Self Identity & Mental Health – Pride Edition

Pride weekend is a pretty big deal in Seattle and while I tend to avoid events like parades (too much standing still with too many people for me to feel comfortable) I found myself on Capitol Hill twice during the celebration. I enjoyed having the opportunity to see all kinds of different people milling around smiling and laughing, and the attitudes of the multitude allowed me the briefest window where my self-consciousness could melt away.

Pride was, in a roundabout way, what led to a conversation where I was asked how important I think it is for us as human beings to be able to categorize ourselves in different ways. Even though I’ve only just started becoming familiar with the particulars of gender when it comes to self identity I couldn’t help but point out that this is a topic of conversation that comes up in regard to mental illness pretty frequently too.

In those instances the question is usually about diagnosing mental illness and if trying to fit our symptoms -which can vary widely even within an illness- into one category or another is more helpful or harmful in the long run. Even though opinions vary greatly on this topic I’ve found that the majority tend to see reaching a diagnosis as something helpful and can appreciate it as a tool to better understand their symptoms and how to live with them. For me being diagnosed with bipolar disorder felt more like a relief than anything else, even despite finding my symptoms don’t line up with the majority of those with the disorder.

In terms of self-identity I’ve always been curious as to how other people live their lives and what we have in common, but for as long as I can remember I have struggled with the idea of who I am. Trying to find commonalities has felt exhausting at times because I’ve had a hard time locking down what my values are, what I want my life to be, and who I am.

Issues of gender and sexuality have definitely played into that. Discovering that I might not be attracted to the same people my friends were was both alienating and isolating. Not being able to really understand why I feel uncomfortable when people address me differently than I imagine myself has been frustrating because being unable to explain this strange off-putting feeling to myself has meant being unable to explain it to anyone else too.

Self identity in that sense has had a huge impact on how I act, how I interact with other people, but also on my mental health. Feeling estranged from people I can relate to has often meant feeling depressed and isolated. Being unable to pinpoint and communicate where a lot of those thoughts and feelings are coming from and, even more, feeling the need to constantly explain myself has fueled a lot of the anger I have toward myself and other people.

While issues with gender and my sexuality have fueled issues like depression and low self-esteem I have found that living with mental illness itself, in my case treatment resistant bipolar disorder and anxiety, has played a huge role in keeping me from being able to pinpoint who I am and what I want out of life. Mood swings make a habit of constantly changing my motives and desires, so getting a grasp on what is underneath has often felt like digging a hole in the sand at the beach that is constantly being refilled by each wave that rolls in.

After six months of DBT (dialectical behavioral therapy) I’ve got a new-found appreciation for the fact that having a real understanding of ourselves and what we want in life is how we are able to find ways to make ourselves happy and move toward our goals. What can we expect if we don’t know how to make ourselves happy? Where do we go if we’re not moving toward the lives we want?

Without categorizing our needs in other ways, like the diagnosis of mental illness, how can we expect to move toward improving our symptoms? Without understanding our needs and being able to communicate those needs in a way other people and healthcare providers can understand, how can we address them?

I can understand how categorizing the elements in our lives can seem limiting to some people, but throughout history mass communication has been based on shared common knowledge. That might come from our language, or our understanding of science and theories at the time, or things we’ve learned from our friends and family (among others). Being able to communicate what we need in a way that other people can understand is a huge part of being able to be successful in both feeling acceptance from other people and moving toward what we want, and while sometimes that communication comes at the price of having to simplify things to help people understand, the understanding and acceptance is the ultimate goal.

Granted, there are big differences between something like identifying gender identity or sexual preference, and identifying a mental illness. I think it is important to remind people that our sexual preference and gender identity are inherent to who we are and to express those things comes from a lot of personal reflection and understanding of ourselves.

Conversely, most people in the mental health camp consider mental illness to be just that, an illness. I would be remiss if I didn’t say there aren’t people that disagree, but to most the symptoms of anxiety, depression, bipolar disorder, and schizophrenia, among others, are things that are keeping us from being happy and living the lives we want to.

If you consider it though, identifying mental illness is one way we are all able to be true to ourselves and to act in a way that will bring us a better understanding of ourselves and how to move toward living the lives we want. We seek treatment to try to get back to the sense of self we understand and feel that we have lost.

What is the expression and self discovery that comes with coming out, or expressing a change in gender identity but an act in the same direction? Taking steps to understand and communicate our identity is another way in which people can reaffirm their sense of self and actively move toward finding happiness and living the lives they want to live.

In both situations we fight to protect our sense of self and our identities, and though it might initially feel like an act of self-preservation both the LGBTQ and mental health communities know the value of protecting our inner-self and see that being true to ourselves, whatever that means for us, will make us happier in the long run.

I know that I’ve felt the effects of ignoring my most inner sense of self, and that whether that came from hiding who I truly felt I was or denying myself help from the constant attack on it that came with my mental illness I like to think that each day I know myself a little better. I understand myself a little better. I can keep moving in the direction of supporting who I am and what I want because I know that I am the only person who can do that for myself –and I deserve it.

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Dumbledore and the Mixed Episode

For the past two weeks I’ve been having the most substantial and intense episode I’ve had since October 2014 (that’s 20 months ago and my last hospitalization).

While I’ve had symptoms of bipolar disorder and anxiety since then pretty consistently I’ve generally found ways to cope with living with negative thoughts and urges without falling into the trap of believing them or acting on them (or, at least, not for very long). Sometimes the rapidity in which my mood swings happen help bring even just a few moments of clarity to me when I find myself slipping into a dangerous place, but when long, somewhat seamless episodes happen for me (and they do, almost always requiring hospitalization) I can easily sidestep from coping with my negative thoughts and urges to believing or acting on them -typically without even realizing I’m doing it.

I’ve written a little the last two or three months about how my depression has been getting worse and I told my boyfriend several times I was concerned that it’s persistance was signaling a long episode for me that might require hospitalization. Imagine my surprise to find that something (though I don’t know what) switched my increasing depression into a mixed episode two weeks ago.

Actually I didn’t exactly notice right away, and that’s where the downfall really started. I was having so much energy and euphoria suddenly thrown in with my depressive symptoms that I felt great at times, leading me to believe I was getting better. It wasn’t until the dreaded agitation and hostility that are usually a trademark of mixed episodes for me showed up in a big way that I felt relieved to see my psychiatrist last week.

That is how one of the most misunderstood aspects of bipolar disorder was dropped in my lap. Yep, I am definitely sick -to the point of wanting to destroy every element in my life. Even though my symptoms are treatment resistant and I am able to take very few medications in the long term I have an antipsychotic (risperidone) I typically take when psychosis or mania show up. The trouble is (and one of the reasons I don’t take it continuously) is that it is notorious for wiping out the mania and psychosis and leaving me with the remainder of the mixed episode, a sedated and faint-worthy depression. I don’t like to take it, who would like disparaging and laying on the couch all day crying and watching Charlotte’s Web?

At the same time, even though wanting to destroy my life doesn’t feel helpful and offending all of my friends isn’t a plus either, that euphoria and energy feels like such a liberation from the straight-up depression I felt before that and I find myself actively not wanting to feel “better”. At least, not when “feeling better” means having to feel worse first. After all, I have found zero treatment options to help with my depression, so having any episode switch into depression can be the potential for weeks, if not months of ongoing depression.

I am fully aware that this “logic” isn’t helpful to me or my life in the grand scheme of things, and I think that is why it is hard for people who haven’t experienced this kind of situation to understand that there is even a question of what someone like me in a position like this one should do. I know that when I feel well I like to believe that I will choose the best option for myself every time, even when I am sick. Unfortunately it doesn’t always turn out that way.

Ultimately I’ve been taking the rispiridone, but the first few times it was too low a dosage to achieve anything helpful. I tried it at a higher dosage and found myself resisting how emotionally pulverized I felt the next day.

I am really lucky that my boyfriend is so intelligent and empathetic. He kindly explained why I need to be taking this medicine anyway, which showed some extreme patience given the fact that my mixed hostility and agitation have often given way to labeling him the ultimate villain in my life, producing constant and obsessive thoughts about how I need to get away from him as quickly as possible (another reoccuring theme for me, the same issue that inspired my hospitalization in 2014).

Somehow I have become Dumbledore and while rational I have told Harry to make me drink whatever foul liquid is in that crystal podium even if I resist until we can get that damn horcrux in our efforts of defeating Voldemort. Now that I’ve drank half I’m kicking and screaming but he’s doing his best to make me drink it anyway.

Even though I dislike the situation, I have to say I find my boyfriend’s efforts quite admirable, and in those brief slivers of moments where I remember that he is kind and sweet I’m doing everything I can to remind myself that I asked him to do this for me in the first place.

Mixed episodes like this one are the worst sort of episodes I come up against. Combining the hopelessness and futility and lack of self worth of depression with the energy, euphoria, and rage of mania offers a dangerous situation where I constantly feel compelled to do whatever I want without any fear of the consequences (because they’re pointless, remember? And with mania I don’t feel anxiety or fear.). Meanwhile it doesn’t feel like I’m really doing any harm (because I feel great!) as I shuffle around and stomp on everyone else’s lego castles.

So far the rispiridone hasn’t made any dent in my symptoms (or perhaps it has and they just keep coming back with a vengeance). I pouted and told my boyfriend I didn’t want to go to the hospital (because I really don’t) but he wisely told me that the hospital “is just another kind of treatment that I might need right now, nothing more.” While I hope to make it through the week as a free woman, the instant I make a beeline to more lego-castles with the intention to stomp I’m going to have to check myself in. After all, if I don’t the cool kids might kick me out of their lego club, even if that only matters to the version of me who is stable.

 

 

Recognizing Positive Forces: Barbara Ballard

The last couple months I’ve been thinking about my high school English teacher Barbara Ballard’s retirement this week. I went to a small public high school in the town of Coupeville on Whidbey Island and she has been a fixture there for quite some time now.

I’ve always been the sort of person to have a brain like a dry sponge. It is often ready and willing to soak in anything and everything given to it which really was difficult to deal with in high school. Most of the teachers didn’t know what to do with me because I tended to be ahead of the curve in terms of their curriculum. I mostly hung out and made art, soaking up whatever new bits of new information I could get my hands on.

That changed my junior and senior year of high school when I began taking Ms. Ballard’s English classes. They were the first classes where I truly felt challenged (apart from never quite being able to get a positive score on the V-sit in P.E.), and even though I didn’t give much mind at the time to any writing skill I may have had it felt wonderful to have something other than sports I could pour my competitive spirit into (even if I was only competing with myself).

Though I didn’t recognize how honing my writing by continuously running the gauntlet in her class might help me in the future I’ve had the last few years to contemplate it. After all, finding myself in a position where living with treatment resistant bipolar disorder has kept me from being able to work a traditional 9-5 job I’ve had a lot of time at home to try to figure out an alternative that would allow for feeling even a sliver of purpose or fulfilment, and it seems I’ve found that again through the writing Ms. Ballard helped me build a foundation in.

In a way this realization has not been unlike when Dorothy finds she had the power to get home all along in the Wizard of Oz. After all, the first time my bipolar symptoms reared their ugly head was in my junior year of high school. Amidst the paranoia and psychosis, the intense mixed episode where I’d find myself feeling both amped up and tragically devastated at the same time I was enrolled in Ms. Ballard’s English class. When it came to the point where I needed to be hospitalized in order for me to get the treatment I required my mother told me that she spoke with my teachers about it to get my assignments worked out.

At 17 the idea that my teachers were aware of such an intense experience I was having, one that I desperately wanted to hide at first, was terrifying. Especially when it came to those teachers (well, there was only one really) who were demanding great work: Ms. Ballard.

I was too young and inexperienced with mental illness at the time to be able to recognize how well Ms. Ballard handled the information and how seamlessly she accommodated my situation in class. Once or twice she allowed me alternative reading from the rest of the class when she thought the content might not mesh well with my situation, and if she eased up on her critiques at all it didn’t keep me from trying as hard as I had before. She never made me beg or try to explain myself and she never acted condescendingly toward me (something many other adults were doing at the time). She simply allowed an unspoken understanding to sit between us and in doing so I felt comfortable enough to go on to complete a University of Washington English course in her class for college credit my senior year.

Like I said, I had little expectations for what writing could do for me at the time, but the treatment I received from Ms. Ballard at a very delicate time in my life left me with an enormous respect for her.

It has only been in the last few years that I’ve merged the skill of writing I’d gained with my experiences with mental illness to create a platform to help other people understand what it is like to live with mental illness and why it is important to be fluid and supportive in how we handle situations with other people. In my mind we could all take a lesson from Barbara Ballard because it seems she’s at the head of the class.

Thanks for providing an atmosphere where I could succeed and congratulations on your retirement!

 

 

 

 

How DBT is Changing the Game

I have been celebrating all week because as of last Thursday I have officially completed all of the sections in the DBT workbook and group. Apart from high-fiving myself (alright, so that’s just a clap really) for seeing this through I’ve been reflecting on how DBT (Dialectical Behavioral Therapy) has been a game changer in a life largely structured around living with treatment resistant bipolar disorder.

Before I can offer up a delightful before and after like some kind of mental and behavioral makeover I have to say that I feel lucky just for getting into a DBT program here in Seattle. I am on Medicaid and the waitlist for people receiving public mental health services here in Seattle means it takes typically months and in some cases years to get into a group. In the time it took me to get in I tried all sorts of treatments and even went to two consultations for ECT (electro-convulsive therapy). Obviously it seemed like DBT was a popular option, but after having a hard time with other types of therapy (like CBT, cognitive behavioral therapy, as an example) I couldn’t be more pleased with discovering why DBT has gained so much popularity and why I had to wait in the first place.

Me

Just so you know where I’m coming from on this I think it might be helpful to tell you a little bit about what I experience.

I have treatment resistant bipolar disorder which means there haven’t been any medications that have been able to help stabilize my ongoing mood swings or prevent new ones from happening. My mood swings range from several intense swings in a day (which can range all the way from euphoria to suicidal depression and back again in a matter of minutes) to long intense episodes that can last months at a time. I experience mania, depression, agitated and sometimes hostile mixed episodes, suicidality, homicidality, and psychosis.

Needless to say… that has been a bit of a handful both for me and for other people to deal with. I can be unpredictable around other people which means they don’t typically know if I will be excited or devastated or aggressive from one moment to the next and I’ve had too many issues with homicidality, suicidality, and psychosis at work to keep a job for the last several years to boot.

The things I have felt needed the most immediate addressing have been things like:

  • feeling strong urges of violence toward myself or others
  • feeling unable to communicate with my boyfriend or others during intense episodes
  • losing relationships and jobs because of my emotional reactivity
  • constantly relinquishing my own self-respect in attempts to make others happy and avoid confrontation or the potential triggering of more episodes
  • isolating myself due to constant fear and paranoia that someone might hurt me or I might hurt someone else
  • negative thoughts I could not seem to stop or make quieter

In addition I have experienced very intense anxiety since I was old enough to remember. This has typically caused problems like:

  • worrying to the point of causing physical illness
  • believing horrible, sometimes life-ending events are about to unfold at any minute
  • fear and panic overwhelming enough to keep me from having a driver’s license (at age 30)
  • attempts to control other people’s actions to keep their unpredictability from making me more anxious (I wouldn’t recommend it…)
  • constant obsessive thoughts that I felt powerless to stop that also often keep me from sleeping
  • Ongoing panic attacks

Sometimes I can pass as a typical stable adult to others because I am intelligent (might as well toot my own horn there but people often point that out as a reason I can be high-functioning at times) and periods of hypomania tend to dissolve the anxiety I feel when they are occurring. Unfortunately as I have gotten older my episodes have gotten progressively worse and those periods of “normalcy” have been few and far between.

Before DBT

The ways in which I have coped with these issues have definitely evolved over the last 15 years. I’ve gone through my fair share of harmful coping strategies (self-harm, alcohol, binge eating) but I have also gone through a long line of coping methods that may not have been directly harmful but weren’t exactly effective either.

Ineffective coping strategies are usually those I’ve come up with and then discarded after a period of trial and error. Without much direction (both from my doctors and therapists previous to DBT – with exception to CBT) I kind of just came up with ideas I thought would work and tried them… I’d like to chalk this up to the scientific method but it may have been equally spurred by a constant feeling of desperation. Sometimes the methods would work for a while and then I would begin to get exhausted because they took all of my focus and effort to maintain. Things like:

  • seeking approval from other people when I was depressed
  • reaching out to every person I knew in times of crisis instead of just people I could trust (resulting in sometimes landing myself in dangerous situations)
  • constantly fighting the obsessive or negative thoughts by arguing with them
  • keeping myself in a state of constant distraction so it wouldn’t get quiet enough for me to hear negative or obsessive thoughts
  • never being alone because then I would be alone with the obsessive or negative thoughts
  • changing jobs frequently in an attempt to find one that “made me happy”.

Obviously I found a few things that worked, even if I didn’t know it at the time. Writing, art, playing music, playing video games… all seemed to make things feel easier, just not enough for me to base all of my activity on them. After all, how was playing the piano going to help me maintain friendships? How could I work retail and be drawing at the same time?

When it came to CBT I could get behind the idea of doing activities like journaling but the idea there was that there was a thought that was ultimately prompting my emotion and behavior. I found many of the activities soothing for a time, but even after I managed to figure out what negative thoughts were prompting my emotions or behaviors I couldn’t find anyone who could tell me how to change those negative thoughts (or stop from obsessing) in a way I could understand and it frustrated me.

I was disheartened when therapists would simply say, “you just stop obsessing.” or “you just accept the situation,” and when I asked how one does those things (as I couldn’t seem to make them happen voluntarily) nobody could answer with anything more than a statement a golf caddy could have given me. It seemed to go against the whole idea of working toward having better mental health, after all… if I could stop obsessing or just suddenly accept a situation I wouldn’t need to ask how to do it.

Beyond that I often felt like I had mood swings that seemed to happen totally independently of what I was thinking or doing. I could be at Disneyland on a roller coaster and suddenly find myself depressed, but none of my therapists or any of my hospital workers were willing to consider or explain why that might be happening. Most of them told me I didn’t know what I was talking about which I could watch transform my curiosity into livid rage.

Needless to say, I started DBT feeling skeptical after my time with CBT but what I found was a language I could understand.

Dialectical Behavioral Therapy

I think it is import to point out that in my situation (one where every previous treatment option has failed) I have been desperate for any kind of help with my mental health for some time which means I found myself in the DBT group both ready and eager to learn as much as possible and practice the techniques. I needed relief from my symptoms and without anything that could provide that previously I was ready to throw my whole self into the class and take it very seriously. Being willing to dive in to the class helped me push through the frustrating or difficult parts I faced in the beginning.

I encountered the material in a structured weekly class with homework each week and I think in my case that structure really helped hold me accountable to practice the skills and do the reading. The previous week’s homework was reviewed each week so I needed to finish it. Being in a group also allowed us to compare ideas on what different ideas meant and discuss which coping strategies worked best for each of us.

The sections discussed were:

  • Mindfulness
    • basically how to live in the moment instead of being distracted by internal thoughts as well as how to enjoy each moment fully
  • Emotion Regulation
    • how emotions work, what goes in to working to keep them balanced, and how to change an emotion
  • Interpersonal Effectiveness
    • maintaining relationships and how to have positive social interactions
  • Distress Tolerance
    • tools for crisis situations

The thing I found most effective about the material is that it suggests that the best strategy for living a balanced life is to operate using both emotion and reason. Each section goes on to describe strategies that work to help you create that balance by bringing in whatever is missing (usually for me it is the reason element) into the situation.

While there were some aspects of the workbook I had already figured out on my own through the trial and error I mentioned earlier this style of workbook offers many different kinds of strategies and basically you keep what you like and leave what’s left. I really respected that idea because I was able to tailor my own set of skills based on my needs and everyone else in the group was able to do the same. In that regard I can see where DBT’s popularity comes from because it is accessible to a wide audience.

After DBT

The important thing to understand about DBT is that I still have mood swings. I still feel suicidal urges, I still feel most of the things I felt before. The group wasn’t a magic cure for those feelings and urges, but it helped me understand how to negate or change them in healthy and manageable ways. More than that, I’ve been equipped with an arsenal of coping skills that work for me, and that is HUGE.

The mood swings may not be gone but being able to bring reason and logic to the table when they happen tends to mean less reactivity on my part. Less reactivity means it is easier to maintain relationships. Being friendlier to people means I feel less paranoid about potential reactions to my reactions. It all starts to trickle down through all these channels because everything is connected.

The only hard part here is that it only works as long as I use these skills. That might seem like a no-brainer, but mood swings can sweep me up sometimes and I find myself swirling around with no idea of how long I’ve been there. Anxiety can leave me worrying so much that I forget to let myself rest or use the skills that might provide some relief. Yes, it takes a lot of effort, but I’m doing my best to be as diligent as I can because even though this may require more energy than if I’d found a medication that worked straight away DBT has led me to the first glimpse of relative functioning in years.

Even though I only started this class six months ago I can see changes. Three or four situations happened just over this last weekend where I found myself thinking, “wow, this really would have ruined the whole weekend before, but I seem to be able to accept and to move past these situations much more quickly now.”

I had a neighbor who kept parking in our building’s guest parking spot in an attempt to dodge paying for a spot. It went on for months, and even though I had to remind myself every time I saw it that it would be better to accept the situation (and not leave rude or threatening letters on his windshield) and to be effective than to make enemies with my neighbors I did it. They moved away and I did a celebratory dance because I was able to keep myself from being a total A-hole.

I’ve also found it very useful to distance myself from my own thoughts and remind myself that just because I’ve thought it doesn’t make it true, it doesn’t mean I will act on them, or that they will happen. I’ve got several ways of weeding out bad ideas now before I find myself doing them, which means creating a sense of self-trust and self-respect where I didn’t have one before.

While DBT has made things easier (less effort for better results) the more stress I am experiencing the less reliable the system is for me. If I am too distracted or upset to complete the skills things simply operate… well, as normal. In some respect that means I’m working to weed out stress before it’ll swamp me now, trying to be proactive about avoiding avoiding things. There are some situations though, like Corey’s broken arm, that came with an intense whirlwind of stress I couldn’t dodge and as a result I quickly slipped right back into a state of crisis. I’m still working on climbing my way out of it but each day gets a little easier.

Finally, apart from being immediately useful to me, I really respect the DBT program because it provided content that wasn’t given to me in a condescending way but made sure to fully explain why each part was important. DBT fits my personal values, and makes room for those with values that are different from my own.

The obvious take away here is that there is some serious potential for more DBT groups in the Seattle area, and I wouldn’t be surprised if that was a trend across the country.

As for me, when seeking treatment for mental illness has often meant taking one step forward and two steps back I am really glad to have had a chance to work through this program because in many ways it is changing my life for the better. Having the opportunity to change my negative behaviors while learning how to take the reigns back from mental illness has given me the footing to be able to respond with, shove off, I’m queen of the mountain now!”

 

My Bipolar vs. Mainstream Life at 30

Since it is halfway through May you’ve probably heard that it is Mental Health awareness month. Living mindfully with bipolar disorder usually means that I am excruciatingly aware of the state of my own mental health, but there have been times in my life where my own awareness of the route my life has taken shines at me like a garish neon sign, complete with several arrangements of plastic plants that have gone too long without being dusted.

Last week was one of those times. I found the experience of having the differences of my life compared to what’s typical for a person my age lined up like a bad buffet a little ironic considering the fact that it is Mental Health Awareness month because no matter how aware I think I am at any given time there is always something more to discover.

Going to happy hour with friends is often an obvious reminder that the people I associate with all have jobs, careers even, and I do not.

Sitting at a friend’s wedding is usually a pretty stark reminder that despite being 30 and having seen the vast majority of my friends get married (and then even about 50% of them get divorced), I haven’t encountered either of those experiences.

Being 30 has seemed to put me in a position where I can feel even more estranged from my peers because many of them are now having children, something so far removed from my own radar that the prospect seems entirely alien to me.

In my mid-twenties it really bothered me that as I moved forward in life I seemed to have less and less in common with the people around me. Queue the “quarter life crisis”.

What was I doing with my life? Why was I different from my friends? Should I change direction to try to fit into the majority? Would it make me feel… better?

Admittedly, it was many of my friends who worked to remind me that I’ve never really done what was expected and that that was one of the things they admired about me. I found myself trying to get a better understanding of my own values and where they came from, but ultimately I couldn’t ignore the elephant in the room.

I live with treatment resistant bipolar disorder.

And while I knew this contributed to being different somehow, my understanding of why has changed a lot over the years.

Through my teens and early twenties I seemed to believe that having bipolar disorder meant I was broken in some way. Like I was a warped piece in life’s puzzle that no longer fit and would eventually be discarded. My depression often made quick work of stripping my self-esteem until I believed I was worthless, and the people I surrounded myself with didn’t always do much to counteract that idea.

Through my teens and early twenties I ALSO believed at times (hello bipolar disorder) that I might actually be a creative genius, or a god of some kind, or that I could ride bipolar disorder like a rocket to leave the planet entirely and find the one I was meant to live on. I thought perhaps harnessing the intense energy it gave me would produce amazing things, and at times it did, but never for very long.

In my mid-ish twenties I made my biggest effort to “fit in” since elementary school. I got myself a degree and a career and a stable long-term relationship. I saw bipolar disorder as a hurdle, something I could certainly overcome with a little help. It was only a matter of finding the right way to dodge it in order to be able to swim in the same pool as everyone else and climb life’s ladder to get promoted, to get married, and to live like anyone might without it.

In my late twenties it became clear that my symptoms were not responding to drugs, and as my psychosis and cycling grew in speed and magnitude the life I imagined would not work as a place for me to reside while I spent most of my waking hours arm-wrestling my symptoms. Bipolar disorder became something constant that I saw evidence of every day, and had to work every day to keep from self destructing.

That evolution that led me from trying to follow the beaten path to realizing that my illness was something I needed to grapple with every day has made a huge difference in how I have created my life’s goals. Of course, this wasn’t something I realized until last week.

I was at a party last week when that neon sign came on, the one suggesting how different I am from the majority of my peers. The moment came when I realized I was having a hard time relating to the conversation because I hadn’t had many of the experiences being discussed. I haven’t been married, I’ve never traveled through Europe, I don’t have a career, and I don’t have children either. I felt ashamed for a moment as I hovered around a 21 year old and discussed art because I couldn’t relate to any discussions being had by anyone my own age.

I left feeling awfully… well, confused. There really wasn’t much room for sadness, as I said this has been a theme that I have been growing accustomed to over the last ten years. I felt no jealousy for not having any of the experiences I listed, just an odd sense of displacement for not being able to relate to them. I wondered what the next ten years would be like if things kept up this way and if I would have to keep continuously searching out people like me to have something in common to talk about. Would I find myself 40 and milling around 21 year olds?

Thankfully it wasn’t twenty four hours before I had a revelation that put my mind at ease. The feeling of not belonging, of not fitting in became much less important (as it usually does when these things happen) once I put my finger on it because the idea that I have accomplished very little in my 30 years was stamped out. After all, that was what was bothering me most. These other women had met huge milestones in their lives and I had hit none, what had I been doing with all my time??

It was just as I mentioned before, having treatment resistant bipolar disorder has had a big impact on my life and the decisions I have made, but the past ten years the biggest difference has been in how it has informed the creation of my goals. Before containing and managing my symptoms were where my work week went, my goals were just like anyone elses.

Work at a job that I enjoyed and get promoted.
Earn money that I could save to travel.
Get married and maintain a healthy relationship with another person.
…yeah, sorry, not the kids thing though. That was never on the list.
Buy a house and land I could call my own.
Live happily.

I am not here to say that having bipolar disorder has derailed those plans entirely, but when I found that my symptoms couldn’t be controlled with medication I had to take a detour. I needed to create goals to help me understand how to live with my illness without the aid of psychiatric drugs because they weren’t working. That means in the last 5-10 years I have been busy working to find the answers to the following questions instead (among others):

How can I have a healthy relationship with another person when I can be volatile?
How can I be accommodating to other people without feeling used?
How can I create balance in my life?
How can I figure out what I am truly good at?
How can I take care of myself in a healthy way?
What can I do to find peace in the fact that my life is different from the lives of others?
If I can’t change it, how do I accept the hand that has been dealt to me?
Are there any ways it is helping, rather than harming me?

Most of my goals have been internal, things to understand and figure to make my life better -and better the lives of my friends and family around me in the process. It has seemed imperative to understand these things before following most external goals. After all, it has seemed clear to me that setting up a stable foundation and understanding of myself and my symptoms can help me build a more stable life that will be less likely to collapse at the first sign of trouble. I’m learning to crawl before I am learning to walk, after all:

If I can’t control myself, what good is earning and saving a bunch of money if I only spend it during a manic episode?

Knowing how difficult it can be to live with or communicate with me because of my symptoms, how can I justify making a life-long commitment to someone when I can hardly keep a friendship or relationship for a few years?

If I can’t effectively take care of myself in a healthy way, how in the world could I possibly take care of someone else?

This reflection definitely helped me feel more at ease with the last few years and how I have spent my time. At first glance I may appear to have little to show for it; a sporadic blog, a failed attempt at applying for Social Security, significantly more days spent in my apartment than anywhere else…

but ultimately the knowledge I’ve gained about myself, how to live with what I have been given, how to interact with other people, and how to be open about the things I am dealing with makes me optimistic that I’ll have a more solid foundation for getting (and keeping) the things that I want. As I said, I may not have a lot to show for it right now, no career or marriage or kids, but I am hopeful that taking the time to figure myself out will put me in a much better position if those things ever pop into my life. It might not be this year, it might not be next year, but I’ve got a lifetime to figure it out.

Raising Funds & Awareness for the 2016 NAMI Walk

Hello folks!

In just about two weeks I am hoping to attend the 2016 NAMI Walk here in Seattle where I will be walking in support of increasing understanding and decreasing the stigma associated with mental illness!

Why walk?

Well it is important to me to show my support for the mental health community both to those who are in it and to those who aren’t. I think creating an atmosphere of community around those of us living with mental illness is paramount to providing support to those who need it and participating in the walk is also a way for me to follow through with my goal of living openly with mental illness.

Living with treatment resistant bipolar disorder has had its share of challenges and I want to show up in mind, body, and spirit where I can say, “guess what, we’re not alone!” I did the walk a couple years ago and found that I was overwhelmed by the number of participants and felt a sort of awe at how many people were willing to be present for the sake of improving our mental health as a community, as a nation, and on a global scale.

NAMI (or the National Alliance on Mental Illness) is an organization that I have had quite a bit of experience with. They conduct free support groups as well as a number of programs (like peer-to-peer groups led by people with mental illness as well as groups to help friends and family learn how to cope, support, and adjust, among others) that I believe are invaluable. Finding support early on after diagnosis can be really challenging, especially for those with little financial support. NAMI does a great job at offering their services to those in need, which is why I am working to raise funds for them through the 2016 NAMI Walk.

Anyone able to spare a couple dollars for the cause can donate to my fundraising page here. Donations, big or small, are greatly appreciated but I hope that even if you do not have the means to donate or you choose not to for whatever reason you take the time in the next few weeks to consider how you can pay forward the support you’ve seen from the mental health community. That might mean lending a non-judgmental open ear to someone in need of one, or even sharing your story with someone feeling isolated and alone. I don’t like asking for money because I know how stressful it can be living with very little, that’s why I wanted to suggest that donating an act of kindness or support or openness to someone else is equally as important and could provide something equally as life changing to someone who needs it.

If you find yourself open to donating an act of kindness or support and want to let everyone know in the comments, have at it! It would be great to hear an act of support being pledged by any of you readers! If you want to do it in secret there’s no shame, trust me -the end result will be just as powerful!

NAMI is a national organization and you can find out more about them (or their work in your area) here. They are hosting walks through the country throurout the year.

Live in the greater Seattle area and have an interest in doing the NAMI Walk for Seattle on Saturday June 4th in Kirkland? Check out the website here!

Finally, once and again you can check out my fundraising page here.

Thanks for your support!

 

 

Antidepressant Turnover

You may have read (here: Back in the (Rx) Saddle Again) that I have been experiencing a significant enough decline into depression to warrant attempting an antidepressant again. Being home with my boyfriend who has a broken shoulder on a daily basis has been quite exhausting, and despite my typically treatment-resistant symptoms (and negative reactions to new medications in the past) I have a new psychiatrist who seems hell-bent on un-wedging me from my latest foray in desperation.

Her latest idea was to start me on 12.5 mg of Zoloft (sertraline). Previously I tried 100 mg of Zoloft and started to vibrate out of my own skin with manic energy so we were hopeful that a tiny dosage might be enough to nudge me out of the black abys without launching me sky-high like some kind of slingshot of euphoric destiny.

As much as I find myself feeling like an emotionally unstable lab rat I admit, I’ve always been interested in science and how the body works. I’ve spent the last six years documenting my symptoms several times a day to try to help me understand where they are coming from and what helps me negate them. This has led to a complicated system of notes I sometimes see my boyfriend trying to read but tends only to result in a lot of head-scratching on his part. That said, even though my doctor has recommendations for my health and what might help, I have worked hard to pay close attention to the process for every medication we’ve tried, even those that were meant to help curb side effects and several that haven’t been related to psychiatry at all.

I guess it helps that I am interested, but much of my documentation has come out of necessity. Living with a mental illness has been super hard to get a grasp on and for many years I didn’t know exactly what was coming from bipolar disorder or anxiety and what was me. My rigorous note taking was what allowed me to show something like physical evidence that my doctors could contemplate to diagnose me in the first place, and beyond that it has been necessary because having treatment resistant symptoms (and often unusual side effects) has made it hard to know if something is helping or potentially hurting me overall. I have enough experience with physicians at this point to know that they are much more likely to believe what I tell them when I can present it in a formal and organized way. Rationality doesn’t hurt either, but sometimes that is hard to come by.

On a personal level, these notes have been totally invaluable when it comes to situations like trying Zoloft again a couple weeks ago, not just because they are something I can show my doctor but because living with a mind that can have trouble judging reality from fiction can make it difficult to believe in myself and the conclusions I am drawing at any given time. Having something tangible I can go back to so I know that I’m making important decisions (like whether to start or stop a medication) based on my experience and understanding of my situation and not a psychotic delusion has made me more confident about understanding my own health than I feel about any other aspect of my life.

As helpful as that can be, it can undermine me as well. Being confident about how I have assessed the results about any medication I’ve tried tends to leave me on the defensive with some doctors and I can come off as hostile or difficult to work with. When faced with the wrong doctor, one who tries to push their own agenda rather than listen to my point of view, I know I can become volatile. That’s why having the right doctor has been equally as important to me as the note taking.

So everything I’ve said about note taking was to get to this: the last two times I tried a new medication each one was a repeat of something I tried many years earlier. 5-15 years earlier. It is the oddest thing because I would almost swear that I’ve become even more sensitive to medications and develop more side effects than I did a few years ago. I don’t know if that is possible, but that’s the way the data seems to lean.

Ultimately this time around 12.5 mg of Zoloft had more adverse effects for me than the original 100 mg did. Yes, last time I was manic, but this time I waded through several days of intense dizziness, nausea, and GI upset only to be blindsided by 8 straight days of severe headaches in a row.

By the time I reached the seventh and eighth day my irritability was rising exponentially, to the point of being more reactive and depressed from the pain than I was before I started the Zoloft in the first place. I didn’t want to gamble the pain continuing(or even worsening) over the weekend since both my boyfriend and dog are relying solely on me for their care and I was already irritable to the point of arguing with every commercial that was coming on tv.

I called my psychiatrist’s office and the nurse suggested the headaches were a product of allergies (due to the intense tree pollen bloom this year) but if I really felt sure I should stop the medication over the weekend and call on Monday to report any changes.

I went with my own gut and stopped the Zoloft and within 24 hours I felt totally fine physically. The 8 day headache was gone, as were the other issues -all except the irritability that took more time to reduce itself. I admit, I did a little jig -both because the headache was gone and because I was happy I had made the right decision.

All too often it seems that doctors are more than willing to force me into a position of feeling much worse before I can begin to feel better, and while I understand the concept of waiting out side effects long enough for them to dissipate, in my particular situation of treatment-resistance it has never once paid off. Either the side effects become debilitating to the point of requiring a trip to the ER or hospitalization or I manage to get through the side effects after several weeks or months of struggle (like with lithium) and find I receive no beneficial effect from the medication.

Thursday I will be meeting with my psychiatrist to go over the notes I took from the trial and I’ll see what advice she has for me next, if any. Writing about the situation in this forum allows me the space to really think about the situation and try to understand it without feeling overwhelmed or sad or angry. I guess I am just ready and willing to accept that this is how things are for me, and even though I would say that is some serious progress I still hope to find whatever it is that will allow me to move toward wellness -or at least the best approximation I can afford.