Tag Archives: stress

O is for Overwhelmed

In my mood tracking book the notation ov stands for feeling overwhelmed. I haven’t written because notation has been gaining momentum in my life for two weeks now, and there is something about feeling overwhelmed that particularly cripples me.

In my experience, ov tends to show up in a period where I am quickly shifting from hypomania to depression, though it isn’t too high and mighty to show up in a mixed state or the deepest reaches of a long, suicidal depression. The only reason I can really couple the feeling of being overwhelmed with the hypomanic->depressive fluctuation is because I am generally moving from a period where I have  been overexerting myself (making plans, starting projects) and the energy and motivation I had been experiencing from the hypomania has quickly been pulled out from under me.

Suddenly finding myself without the drive or energy to finish the half dozen projects I’ve started or continue showing up to the week’s worth of commitments I’ve made can make some serious problems, especially when the commitments involve promises to family and friends or the projects are work-related or deadline specific.

Initially, in hypomania, I feel over-capable… so my list of projects and commitments seem miniscule compared to my drive to complete them.

In depression, however, I am flooded by this long list of things to do, a long list of obligations when all I can think about is how much I want to be sleeping and how completely ridiculous it seems to attempt to finish these things now my trajectory has become broken.

Feeling overwhelmed is only one part of it. I often also feel a lot of guilt for potentially scrambling (and failing) to complete these things or for cancelling plans with others. Trying to explain to people that the “car” I’ve been speeding in has suddenly stopped and thrust itself into reverse is… confusing, at best.

Often I try to continue on like nothing has happened, and this is seemingly the worst thing I can do. My defunct abilities are wildly noticeable to the people around me (even if I think they’re not) and becoming overwhelmed and trying to continue having social engagements has led to blow ups, resentment (on my end) and generally wanting to dig a hole to curl up in so I can be alone. When I feel too overwhelmed to be around people in a healthy way, it is obvious. I become distant and curt and have even ended relationships and friendships when people have felt the need to try to comfort me by getting closer. Anyone or anything that adds to my feelings of being smothered are often eradicated from the situation. Period.

The continuation of activities after hypomania also tends to flood me after suddenly dropping into depression and I am overstimulated by even the smallest things. Last night I told Corey it felt like I was an egg, and the noise, the light, and the energy of the world around me were trying to pierce my skin and eyes and ears like a million little microscopic sperm. It left me waving my arms around me, like light and sound were bugs I could scare off. All my mind seemed capable of was tripping the “escape! escape!” alarm as my chest tightened up and I couldn’t breathe.

In these periods, living in the city is extremely challenging. Our technological way of life is extremely challenging. Not running for the mountains is… extremely challenging.

Things that potentially help? For me, the big one is nature. I haven’t been able to experience much of that lately due to the location of our apartment and the surgeries I have had this year, but I find that being in a quiet place in nature is one of the only things that helps me combat the feeling of external stimuli becoming physical.

Sometimes the best I can find is a dark quiet room, and (like last night) inquiring minds around me want to know why I am sitting in a dark quiet room.

My therapist told me I might need to tell the people close to me that I need extra space sometimes, and that there is nothing wrong with asking people for a little extra space.

In all of this, that is my greatest challenge… when the weight of all things are pressing down on me it can be hard to remember what words to use or even that words exist at all. In the end, I expect using words are likely to be far more effective than waving my arms around, insulting others, and sitting in a hole.

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(Snippet)

My new therapist seems to be working out. I have only seen her three times, but she has a face that closes tight like a brick wall when she is listening. Frankly, that is exactly what I wanted… I hate watching people pass judgement on me or my situation while I am talking to them.

I have been having trouble writing for a myriad of reasons, I think I may have been traversing some hypomania last week or the week before but the energy and activity associated with it has taken a toll on my body (that is still healing from surgery). This week has been the physical crash that follows, and my 13-14 hours of sleep followed by exhaustion during the day has not leant itself to much motivation or productivity whatsoever.

My optometrist suggested I have been having ocular migraines -honestly I didn’t know that was something that even existed. I am pretty tired of heaping physical health problems on top of already crippling emotional ones… but such is life I suppose. If it isn’t one thing it is another, I am just glad I can eat relatively normally again.

 

Revenge of the Emotions!

It seems that sometimes when I am in a very stressful or emotionally overwhelming situation my mind likes to go on vacation. It totally checks out, teleporting from my skull-cavity to somewhere a few feet above my body where it takes a nap, or dances, or sometimes swims with dolphins. The resulting husk (me) can no longer effectively communicate, but I also can no longer feel the distressing emotions that situation x-y-z would normally bring on.

I’m pretty sure the clinical term for moments like this is “disassociation”. I leave the situation, my consciousness goes away to avoid undue stress or traumatic factors. What is left behind can be on autopilot and at other times a still, blank meat puppet.

When this happened last weekend, I [operating as a detached husk] found the result almost a little funny. Things I would generally consider horrible were no longer an issue. While friends and family members were writhing in agony, my mind was dancing the cha-cha. Frankly, I was a bit glad because I knew going into the specific situation that it would be difficult… and having checked my senses of despair or concern at the door felt, well, nice.

I realize how that might sound, but imagine you’ve found a jack in the box and you know without a doubt that causing that clown to come out of the box will be disturbing, yet you feel compelled (and even obligated) to do it. You wind the little lever, hear the delicate chimes playing “pop goes the weasel”, but nothing pops out.

No clown, no demon, no carnage.

My life is full of these boxes that I am constantly opening, constantly being wrecked by outrageous emotional turmoil over a simple plastic clown, or a ceramic chipped demon. I admit, when nothing emerged (or maybe it did and I couldn’t see it) I felt a profound, perhaps even spiritual sense of relief.

That relief began to grow into feelings of hope that I might have somehow stumbled onto the secret management technique for mood swings and reactivity that would inevitably save me. Hope that maybe I have finally become desensitized enough to some of these clowns and demons to live comfortably with the acceptance of their existence but without judgement or the need for them to change. I pat myself on the back, good job, I thought. Maybe I am evolving.

My brain came home slowly. It might have come through the door into my void skull on Monday but by Tuesday it still hadn’t settled in. It was still unpacking the damp bathing suits and stolen hotel mini shampoo from the vacation, and by Wednesday with the suitcase put away and the laundry done it sat down in it’s chair and went to work plugging in all of the electrodes back into itself to reconnect to the husk.

Sure enough, as my brain reconnected every moment of the few days prior began to replay in my mind but the unconcerned and relatively emotionally blank tracks fixed to the images began to change. Every humorous moment became a punch to the gut. Every jack-in-the-box that hadn’t opened now erupted with laughing clowns, doubled over and demons waggling their fingers, satisfied that my sense of relief and self-satisfaction were a sham.

As I saw the true nature of things and the way these emotionally binding moments have been for many years sprung at me all at once, I felt ashamed for thinking I had somehow skated past them. For thinking I had evolved. For thinking I had won.

When the emotional flood hit me, it took my breath away. The best I could do was to sit and wait and cry until it was over, and even then -even today my guts and ego and emotions feel bruised.

Tug-of-War Psychiatry; Fighting for Better Policies

This week is one of those rare weeks where I find myself in limbo, last week was my last appointment with my psychiatrist and next week is my first appointment with a new (potential) psychiatrist.

The last five years I have grown very close to my recent psychiatrist, and I could tell both over email and when we met that he was deeply apologetic that we wouldn’t be able to work together anymore.

After he told me why he was leaving the hospital he was currently working at though, I abandoned all regret and any frustration I may have been harboring. He was making the decision to leave because a group of psychiatrists (the majority) quit after the hospital was implementing new policies to try to make their office visits with patients shorter (mind you, they were already 15 minutes a month) and forcing psychiatrists to pass some patients off to primary care doctors to make room for new clients (among other things).

The first thing I did was blurt out, “um, no I think you’re doing the right thing!” and he looked at me perplexed. Even though his departure from this hospital means we can’t work together anymore, I was thrilled to hear the reason he was leaving.

Obviously I am not thrilled that the hospital is trying to implement policies that treat patients in the mental health arena as little more than cattle that need to be herded in and out as quickly as possible, but I AM thrilled that the mental health professionals acted in such a way as to denounce these efforts and protect the right of their clients to receive proper treatment.

“Most of my clients have responded the same way you just did,” he said to me. Unfortunately, this is just a situation where our doctors leaving us means they are protecting our rights, they are standing up for us (in places we can’t stand up for ourselves) and I am happy to think that if I have to work to find a new psychiatrist (trust me, not an easy task) it is because there are other good, ethical people fighting for me and my rights to be treated fairly.

From what I’ve heard, the hospital has began to backpedal in regard to the new policies they were attempting to implement and while some psychiatrists may be returning to work there, mine isn’t. I don’t blame him, think being put in an environment where major decisions about patient care are being decided by board members (and not their doctors) is ridiculous.

In the last five years I have been down this road twice, finding myself without a psychiatrist (and not of my own accord). The first time was when I was put on the state disability program and was no longer allowed to see my regular doctors. After six months they still had not paired me up with a psychiatrist so I dropped the program. Being able to see my competent doctor through a charity service was a much better investment for me at the time than $200 a month and being able to afford the medications I couldn’t get prescribed without the doctor!

The second time was during the healthcare reform, the psychiatric department at the hospital did not want to accept my medicaid insurance but I managed to pick the one subgroup my psychiatrist was able to accept. After several months I was able to start seeing him again.

To say I am not nervous about finding a new doctor and explaining all the odd quirks about my mental health, about my resistances and intolerances to so many medications, and potentially finding someone who is capable of listening as much as they speak would be… well, a lie. However, I have three things on my side that I didn’t have the last few times I went looking for a psychiatrist.

1. I have insurance. Say what you will about Obama, about politics, I don’t care. Ten, even five years ago in Seattle doctors were lined up to turn me away without having hundreds of dollars to make a deposit before a psych appointment or insurance to cover the appointment. Though I am lumped in with a group of people, many who desperately need psychiatric care (with very few psychiatrists to treat them) I cannot be turned away completely. For that, I am grateful.

2. I know who I am. I know so much more about my symptoms and how they effect me than I did five years ago, and also how my body reacts to medications (generally poorly). Knowing these things makes communicating them much simpler, to say the least.

3. I can tell the difference between a good doctor and a bad doctor. In my life, a pychiatrist is the one person I want to be able to trust explicitly. Luckily, I have also formed bonds with many of the good doctors in the city, each of whom has passed on the names of good doctor colleagues to me in case I might need them. I am not willing to see a doctor who is going to be detrimental to my mental health by being manipulative or uncommunicative. Period.

Ultimately I know all of this is just another situation of fallout coming from the healthcare war that happens every day. As much as I don’t like finding myself in a stressful situation, the fact that it has come around because my doctor is trying to be the best advocate for me that he can be is uplifting.

Thank you, Seattle psychiatrists who have been willing to make big life changes to advocate for better mental health policies. I know I am not alone when I say it is appreciated.

Giving Someone With Bipolar Disorder Bad News Safely

I’ve had a number of people tell me lately that they don’t feel comfortable telling me bad news. The idea that people close to me are hiding serious issues from me because they are afraid of triggering my bipolar disorder is extremely frustrating; while I appreciate that people are trying to be wary of my feelings, the plan almost always backfires. Hearing bad news and that the people closest to me have been hiding it makes for an even bigger mood implosion.

The best I can do is try to convey that I realize I have trouble processing bad news, but the manner in which that news is passed on to me has a huge impact on my reaction.

When frightening or serious news is dropped in my lap suddenly (without warning) it can feel significantly more shocking; likewise if the conversation ends moments later (and I haven’t been able to ask any questions or begin to wrap my head around the news) I often find myself trapped in emotional quicksand. The more I struggle to understand on my own, the faster I sink into depression, anxiety, and irritability.

Through my experiences I have devised some tips to help ease some of the emotional reaction in situations regarding passing-on upsetting news. Personally, these things have all lent themselves to a much more safe emotional environment and a quicker recovery from intense bipolar emotional reactions.

1. Be up-front that the news might be distressing.

Letting someone know that a conversation is going to take a serious turn (instead of taking the turn suddenly) can make serious news much less jarring. There is something to be said about being able to prepare oneself mentally before receiving bad or serious news, and part of what contributes to a bad emotional reaction in my case has often been feeling blindsided and totally unprepared to hear something jarring.

Having said that, I have found even very broad, general statements like, “I have something serious to tell you,” or “can we have a serious talk?” are effective in this arena. If I know I might be at risk of having an emotional reaction, I can do a better job of containing myself than if the news is just dropped on me suddenly.

2. Bookend the bad news.

The best way I have found to receive (and give) potentially upsetting news is to bookend the serious subject matter with more lighthearted information. Starting the conversation in a casual way to ease the tension before launching into serious content can help folks feel less anxious about the upcoming serious bit. Probably more importantly (to me anyway) is ending the conversation with something more light-hearted to bring the mood back to the present can help with avoiding being caught up completely in the emotion of the serious bit.

Often hearing bad news can put us in a situation where we feel attacked or fearful, even unsafe. Being able to laugh at a bad joke or talk about a cute puppy really helps nullify that feeling of fear that can be the beginning of a big emotional spiral. In my life, being able to sidestep that fear makes for a totally different reaction to bad news and I am able to focus on counteracting my shock more than having to counteract my fear.

3. Make it a dialogue.

One of the things that really feeds into my fear when I get bad news is being unable to get answers the questions I have about what has happened/is happening. I do not want my mind uncontrollably fantasizing about all of the questions I have (and it will) so being able to ask questions and get answers that I understand makes a big difference in how my reaction will unfold. If we don’t have time to have a dialogue about the topic (and not just be subject to a monologue) then the timing probably isn’t appropriate.

4. Consider timing.

A couple days ago I received some bad news about 15 minutes before I was about to go to bed. Needless to say, I didn’t sleep that night.

Likewise, stress can be a big factor in how reactive my bipolar disorder is in any given situation. Laying some bad news on me when I am already agitated or stressed will yield worse results than providing the same information when I am relatively stable or calm. Again, even in an unstable situation, following tips 1-3 can pave the way for a better reaction.

5. Life happens.

Life is full of good news and bad news, that is just the way it goes. Unfortunately, living with bipolar disorder can make getting bad news extremely disruptive to our lives and our relationships, but pretending that bad news doesn’t exist doesn’t help us learn to cope with our reactive nature or practice living a full life.

Ultimately, I want to believe that the people in my life are genuine with me and open about their lives and their experiences. Honestly, in times where I could tell people close to me were holding back bad news it felt almost more maddening than if they had just been honest! Though this is an area that is very sensitive for many people with bipolar disorder, being gentle about the subject matter and being respectful to our situation when being open with us can mean a world of difference -not just for us, but also for our relationships.

Overwhelmed By Positive Emotions

Normally when I think of being overwhelmed by emotion, I think about my day to day life and the fear, anxiety, and depression that I experience. These emotions often make me feel overwhelmed by the world and everything it entails, from social gatherings to daily living. One thing I had forgotten however (up until recently) was the feeling of being overwhelmed by positive emotions.

Looking back on my life up to this point, I can remember small snippets in time where a joyful sort of emotional floodgate opened and I found myself, almost drowning, in whirlpools of joy or appreciation or beauty. When I was younger, most of these moments took place where something as simple as hearing a song (that I had only heard on a recording) played live for the first time swept over me; when something powerful that I already had an emotional connection to came close enough to me that we came as close to becoming one as possible.

In these moments I found myself so overwhelmed by beauty and joy I could not speak, and my heart often felt like it was trying eagerly to escape my body. I would cry uncontrollably, but not out of fear or sadness or desperation; simply tears of love and appreciation and joy.

I can recognize well enough that this sort of reaction to something beautiful or profound can be just as jarring to the innocent bystander as my typical negative emotional reaction. In fact, many people can’t tell the difference from the outside when they see me overwhelmed in either a positive or negative light; they see simply someone who is overwhelmed.

Becoming emotionally overwhelmed in a positive way is something I don’t hear many people talk about, and for me it has been one of the most profound experiences I have associated with bipolar disorder. Unfortunately, for every thousand days I experience being overwhelmed in a negative way, I only seem to get that positive overwhelmed feeling once or twice. For me it is exceptionally rare, and as I’ve gotten older the moments have become few and far between. I also can’t orchestrate them anymore, many years ago live music stopped producing this tidal wave of emotion for me… so I slumped into a dark depression for several years without that punch in the face of joy or beauty.

The moment this concept and these memories came flooding back to me was last week. Through an odd turn of events I witnessed one of my childhood heroes give a talk and sign autographs for charity. I know people say you should never meet your childhood heroes (because they will be sure to disappoint), but all I saw was an aging man who was genuinely interested in doing something kind for others.

I spoke to him for a couple minutes (as best I could with my throat closing up anxiously) and he was very sweet. When I walked away it hit me like a ton of bricks; the joy, the appreciation, the beauty, the hope and compassion I don’t normally feel toward others. Within moments I was running for the bathroom because tears were spewing out of my face and I had no way to control them.

For the next two days, every time that memory came up I would start crying and grinning like an idiot. On the bus, down the street, at home, talking to my sister, it didn’t matter. I normally spend so much time trapped in a place where I can only ever seem to see the negative things in the world, being afforded a moment, even a split second, where I could see something wonderful felt extraordinary.

Happiness and I have not been the best of friends this year, but I am very appreciative that it is something I’ve been afforded (even briefly) this holiday season, even if it came at me like a tidal wave. Here’s my wish for each of you; if you’ve got to be subject to feeling completely overwhelmed over the holidays, I hope the tidal wave approaching carries joy and love and hope.

And maybe a personalized surfboard.

The Number You Have Dialed Has Been Disconnected

I don’t know if you have ever spoken and felt like nobody could hear you, but for me this feeling can potentially trump symptoms like delusions and hallucinations for the most maddening feeling I’ve ever experienced. Even when I am experiencing hallucinations or delusions (and maybe even don’t recognize it) I can talk to someone about it; but the times when my mouth and body do not convey what I want them to (or they do but in such a way that nobody can understand them) have left me (the innermost me) feeling like a phantom limb.

Last weekend, in a matter of days, I became engulfed by that feeling. Everything I was trying to say, the jokes I was making, the observations I attempted to casually convey, became hostile. It seemed no matter how I spoke or stood or gestured, people were genuinely afraid of me. Those desperate sorts of pleas hoping to convey my intense sorrow came out, instead, angry.

My manic episode from the week previous had turned dark, and as the depression I was experiencing became more and more intense, so did my apparent rage. The rage left me incapable of conveying the depression, and being unable to express myself left me feeling so isolated and alone that I could feel the depression feeding on it and growing exponentially.

When Monday rolled around I tried everything I could think of to crawl out of the disconnected, suicidal funk I was in. I emailed my psychiatrist only to find out he was on vacation. I called the intake coordinator for the new clinic I’m trying to access therapy through but she did not have time to talk. I called the crisis line (as I’ve been calling them a lot lately) but all the phones were busy! This, if nothing else, seemed like a sign, so I grabbed my purse and a book and went straight to the emergency room.

It can be very confusing to watch yourself begin to destroy your own life (your job, your relationships, maybe even yourself through impulsive drug or alcohol use) and feel like you are a passenger during the whole experience. Unfortunately, this is a feeling I am familiar with so I knew that the only real card I had left to play was hospitalization.

What I didn’t know was that I would be spending all day and all night in the emergency room before reaching that inpatient bed. I was awake for 36 hours and extremely alert and energetic (as I said, mixed episode) fueling those depressive and hostile waves that kept coming until I was (somehow now in an inpatient room) crying uncontrollably for hours, and periodically ripping up anything in my room I could find to rip up.

My goal was to outlast the episode until it switched into depression or stability (whichever came first), a fairly easy goal I figured, since my episodes cycle so rapidly and I was already 12 days into the mixed episode. Though it wasn’t fun (but hospitalizations never are) I seem to have outlasted the hostility and was expelled through the other end of the hospital Friday experiencing severe depression instead.

So I am home now, and though my decision-maker seems to be broken and I had a panic attack trying to go into the grocery store I am, seemingly, a free woman again.

My mind has still been trying to whisper all manner of horrible things to me, but I can eat food that wasn’t produced in a hospital now… so it makes all that a bit easier to live with.

Needless to say, my posts may be somewhat spotty for a bit. I’ve been very overwhelmed by a lot of the things that have happened this year, and several more big things are scheduled to go down this month.

In the meantime, take care of yourselves! I’ll be doing the same.