My Experience Only. YMMV.

Posts tagged ‘concentration’

As a Muse, Depression Sucks

Pencil tied in a knot on a white backgroundRecently, someone commented that I didn’t write like I was depressed, even though I actually was at the time I wrote.

This week I am even more depressed, so I thought I’d give you a look inside my head as I try to write while depressed and/or anxious.

::typing:: “Donald Trump Is Not a Monster. He may be a liar, a bully, and a misogynist who is uninformed, egotistical, and thin-skinned, but he is not a monster. Monsters are mythical. They are what we invented to be The Other. To say a person – Timothy McVeigh, Ted Bundy, Donald Trump – is a monster is to say that they are Other: not human beings. In reality, they are all human beings, who may have done monstrous things. But they are motivated by the same things as all humans: greed, fear, hate, sex, fame…”

::thinking:: No. That stinks. Half the people who read my Et Cetera, etc. blog will hate me because I said Donald Trump is not a monster and the other half will hate me because I compared him to Timothy McVeigh and Ted Bundy. I’ll offend everyone at once. Maybe I could write “How to Offend Everyone at Once.” No, that’s a terrible idea. My goal is not to offend.

::still thinking:: Why am I so afraid of offending anyone? Is it because when I’m depressed, my self-esteem is super-low and I can’t afford to lose any more friends? Is it because I’m female and was raised to be a people-pleaser? Then why haven’t I pleased more people? Is it because I don’t want to be called a “special snowflake”?

::still thinking:: My knee hurts.

::still thinking:: Maybe I should write something about education. What, though? The education issue everyone is talking about is Betsy DeVos. I only know about her what others have written. Writing about her would be useless and boring. Crap. It’s already Friday and I don’t have anything. I’m not going to have a thing to post this week.

::still thinking:: What’s another go-to topic? Books. I just re-read The Handmaid’s Tale and that’s totally relevant.

::typing:: “The Handmaid’s Tale: A Tale for Our Times”

::thinking:: No.

::typing:: “Written Thirty Years Ago and Still Relevant”

::thinking:: No. Hardly anyone reads my book posts anyway. How can I have been doing this for three years and not have more followers? Is that why I write? Ego gratification. I’m a sad, sad person who needs external validation instead of interior satisfaction.

::still thinking:: My husband doesn’t even read my posts half the time, even if I mention him. Maybe I could write about bipolar disorder and sex. No, I’d have to do too much research and I’m running out of time. Besides, with my luck, my husband would read that one and not want our sex life all over the Internet.

::still thinking:: My knee still hurts. How long have I been sitting at this stupid computer?

::typing:: “I Hear Voices” – I’ve been meaning to write that one.

::thinking:: No. I don’t hear voices like psychotics hear voices. All I hear are Pete Seeger singing pizza commercials or a men’s chorus or an NPR broadcast that I can’t quite make out. That’s boring. My life is boring. Besides, I’d have to do too much research and I’m running out of time.

::still thinking:: I could look up some quotes about bipolar and say whether I agree with them or not. More research again. Besides, who cares whether I agree with them or not?

::still thinking:: Maybe I could re-post one of my old posts. Wouldn’t that be cheating? If I can’t some up with something by tomorrow, I may have to. But that’s like admitting failure. Like I can’t write. Maybe I can’t write anymore. Maybe I’ve already written everything I know.

::still thinking:: Maybe I could write about not writing. Too boring? Too meta? Don’t people hate stream-of-consciousness? Especially stream-of-depressed-consciousness. It’s so bloody depressing. I’m so bloody depressed.

::typing:: Recently, someone commented that I didn’t write like I was depressed, even though I actually was at the time I wrote…

::thinking:: Now how am I going to illustrate this?

Senses and Sensitivity

When I was a child, I was often told that I was “too sensitive” – meaning that I took things too much to heart, especially criticism and the taunts and bullying of other children. It was something that I assumed was innately wrong with me, and that I didn’t know how to fix.Sensory Overload in Children

These days, however, I’m too sensitive to sensory input.

I used to be able to write or read or edit with music on (instrumental music, at least). I used to be able to hold a conversation while the television was on. I used to be able to drive a car and look at the scenery around me.

Not anymore.

A fan is about all the sound I can handle while I write, and sometimes quiet is the only thing that will calm my nerves. I can barely process remarks anyone makes about the TV show we’re watching. And if I’m driving, I never even notice a deer in a field off to the side of the road. I doubt that I would notice a hippopotamus.

I’ve written before about my brain being overwhelmed with too much input, meaning too many thoughts, anxieties, and fears. But over the years – at least since my last major meltdown – I have trouble processing more than one sensory signal at a time.

It’s not just a matter of focusing in too completely on just one thing. (I have in the past entered into some movies so thoroughly that I’ve nearly killed my husband when he has asked questions like, “Will you look at this pimple on my back?” or whispered to me, “I think I know what makes that spaceship fly.”)

My ability to focus – to concentrate intensely – has been a casualty of my mental disorder. At my lowest point, I couldn’t even read a book, which is something I’ve been doing since I was three or four. I still can read only one chapter or one magazine article in a sitting

Now that I’m recovering (thank God and Drs. R. and B.), I can concentrate enough to read, and write, and edit. What I can’t do is separate out multiple sources of information on the way from my senses to my brain. If my husband talks while a TV show is on, it’s not just that I can’t make sense of what he’s saying, I can’t process either signal – the TV or him. It’s all a jumble.

If I went to cocktail parties (I don’t), I would be unlikely to have an intelligible conversation because of all the ambient noise and clashing voices. I recently went to a workshop that held a mix-and-mingle event on the first day. Having people chatting all around me was not just distracting, but almost painful and immobilizing. Focusing on one person at a time was the only way I could get through it.

And forget about Chuck E. Cheese or Cici’s Pizza! No. Just no. Video arcades – are you kidding? It’s a good thing I have no reason to frequent places like that. When I go to a regular restaurant, I have to ask not to be seated near any birthday parties or office functions. I wish they had a “no screaming” section.

I understand that sensory processing difficulties sometimes occur in persons with autism spectrum disorders (ASD) and/or ADHD. I have never been diagnosed with ASD, though I may have manifested Asperger-like traits in my youth (well, OK, in my adulthood too). And I have been told by doctors that I have hyper-sensitive nerves. Is that the same as what I experience? I don’t know.

Most of the research and discussion of sensory processing and bipolar disorder occurs in the context of children, though I never noticed such difficulties when I was a child. But just as articles about autistic adults are rare (except, of course, for the high-functioning) and learning disabilities are forgotten about as soon as a person leaves school, it seems that sensory processing problems in adults also get little attention.

I can’t be the only one dealing with this.

As I learn more about my own difficulties and conditions that affect others, there is one conclusion I’m rapidly approaching:

Neurodivergent is neurodivergent. We may have different diagnoses, but there is much we share.

The Pluses and Minuses of Highs and Lows

Low polygonal shape mountain background with clouds.

Bipolar disorder comes with highs and lows – mania and depression, for those who still call it manic-depressive illness. Bipolar 2 comes with plenty of depression (trust me on this), but mania that doesn’t reach the heights of regular mania. Hence the term “hypomania” – low mania. Like “hypoglycemia” – low blood sugar. (Actually, low blood sugar can affect the bipolar person’s – or anyone’s – moods, but that’s a story for another time.)

So. Mania. Mania comes with pluses – exuberance, euphoria, ambition, confidence, and other good feelings. It also comes with minuses – risk-taking behaviors that can ruin relationships, careers, finances, lives.

Hypomania, however, is usually not so extreme. Sometimes you don’t even realize that you have hypomania at all, because it comes out sideways, as anxiety. This is what happened to me, and is the reason it took me so long to get the proper diagnosis of bipolar type 2.

Recently I have been exploring the realm of hypomania, and I’m here to report that, similar to regular mania, hypomania has its attractions and its drawbacks. And they are intertwined.

On the plus side, I have more energy – more spoons to spend. I can go longer between naps. I have now gotten out of bed, dressed, and out of the house for three days in a row. I can concentrate longer on the books I’m reading and spend more time with my husband and do some actual paying work.

On the minus side, I pay for that energy. It’s like borrowing spoons – you can’t keep doing it. Sooner or later the spoons have to be replaced. Right before my most recent spurt of energy, I had a need for a nap that turned into a mega-nap – almost six hours. I woke up just in time to get ready for bed. Then I slept at least ten hours more – maybe 12. It’s impossible to schedule these things, but I have left tomorrow open just in case my body and brain decide that’s payback day for the three days of activity.

Another plus is that my creative juices are flowing. I’m working ahead on blog posts because I know at the end of the month I have a huge commitment that will keep me from writing something for that Sunday. I’ve also taken steps to spiff up my posts with visuals. And I’ve been thinking that I ought to write some fiction.

However, there’s a however. The last time I had a creative spurt I almost talked myself into starting two new blogs, for a total of four. I have plenty on my plate already, what with these blogs and paying work and trying to find an agent for my book and getting ready for a writer’s conference. This is no time to start a big new project that could easily devour my time and my ability to do the things I already need and want to do. But I do now have a computer file set aside for notes and ideas that flit through my busy brain. Call that file “Later.”

And let’s not forget anxiety. It’s hard to find the pluses there, except that anxiety, if properly harnessed, helps me prepare. I suppose it sounds better if I call it anticipation instead of anxiety. Anticipating my upcoming dental work spurred me into putting together the financing for it. Anticipating the writers’ workshop allows me to prep for all the details – wardrobe, business cards, directions, strategies to cope with exhaustion – that would make my nerves fray even more at the last minute.

I assume I needn’t discuss the minuses of anxiety. Let’s just say that for me, they include regrettable and appalling physical symptoms that no one wants to hear about.

Any way you look at it, the dental procedures are going to be a low and the workshop a high. I can already predict some of the difficulties that will accompany the workshop boost. It’s harder to think of pluses related to the dental work. Except that I really need it done, and with luck it will (eventually) improve my looks, my breath, my health, my pain level, and my self-esteem. At least that’s what I’m telling myself now.

Bipolar disorder is often compared to a seesaw (or teeter-totter, if you prefer) or a swing set or a roller coaster – for some reason, usually as a form of amusement that involves ups and downs. The amusement is debatable and fleeting. But the ups and downs are with us always. Better to learn to ride this beast rather than let it ride us.

Am I Ready to Stop Therapy?

I got my first hint that I might be ready to stop therapy when I realized how little I was going. Over the years I have scaled down from weekly sessions to biweekly.

Then I noticed that, effectively, I’ve been going only once a month. I’ve been forgetting appointments, showing up on the wrong day, oversleeping, feeling poorly physically, or having too much freelance work to do.

Of course, those could be signs that I’m in denial, that I’m resisting therapy, that we’ve hit a bad patch of difficult issues and I just don’t want to deal with them.

But I don’t think that’s what’s happening. Here’s why.

I’m stabilized on my medications and they’re effective. When my psychiatrist moved away a few months ago, he left me with enough refills to last until this month and a list of other psychiatrists. My PCP agreed to prescribe my psychotropics if I lined up another psychiatrist for emergencies. I’ve done that, though I couldn’t get an appointment before March.

And that doesn’t alarm me. I don’t have the oh-my-god-what-if-my-brain-breaks-again panics. I don’t have the feeling that my brain is about to break again. I’ve thought about it, and I’m comfortable with letting my involvement with the psychiatric profession fade into the background of my life.

As long as I keep getting my meds.

I have more good days and I’m beginning to trust them. Oh, I still question whether I’m genuinely feeling good, happy, and productive or whether I’m merely riding the slight high of hypomania. But really? It doesn’t seem to matter very much. A few days ago I reflected on a string of particularly good days – when I accomplished things, enjoyed my hobbies, and generally felt content. And I simply allowed myself to bask in those feelings.

That’s not to say I don’t still have bad days. After a few days of hypomania, I hit the wall, look around for spoons and don’t find any, and require mega-naps to restore me. (I’m intensely grateful that I work at home and can do that. Most offices don’t appreciate finding an employee snoring underneath her desk. And my cat-filled bed is much more comfy-cozy.)

I still get low days too, but they are noticeably dysthymic rather than full-out, sobbing-for-no-reason, Pit-of-Despair-type lows that last seemingly forever. I know – really know, deep within me – that they will last a day or two at the most. And just that knowledge makes me feel a little bit better.

My creativity, concentration, and output are improving. I can work longer, read longer, write longer, take on new projects, think past today or even next week. I can trust my muse and my energy, if not immediately when I call on them, at least within a reasonable time.

I have trouble remembering how bad it used to be. Recently I’ve made connections with several on-line support groups for bipolar and mental health. I find I’m astonished at the crises, the outpourings of misery, the questioning of every feeling and circumstance, the desperate drama of even the most mundane interactions. They are overwhelming. But I realized that it’s been a long time since they’ve overwhelmed me. I recognize that I could some day be in that place again – that’s the nature of this disease. But I have a good support system that I trust to help me not fall too far without a net.

I don’t have much to talk about when I go to therapy. There are issues I need to work on – getting older, getting out of the house more, reclaiming my sexuality. But most of those I feel competent to work out on my own.  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.

So I’ve talked it over with my psychotherapist and I’m not completely quitting therapy, but I am cutting back officially to the once a month I seem to be going anyway. I know that if and when the bipolar starts giving me major trouble again, I can always call for an appointment or a telephone therapy session.

I’m not going to stop writing these posts. I still have a lot to say about where I’ve been, how I’ve got to where I am now, how things will go in the future, and all the many ways that mental illness affects society and vice versa.

You’re not getting rid of me that easily. I’m sticking around.

Things That Work – Sometimes

Right now I am in the middle of a fairly deep depression. It has gone on for days, which is unusual now that I am more or less stabilized on medication. But there is no let-up in sight.

This time is one of those I-have-nothing-to-look-forward-to moments; plus the holidays; plus the need-to-see-my-therapist thing; plus the have-an-appointment-with-new psychiatrist-but-it’s-not-till-March thing; plus the whole no-spoons-to-get-out-but-really-need to-get-out-of-the-house feeling; plus the various catastrophizing-about-finances-and-the-IRS problem; plus the there’s-something-I-really-want-to-happen-but-if-it does-it-won’t-be-soon-and-may-not-happen-at-all.

Let’s see. Is there anything else?

Oh, probably, but that will do for starters. Of course to a lot of people, those would be everyday annoyances and I would be having your standard pity party. But for a bipolar person, with my brain chemistry, it’s an invitation to a deep, dark pit.

So what are the things that help pull me through, or out, or up? And what are the things I can do while I just ride it out?

Well, there’s music. I’ve written about that before (http://wp.me/p4e9Hv-42). There are two long-form musical bits that have been known to lure me out: The Mikado and The Pirates of Penzance. Occasionally when I haven’t gotten out of bed in a while, my husband will put on a DVD of one or the other and wait for me to appear in the door of his study. There is usually beer or snacks, and I can sing along (badly but loudly) to my heart’s content. Heart’s content – now there’s a good thing. Going to see live productions of Gilbert & Sullivan was an activity my sorority used to do, and one of my best memories of otherwise-difficult sorority life. (I mean, really, can you picture me in a sorority?)

Then there are distractions. These don’t actually improve my mood, but they can help me avoid dwelling on the above list of what’s-wrongs. If I have the concentration needed to read, that’s my go-to choice. (I’ve also written about “comfort reading”: http://wp.me/p4e9wS-3n.) I usually try to keep one fiction and one nonfiction going, so I can switch back and forth.

Sometimes, though, I don’t have the concentration to make it through a chapter. Then it’s time to try TV. Something familiar, non-challenging, not too fast-paced. Cooking shows work, or something like Pawn Stars. True crime or true medicine. Shows where I already know the characters and the back-stories: Castle, Bones.

When I don’t even have enough concentration for that, I go for stupid clicky games. One round of Candy Crush Soda Saga is about as mindless as you can get and still be breathing. Even playing out all five lives takes about 15 minutes. Or I can turn off my brain entirely, play obsessively, and get lost for hours of not-worrying about anything more important than making six-letter words in AlphaBetty.

Occasionally I can do light-as-popcorn forms of social interaction. Phone calls with a depressed friend or one who always has a silly joke ready or one who reads the same sorts of things that I do. Instant messaging. Facebook.

Sometimes, though not often in this state, I can force myself to work a little. Or work on my blogs. It’s difficult and not really satisfying and sometimes even painful, but if I can do it, it’s probably the best thing for me. Accomplishing something – anything – helps build a step out of the pit.

As for the usual advice – rest, exercise, nutrition, meditation – I usually can’t manage those. Except for sleeping. I’m a world-class napper. Also a world-class insomniac. Don’t ask me how I manage that. It’s a gift. I have a new exercise regimen that involves walking up and down the stairs more times than I really have to. My husband makes sure I eat at least one good meal a day. For meditation I pet a cat.

Then I wait.

I know that this will not last for weeks or months or years the way it used to. I’m just going to be miserable until I’m not anymore.

Mini-Meltdowns and Many Meltdowns

When my brain broke back in 2001 or so, I thought it was the first time that had happened. Later, on reflection, it turned out that wasn’t so.

The 21st-century breakdown was certainly the most dramatic. Although I had just quit working in an office to start a freelance career, I found myself unable to work after a few months.

I had become unable to work in the office because of mounting difficulties that I now realize were warning signs of the impending breakdown: inability to concentrate, increased anxiety (the feeling that an angry badger was about to claw its way out of my stomach), lessened ability to interact with coworkers, sudden flares of temper, turning people away with unintendedly cutting remarks and sarcasm, isolating, inappropriate affect, catastrophizing – you name it, I had it.

What was causing all these symptoms? My bipolar disorder, obviously. But I’ve had that for years. What was pushing me over the edge this time? I had trouble at work. My boss left and, when I “came out” to my new boss as depressed (which is what I was diagnosed with at the time), she reacted with wariness and incomprehension. She gave me the first bad review I ever had at that job.

My mother’s health was deteriorating seriously, too, about then. I lost time at work taking her to various appointments and I had to have “the talk” with her about how much longer she could live alone. Eventually I took over her finances – and by then I was scarcely handling my own.

I experienced a lift when I quit my job and began freelancing. Hypomania? You bet! My new flexibility allowed me to take better care of my mother, and the assignments kept coming in.

Then everything came crashing down. I screwed up my finances and my mother’s. She began having worse falls and injuries, hospital stays and drug reactions, even hallucinations which scared the hell out of me. I emotionally judo-ed my sister to come up and help, then fought with and resented her, and had to take care of parts of her life as well.

Those and other difficulties on top of my mental disorder added up to a non-functioning me. I dumped all the chores and coping onto my husband, which was a rotten thing to do, fought with him, sobbed for no discernible reason, became unable to work, or care, or do much of anything except think up at least three different ways (and reasons) to kill myself. Fortunately, I was too immobilized to try any of them.

I’ve written before about the things that helped me get back to some kind of functioning – a proper diagnosis, the right meds, time without work (as we gutted our retirement savings), lots of psychotherapy, and my wonderful, patient, ever-helpful, devoted husband.

But now, looking back, I can see that it had happened before, though not so dramatically and completely. In childhood, in my teens, in college – at every stage of my life I had at least one breakdown, often triggered by the circumstances of my life, but fueled and stoked by my mental illness. In every one, my ability to function deteriorated a little more.

The first one that I remember clearly was when I was around 12. My best friend and I were in charge of a birthday party for her younger sister and some friends. This was the old-fashioned kind of party that everyone in the neighborhood had then: cake and ice cream, party games, presents, and not much else. It happened during pin-the-tail-on-the-donkey. I was blindfolded – literally – and my friend kicked me in the ass – again, literally. In front of all those younger children.

I ran home sobbing. And I curled up into a fetal ball and didn’t quit for at least three days. Non-functioning, non-responsive, non-everything. What finally brought me out of it was seeing my mother’s pain at this inexplicable (to her) meltdown.

I had a mini-meltdown in my freshman year of college, which involved sitting in my nightgown in the hallway, staring for hours at a richly detailed poster of a fantasy realm. (I managed to frighten an intruder by arising, ghost-like, in my pale yellow shroud as he entered the suite.)

This one was triggered by my realization that I had probably chosen the wrong major and that there were no job prospects ahead for me. (It turns out I was wrong about that. Maybe I should have stuck with it, but my next choice turned out pretty well.) I took a year off college and took a job as a cashier in a restaurant, where I spent a lot of time crying into the roller towel and being told I should smile more. This convinced me that going back to college, with a new major (and even fewer job prospects), was the right thing to do.

The next meltdown was major. I had finished college, endured a year-long train wreck of a relationship, and lost a job as an assistant restaurant manager (I hadn’t fully learned that lesson yet). I got unemployment, which meant I lay around the apartment for most of the week (except for making half-hearted attempts at job hunting).

One notable symptom of this breakdown was my near-complete immobility. One errand in a day – say, going to the post office for stamps – made it a productive one for me. I had maybe three of those a month, with one being the obligatory visit to the unemployment office – a supremely depressing place to be depressed.

I had some truly irrational thinking that time, too. I thought I could cheer myself up by watching light, fluffy sitcoms on TV. But as I lay there on the couch, I found myself crying with every upbeat, cheery theme song that came with them. Laverne and Shirley making their dreams come true. One Day at a Time, which advised me to get up on my feet because somewhere there was music playing. And, oh, Mary Tyler Moore. Love is all around, my ass.

After that, it was a long, slow slide to my major breakdown. It wasn’t unrelieved misery. I got married. I got a master’s degree and a job in publishing. We acquired a house and cats. We traveled. But the Big One was waiting for me.

Nowadays, I still have mini-meltdowns, but they usually last a maximum of three days, rather than weeks, months, or even years. They still tend to be triggered by stressful life events, especially financial ones. But when I get one, I know I’ll be coming out of it soon. And that’s a wonderful feeling buried in all the misery.

 

 

Abilify: The Next Chapter

I’ve been taking Abilify as an add-on to my other psychotropics for about six months now, and I have some pieces of good news to share.

Good news #1: The generic (aripiprazole) is now available! There was a slight delay between the time the FDA gave approval for the generic (April) and the time it went on sale. But now it has arrived in drugstores. (I understand that the same company makes both the brand name and the generic, which strikes me as goofy, but then what do I know about drug marketing?)

Good news #2: Between my insurance and my pharmacy, I now have to pay only $15/month for the generic. The brand-name Abilify was $800 without insurance and $125 with. My insurance is not cheap, though it is still less than the cost of brand-name Abilify. When you add in all my other prescriptions and doctor visits and tests and such – plus all my husband’s drugs and other medical expenses, the insurance suddenly doesn’t seem so pricey. (I got this insurance through the Affordable Care Act, and I hope the Supreme Court doesn’t screw it up for me.)

Good news #3: Despite my tiny dosage (2 mg.) I have noticed significant effects. After six months on the drug, I have more energy, better focus and concentration, and fewer down/useless days (unless I overdo and run out of spoons). (See http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/ if you don’t know what I mean by that.)

I’ve been doing major housecleaning/sorting, going out – actually outside the house – to run errands other than my shrink appointments, and I even went to a party – a reunion of people I used to work with. I wore my new skirt, navigated the social milieu successfully, and stayed an hour and a half. (The next day was one of my no-spoons days, though.)

This is only the third time in my life that I’ve noticed a significant effect from taking a new prescription. The first was Prozac (fluoxetine), which felt like looking at a color television after years of black-and-white. With static. Showing only commercials. The second was Lamictal (lamotrigine), which felt like a switch flipping and turning on my ability to think rationally. And now there’s Abilify.

Whatever side effects I may have, I’m willing to live with. (Unless I get the tardive dyskinesia. That would be a deal-breaker.) This feels like real living and I’m happy about it. I don’t think this is hypomania, either. I think I’m supposed to feel this way. I’m going to run with it.

Of course this isn’t the end of bipolar disorder for me, or the end of this blog. I still have plenty to say about my experiences with bipolar depression, mental health in general, and particularly mental health in the media and society.

Sorry if I sound sappy, but it’s good to be alive and functioning!

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