing up in a time where I was led to believe that the slightest proximity to any and every “drug” out there (D.A.R.E!!) would immediately make me an addict or banish me to hell or make me lose everything I loved made me initially totally recoil from the idea.  The legalization of medical cannabis only dampened this mindset slightly, but after speaking with three different psychiatrists and four separate therapists, all of whom who told me [given the nature of my treatment-resistant symptoms] I should proceed with anything I found that was helping, I felt a little more comfortable. Even so, it took some time for me to feel ok when other people were being judgmental about it but the fact that my doctors had my back (and heck, even my grandmother agreed) made me feel less squeamish about the whole thing.

Once I was able to pinpoint a couple strains that helped alleviate the anxiety and panic I was feeling (without sabotaging something else, like my mood for example) it was a matter of using it strategically (not all the time) to introduce me into settings where I might normally totally freak out, but because the cannabis removed the elements of anxiety and panic I was able to experience triggering situations in what felt like a non-threatening way.

Basically, cannabis allowed me to remember what it was like to be around people and feel safe, or at-ease, and after long enough it became the default setting for my brain again.

For Regaining a Sex Life

This has been very tricky, and while the cannabis was helpful enough to get me to the point of being able to be touched in general (like a back rub or foot massage) I had a big blinking red stop light in my brain around sex for a long time. Not super helpful, considering my PTSD symptoms didn’t actively show up until several years into a committed and safe relationship! Even though it had been years since I was in a place where I was in danger, once those seeds sprouted it didn’t matter.

I am sure it will sound a little funny, but the most helpful thing to removing fear and panic around sex for me was when I had surgery and my doctor told us we weren’t allowed to have sex. That’s right! Having even the possibility of having sex taken off the table made me feel more comfortable because then it wasn’t this awkward thing (or an obligation) I felt compelled to dodge constantly because I felt uncomfortable. Effectively we had to almost start our physical relationship over at square one (I recognize I am really lucky my boyfriend is the most patient person I’ve ever met) and in doing so we re-built the trust that I knew was there, but couldn’t feel because of my anxiety and panic.

For Fear and Paranoia

First I would say going to therapy and spending a lot of time talking about being assertive about boundaries helped me feel a bit more confident, but I was still really afraid that if something happened again I would freeze up and be unable to assert myself.

Something that really helped solidify a confidence in my ability to protect myself was taking a self-defense class with a friend at Fighting Chance Seattle. The staff was really knowledgeable and our male instructor made me feel very much at ease and did not require us to practice defensive moves with him, instead with anyone we felt comfortable with. Being able to connect a physical action to a feeling or desire to protect myself made me believe that if there was ever another situation I knew what to do and would be less likely to freeze in the moment. The class was only one day, but it really helped me feel like I was moving forward.

Another milestone was getting a tattoo that would act as a reminder that the fear I was feeling was coming from me, not from threats around me.

Over the last few years I have tried to keep my apartment feeling like a safe space for me. At first that meant coming home and looking behind every curtain and in every closet to be certain it was safe, but now that I have made some progress with my fear and paranoia I try to talk myself through the fear and visualize every detail of the apartment when it is dark to remind myself it is empty and safe. It is funny to me sometimes to think that my brain wants to imagine all kinds of horrors waiting for me when I close my eyes, but I spend a lot of time actively un-imagining them!

***

While I can’t sit here and say, “and that’s how I kicked PTSD in the face! It is gone forever!” Things have gotten significantly better.

I still get triggered from time to time, but I’ve got enough tools to keep myself from replanting that same seed over and over again. After taking that self-defense class I felt quite empowered when I was faced with a situation on a city bus, a creepy dude next to me put his hand on my leg.

Initially I started to freeze. I could feel myself starting to shut down as I had in the past, but somehow I managed to turn things around and do the total opposite of the cowering I felt like doing.

“Excuse me?!?” I yelled in his face and then stood abruptly, pushing past him to sit in another seat. He looked over at me and I scowled, shaking my finger at him. Even though my hands were shaking and my heart was racing I turned away to look out the window and my scowl turned into a faint smile.

I was free.

Travel; Mental Health Hurdles

This year my Grandma turned 80 years old, and to celebrate my family wants to host a camping trip in her honor. The reality of the situation though is that traveling anywhere (whether it is just heading downtown, upstate, across country, or across the globe) while living with a mental illness involves taking a bit more into consideration than the “where” and “when”.

Things got panicky last week when some crossed communication left me under the belief that my boyfriend and I would not be able to bring our own vehicle to the camp because of it’s affiliation with the military.

For anyone else, carpooling seems like the obvious answer, right? Well for me, living with bipolar disorder means knowing my triggers, and anytime I start to feel trapped in a strange place without an exit strategy (oh, say, like on a beautifully landscaped but guarded-by-armed-men sort of military recreation site – I have no affiliation with the military personally) I melt down. And I mean total manic/psychotic, you’ll-find-me-in-the-woods-later melt down. It is almost like a guarantee, and knowing myself well enough to know this would be an issue (after kicking countless ‘vacation’ situations in the balls while psychotic and trying to escape) left me in a bit of an odd position.

Of course, it isn’t unusual for me to try to push myself through things like this. Tell myself, “well, those other times are a fluke, and you will be totally fine this time.” I start to feel like I am making a big deal over nothing, and when friends or family who don’t have to make these kinds of considerations for themselves agree, I have a bad habit of walking into the same situation over and over again and reacting poorly on ‘repeat’.

Last week’s situation was a little more special because I went in to see both my therapist and my psychiatrist, and both immediately sided with the rational, more cautious part of me.

“Absolutely not,” they both said. “You’ve been triggered this way several times before, and you know that walking into a situation like this will be more of a strain than you are likely to handle.”

Keep in mind, my situation is really pretty singular in that my symptoms are not regulated by medication. My symptoms of bipolar disorder and anxiety are treatment resistant (they have not responded to any medications), so I am largely in a position to have to cope with them on my own. That is another big reason why it is important that I am familiar with my own triggers, because knowing what could put me in a dangerous position and either preparing myself for the outcome or avoiding the situation altogether are the best strategies I have for dealing with my symptoms on a regular basis.

I have found one of the biggest strategies that helps me when traveling or heading into a potentially stressful situation is knowing I can leave at any time. If I have an exit strategy, if I can leave the stressful environment before my irritability or mania becomes psychosis things are much more likely to go smoothly.

Even though my therapist and psychiatrist both agreed this trip would be detrimental for me, I couldn’t help but feel bad about needing to cancel. I mean, my granny is 80, and you can believe she has been talking about this for a month already.

The final decision I made was to go back and double check the policy that would keep me from having my escape route. I scoured websites and even eventually called the navy to help clarify their policies on bringing in civilian vehicles to their recreational sites. And -wouldn’t you know it? The entire situation was a communication error. We should be able to bring a vehicle to the site without a problem (so long as we have the proper documentation, yada yada yada).

Ultimately, the problem is no problem at all, but I am proud of myself for taking the steps I did (talking with my boyfriend, my therapist, my psychiatrist, and looking for a solution) before responding emotionally or making a final decision about going, or not, to this event.

Sometimes living with my current mental health situation can feel like I have to live in a small bubble to survive, and while the bubble feels safe it also shields me from many of the life experiences I want to have. That bubble doesn’t guarantee I wont become depressed, or manic, or psychotic, so I don’t feel like forgoing all manner of travel and personal growth that comes with it should be kept from me because doing so does not mean I will be able to live peacefully. I will have bipolar and anxiety outside the bubble, but I have it inside the bubble as well. For me, the trick is knowing what my absolute deal breakers are (like transportation) to keep me from moving from a “moody” travel situation to an emergency travel situation.

Of course, there is a lot that goes into it beyond that to prepare, things like

  • having my doctor’s information handy and with me at all times
  • bringing all medications, and extra in case of emergencies
  • making sure I will be in a position where I can eat regularly
  • making sure I will be in a position to have the best chance of sleeping fairly regularly
  • using coping skills to help counteract instabilities
  • maintaining an awareness of my current state
  • informing my fellow travelers how to best help in an emergency situation
  • and knowing when to pull the plug on the trip

to name a few.

Even though I have gotten over the transportation hurdle regarding this short trip, it is still a few months away. I have plenty of time to worry (heh) as more things come up, but I hope to smooth over as many of the rough edges as I can before I get there.

Revenge

Over the weekend I went to see The Revenant, and though I am not typically interested in dramas or anything relatively violent I am interested in stories about mountain men and stories about revenge.

I’ve been thinking a lot about revenge and why it is so interesting and even consuming, at times, to me. True that in a heightened state of emotion revenge can seem that much more gratifying, but most of these stories about revenge (or my experiences with revenge) well… they never quite end well.

The thing that interests me the most about revenge is how my own mental health has been able to completely warp this concept in different situations. For example, I started having my first full-on panic attacks in elementary school in P.E. when our teacher had us running around the track. He told us that we were not allowed to stop for any reason, not even to get a drink of water. When I asked him if I could stop to tie my shoe (which had become untied) he said no. I was supposed to keep running.

Now, this might seem totally mundane in terms of “personal threats”, but I have always been a somewhat awkward being who is able to trip on a line in the road. Having my shoe untied was a serious invitation to biff it on the track, and I was both pissed off and terrified. However, my fear quickly turned into something else as I found myself desperately wanting to trip on that shoelace, fall, and get hurt enough for some kind of punishment to befall my P.E. teacher.

It didn’t happen, but there have been many situations where my apparent inability to do anything about a perceived injustice has left me believing that the best form of revenge would be to take that revenge out on myself and subsequently whoever I meant to get revenge on would be forced to watch me withering away… potentially causing them inexplicable amounts of pain. At times I have thought that my younger self may have wandered into believing herself some kind of witch-doctor, capable of performing voo-doo. Of course, that almost never, ever worked out the way I expected it to, and while I admit the idea of hurting oneself to exact revenge on someone else seems totally ludacris there have been times where the act of revenge seems to completely outweigh the act of living. Watching any number of “revenge” themed movies will typically suggest the same.

I fought this notion a lot via the church. The act of forgiveness being the total opposite of revenge, I figured that might help me shy away from a lot of the odd, convoluted notions I had about punishing others or using myself to do so. Unfortunately, I found myself living in the opposite extreme, constantly in a state where the people around me were taking advantage of me and I would be ushering out forgiveness in a never ending revolving door of pain.

As it turns out, forgiveness without any sort of boundaries can be just as detrimental as revenge.

The road since then has been awash with many different theories and attempts to live a healthy life. I would say I have made significant progress on that front, but as a profoundly emotional individual it still swells up, from time to time, and revenge becomes something shiny and wisp-like begging me to chase after it. Even if I can withstand chasing it, it isn’t hard for my imagination to take the bait and for days, weeks, or even months I become trapped, seeking this thing out -if even only in my mind.

I am hoping that one day I will have replaced that inexplicable pull with something as simple, but as important, as acceptance. While it is something that seems distant to me now, I hope that little by little, inch by inch, it will become a more central part of my life and my future.

One day I will be able to sit with my life as it is as opposed to being haunted by the notion of what it should be.