Tag Archives: triggers

Brain and Body – One Unit

With my next surgery only three weeks away, any sort of mental stability has been… skittish, at best. The nice weather has helped instill some good hypomanic moments, but I have been randomly transforming into a raging hose-beast from anywhere to 5 minutes to several hours at a time. Highlights include when my lawyer told me to “call him back when I felt more emotionally stable,” (good luck there buddy), or my explosion at my boyfriend for [me] not being able to find a reasonable anniversary gift for him. Whoops.

Overall, pain and eating issues/the fact that my body isn’t interested in going more than 15-45 minutes without requiring a restroom has been a large stressful addition to an already jacked up mental state. Not being able to eat the food I want (that would normally comfort me in times of stress) has been pretty difficult, and the embarrassment of having to ask the deli clerk to watch my basket at the grocery store while I use the bathroom three times in one 15 minute visit doesn’t feel so nice either.

Ultimately, the issue that my surgeon found during the last surgery is that my uterus (having grown diseased endometrial tissue) has become connected to my colon. While this seemed weird (and the doctors expressed that feeling too) I imagined the two bound by a small, maybe quarter size area that could be sliced apart… case closed right?

Uterus vs. Colon

Unfortunately that isn’t the situation. My uterus is now holding my colon hostage and is connected for a long stretch of both. I am happy that this explains the pain, nausea, and inability to eat… as well as some other, less pretty problems I’ve been having, but the fix isn’t quite so quick as I might have imagined.

Why even write about that here? I mean, I thought about that, and I thought about not going so in-depth about a health problem that isn’t mental health related.

Oh wait! But it IS!

The biggest issue my doctors and surgeons have had to wrap their head around is that I have a pretty severe case of bipolar disorder. Because of this, many aspects of my symptoms, my treatments, and my recovery are different from most people.

My symptoms include physical pain, but this is a big purveyor of emotional stress for me, which means triggers for emotional outbursts and episodes . At the same time, my symptoms of being unable to eat a long list of yummy things (dairy, beef, spices that aren’t salt, fatty or fried foods, seafood, acidic foods, the list goes on…) disrupts my typical “self-care” routine when it comes to finding joy in what I am eating. Having less options to draw on in maintaining my mental stability means less stability!

My treatment of this health problem is atypical because all typical treatments (using hormone therapy) trigger severe emotional reactions for me. That means the best option I have is a procedure (hysterectomy) that is normally reserved for women much older than me. Granted, I have never been interested in having children (so I dodged a bullet there) but upcoming surgery is, again, stressful, and despite my disinterest in having children my subconscious is still grappling with the idea and I’ve had nightmares every night.

My recovery will also be different than the norm because I have the added risk of post-surgery medications triggering episodes (like last surgery). Once again, the pool of self-care resources I will have will diminish as I will be immobile, and feeling “trapped” has always been a big trigger for me. The physical pain will continue to be an issue for a while and there is the possibility I will need to be on a liquid diet for a while as well (depending on how much surgery is done on my colon). So, um… stress much?

All in all, there is no separating my mental and physical health from one another. Even though my brain isn’t down in my abdomen having tug-of-war party with my uterus and colon, they are connected. It’s called a body! It is generally considered one unit.

At any rate, this is a situation that I know will require physical work. It will require mental work. It will require emotional work. If that is the price it takes at a chance of feeling better, as usual, I will take it.

 

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Like Black and White

The effect bipolar disorder has on my life is never quite as apparent as it is when I see two distinct periods book-ended together.

The way things have been for the last four years I generally have found myself in a “stable” headspace for a week (maybe two if I’ve been really good) each year. During these periods it feels like slipping back through time, and the sounds of birds and expansive sky are not blacked out by a wall of noise and fear in my head.

I admit (though somewhat embarrassingly) that it is has been pretty common for me to begin to believe I am free of it. That life will go on with birds chirping and the sun shining and everything I have experienced will fade like a bad dream.

The truth is that in my life, those stable moments have been both the bearer of exceptional hope and the product of immeasurable fear. Hope that I could once again live my life feeling relaxed and calm… but fear that the rug will be swept out from under me at any moment.

So this is what I mean by two distinct periods book-ended together. Sometimes the clarity I find comes from experiencing mania and depression back to back, but overall the moments I am able to truly see the difference between a stable, rational me and what I experience the other 95% of the time are when the chirping birds and blue sky are suddenly drowned out by the inescapable noise and dampening via my brain.

This has been my situation the last two weeks. Though I have done my best to “avoid stress” it isn’t possible for me to avoid my health problems and the surgery I need to help correct them. With this news came the curtain, and with the curtain has come a very interesting view of how dramatically different my brain works when cycling vs. not.

At any rate, I just wanted to mention that I may be absent from this blog for a few weeks while I get surgery and heal up. I need to focus on coaxing my brain through this emotional maze with as much cheese as I can get my hands on.

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.

Attempting Hormonal Therapy with Mixed Emotional Results

I know I have been somewhat MIA the last couple weeks, but here is a quick rundown of my current situation and how things have been faring.

It looks like some (if not all) of the GI problems I have been having since trying Seroquel (all of which are still present even after almost six months of stopping it) are potentially due to a hormonal problem triggered by the drug. After having an endoscopy (having a camera put down my throat to inspect my stomach) and a colonoscopy (same thing, only in reverse… and with significantly less dignity) the result was that the doctors could find no reasonable cause for the intense amount of pain and other odd symptoms I have been having.

After everyone scratched their heads for a while I did some of my own detective work and I went to see a gynecologist. She recommended hormones. I started taking them two weeks ago… and the result was pretty much exactly what I expected – the same sort of response I have had to pretty much every drug (even the flu shot) the last couple years.

A bad reaction.

You see, not only do I experience a treatment resistant, very sensitive, easily triggered version of bipolar disorder (type 1), most medications I have tried (even something as simple as a nasal spray) have triggered big problems for me either by making my emotional state completely deteriorate and triggering a big bipolar episode, or by triggering significant side effects (which generally just go on to trigger more bipolar episodes).

So on day 5 of hormone treatment when I began crying uncontrollably for an entire day I pretty much knew it was the end of that road, but I kept taking the drugs for two more days (just to be sure it wasn’t my own rapid cycling). Nope, by day seven I had become completely engulfed in suicidality and promptly called the gynecologist’s office to inform them and stop taking the new hormones.

Stopping the hormones suddenly was also a problem. Within two days I was no longer in the throes of depression, but instead I became manic and couldn’t sleep for three days.

I had another appointment with the gynecologist yesterday to try and figure out what to do next. She recommended another form of hormonal therapy (with significantly fewer hormones) which I started last night. Personally, I don’t expect this to end up any different than the last round, but I am willing to give this treatment option a shot because my only other option is surgery… which, frankly, scares the bajeezus out of me a little bit.

Like my continuously evolving trial of medications to potentially treat my bipolar symptoms, after hearing about my experiences the doctor concluded that I am very brave for being willing to try hormones again. It is my belief, however, that bravery and desperation can often look a lot alike from the outside looking in…

At any rate, that would be what I have currently been up to. I am sure the mania was also partially fueled by the fact that it has been summer-time weather (sunshine in the 60’s) in Seattle last week, the total opposite of what normally goes down here in January. It seems weather like this could make for an entirely different kind of winter than I am normally used to (30+ days of rain in a row potentially ending in a depressive hospitalization). Mania has its pitfalls, but honestly there are times (like the winter) where it just feels nice to have a little variety.

I expect I will know pretty soon if I will be able to tolerate this new drug, ironically enough it has the potential to alleviate my lactose-intolerance that started when taking Seroquel, however the pills themselves contain lactose so taking it so far has not been a fun ride. Really, just the fact that I have found a doctor who has found evidence of a diagnosable problem after six months of doctors being unable to give me any kind of answers has been encouraging, even if the treatment options do turn out to be somewhat torturous.

In my life, a little hope can go a long way.

Exploring Mindfulness; Anxiety and Bipolar Rage

I have a new therapist. So far I haven’t decided if I like her because we are total opposites in terms of our beliefs and methods. While this has been pretty helpful in terms of learning new things (like mindfulness techniques), it can also be entirely exasperating when it comes to explaining my point of view.

The first day we spoke she seemed confident that the practice of “mindfulness” would help solve a lot of my problems.

For those of you who haven’t come across this technique, mindfulness comes from a Buddhist practice involving keeping your focus on the present, including “regarding your emotions in a non-judgmental way” (that is a direct quote, I can’t say I totally understand).

The mindfulness meditation I took on takes about five minutes and involves taking deep breaths, focusing on relaxing my body, looking at my surroundings and finding 3 things that are pleasing to me (colors, textures, etc.) and then formulating an appropriate emotional response.

What I found was that after a week of using this technique (several times a day, sometimes 10 to 15 to 50 times as needed) my anxiety was somewhat responsive. I say somewhat because I often found a bit of relief after the exercise, but it wasn’t uncommon for the relief to last about five minutes and then I needed to do the exercise again. I could see how it would be easier to continue doing the exercise for someone who is seated much of the day, however when walking down the street or overwhelmed at the supermarket I was having a really hard time dropping everything to breathe and relax.

At the same time, I also was curious about using this technique to combat bipolar mood swing reactivity, but the results I experienced were somewhat catastrophic.

If you’ve ever seen the episode of Seinfeld (yes, I know, a common theme lately in this blog) George’s father begins using the mantra, “serenity now!” to help combat his rage. What we find out at the end of the episode however is that this practice was only bottling his rage up to a critical breaking point.

However comical, this is actually fairly similar to what happened to me when I was trying to use the mindfulness meditation to address (primarily) bipolar reactive rage. At first it seemed like it was working great and I felt quite pleased (less like breaking things or shouting or hurting myself), but within a span of four or five days the rage suddenly exploded out of me, and I leapt off the couch, threw the remote control in one direction and my glasses in the other and made a mad dash for the hallway where I very seriously expected to throttle whoever was on the other side of my door.

It wasn’t as if this was a situation that had gone on all day and I had been “stewing”, I felt perfectly fine one moment and then within two or three seconds (literally) I was ready to break someone over my knee like a piece of kindling. All I can say is thank goodness for my boyfriend, because if he hadn’t been home to divert me… well I am still shuddering at the notion of what might have happened. Instead I just stood in the bathtub and screamed and cried for a solid half hour.

I have a couple theories about why this happened.

The first involves George’s father from Seinfeld screaming “serenity now!” The thing about rage that I find makes it so difficult to deal with is the energy that comes with the feelings. For me, it has never felt like the emotion builds up if I don’t express my anger, frustrations, and rage, it is the energy. Since childhood my methods of expressing rage have all been physical because they allow me to address and release the energy that is overwhelming me. Unfortunately, they also have all been more or less unhealthy.

With this mindfulness technique I used, I was addressing the emotion I was experiencing, but not the energy that came with it. Once it built up it only took the tiniest moment to trigger it and… kaboom.

My second theory involves PTSD as I have encountered several situations where very minor things have seemingly flipped an invisible switch in me. Frankly I find this to be less likely in this situation because it did not involve any of my typical triggers (being in close proximity of a stranger, the bus, etc) but I can’t discount this as a possibility.

Finally, one could suppose the incident and meditation were not related. Frankly, I can’t say with absolute certainty that they are, but I am nervous to try again given how close I came to, well, certain incarceration.

At any rate, being able to try new “treatment options” that don’t involve pumping my body full of chemicals has definitely been a welcome change. And as frustrating as my new therapist can be, I think a little change can do me good.

At this point we are brainstorming ways to potentially address that rage-energy in conjunction with mindfulness meditations so stay tuned, I am sure there will be more to come on that topic!

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.

Leaving on a High Note

If you’ve ever watched Seinfeld you may remember Jerry (a comedian) advising his best friend George that the best thing he can do is to “leave on a high note.” Lately I’ve been trying to change some of my habits to reflect this idea.

A big problem I have been facing is that no matter what my mood is like during the day, it often takes a big downward spiral (even more downward in the event I am already depressed) in the evening before bed. Going to bed feeling so negative has lent itself to trouble sleeping and nightmares for me, so when I first discovered that the specific mindset I am in when I go to bed plays a big role in my ability to be fully rested the next day I began to do some experimenting.

Lately I have been trying to go straight to bed during a brief moment of contentedness. Sometimes that means booking it to the bathroom immediately after watching a show that has made me laugh or smile, or even going to bed earlier than I normally would (to cut off my emotional nosedive before it gets too out of control). Sometimes that means picking a moment where my rapid cycling is affording me a breath of fresh air from the depression I was experiencing moments earlier.

My general desire in these moments is to stay up later (because I may feel, for a moment, a bit better) but experience, at this point, has taught me that if I do the waves of depression and pointlessness can wipe out those small, good (or even just neutral) moments and leave me stewing for the rest of the night.

So far this experiment has provided me a slightly easier time falling asleep, and though I am sleeping slightly less, I am feeling more rested from the time I am asleep.

I have also been working to incorporate the idea of “leaving on a high note” with my therapy sessions. Let’s face it, they can get pretty… well… glum (is a nice word for it). Spending five minutes at the end of the session bringing the mood back to a happier or funnier place has helped me leave therapy sessions feeling slightly less like a sack of discarded potatoes.

This idea is also something that has made a big difference for me in terms of communicating with friends and family members as well. Leaving a conversation in the middle of something serious or even triggering without bringing things back around to a happier place has been extremely detrimental to my overall mental health. It is almost as if those negative topics, if not contained, spread through my system and drain me of all my energy. Encapsulating those moments in specific conversational bubbles (and moving to another lighter  bubble after hitting a dark one) seems to make a big difference for me, in terms of becoming triggered.

One of the things I like most about this idea is that no matter how dark, or weird, or awkward things get, there is always opportunity to make things a little lighter before moving on. While this is something I tend to do with humor, even something as simple as apologizing to the store clerk who I’ve just been short with has been enough to help me leave a potentially negative situation feeling slightly better. Sometimes it feels really important to me to recognize that I can’t always keep situations from being negative (or keep myself from feeling negatively about something), but if I do what I can to turn things around before walking away, that negativity seems to have much less power over me and doesn’t linger the way it might otherwise.

Maybe this holiday season a good option might be to leave on a high note. A polite goodbye before a party or gathering turns into total chaos could be the difference between a short, sweet appearance and that dreaded stressed out holiday meltdown. Not only that, but leaving when you feel good might also help keep you from feeling negatively about your friends, relatives, and yourself!