My Experience Only. YMMV.

Posts tagged ‘bipolar type 2’

When Bipolar Disorder Wrecks Your Sex Life (NSFW)

I had a hot sex dream last night. That’s fortunate, as it’s the only hot sex likely for me these days. I have bipolar disorder 2 and tend toward the depressed.

I have only once experienced the hypomanic rush that leads one to the desire for uninhibited, crazy, insistent, steamy motel sex. So I can’t really tell you much about that, except to make sure it’s safe sex, even if it is spontaneous, wild, and compelling. Coping with the aftermath is also something I can’t help with.

So. Bipolar depression and sex. (I am writing from the point of view of a cis-gender heterosexual female, so YMMV.)

It will likely come as no surprise to you to learn that bipolar disorder has an effect on your sex life. And, aside from mania, that effect is to lessen or completely kill it. And there are varying levels: low libido, lack of desire, difficulty ejaculating, etc. The question is what to do about it. Here are some examples of advice:

[S]ex is a part of life and it’s a part you don’t want, or need, to hang up just because you have a mental illness…There are therapeutic techniques that can deal with hypersexuality or low sex drive, and, of course, there are always medical options as well.

http://www.healthyplace.com/blogs/breakingbipolar/2013/01/normal-sex-bipolar/

And this:

Getting bipolar disorder under control is the first step to improving your sex life. It’s easier to address these issues when your moods are stable. Many people with bipolar disorder have healthy relationships and satisfying sex lives. The key is working with your doctor to find the right treatment and talking with your partner about any sexual issues.

http://www.healthline.com/health/bipolar-disorder/sexual-health#outlook5

And that’s all well and wonderful, but how much does it actually help?

Not that I’m an expert, but here’s what I can say about the subject.

Realize that most of sex happens in the brain. The body goes along for the ride. If you’re bipolar, you’re already having trouble with your brain. It makes sense that you’d have trouble with sex too. Don’t beat yourself up. It can be a nuisance or a sorrow or a loss, but it doesn’t have to be a tragedy.

Decide how much sex you actually need in your life. Some people have naturally low sex drives and are quite satisfied with long gaps between sexual encounters or occasional masturbation. If this is the case for you, dandy. The real problem comes when you and your partner(s) have a mismatch in your sex drive. That’s where the talking comes in.

Ask for what you need and encourage your partner to do the same. And accept and/or give what you can. If you need a hug or a cuddle, ask for it. If your partner asks for one, give it. Don’t push for more right then. Even if you have no desire for “the act” yourself, you may be able to give your partner some of what she/he needs. Or vice versa. Of course, if you’re at the very depths, you may not even be able to ask for a hug. But if one is offered, don’t turn it down. Keeping that bond going may improve your connection when the depression has eased.

You can try different medications or see an endocrinologist, but don’t expect quick results. Or any, necessarily. The one drug that peps up your libido may also be the one that gives you side effects you can’t handle. And after years of trying different combinations of pills, you may decide, like I did, that having a reasonably functioning brain is more important to you than having regular sex. In other words, you may face a trade-off.

Listen to your body as well as your brain. I already know that my brain is not performing up to specs. Occasionally, when I’m reading a book or watching a movie or remembering a dream or thinking about an old friend, I feel something that reminds me of what it is to feel desire. If that happens, enjoy and encourage it. It’s a signal that you may not be totally numb from the neck down.

I could tell you that everything will be okay and you’ll soon be back to romping between the sheets with wild abandon. I haven’t seen statistics on it, but it seems unlikely. If you want to get your sex life started again, you’re going to have to work at it, just like you work at taming your bipolar disorder.

 

Five Things Psychotherapy Has Done for Me

Why pay $250 an hour just to talk to someone?

That was my sister’s reaction when I said I was going to start seeing a therapist. This is my answer.

Mental health symbolWell, Lucy, while a psychiatrist doesn’t cost 5 cents anymore, therapy can be had for a lot less than $250. There are community mental health centers with sliding fee scales – which is what I was going to then. There is insurance, for now at least. I’ve even known psychotherapists who would accept less than their usual fee for long-time patients in temporarily dire straits.

And I’m not paying to talk to just “someone.” A therapist usually has at least an M.A., and sometimes a Ph.D. Psychiatrists have an M.D. or D.O. They have years of training, more years of experience, and colleagues they can consult if your problem is particularly challenging or out of their area of expertise. You can also find peer counselors, religious counselors, and proponents of every variety of therapy or treatment you can name, from neuro-linguistic programming to electroconvulsive therapy.

Now, as I reflect on my clueless sister, I’ve started thinking about all the things that therapy has done for me.

Diagnosis. When I first started going, back in the 80s, I could only afford one of those community mental health centers with the sliding fee scale. (At the time, I paid $5 per session.) There I was diagnosed with depression. The primary treatment they offered was “talk therapy,” but I had years and years of mental difficulties to talk about. Later, when I was seeing a psychiatrist, I was re-diagnosed with bipolar 2 and anxiety disorder. Suddenly, my past became a lot clearer, even if my present was still messed up.

Medication. There has been a lot of it over the years. I started, as so many did, with Prozac, which had a noticeable effect on my depression. It was like the difference between watching a black-and-white TV that got only one channel that showed only tampon commercials, compared to a wide-screen color TV that got hundreds of cable channels. The meds I’m on right now keep me functional, at least enough to make a living and be creative.

Perspective. When I first started going to my current therapist, the word I used most often to describe myself was “pathetic.” I no longer call myself that. Dr. B. helped me view parts of my past in a different light and helped me develop techniques and strategies to deal with the problems I was facing at the time. Now she keeps me on track, reminding me that I have the tools to cope with many of my recurring problems. And she reminds me how far I’ve come since my “pathetic” days.

Couples counseling. When we married, I was still smack in the middle of clinical depression. (My husband had problems too, but I don’t want to talk about them here, except to say that a codependent and a depressive living together can never decide where to go for lunch. And that was the least of our difficulties.) Several times since then, we have had to turn to counselors to work on problems related to sex, money, and just plain living and communicating together.

Group therapy. Actually, though I’ve attended group therapy a few times, what I’ve learned from it is that it’s not for me. I do appreciate the fact that it’s there if I should need or want it, and that my therapist can recommend a group if she or he is going to be away for a while. Perhaps I just haven’t found the right group yet, although the support communities I’ve found online may serve part of the same purpose.

In short, therapy has given me my life, my sanity, my coping skills, my emotional strength, and my creativity back. And I can definitely say that professional therapy has been worth more than 5 cents, or whatever insights my sister could have offered.

 

Getting in Touch With My Hypomanic Side

I know all about how it feels to have depression. For dozens of years, that was my diagnosis and my daily companion – unipolar depression.

In the last dozen years or so, however, I have had to come to grips with the idea that I am actually bipolar – bipolar type 2, specifically. And that I sometimes have hypomania.

It was quite a revelation.

I didn’t believe I had ever felt manic in my life. I couldn’t recall feeling anything but miserable, despondent, and worthless. Although objectively, I was doing well in school and in college, had a few friends, and was never suicidal, in fact I was a depressive mess. Later, as I learned more about mania, I was able to identify some manic – or at least hypomanic episodes that had occurred during that time, but that I had never noticed when they were happening.

When I was hypomanic, I thought I was just feeling what everyone else described as “normal” – happy, able to enjoy activities, functioning pretty well. They didn’t last long, but I didn’t realize how very tenuous and brittle those good feelings were – how they could be shattered by the slightest bump, plunging me back into the old familiar depression. It was even more depressing to think that I couldn’t even do feeling good right.

I struggled along under these circumstances for years, until at last one-half of my problem was diagnosed – the depression half, of course. It certainly was the most noticeable half, the most troubling, and the most disruptive of the problems that plagued me.

My doctor prescribed Prozac and I remember it working pretty well at first – at least when it kicked in after about six weeks of taking it. I can remember feelings of calm, contentment, and enjoyment. It changed my life, and probably saved it. Prozac didn’t alleviate all my problems, but it did let me glimpse a world in which they were not the only things that existed. It’s not too extreme to say that I rejoiced.

But, unknown to me (and my doctor), I was not purely unipolar at that time – or ever. What was happening to the lurking hypomania during while the depression was being treated? Did it disappear? Did the Prozac take care of it too?

No. With the depression more or less at bay, hypomania found new outlets to express itself – as anxiety, for example. I had a spell of being alarmed in the cereal aisles of grocery stores. There was a time (not yet completely gone) when I thought other drivers were swerving into my lane, even when I was a passenger. (That one alarmed my husband too, when I would fling out my arms and gasp or cower, shaking in my seat, at the thought that a crash was imminent.)

My psychiatrist later explained to me that these were manifestations of hypomania that came out sideways, as anxiety instead of euphoria, ambition, desire, exaltation, and assorted addictive or destructive behavior. Trust me to have the less-fun alternative. (Although somewhat less life-wrecking.)

Since that revelation, I have tried to harness my hypomania and use my power for good. I channel my hypomanic binges into writing, for example. I can’t say that it’s always good writing, but at least I get words on the screen that I can fix up later. I usually have several projects – paying and non-paying (like this blog) going at the same time, so I can switch among them as needed. That may be hypomania too.

Sometimes I can even use my hypomanic fits to enjoy myself – have a pleasant lunch out, read a book, do a puzzle, have a conversation with my husband or another friend. Of course, these activities do not always fit in well with my hypomania. At times, instead of simply enjoying these activities and sensations, I am too twitchy and nervous to relax and enjoy them.

I must admit that two of my strategies for controlling my hypomanic spells are naps and anti-anxiety pills, not necessarily in that order. But at least I am getting better at identifying when the anxiety, which I used to think of as free-floating, is actually a form of hypomania. Then a combination of hot tea, silence, cat-petting, reading, and Ativan can bring me back to some kind of stasis.

If not, I just have to accept that I’m having a hypomanic episode and try to stay away from things I can buy using my PayPal account.

Bipolar Robbed Me of Reading

I don’t remember a time when I couldn’t read.

Except when bipolar disorder took it away from me.

I was what they call a “natural reader” – someone who learns to read without being taught. Someone who just picks it up out of the air. And for me, reading was like breathing. It kept me going, kept me alive. Reading was part and parcel of my identity. I was never without a book within reach. I read while eating, walking down the hall, going to sleep, riding in a car.

Throughout my undiagnosed childhood years, reading was a way for me and my brain to play nicely together. If I was depressed, I could lose myself in escapist fantasy. If I was hypomanic, I could soar on adventures. And during the in-between times, I had access to unlimited worlds – places, people, situations, ideas, conversations – both familiar and strangely new. Reading was my joy and my solace.

For many years, reading was therapeutic. I could not only lose myself and escape the unpleasantness of my disorder for a time, I could learn more about depression and bipolar disorder, compare my experiences with those of others who struggled with mental illness, discover how medicine and law and psychology and sociology could shine a light on my experiences. I could even (God help me!) read self-help books, which were popular at the time, and learn all sorts of theories and techniques that didn’t improve what was wrong with me.

Books and words were my life. I got degrees in English language and literature. I read for work and for fun. I edited magazines, wrote articles and (occasionally) children’s stories, worked on textbooks.

Then my brain broke and reading went away.

I had a major depressive episode, which lasted literally years, and during that time I found it nearly impossible to read.

Why? My old companions, depression and hypomania.

Depression made me dull. I didn’t care about anything and found no happiness even in the books that had always been my refuge. I remember picking up a book that I more than loved and had returned to dozens of times, that had shaped my life in many ways, thinking that the familiar words would touch something still buried inside me. But this time there was no magic. Not even interest. The words were flat and dull, mere ink on the page. Reading – engaging with an author’s ideas, imagining characters, following plots and dialogue, discovering facts – was beyond me.

And hypomania? My version, instead of bringing euphoria, brought anxiety – an overwhelming twitchiness and fear of the unknown, jumping not just at shadows, but at the idea of shadows, things that had never happened. My attention span shrank to nearly nothing. I could barely read a few pages, not even a chapter, and when I was finally able to get back to a book, I was lost, disconnected.

Now that I am recovering from that episode, I am glad to say, I can read again. I read myself to sleep at night once again instead of crying myself to sleep. I devour entire chapters, keep at least two books going at once (one fiction, one nonfiction), delight in revisiting old favorites and seeking out new authors and genres (YA fiction and steampunk) and topics.

Not everything I read is uplifting. At the moment I’m deep in Octavia Butler’s Parable of the Talents, a post-apocalyptic science fiction dystopia that is eerily prescient for a book published in 1998. But I can tell when it’s getting too deep and frightening and switch off to Jasper Fforde’s Thursday Next literary fantasy Lost in a Good Book before the strife and struggle can drag me down.

And I can tell you this: It’s better to be lost in a good book than lost in your own broken brain.

 

Out of the House – At Last

Brandywine Falls

Brandywine Falls

If everything goes according to plan (which we all know it never does), this post will be publishing itself while I am at or on my way to this scenic location, Brandywine Falls in Cuyahoga National Park.

I was attracted to this particular location when I read on the Internet that, in addition to access via a 1.75-mile hiking trail, the falls could also be reached using a wooden boardwalk from a nearby parking lot.

This easy access appeals to me because I have balance problems and sometimes use a cane, as well as because I seldom leave the house and have difficulty walking any distance. My husband encourages me to get out and walk, reminding me that exercise is good for depressive episodes, but just getting out of the house for doctors’ appointments and a few errands leaves me with no spoons for recreational walking. It’s a pretty dreary life, though there is a nice window in my study, through which I can see shrubs and trees, the occasional hummingbird or squirrel, or that stupid bird that sometimes flies straight into the glass and bonks itself silly.

There were actually tears in my eyes when I mentioned the expedition to Dan.

“What’s the matter?” he asked.

“Would you drive a long way with me to do something that requires very little time to do?”

“What do you want to do?”

“See this waterfall,” I said, pointing at the screen. I explained about the parking lot and the boardwalk.

“How far is it?”

“Near Cleveland. About three hours. Each way.”

It sounded ridiculous even as I said it. A six-hour drive to walk a very short distance and look at a waterfall.

“We could stop along the way to get something to eat. Or we could pack a picnic. You could bring your camera and take nature photos.”

I needn’t have worked so hard to make it sound attractive. Getting out of the house to go see something scenic and outdoors is something my husband has been longing for us to share.

Naturally, as soon as we agreed to go, my brain went into overdrive, doing my usual job of trying to anticipate everything. We would need to GoogleMap directions, of course. We would need some kind of waterproof bag with cold packs and bottles of water. Bandanas to moisten and wipe our sweaty brows (the temperature will likely be in the 80s and I don’t do well in heat). Bug spray. My cane and maybe a walking stick for him. At times like this, I tend to plan the Normandy Invasion.

This is a ridiculous idea/plan. After the last month and a half I’ve had, it’s a wonder that I’m not just crouched in a corner going beeble-beeble-beeble. But if it works, we may make the same drive in a few weeks to go to a horticultural center and canopy walk, if only so I can make the old, bad joke (You can lead a horticulture, but you can’t make her think) and we can meet up with some Cleveland-area friends we haven’t seen in far too long.

So. Getting out. Exercise. Nature. Relaxation. Fresh air. No computer access. Potential socializing. I don’t know whether these things will have any actual positive effects, but I like to think that my therapist will be proud of me.

Never mind that there are plenty of places nearer – even locally – to walk short distances and see nature. Never mind that my therapist often recommends that I take baby steps. This is a baby step. For God’s sake, I used to be able to hike in the Adirondacks. To travel. To Europe. By myself.

I don’t know why I was able to do that then, but can’t now. Bipolar disorder didn’t strike me suddenly, after I had done all those things. Maybe back then I was better at functioning. Maybe life and bipolar had not yet overwhelmed my ability to cope. Maybe I was in remission (or whatever they call it). Maybe I was hypomanic. It’s a mystery to me.

But maybe, just maybe, I can take this baby step toward reclaiming some of the things that used to bring me pleasure. It’s about damn time.

 

 

A Bipolar Child

I suppose I was a bipolar child. I don’t really know, but I assume I was, because now I’m a bipolar adult.

I think I was more of a depressed child, which actually makes sense, since I have bipolar 2, with depressive episodes far outnumbering hypomanic ones. There were some times, though, when I would laugh loudly and inappropriately in class, triggered by a word that reminded me of something funny I’d read. There were times I’d walk around with a village-idiot grin because of some minor accomplishment like winning a live goldfish at a school fair.

Depressed child with toyBut mostly I remember misery. Tears. Loneliness. Hysterics. Confusion. Isolation. Hurt. Despair.

I’m fairly sure my depression wasn’t reactive, mostly, although parts of it surely were. The bullying, betrayals by friends, not understanding social conventions – all these were things that could easily make a person depressed, regardless of brain biochemistry.

But by and large my life was what would be considered pretty damned idyllic. I had stable, loving parents, a comfortable home in the suburbs with good schools, all the food I wanted, and as many toys as I could play with. I had a sister and a neighborhood full of children my age, but I remember being perpetually lonely. I had a good education, but looking back I realize that my illness prevented me from getting the most from it. There was no sexual or physical abuse or neglect. No one close to me died or suffered major trauma, at least until I was in high school and my parents suffered illnesses. Even then, they did a good job of keeping life as normal as possible. At the time we never felt it was a tragedy. It was just something we got through together.

That just leaves endogenous depression. Or at least the depression half of bipolar disorder. I remember one day walking home from elementary school and thinking, “All these houses look so pretty, but the people in them aren’t all happy.” It was somewhat of a revelation to me.  I had several major meltdowns, which I’ve written about before, and hundreds of smaller depressive episodes (http://wp.me/p4e9Hv-6J). I had nervous twitches and tics, and was prescribed Valium for them.

During my high school years, it was suggested that perhaps I ought to go to the school district’s psychologist. (This was probably during the episodes of inappropriate laughter in class.) My parents, who were not really familiar with mental illness and psychiatry, asked me if I wanted to go. I didn’t. I probably should have, although back then – the seventies – it’s fairly unlikely that I would have been diagnosed with bipolar disorder, of any type. I might have gotten some help for the depression, though. They might have taken me off the Valium.

Like most lonely and misunderstood kids, and perhaps most depressive children, I found my salvation in books. They were friends, distractions, instruction manuals on how to survive, food for my emptiness, a place to lose myself when the world was too much with me. By and large it worked, at least as well as anything could – a self-prescribed and self-regulated form of instinctual bibliotherapy.

These were not books on how to make friends, or ones that promised to teach a child how to cope with emotions. They were for the most part pure escapism. Fantasy and science fiction, mysteries and adventures, literature and bestsellers – a complete mishmash of classics and trash. Those were my doctors, my therapists, my Prozac, my mood stabilizers.

I look back now on myself as a child – mentally disordered, undiagnosed, untreated – and wonder how I survived  as much as I did.

If I were a child these days, would I get the help that I needed then? Would my parents recognize that I was not just odd and unhappy, but mentally ill? Would I have been diagnosed properly? Medicated properly? Counseled properly?

With all that needs to go right and all that can go wrong during the process, it feels like getting help for a bipolar child certainly was – and perhaps still is –pretty much of a crapshoot. I made it through, but I hope it’s easier for a kid like me these days.

 

The Week of Living Alone

Sometimes, when I get tired of my complicated life, I imagine what it would be like to start over someplace new, or what it might have been like if I had made different choices. I envision myself, living alone (well, with one cat), in a small town like Benson, AZ. I would have a small used book store or secondhand shop and live in a small apartment over it or behind it. I would have a couple of friends I met in my shop and go out to lunch or dinner once in a while, but mostly spend my free time listening to music, watching TV, or on the Internet.

Sounds simple and peaceful, doesn’t it?

Portrait of a young woman drowning, shark fin on the backgroundThis past week has convinced me that even such a stripped-down existence would not be possible for me. My husband was out of town for nine days, and I could barely manage.

Those of you who follow this blog know that my husband is my rock and my support. I often say I could not get through without him, and my recent experiences only reinforce that.

I didn’t begrudge his leaving, though I wish he had not been gone quite that long. His mother needed him to help her get ready to sell her house and move, and nine days was barely enough time to start on all that needed to be done. There are times she needs him as much as I do.

But coping on my own was difficult. I have paid work I have to do. It matches perfectly with my skill-set and I’m grateful to have it, but sometimes it’s just plain hard to do and hard to make myself do. And I have two blogs (the other is at janetcobur.wordpress.com) that I have made a commitment to posting in once a week, each. Plus, I have started writing a novel.

We have four cats, two of them ancient, and one dog, also ancient. I was afraid that one of them might die while my husband was away. (None did.)

As scary as the idea of coping with a dying or dead animal on my own was, just caring for them was difficult. They keep demanding food several times a day, you see, and they have no thumbs to open cans with. Then there’s the water bowls and the litter boxes. I used to live alone with one cat and manage okay, but that was many years and many meltdowns ago.

Then there was feeding me. Dan had stocked up on things I like before he left, but after the French bread pizzas were gone, I lived largely on salami sandwiches, cheese and crackers, and cereal. (I did eat vegetables. I had a small tray of sliced veggies and dip.) Once I made a couple of baked (frozen) fish sandwiches early in the week, but later I had devolved to the extent that my evening meal was peanut butter on a bagel. Another night I had mashed potatoes and a glass of red wine. Other meals I simply skipped.

Then there was Dealing With Stuff. Life Stuff. You know. The Stuff that happens to everyone sometimes piled up on me. I had to talk to (argue with) the utility company and the IRS. I had to pay bills. Life stuff leaves me exhausted.

Plus, I kept having to Go Out. Deposit my check. See the doctor. Pick up prescriptions. Buy cat food when I ran out. I wore pants more days last week than I had in the previous month. (Dan wanted me to water his butterfly garden daily, but it rained every day or night, so I didn’t have to put on pants and go out for that.) I treated myself to lunch twice when I had to go out to do those errands, but it was nearly impossible to decide where to eat.

Now Dan is back. I had to put on pants again so we could return his rental car.

But you see what I’m getting at here.

My fantasy of retreating to a simpler life is not feasible. It simply wouldn’t work. The everyday tasks and trials of managing a shop, caring for myself and a pet, negotiating all the stuff of life would overwhelm me. Oh, when I’m hypomanic and can sometimes focus, I might do all right for a while, but life – even a very basic one – would eventually overwhelm me. There are so many things I can no longer do, at least not without serious amounts of help and support.

I can muddle through for a while mostly on my own. I am getting better. But not better enough to live independently, at least not right now.

 

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