My Experience Only. YMMV.

Posts tagged ‘bipolar disorder’

Twelve-Step Groups for Bipolar?

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.

Using Facebook to Track Bipolar Depression

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.

 

 

Gaslighting and Bipolar Disorder: A Follow-Up

Over a year ago, I wrote about gaslighting and bipolar disorder (https://wp.me/p4e9Hv-pm). In my post I said:

[W]hat does gaslighting have to do with bipolar disorder? Someone who is in the depressive phase of bipolar – especially one who is undiagnosed – is especially susceptible to gaslighting. The very nature of depression leaves a person wondering, “Am I insane?” To have another person reinforcing that only strengthens the idea.

Since then, gaslighting has become a hot topic, appearing all over the Web, so I thought I’d write about it again.

The essence of gaslighting is that someone denies your reality and substitutes his own. (Gaslighters are mostly – though not exclusively – men.)

What I believe is driving the interest in gaslighting is the “#MeToo” movement. Women everywhere are speaking up about incidents of sexual harassment, sexual abuse, sexual assault, and even rape that they had not spoken of before. Or that they had spoken of but not been believed.

In many of these cases, gaslighting was involved. The women say, “This happened.” The men say, “It was a joke/flirting/a compliment/not that big a deal/consensual.” Until now men have denied the women’s perception of abusive reality and substituted their own innocent explanation. And, for the most part, the men’s reality has been accepted. Again and again.

Some of the high and mighty have recently been brought low by revelations of misconduct. The more we hear, the more it seems that men who achieve prominence in any field see women and especially their bodies as just another perk – like a company car or a key to the executive washroom. An audience for a dick pic. A pussy to grab.

Those are the cases that make the news. But the problem goes all the way down to the least prestigious situations. Any male in a position of power over a woman has the opportunity to exploit that relationship. Many are decent men and don’t. But many – from your local McDonald’s manager to the city bus driver to the head janitor – do. That’s millions of men and millions of women, the gaslighters and the gaslit.

Again, why discuss this in a bipolar blog? Because the very nature of our disorder makes us a little unsure of reality anyway. Perhaps this is mania and my boss is complimenting me because I really am sexually appealing. Perhaps this is depression and I deserve the degrading thing that just happened to me. Perhaps this is somewhere in between and I can’t guess what’s what.

A person unsure of her emotions is more likely to take the “bait” that the gaslighter dangles. A person unsure of her reality is more likely to accept someone else’s definition of it.

The #MeToo movement is empowering. It allows women to bring into the light the shameful things that have been hidden away. And it gives the bipolar person a more objective standard against which to measure reality. “That happened to me too! I was right that it was inappropriate!” “I saw that happen to my friend. Next time I’ll be strong enough to speak up!” “I see what’s happening. I’ll teach my daughter not to put up with that behavior. And my son not to do it.”

And it says to the bipolar person, “You have an objective reality outside your moods. You can trust your perceptions on these matters. You too have a right to live without these insults, these aggressions, this gaslighting. You can trust your feelings when you perceive that someone has stepped over that line.”

We have bipolar disorder. We are not the disorder. And it does not rule every aspect of our lives. When we perceive a situation as unprofessional, harmful, insulting, degrading, we can say so – and deserve to be believed. Just because we have a mental disorder does not make us any less worthy of decent, respectful treatment by the men in our lives, whether they be boyfriends, husbands, fathers, employers, or supervisors.

We have enough problems in our lives. We shouldn’t have to deal with gaslighting too.

 

 

Bipolar Me, Looking for Work

I have been very fortunate over the last few years in that I have been able to work and that, combined with my husband’s far-from-large – but steady – paycheck, we have been able to pay the bills. Now that seems to be changing.

After my last big emotional crash, I was unable to work at all, and after my husband’s major burnout, he was not able to work for a while. We ran through our IRAs and ended up in the situation where we are now.

I do writing, editing, and proofreading jobs from my home computer. It is really ideal, in that the projects usually come sporadically, with time in between them, so I seldom require more energy than I have available. I do not have to go out very much, or dress up very often and can work in my comfort zone, in my comfortable study, in my comfy pajamas. In these respects I am lucky or blessed, or however you wish to define it.

But clients have become a little thin on the ground lately. And I am afraid. I fear both a financial crash and an emotional one. The two are not unrelated. Finances and dealing with them were two of the largest triggers that started the major depression-plus-anxiety that swallowed me up for quite a few years.

Now I am feeling the pinch again. I felt it back in August, when my “proactive hypomania” helped me get through (https://wp.me/p4e9Hv-y4). But one can do that only so many times. Or at least I can’t summon the necessary mood at will. (Surprise, surprise.)

I have a writing project now, but it will run out in January. I have another client, but work from them is not as consistent as it used to be. We are already behind on some of our bills, including the mortgage.

So I am looking for more work, and it is scary.

The kind of work I’ve been doing is ideal, even when my symptoms increase. It lets me work around the deficits that bipolar heaps upon me. If I have a project due Monday, I can work during the weekend. If I have insomnia, I can work at night. If I am immobilized, I can usually schedule my deadlines so they don’t all hit at once.

I try to network, also at home from my computer, but that lets out job fairs and professional organizations and groups inhabited by people. I should put together a resume and sample packet and then try to figure out whom to send it to. Which is kind of like throwing spaghetti at the wall and seeing if any of it sticks. And the impressive kind of packet – slick, personalized, colorful, foil stamped, business-carded, sample-stuffed, stationeried – costs money to prepare, which of course is itself a problem since you have to spend it before you get results, if any.

So I have signed up with a number of sites that provide leads on jobs, and some of them don’t even want me to drive for Uber or move to Massachusetts.

Each time I apply, I ask myself, “Can I really do this job?”

Sometimes the answer is “Probably not, but I’m going to apply anyway.” Those are the 9-to-5 office jobs that would require me to upgrade my wardrobe just the teensiest little bit and try to keep the depressive phases under control if not totally under wraps. I have serious doubts about my ability to be “on” for eight hours a day, five days a week.

The Americans With Disabilities Act says that certain categories of people are entitled to “reasonable accommodations” in order to fulfill their job requirements. For someone like me, accommodations might include flextime, doing part of my work at home, time off for doctor appointments, and the like. If I got one of those jobs, I would have to reveal my mental disorder in order to receive accommodations, and I would have to decide whether to speak up about it before or after I got the job. Probably after.

The not-quite-as-frightening jobs are part-time ones, like working the circulation desk at the local library. They have their drawbacks too, including the same ones as full-time jobs, with less pay besides. Would it provide enough income to make a difference? Maybe not. Would I be able to do a part-time job and still squeeze in a little freelance work? I just don’t know. The idea is still daunting, to say the least.

(Another potential solution would be for my husband to get a better-paying job, but he is in the process of changing his meds, so that doesn’t seem likely either, at least for now.)

I know this seems like a better class of problem than many people with bipolar disorder have. Trying to keep up the mortgage payments is better than living under the Third St. bridge, fighting stray dogs for cold french fries. My husband’s job may be low-paying, but at least it’s steady and has a health insurance plan. I am truly grateful for these things.

And I am truly scared nonetheless. And tired. And sliding back down into depression.

Is My Pain as Real as Yours?

The other day I got a comment on a post I wrote a while back called “Who’s a Spoonie?” (https://wp.me/p4e9Hv-h6).

The commenter said that I was wrong to use the term “Spoonie” for those with mental illnesses. The kinds of disorders that merited the appellation “Spoonie” were only those that involved a “physical debilitating condition where pain and fatigue play major roles.” That I am not a Spoonie. That the language is not mine to use. That I am a part of the problem.

Let’s take a closer look at some of those assumptions.

Mental illness is not an invisible illness.

I wrote about that, in a post called “Is Bipolar Disorder an ‘Invisible Illness’?” (https://wp.me/p4e9Hv-gI). Disabled World (https://www.disabled-world.com/disability/types/invisible/) seems to think it is. Their definition specifically includes mental disorders:

These [mental] diseases can also be completely debilitating to the victim, and can make performing everyday tasks extremely difficult, if not impossible.

Bipolar disorder and depression are included in their partial list of “invisible illnesses.” And if you want to talk about “everyday tasks,” consider the number of bipolar and other sufferers who can’t get out of bed, can’t shower, can’t leave their homes, can’t work.

The condition must be physical.

To the best of our current knowledge, bipolar disorder and many other mental illnesses spring from glitches in the neurotransmitters in our brains. The brain, a physical organ. Neurotransmitters, a physical substance.

Pain and fatigue are required to play major roles.

Well, I’ve written about that too, in a post called “Depression Hurts” (https://wp.me/p4e9Hv-6Z).

My head and eyes hurt from all the crying spells. My back hurt from lying in bed all day. I had painful knotted muscles from the anxiety that went with the depression. I had intestinal cramps because my overactive nerves led to irritable bowel syndrome. I had headaches and eye strain from the over sensitivity to light and noise. And I had the general flu-like malaise that is practically the hallmark of depression. You know the one. Every bone and muscle aches, but you can’t think why.

Were these aches and pains psychogenic? Undoubtedly some of them were. But others, like the irritable bowel, were all too demonstrably physical phenomena.

Oh, and are they chronic? I’ve lived with them all for years. Not all at the same time, maybe, and not without times when the pain let up. But are all Spoonies required to be in constant pain and fatigue? Again, Disabled World says not.

The language is not mine to use. 

Sorry, but language doesn’t work that way. Once a word is released into the wild, it goes where it wills, acquiring new usages and new meaning. And “Spoonie” is certainly out in the wild. The essay that first defined it is all over the Internet. The suffix -holic has escaped from the word “alcoholic” and is now used for dissimilar ideas including “shopaholic” and “chocoholic.” Can we say, “No, you mustn’t do that. It must be reserved for alcohol addiction”? We might, but it’s not going to happen. Trust me on this. I have some training in linguistics.

I am part of the problem.

I suppose so, if you believe there’s actually a problem. In my post on Spoonies, I asked:

Isn’t that how Spoon language started – as a way to begin a conversation on what invisible illnesses are and how they affect our lives? Not a secret language that only those who know the password and handshake can use.

Obviously, opinions on the subject will vary, and mine is only one among many. I cordially dislike exclusionary language. Does anyone else want to weigh in?

At Last, Some Encouraging News

 

 

 

 

 

You know I bitch a lot about the science and research associated with mental health in general and bipolar disorder in particular. It seems like I bitch about nearly everything I read in the press. Here are some examples:

I have been told that I have a weak understanding of science and the scientific process. It’s true that I have no degree in any science, not even the “soft” science of psychology. Yet I persist.

Some of my major objections (if you don’t want to read the above-mentioned posts, which I fully understand) include: that article headlines seldom match the stories they’re attached to; that too many qualifiers like “might” and “may” occur in the stories; that the research is still in the rats-and-mice stage, which is a lo-o-o-o-ng way from human trials or public availability; and that many reports contain yes-it-does/no-it-doesn’t debates.

Most of all, I hate “false hope” headlines that I don’t believe will ever trickle down to the bipolar-person-on-the-street. Certainly not in my lifetime, and maybe never. And if they should become available, the cost will be prohibitive. I can’t believe that many of us will have the wherewithal (meaning both access and money) to avail ourselves of the new solutions. I mean, can you really picture the average bipolar patient getting genetic testing or fMRI? Or insurance paying for it?

Then came the headline “Simple EKG can determine whether patient has depression or bipolar disorder” (https://www.eurekalert.org/pub_releases/2017-11/luhs-sec112017.php). Published by Eurekalert! (which, despite its name, appears to be an aggregator of science press releases from sources such as universities and labs around the world), the story reports on work done at Loyola University Health System.

For me, the take-away points are these:

“Bipolar disorder often is misdiagnosed as major depression. But while the symptoms of the depressive phase of bipolar disorder are similar to that of major depression, the treatments are different and often challenging for the physician….

“The study found that heart rate variability, as measured by an electrocardiogram, indicated whether subjects had major depression or bipolar disorder….

“Dr. Halaris said further research is needed to confirm the study’s findings and determine their clinical significance.”

And yes, this does feed into my dislike of small studies (under 200 participants) that admit “further research is needed.” But this one, it seems to me, could actually be of some benefit.

Misdiagnosing bipolar disorder as major depressive disorder is a real and perhaps not uncommon thing. I was diagnosed with major depression for decades before a psychiatrist realized I had bipolar disorder. The treatment I got in those decades helped, but the treatments since have helped more.

And I can see a 15-minute, three-lead EKG becoming more available, at least to those of us who still have insurance (a dwindling number, to be sure). In cases like mine, it could save years of incorrect diagnosis and less-than-effective treatment.

Of course, here I am using the hated word “could.” But I take heart from the fact that it is a noninvasive procedure, there are plenty of potential test subjects, the expected resulted is focused on a single, more manageable result – misdiagnosis of one condition – and the test uses a relatively simple, already available technology.

It won’t help me, of course, since I already have my diagnosis, but I think of the people – even people I know – who could benefit from it, and in the not-too-distant future. Would the person who swings from depression to anxiety and doesn’t respond to the usual medications for depression actually have bipolar 2? Would the one who has wide mood swings and a diagnosis of OCD prove to have both, in reality?

Who knows? Not us, at the moment. But in the near future? This time I think there really is hope.

Dear Bipolar Disorder

Dear Bipolar Disorder,

We’ve had a relationship for decades now, though it’s one I never chose. To tell the truth, I can’t even remember when we met. Gradually, you just moved in. So I guess we’re stuck as roommates for the rest of my life. You can’t break your lease and I can’t move out. That being said, there are some things I need to talk to you about. We’ve never been friends. We never will be. I have some issues with you; there are compromises we need to make.

I’ll take my meds faithfully, if you keep working with them. By that I mean no major depressions of longer than a week and no panic attacks while I’m trying to sleep.

I’ll pay for those meds, as long as you back off enough to let me keep working and earning money and paying for insurance. Just leave me enough concentration to do that and to read, and I’ll be satisfied.

I won’t go to Chuck E. Cheese or Cici’s Pizza or shopping at a mall anytime after Thanksgiving, if you will let me go out at other times to other places without getting your figurative undies in a bundle.

I will try to minimize the stress in my life (see above), if you will cut out the physical symptoms when there is stress anyway. You know the ones I’m talking about. Ick. Just ick. I hate cleaning up after you.

And can we talk about spoons? I know you only give me a limited number per day, but it would sure help if I knew what that number was. Is there any way you can be more consistent? If I have to borrow spoons from the next day or force myself to attend to some vital call or lengthy errand despite not having spoons, I promise to spend the next day in bed, just to satisfy you.

Please, if you can, give me some non-anxiety-laden hypomania so that I can go out and enjoy things with my husband and friends. If you agree to this, I will occasionally let you buy things off the Internet, for $20 or less.

And while we’re on the subject of enjoyment, I would appreciate it if you would give me back my libido. So would my husband. I know you don’t take orders from him, but it would be esteemed a favor.

Don’t even talk to me about hurting myself. I won’t listen. No matter how loud you get.

Don’t get between me and my friends. You’ve done that too often already and I just can’t put up with it anymore.

No more screwing with my memories. I’ve already lost enough. You can keep the ones of everything stupid I’ve ever done, but I will not watch when you push play on my internal video playback.

Now that I’ve finally got some self-esteem back, you just keep your claws off it. I need it and you don’t.

No dogs allowed. Especially large Black Dogs.

Oh, and tell your buddy Depression to leave my husband alone.

No love,

Me

 

 

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