Monthly Archives: August 2016

Tapped Out

This week I went to not one, but two family reunions back to back (with a total of 12 hours spent in the car between the two days). At this point I will take the fact that I didn’t have any major meltdowns as a huge sign of success, I used the crap out of my DBT skills to remain on a fairly even keel the whole time.

Had I gone to only one event I think the aftermath would have been less jarring, but since I, an erratic and sensitive introvert, essentially spent two FULL days around large groups of people I felt quite a lot like I had been hit by a truck on Monday and could do little more than lay around in a grouchy state of exaustion. Moods have been touchy since then, I have definitely been crying more than usual, but I’m doing my best to manage while things even back out.

So I’m getting better at this, but as I’ve been saying the past six months taking it slow is still a big priority for me with these things. Unfortunately when sick grandparents come into play, taking things slow tends to get put on the back burner.

To some extent I feel like I am in a place where I can plan for social situations so I am having less issues with them, but at the same time there is a natural sort of suction that happens around people where my life force appears to be depleted simply by being in the same room. I’ve always just chalked that up to being an introvert, but it would be nice if there were some kind of anti-soul-suction suit I could purchase for these outings (like a diving suit?)  to keep me in the social waters longer without being completely tapped out.

At any rate, I’m still working toward un-exhaustion so this week’s post is short. I just wanted to mention some good news in that the T3 (thyroid hormone) medication Cytomel I’ve been trying for my treatment resistant symptoms of bipolar disorder & depression has officially been tolerated by my system for an entire week! Considering the fact that my body doesn’t want to tolerate medications at all most of the time (not even nasal spray) I’m feeling really encouraged. Whether it will work or not is a different story, but having gotten past this first week’s hurdle of not having any mind-blowingly horrific side effects is huge considering how few medications make it this far for me!

 

 

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Bright or Blight

There is something strange about being old enough to see fashion recycling itself. I have a degree in fashion design, so I have been finding myself acutely aware of the fact that people half my age are now wearing reissued platform sandals and overalls.

I’m thirty and despite growing up on an island a few hours from Seattle I missed grunge. I don’t remember the kids in my school having many options in terms of fashion, my high school wasn’t awash with much style diversity. A lot of us wore whatever odd second hand clothes we could come by, and even those that seemed to linger on the fringes of the social structure typically didn’t make it all the way into the realm of “goth”.

I was infatuated with punk rock and found myself seeking out skinny jeans before they became a staple. I listened heavily to the Clash as a teenager and, bored with the social norms I had grown accustomed to every day, began dying my hair in bright, new, interesting colors.

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Me at the Denver Art Museum in 2003, Photo by Michael Putlack

 

That was a lot for a small rural town to handle at the time and every day I was greeted politely by someone telling me I didn’t belong. To be fair, they usually said, “you ought to be living in the city!” but no matter how it was phrased, I knew that we agreed on something: I didn’t quite fit where I was.

Experiencing the budding effects of bipolar disorder and psychosis in my teens made it hard for me to see a place for myself among my peers and as funny as it might sound, dying my hair orange (or blue, or pink, or green) was one of the only ways I felt like I could express that. Trying to avoid how different I felt, how much I felt like I didn’t fit in only acted as fuel for my depression and a little hair dye went a long way in helping me accept those differences and realize that being myself was something worth doing.

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Living in Seattle the last ten years and working in the fashion industry in particular has meant seeing all kinds of trends come and go, both in style and in my own life. Some seasons I am happy about some cute boots and sweaters, some seasons I am happy with where I fit in the world. Other seasons everything in stores is mustard yellow (which is crap for my complexion), other seasons I find myself hating Seattle. The city has been tumultuous that way, and every March I tell myself I can’t stand anothe Seattle winter… but here I am.

I gave up the neon colored hair almost nine years ago. It was hard to keep up as a broke student and then, even working in fashion, it wasn’t something that was exactly welcomed when the economic crisis hit in 2008. Making my departure from the fashion realm didn’t pave the way for brilliantly colored hair either, there were no studies I could point to that suggested pink hair might sell more condos.

Somewhere in the interim I slipped back down into depression first, and then found myself with post traumatic stress disorder after a slough of unwelcome male attention. It seemed to be something that was all around me, coming from bosses and strangers and people I couldn’t seem to get away from. I found myself wanting to fold myself up like a tiny note and hide in a crack somewhere. I was having so many panic attacks that I had to wear sunglasses on the bus in an effort to hide the fact that I was crying most of the time.

So even when it began, when the citizens of Seattle began showing up more and more with brightly colored hair, it wasn’t something I could celebrate. I was too busy hiding to be willing to put a neon sign on my head, too busy wanting to be invisible.

That hesitation followed me for several years. I felt too afraid of the police, too afraid of anyone noticing how agitated I might be at any moment, how aggressive I might seem without realizing it, how manic I might be acting to feel like drawing attention to myself. I obliterated my wardrobe in an effort to remain unseen, packing anything noteworthy up in boxes or giving it to charity. I became an expert at blending in, even when I found myself so overcome by my symptoms of bipolar disorder, PTSD, & psychosis I was only really blending in with the rampant population of those living with mental illness on the streets in Seattle.

I told this to my therapist a few weeks ago and she seemed confused by the idea that I didn’t want to be seen, she kept asking why I would be afraid of people looking at me and if I was always afraid of attention from other people. Instead of try to explain how much anonymity has eased my anxiety about a local police force with a poor track record regarding those with mental illness and the expanse of men who have always seemed to believe that I owe them something simply for existing I revised my statement to say that so many people are dying their hair “just because” that it didn’t feel punk rock anymore.

Gross, I feel gross for saying that. At this point doing something because it is in fashion is not enough to motivate me, but not doing something just because everyone else is doing it is something I find equally disturbing. I don’t want trends or what people want or expect to play into the decisions I make about what I wear or how I look or the confidence I feel in myself. I want the freedom to look however I want, and even though chipping away at my own anxiety is what will eventually help me tear through all of that (though hypomania seems to work too) it is important to me to work toward doing what I want, regardless of any other opinion.

You know, when the idea came up of changing my hair again I really wrestled with it. I had so many excuses not to, I didn’t want to relive the past (heck, I’d already done every color), I didn’t want to spend the money, I didn’t like the idea of people looking at me… but ultimately I had nothing to lose (well, except hair and mine grows so fast it would only be a travesty for a month or two). Without remembering the sense of peace it gave me the first time around, the confidence, the comfort, I had a hypomanic sort of upswing a few weeks ago and just let it happen.

It’s true the fashion police in my head were in an uproar (“you’re just trying to recapture your youth!” they cried furiously) but something funny happened that I didn’t expect. I didn’t revert to a past version of myself, I just found her in one of the deep recesses of my mind reading John Irving. I tapped into her sense of levity and found that I feel more like myself than I have in several years. That might sound goofy, the idea that orange hair could produce such an outcome, but I find that I’m remembering what it was like back before I felt the need to hide all the time.

Whatever I thought might happen when people looked at me, well it hasn’t. Heads haven’t exploded, I haven’t had strangers trying to talk to me every five minutes, and I haven’t been approached by dozens of creepy stalker suitors because even though my hair is different, that isn’t the key. I am different too. I am older, yes, but also wiser. It has been important for me to realize that I don’t need to hide from unwanted attention, I am strong enough and capable enough to deal with it when it comes, even if there are times I don’t feel that way.

 

 

 

Thyroid Hormone for Depression

I mentioned recently that my psychiatrist has decided to change directions in how we try to treat the mood swings I have emanating from treatment resistant bipolar disorder (type 1).

In the past six years I have actively tried several benzodiazepines (like clonazepam, or lorazepam) , antipsychotics (risperidone, ziprasidone, olanzipine to name a few), mood stabilizers (lamotrigine, oxcarbazepine, gabapentin & more), and antidepressants (sertraline, fluoxetine, bupropion, etc.) but have always experienced either:

  • worsening symptoms
  • side effects severe enough to warrant stopping the medications
  • or tolerable side effects with no response from my symptoms.

The only psychiatric medication I’ve been able to keep taking regularly is Lithium, and while there is some debate on whether it is helping I’ve been taking it for long enough that I am having no side effects so the consensus is usually just to keep taking it.

Starting any of these new medications has typically made my mood swings worse (more frequent and more severe) so it has been a bumpy ride. After my new(est) psychiatrist got a good look at this happening she decided it is probably useless at this point to keep trying in these same classes of drugs I’ve had problems with. Needless to say, this was both a relief (hooray for no more psychiatric drug barrages!) and a little disheartening (alright then, now what?) but after all I’ve been through I’m more than willing to break away from this cycle and try something new.

Like anyone who finds themselves chained to the great lithium beast I have to go get my blood checked every few months to monitor the level of lithium in my blood. During these times I often also undergo other tests to check things like kidney and thyroid functioning.

Apparently my thyroid level doesn’t appear to be outside the range of “normal”, but my doctors have found that for me a tiny change can make a huge difference (as seen with my reactions to most drugs). My psychiatrist also told me that sometimes thyroid medications can be used to treat resistant depression, so our next route is to give liothyronine (cytomel) a shot and see what happens.

I always get a little nervous when I’m given a new drug to try and my doctor asked if I thought it would be better to start it when I am feeling more stable or unstable. That has always been a tricky question for me because if there are significant side effects a drug can easily take me from stability to a place of being unstable, and having less stability I tend to want to take advantage of those times as much as possible. At the same time if side effects occur when I am already very unstable I am less likely to cope in a healthy way so I told her don’t think there is a right answer here.

Ultimately, I’ve had the flu for the last week so as soon as I feel better physically I’ll start the liothyronine regardless of what my mood decides to do. This one comes with all kinds of obnoxious directions (take on an empty stomach at least 30 minutes prior to eating, no antacids for at least four hours after taking it, can’t be taken at the same time as vitamin or mineral supplements -sheesh!) so I need to do some work shifting all of my medications into a system that will allow me to follow those rules.

As scary as it can feel not knowing what will happen, I always feel some element of hope that this time might be different. If I didn’t feel that I’m sure I would have given up ages ago. It might be that I’m just stubborn or absurdly optimistic at times too, but it is easy to gamble when I feel like I don’t have much to lose and there is potential for increadible gain.

Putting Myself Out There

Despite how busy summer has been I have found myself doing very few of the things I wanted to do. I’m fully aware that feeling helplessness doesn’t look good on me, so I decided to try a few things outside my comfort zone in an effort to feel more in control of my own life and to pep up a potentially dangerous sense of boredom.

For better or worse, my sense of curiosity has always been able to steer me into the mindset of, “well let’s try _____ and see what happens!” Sometimes the results have been wonderful and sometimes they have been devastating, so when I went to work trying to decide what new thing to try I wanted to be a little conscientious of that fact. Ideally trying something new and maintaining whatever scrap of emotional and mental stability I have is the goal, but knowing that living with treatment resistant symptoms of bipolar disorder means that any little detail could potentially rock my brain-boat is challenging. I have often found myself opting to do nothing at all because doing anything is potentially risky (in terms of creating instability in my mental health) but, tired of doing nothing, I decided the reward was potentially worth the risk.

I have been described as having an “overactive imagination” and more than one therapist has told me that when things are perfectly fine my mind has a tendency to imagine problems that aren’t really there… these days I would consider this description to be something like a cute version of saying, “psychosis”. For a time I thought this might lend itself well to writing fiction, but back in 2007 when I tried my hand at writing a novel I found that I lost track of where the novel ended and reality began. The problems in the story became the problems of real life, and I abruptly vowed never to venture down that path again.

All this time I’ve been writing nonfiction instead, and while I’ve enjoyed writing for this blog the past five years I feel like I am constantly moving toward the point where I wont have anything more to say without being redundant. I’ve been learning a lot about myself and writing in the process (and I don’t expect to stop any time soon) but part of me has wondered if I could write about something else. Anything else, really. I admit there are times where I don’t want to think about my own mental health. I want the freedom to think of other things, of other problems, and for the love of Pete, to talk about something other than myself.

With a little experimentation I found that while writing fiction that takes place in a modern setting (like my writing in 2007) is too close to my own life for me to separate myself from it, writing about situations on other planets or in places I’ve never actually been seems to create enough distance to keep my mind from getting the two confused. It seems that following an odd story down a rabbit hole makes perfect use of my (previously useless) problem-generating brain because stories need conflicts to be interesting.

Writing any fiction at all certainly took me out of my comfort zone, but in the past few weeks I decided to take things one step further and I joined a local writing group. Frankly just getting out of my apartment to meet with them was a huge step and even though I was anxious as heck to make my first appearance I did my best to remind myself that they’re strangers, so who cares if they like me anyway?

It turns out they are all quirky, imaginative, and intelligent individuals and just passively listening to them share about the different projects they are writing was both interesting and encouraging. Within an hour or two I found myself holding conversations with people casually and I left knowing that I wanted to go back again.

Of course, I put it off a little. Since it is a critique group I knew that at some point I would have to share something I had written, and when I’m working on something I’m typically very private about it until the final version is completed. Even though I don’t like sharing something unfinished because of how vulnerable it makes me feel, I have had a lot of questions that I knew would probably be answered if I just powered through my anxiety and shared my work.

So the thing I did this week to step out of my comfort zone was to read something I had written in front of a group of people and listen to their feedback. I had a knot in my stomach all day leading up to the group and every five minutes I could feel myself changing my mind, thinking, “well… I’ll print these read along pages and bring them, but I don’t have to read them.” Then, “well… I will tell the moderator I have something to read, but maybe they wont get to me before the group ends.”

Finally, that night at the group after an hour and a half the moderator asked me, “do you want to go next?”

I knew that if I left without reading I would feel twice as anxious the next time around and I knew I couldn’t handle a double dose of anxiety driven irritable gut another day. I had already gone through 5 or 6 tums and it seemed there was little to do but press on.

I decided to take a leap of faith and even though it was wildly uncomfortable, even though my hands were shaking and my ribs were contracting as I powered through a panic attack while I read, I reached the last page in a triumphant (and slightly dissociative) stupor.

I never used to have problems reading aloud, not when I was in school. I gave so many presentations, so many speeches (even publicly at the state fair) that I never expected to feel so overwhelmed when speaking publicly. I know my anxiety is much worse these days, but I also think that the unfinished nature of my story and the effort I had put into it were huge in informing how nervous I was.

I also know that my Achilles heel is judgement. I’ve never taken criticism particularly well, never felt good about the idea of being examined and torn apart. I feel like I can say that I generally feel good about who I am, but there has always been the fear of judgement present in some form in my life. Fear of God’s judgement as a child, fear around the judgement from my peers in school, fear around critiques in college, and fear around the scrutiny of Social Security and the government as a disabled adult.

By the time I stumbled into the critique portion of the reading I had catastrophized the whole situation so much that it inevitably went much better than I expected. Some of my concerns were confirmed, some new issues were brought to my attention, but for the most part everyone seemed excited about what I had written, which acted as a cork in my odorous anxiety bottle.

My boyfriend, sweet as he is, went to work right away when I got home to remind me that I don’t need to take any of the advice I was given. I don’t need to change anything I wrote if I don’t want to. I know he has continuously witnessed the way other people’s opinions have acted like quicksand for me in the past. The defiantly obsessive portion of my brain loves to latch on to those statements without letting go, and I immediately found myself wrestling with them as they echoed (ironically) in my mind, “redundant, redundant, redundant…”

The difference now comes from the knowledge that has come from my DBT group. I know that when I’m closed in with the garbled echoes of disappointment or disapproval or judgement I can open the windows in my brain-house and let that stuff escape. I don’t have to be hosting the equivalent of a mental dinner party six years from now and set an extra place setting for “redundant” because it’ll be long gone. That’s the hope, anyway.

Having said that, I don’t know if I will read my writing aloud again any time soon. I need time to practice letting go of these comments, time to sort them out of the “terribly important, don’t stop thinking about this,” pile into the, “backlog” bin. If I can manage it without much incident I expect to have another go, because having the opportunity to practice letting go of, “this sentence is redundant,” is infinitely easier to me than having to let go of considerably more cruel and pointless scrutiny. Anything I can do to help myself learn and grow is good, but anything that also helps me learn to be less reactive and less prone to destabilization is a serious win.