My Experience Only. YMMV.

The Question I Hate the Most

There are many things you shouldn’t say to a bipolar person: Cheer up. Smile. What have you got to worry about? We all have mood swings. Calm down. You’re overreacting. You don’t look depressed.

Each of these remarks contains a hidden assumption, from simple – you can choose your moods; to dismissive – your anxiety is not as severe (or as important) as mine; to possible gaslighting (see https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-C2, https://wp.me/p4e9Hv-Cu).

I’ve gotten all of those and more. Once I revealed my disorder to a coworker and she’d ask me, “How are you?” with a concerned look several times a day, taking my emotional temperature. But the question I hate most is a simple one.

Are you off your meds?

Let’s unpack this, shall we?

First, the underlying message is that, to the speaker, you are acting in a strange, inappropriate, frightening, incomprehensible, or otherwise “off” manner.

The second assumption is that you must be on medication in order to appear “normal” at times.

Third, that since you do not appear “normal” to the speaker, the only explanation is that you must not be medicated at the moment.

Fourth, that the speaker has the right to give you advice on how medicated you need to be in order to appear “normal.”

And, finally, that “meds” are the answer to all your problems. If you want to fit into society you must be on your guard at all times and medicate until you are acceptable to them.

There is a slightly less offensive version of the question: Have you taken your meds today?

This might be marginally acceptable from a loved one, who knows that you take medication for your disorder and also knows that you are sometimes forgetful.

But really. Most psychotropic medications build up in a person’s system over time and leave the body over a long time as well. Missing a single dose is not likely to have an appreciable effect on a person’s moods or actions.

There are some anti-anxiety medications that have short-term effects, and a bipolar person might have forgotten a dose or two.

But unless the speaker is the bipolar person’s caregiver, official or unofficial, it’s still rather parental and demeaning – suggesting that we aren’t competent to handle something as vital as our own medications.

Of course, sometimes it may be necessary to help a loved one remember to take medication, whether that person is bipolar or not. On a vacation, for instance, when one’s normal routine is disrupted, a gentle reminder may not be amiss. When one has just started treatment and the routine is still unfamiliar. Or if the person actually is a child.

You wouldn’t ask an adult with the flu “Have you taken your antibiotics today?” You wouldn’t say to a blind person “Now, don’t go out without your service dog.” Most people, most of the time, are deemed competent to know their needs and take care of those needs themselves.

But bipolar disorder and other psychiatric conditions, being largely “invisible illnesses,” seem to invite meddling. Everyone else knows what’s best for us, from a different drug to herbal medicine to a walk in the park to prayer.

They know a little bit about the disorders, perhaps, largely through television and celebrities. But they don’t know your particular version of the disorder (bipolar 1 or 2, rapid cycling, dysthymia, hypomania, anxiety, etc.)

So if I snap at you, or seem anxious, or don’t want to go out, don’t assume. I have regular “normal” moods too, even when I’m on medication. Sometimes I get annoyed if my husband has lost his cell phone for the third time this month. Sometimes I feel sad if my picnic is rained out. Not every mood is pathological.

So don’t assume you know what’s going on inside my head. Unless I ask for help, refrain from putting in your oar.

And don’t ask me, “Are you off your meds?” It’s an insult, not a question.

I know it’s common when hypomania or mania hits for the bipolar person to go shopping.

The thing is, I hate shopping. Always have. Probably always will. I don’t like to shop for clothes or groceries or shoes. I don’t like to go out to stores.

Ah, but there’s always the Internet (I hear you say). You can shop without ever leaving your house, or for that matter your desk chair.

The problem is, I don’t have any money to spend on online shopping. And that’s one of the reasons I don’t have a credit card. It’s too easy to spend non-money.

What I do have are a debit card and a PayPal account. If there’s no more money on my debit card, too bad – I have to reload it (or more likely ask my husband to reload it). This requires taking money out of the bank account.

The PayPal account is where I usually get paid for the bit of writing and editing I do from home. I really should roll that money straight into the bank account.

But sometimes I don’t.

In fact, when the PayPal well is dry, it reverts to my backup payer – which is my bank account. It does this automatically. My husband never knows about it, since I’m the one who handles the online banking.

You see the problem here. I could shop to my heart’s content, and pay with PayPal/bank account as long as there was money available. Theoretically, I could bleed it dry.

Even with my meds working and all the progress I’ve made, I still get hypomania occasionally. I try to keep the shopping under control as well as I can.

There are several dresses in my closet that I never wear because I hardly ever go out, especially to places where a dress is necessary. I even have a party dress that I bought recently. It’s really becoming. But I never go to parties. I was just overwhelmed with the butterfly pattern and how cheap it was ($20).

But still, five dresses in two or three years isn’t bad, considering. (I once actually hyperventilated over a dress, and often do over amber jewelry.)

The real problems I have always had are books and music.

When I was still going out to malls and shopping centers and the like, the bookstores were always my downfall. My husband would take my arm and steer me past them, unless he was jonesing for a book too.

I’m trying to keep my online book-buying to a semi-reasonable level, too. I buy full-price books only when they’re absolutely essential – the last book Sue Grafton ever wrote, for example, which is not going to be discounted anytime soon.

For the rest of my ebook purchases, I subscribe to various newsletters that present me with cut-rate book choices every day. (Early Bird Books and Book Bub, for example). These books sell for $.99 (rarely), $1.99-$2.99 (usually), or $3.99 (occasionally). Once in a while I can even get a free classic – for instance, Tess of the D’Urbervilles or Ivanhoe (which I don’t recommend) or Journal of the Plague Year.

Back when I was going out, in the days when I did that, my other hypomanic shopping thrill was the used CD shop. I had a strategy for curbing my hypomania there, too, even though I didn’t know that hypomania was what I was feeling at the time. I would fill my little basket with everything that caught my eye.

Then I would weed. I made three piles – must haves, can pass on, and maybes. Then I would angst over the maybe pile, juggling price, artist, essential tunes, and the like until I had the piles down to something more manageable. Under budget or just a wee bit over. I can do the same with my online “cart.”

Again, this is a thing that could get me in trouble on the Internet, but since I have all those CDs and have loaded them all into iTunes, I seldom get the music shopping urge anymore.

So, yes, I do hypomanic shopping and no, I don’t let it break the bank. Just chip away at the edges.

Why are there no 12-Step groups for persons with bipolar disorder?

There are a number of support groups, both online and in local areas – and even a Facebook page called Bipolar Anonymous (https://www.facebook.com/bipolaranonymous38/) – though it’s not a 12-Step group and seems to consist mostly of posted memes of encouragement. They describe themselves as:

a group page for people who suffer from a Mental Illness, or are having a rough time of things, to seek out people with like problems, for support and a place to vent.

My short answer is that a 12-Step program would not work for bipolar disorder.

It’s not that people with bipolar don’t need AA. Some do. As James McManamy says at Health Central (https://www.healthcentral.com/article/bipolar-and-alcoholism-is-aa-the-only-game-in-town):

One-half of those with bipolar experience alcoholism at some stage in their lives, far more than the general population. Four in ten experience other substance use issues. This extra burden comes at a huge personal and family and social cost. As if bipolar weren’t bad enough, already.

However, at many 12-Step meetings, according to David Oliver (http://www.bipolarcentral.com/articles/articles-644-1-Ailcoholics-Anonymous-and-Bipolar-Disorder.html), alcoholism is the only condition discussed at meetings. Bipolar disorder is considered an “outside issue.” However, he also notes that for those with a dual diagnosis:

Part of the program of Alcoholics Anonymous is to get a “sponsor.” A sponsor is a person who will help the member through the 12 steps of the program, to help them stay sober, and to help them deal with the issues surrounding their alcoholism.

Hopefully, the member with bipolar disorder can find a sponsor who is sensitive to the fact that bipolar disorder is one of the issues that does, in fact, affect their sobriety.

Another facet of AA that can be applicable to those with bipolar disorder is Reinhold Niebuhr’s Serenity Prayer: God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference.

But as to the 12 Steps themselves, only a few are likely to be helpful to bipolar sufferers, and several apply not at all. Let’s take a look at a few:

  • We admitted we were powerless over alcohol – that our lives had become unmanageable.
  • Came to believe that a Power greater than ourselves could restore us to sanity.

These, the first two steps, are problematic if you replace alcohol with bipolar. We are not powerless over bipolar. There are treatments, involving therapy and/or medication, that give us power to manage how bipolar affects us. And that Higher Power so essential to AA – often expressed as “God as we understand Him” – will not restore us to sanity, through prayer may help us get through the difficult times associated with the disorder. (https://wp.me/p4e9Hv-B6)

On the other hand, a few of the 12 Steps may be relevant:

  • Made a list of all persons we had harmed, and became willing to make amends to them all.
  • Made direct amends to such people wherever possible, except when to do so would injure them or others.

Few would deny that bipolar disorder has often been a factor that affected our relationships with others. We can certainly acknowledge that we have hurt others as well as ourselves while in the grip of mania and/or depression, and we can offer or try to make amends.

But, overall, it seems that 12-Step programs are not for us.

What is there to suggest instead? Here are two places to look:

  • Therapist-led support groups in your area
  • Depression and Bipolar Support Alliance (DBSA), which offers online and in-person peer support groups or chapters http://www.dbsalliance.org/site/PageServer?pagename=home

DBSA has a page that helps you locate support groups in your area. Unfortunately, there are none within a reasonable distance of where I live.

However, I could always start one. And so could you.

Also, I invite you to write any number of steps that would be appropriate for a support group along the AA model.

You can’t make someone get help for a mental illness problem. It is that person’s decision, unless he or she is actively psychotic or suicidal, in which case you can call the police or take the person to an emergency room, if possible.

But other than that, all you can really do is assist another person in getting the treatment he or she needs. There’s still a lot you can try.

Let’s say, for example, that Jill notices her partner Jack seems depressed and the depression has lasted several months or worsened over time. Maybe he is moody, sleeps too much, doesn’t seem to enjoy anything, and hardly talks to her. Maybe Jack spends too much money that they can’t afford. Maybe he talks about death.

Jill knows a little something about mental health issues and realizes that Jack is in trouble. What can she do?

Listen. If Jack communicates at all, Jill listens to what he says. She should especially listen for clues that might indicate suicidal ideation. But she also listens carefully to any problem Jack discusses: “I miss the house I grew up in, now that it’s been sold.” “I think the people at work are talking about me and laughing at me.” “I don’t want to wake up in the morning.”

Encourage him to go to his primary care physician. PCPs are the first line of defense in dealing with mental health problems. The doctor may administer a depression screening checklist. She may prescribe antidepressant medication. If Jack wants her to, Jill can go into the doctor’s office with him. He may need help expressing his feelings and talking about his symptoms.

Proactively encourage him to seek help. This can also be called, or seem like, nagging. But if Jack continues to suffer symptoms, Jill reminds him that help is available and that she will help him get that help: “You feel miserable all the time. Don’t you want to feel not-miserable, like you used to?” “You know how much therapy and meds have done for me. They could do the same for you.” “Your friend John is also concerned about you. He and I both think you need help.”

Investigate options. Considering that Jack is immobilized by his suffering, Jill researches local therapists who are taking new clients, who take their insurance (if any), and who deal with mood disorders. Community mental health clinics shouldn’t be overlooked. Jill makes a list of four or five possibilities.

Extract a promise. Jill’s observations make her frightened for Jack’s safety. She gives him a deadline and gets him to promise to call someone on the list of therapists by Monday, say. This is also proactive encouragement.

Go with him to the first (intake) appointment. Jill drives Jack to the office and waits for him while he sees the therapist. Afterward, she asks general questions: “How did it go?” “Did you like her?” She doesn’t ask for details. Those are between Jack and his therapist.

Facilitate. Now that Jack is getting help, Jill helps him keep track of appointments, medications, and the like. These may seem like things Jack could do for himself, but until his mood changes, he may need her help in following through.

Of course, the helper and the helpee in this scenario can be of either sex. They may have a romantic, sexual,  or family relationship – or not. The important thing is that someone be willing to take on the role of helper until the partner, mother, son, friend, or whoever gets enough help to take over the tasks of getting treatment.

It takes work on both their parts, but help is available. You can make a difference for someone who is suffering.

Back to the Therapist

A number of months ago (about seven according to my blog, which is the main way I measure time), I stopped going to my psychotherapist (https://wp.me/p4e9Hv-xj). There were a number of reasons, but here’s the main one:

My sessions are mostly an update on what’s going on in my life at the moment, plus a recap of my recurring problems. But those problems are ones I’ve faced before and know how to cope with. I already have the tools I need and use them without needing a reminder.

This week I had a new session with my therapist, also for a number of reasons.

My triggers are looming large. The last time my brain broke, there were a number of stressors piling up on me. Financial reasons. Health reasons. Relationship reasons. Job reasons. All combined with good ol’ bipolar, type 2.

Now those stressors are back, in slightly altered versions. So far I’m holding my own, but I know there’s a danger that they will do the same to me as they did the last time.

I’m catastrophizing. The lurking triggers are setting in motion a thought process in which I assume the worst. And the stakes may even be higher this time. Financially, we could crash and burn, owing our souls to the IRS and maybe losing our house. I need a reality check from someone outside. (I’m also consulting a tax attorney; these fears aren’t completely all in my head.)

I need another person in my support system. My husband is great, but I can’t always talk to him about my problems. For one thing, he’s not objective, since he’s facing the same stressors I am. And my friends offer me encouragement and moral support, but I hate to do a total meltdown in front of them. Dr. B. has seen it all and helped.

I need emergency help readily available. My irrational thinking at times such as this has caused me some suicidal ideation in the past. I know that’s not the right thing to do, but my brain has betrayed me before now and I can’t guarantee it won’t again. So I need someone – preferably someone more informed and present than an online help group or a 1-800 number – that I can talk to when the inside of my head gets too scary.

I have a therapist I know and trust. If there’s one thing I hate, it’s breaking in a new therapist, having to go through the Reader’s Digest Condensed version of my screwed-up life. Dr. B. at least doesn’t have to start from ground zero. I’m fortunate that she’s still available.

My meds have remained relatively stable; what I need is talk therapy. I’ve been on the same meds and the same dosages for quite a while now. I know within reason it’s not another or a stronger drug I need now. It’s something that meds don’t offer – a face, a voice, a presence that understands, listens, calls me on mistaken assumptions, suggests strategies, reminds me of what I’ve done in the past and how far I’ve come.

You’ll never find that in pill form.

 

In the series of posts I have done on “gaslighting” (https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-C2), the focus has been largely on male gaslighters and female victims of gaslighting. Now it’s time to take a look at the other side: men as victims of gaslighting.

In researching the topic, I found that very little had been written on it. I did find James Barnett. I will not be addressing Barnett’s view of gaslighting as false allegations by narcissistic females to accuse innocent males of emotional abuse (https://www.linkedin.com/pulse/reality-situation-male-victims-abuse-james-barnett/). That, I think, is a different topic.

In my earlier posts, I tried to include the statement that either sex can be gaslighted (gaslit?) and either sex can be the gaslighter, but most writing on the subject, including mine, has treated the one version of gaslighting without the other. Here I will try to expand the dialogue.

Just to recap: Gaslighting is a form of emotional abuse in which one person denies the other’s perception of reality, usually with the intention of discounting the victim’s legitimate complaints, often to the point where the victim believes she or he is going crazy.

At its core, gaslighting is a form of emotional abuse – a very specific, toxic, dehumanizing form of bullying, if you will. As in bullying, there are three conditions: a (real or perceived) mismatch between the two people, harm done, and repeated instances. It’s easy enough to see the harm done and the repetition of behaviors in gaslighting.

So, let’s look at the mismatch: One of the people involved (the abuser) has (or is perceived to have) power of some sort over the other. This can be emotional power, as in the dominant person in a relationship; financial power, as in a boss/employee relationship; physical power, as in a caregiver/disabled person relationship; or any other version you can think of.

In any of these situations, either a man or a woman can be the abuser and either a man or a woman can be the abused. Same-sex couples can include a more powerful partner who can exert psychological dominance over the other. Boss and employee can be same or opposite sexes, and so on. So, although we often call the gaslighter “he” and the victim “she,” that is inaccurate and prejudicial.

It is also the most common dynamic in a gaslighting relationship. Sad but true, in most emotional relationships in modern America, a male has psychological or emotional power over a female and hence is more likely to be the gaslighter.

In cases where the male is the victim of gaslighting, however, great harm can be done, simply because of this assumption. The male victim of gaslighting (as indeed the male victim of any emotional or physical abuse) may be discounted – not be believed, be accused of lying, be put down for being a victim. In effect, the male victim has been gaslighted twice – once by the actual abuser (male or female) and again by the system and the people in it who discount his perception of reality.

Women who are victims of gaslighting can, if they are able, recognize the gaslighting for what it is and get help in undoing the damage, either by getting out of the relationship or by having her perception of reality validated and strengthened by a therapist or other caring individuals.

Male victims of gaslighting have the deck stacked against them in this regard. A man may be believed if he reports that a male boss is gaslighting him, and will be encouraged to leave the situation. A male who suffers gaslighting in a romantic relationship is much less likely to be believed and may in addition suffer scorn, pity, or derision for mentioning it.

In that situation, it is a lot more difficult for a man to get help. Friends, relatives, and even therapists may not see or recognize the gaslighting for what it is. The male victim can often believe a gaslighter who says that the victim is indeed crazy and that no one will believe him.

Discussion of this dynamic does nothing to diminish the plight of female gaslighting victims. What it does is acknowledge the male victim’s situation – validate his perception of reality, if you will – and begin a conversation that may help lead to healing for all victims of gaslighting.

 

 

 

 

I never planned it this way, but I’ve just realized that I can track my moods (roughly) by looking back at my Facebook posts.

When I joined Facebook, I must have been in a hypomanic phase. Thanks to Facebooks “today’s memories” feature, I can see that I posted numerous things going on in my life and assorted weirdness I’d encountered, usually about language or science or feminism:

Plenty of food in the freezer. (Spare freezer outdoors.) Plenty of food in the fridge. (Spare fridge downstairs.) Plenty of seasoned firewood. Plenty of sweaters. Plenty of cat food. Plenty of cats. We’re ready.

Little to no snow here. But bring your brass monkeys inside tonight, folks!

Weird Non-Word of the Day:

bang (a fine word, except when it purportedly means the singular of bangs, the hairstyle)

I also posted an ongoing series of amusing or stupid headlines I saw on the Internet:

“Oh, Who the Hell Cares?” Headline of the Day:

Is 2014 the year of the biscuit?

Unless you’re a dog. Dogs care deeply about this.

Those were all from January 2014. And from 2013:

Just so you know – do not put a whole summer squash in the microwave. It will explode. This tip courtesy of someone who prefers his name not be mentioned. Thank you. You may now go back to whatever you were doing.

I was engaged. I was communicative. I was – dare I say it? – buoyant.

I was hypomanic, or at least on a level playing field.

This year I have taken two breaks from Facebook for my sanity’s sake, in reaction to all the negativity and bad news appearing there. When I do post, it’s always pass-along memes or cartoons. (I’m glad I’m still “alive” enough to find some things funny.) Occasionally I make comments or ask questions about my friends’ posts – but not damn often. I IM with one or two close friends, and that seems the most “productive” thing I do, some days. A series of days or months like that are a pretty clear indication that I’m on the downswing.

I understand that now Facebook’s memories feature will let you weed out bad memories, instead of reminding you of them and offering to repost them for all to see. (If only I could do the same for my brain!) The problem is, right now, you can only have them block references to certain people and certain dates.

Birthdays and holidays are tough for me, as I know they are for many of you, but, anymore at least, they are not so traumatic that I have to expunge them from my life. I can always choose not to repost them. Just as I can choose not to repost things I said that were about depressing topics – not getting a job, being angry about political bullshit, the death of a pet. The people I would block are already on my blocked list, or are ones I never “friended” in the first place.

Facebook also reminds me what I posted on my blogs in various years, and that gives me some idea of what I was thinking or feeling at the same time in various years. If I wanted or needed to, I could look through my Facebook memories and plot a graph of how my moods fluctuated from month to month, year to year. Yes, I know that there are software apps that will do this for you and that I could keep a mood journal or even a paper-and-pencil graph.

Instead I check my Facebook memories and re-repost things that I still think are funny.

 

 

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