My Experience Only. YMMV.

Posts tagged ‘mental health’

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.

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

 

 

The Other Holiday

I’m not going to write the standard “Surviving the Holidays” post this year. You all probably know what that one says: Self-care, self-care, self-care. Avoid toxic people, and if you can’t, get away from them as soon as possible. Don’t drink. Take your meds. Make sure you’re not alone unless that is what you truly want. And if you don’t know these things, you can read them in dozens, if not hundreds, of places. There’s not a lot I can add to that.

No, I’m going to write about the other holiday – the one we all have. The one that happens to fall – for me – right during the other holidays. The birthday. I wrote earlier this year about birthdays, and parties, and surprise parties in particular (https://wp.me/s4e9Hv-surprise), and I also wrote about the low-grade depression that dogs me this year (https://wp.me/p4e9Hv-AC). The two, I suppose you’ve guessed, are not unrelated.

After I experienced a severe trigger at a birthday party while in my teens, I tried to disown my birthday. In my dysfunctional way, I told people that it was on March 1, rather than in December. This was a stupid coping mechanism, not unlike the time prescription Ibuprofen caused me stomach trouble in college and I sat by the door in my classes, hoping that the burping would be less noticeable there. Don’t ask me why. Irrational thinking, I guess. My birthday didn’t go away (the burping didn’t either), my family still baked me cakes, and I still got presents or cards.

Eventually, I reclaimed my actual birthday. As the years went by and my friends scattered and my general holiday depression got more debilitating, I barely celebrated at all. Now it’s pretty minimalist – a meal out with my husband, a non-wrapped present or two, and on with the regular day. Dan tries to make it special, God love him, but my definition of “special” is telling the wait staff not to gather around me and sing. Then Facebook came along and now I have the opportunity to count the number of people who wish me happy birthday. As excitement goes, it’s not much.

I can’t say my lack of enthusiasm for birthdays is limited to myself, either. On Dan’s birthday, we have the same sort of celebration, except with fewer presents. (Dan stashes away little gifts for me all year long and often gives me things he’s bought back in July. I lack the wherewithal, in terms of energy, to do likewise.) Online shopping has made things easier, but Dan brings in the mail, so he usually has an idea what he’s getting, based on the size and return address of the package.

In a way, I suppose it’s more efficient to have my birthday tucked in among the other holidays so that one gray fog can cover them all. I could also be experiencing a bit of Seasonal Affective Disorder, but I’ve never been diagnosed with that, so let’s stick with what I know I’ve got. (I’ve tried using natural sunlight bulbs, but I really couldn’t notice any difference.)

Do I ever get hypomania at the holidays? Rarely. Although there was that one Christmas when I got Dan socks and underwear and wrapped each sock and t-shirt in a separate, different-sized package.

But we were talking about birthdays (or at least I was). Maybe it’s aging, and maybe it’s my bipolar disorder, but I’m content these days just to let birthdays slide by with an emotion that ranges from meh to Bah, Humbug, depending on the year.

I know, I know: self-care, self-care, self-care. It’s not just for Christmas anymore.

 

 

Prayer and Bipolar Disorder

My mother believed in the power of prayer, and thought I should do more of it. I can’t say she was wrong. She prayed for self-improvement (for God to take away her bitterness at someone) and for social issues (returning prayer to schools). I don’t know whether she ever prayed for an end to my bipolar disorder (she kept most of her praying private between her and God), but I never have. I don’t think it works that way.

So, what do I think about bipolar disorder and prayer? I think there are many things about bipolar disorder that you could pray about.

You could pray that science finds better treatments for bipolar disorder.

You could pray that you find a support system that helps you (or give thanks for the one you already have).

You could pray that you find a therapist, or a therapy, or a psychiatrist, or a medication that helps you. (Though I would recommend putting some effort into this one yourself as well as praying.)

You could pray that you have the strength to get out of bed in the morning or to sleep at night.

You could pray for understanding of what you’re going through – by another person, by an employer, by the world at large, or even by yourself.

You could pray that you not do too much harm while in the grip of mania or depression.

You could pray that you will recognize when someone is reaching out to you, and that you will have the ability to accept.

You could pray that you have the courage to reach out to someone else, and the wisdom to keep reaching.

In my opinion, what you can’t do is “pray away” the bipolar disorder. If you’ve got it, you have to find a way to live with it. If prayer helps you do that, more power to you. But, again in my opinion, prayer is not a cure for the disorder. There are some things that are meant for religion or philosophy to make better, and things that science has a better shot at.

You can point to various miraculous remissions of cancer or other diseases, or make the argument that removing demonic possession would now be called healing of mental illness. And if those give you comfort or hope, again, good for you.

St. Dymphna is the patron saint of the mentally afflicted (though personally, I think she should be the patron saint of abused children). If she, or God, or some other higher power of whatever religion or denomination or sect can lessen your suffering, go for it.

I just don’t believe that you – or I – personally will be cured of bipolar disorder by prayer.

Feel free to disagree with me.

Does It Help When Celebrities Talk About Mental Illness?

It usually doesn’t hurt.

But how much does it help?

That depends on who is talking about mental illness and what they say.

Celebrity Activists

We need more mental health advocates like actors Carrie Fisher and Glenn Close. Both of them have spent years talking about their own and their loved ones’ experiences with bipolar disorder and schizophrenia. Neither one is a one-benefit-and-they’re-gone supporter. They repeat their vital messages again and again, in different ways, in different venues, in different words. Carrie Fisher, in particular, used her mega-star power and witty personality to keep the discussion alive and spread it to millions of people.

Active Celebrities

While not devoting as much time and attention to mental health activism as Fisher and Close, other well-known entertainers including Demi Lovato and Lady Gaga have made contributions to the public discussion on various mental illnesses. Because of their large number of fans, these messages reach millions of people. And their music reaches people at an emotional level that PSAs just can’t. If even a small percentage of their audiences pays attention to the messages, that’s a lot.

And we can’t forget Prince Harry. Positive messages about mental health coming from royalty are ones that people will listen to. (You know how we Americans love royals.)

Celebrities

Other celebrities mention their mental health diagnoses in public, but do little more to campaign for mental health causes. Catherine Zeta-Jones spoke of her bipolar II diagnosis when she was hospitalized for five days, saying that it was brought on by stress. And renowned glass artist Dale Chihuly admitted his bipolar disorder when he was more or less forced to by a lawsuit.

Staying quiet certainly is their right. Mental illness is a deeply personal and to many, a private thing. And celebrities as much as any of us must struggle with when and how and to whom to reveal their struggles. Perhaps in the future they may become more comfortable talking about their problems and contributing to mental health causes and organizations.

Suicides

Unfortunately, suicides speak loudly. Robin Williams’s death by suicide made a big impression. It got people talking – if only to ask “why?” Though a lot of the conversation revolved around “Even funny people can have suicidal depression,” that’s a start on the message that you can’t tell who’s suffering inside just by looking at them. It’s just too bad that the death of a beloved entertainer is needed to start that discussion.

Media

Are the media “celebrities”? A few individuals truly are, But as a group, the media have the largest platform of all. And what do they say about mental health? I think you know the answer. Mental health gets discussed in the news media in cases of terror and tragedy, and when no other explanation comes readily to mind.

The media bear a huge responsibility when it comes to stigmatizing mental illness. Theirs are the only messages that many people hear – and believe. The news media have (or at least used to have) a reputation for spreading the truth. Nowadays we can’t even count on that. The splintering of the news media into “sides” to promote opposing ideologies – combined with shrinking budgets that have nearly eliminated informed science reporting – make it difficult for the average news consumer to know who and what to believe.

Who does that leave to spread the message? Us. Those of us who live with mental illness or have loved ones who do. And sometimes I worry that we are talking mostly to ourselves – to each other. Don’t get me wrong. Those conversations are vital in helping one another deal with our difficulties and sharing messages of support and understanding.

But maybe we can do more – even if it’s educating a family member about depression or wearing a semicolon tattoo to promote suicide prevention or posting/commenting on social media when a news outlet has gotten its coverage of mental illness all wrong.

Among my fondest hopes is that one or more of my blog posts will be passed along to someone who needs to hear the word. “Here – read this,” is a message I would be proud to spread, even though I’m no Carrie Fisher.

The Gray Dog and Me

Nothing is really wrong.

Feeling like I don’t belong.

– The Carpenters “Rainy Days and Mondays”

After quite a long spell of stable feelings (and maybe some productive hypomania – https://wp.me/p4e9Hv-y4), I’ve hit the wall of depression again.

Not full-blown depression, like I’ve had so often in my life. This is technically dysthymia, which is psych-speak for a low-grade depression, sort of like a low-grade fever that makes you tired and headachey and not wanting to get out of bed. To curl up in a blanket and sleep. To take aspirin and forget about everything else.

That’s where I am. I’m not wrestling with the Black Dog (https://wp.me/p4e9Hv-5Y). Call it the Gray Dog.

I am finding it very hard to write this, but I am pushing to do it, because at the moment, that’s one of the few positive things that I can point to – that my husband can point to – and remind me that depression lies.

What depression is telling me now is that I haven’t accomplished anything in my life. That I skated through high school and missed wonderful opportunities in college. That my jobs have been a pointless series of minimal value to anyone. That my writing is self-indulgent crap, unoriginal and meaningless.

Depression is telling me that I don’t matter. That I am becoming invisible. And that it’s my own fault, for never going out, for not reaching out. It’s not quite the self-pitying whine of “If I died, no one would come to my funeral.” It’s more like turning into a particularly ineffectual ghost – frightening no one, bringing no message from beyond, just fading and losing substance.

Depression is telling me that the future is bleak. I have a writing assignment now, but in a month it will be over and I’ll be right back where I was – at the edge of panic or worse, despair, or worst, both.

Depression is telling me that I’m a terrible burden and I don’t deserve my husband, who takes care of me when I’m like this.

At the moment I don’t have the ability to believe that all these are lies.

I do know that this won’t last forever. I’ve come far enough in my healing to believe that. And comparatively, it’s not that bad. I am quietly leaking tears, not weeping copiously. My bad thoughts are not as ugly as they could be, have been.

I haven’t given up.

But I almost want to.

It’s the “almost” that makes this the Gray Dog and not the Black Dog. That keeps me taking my meds and waiting for the Gray Dog to depart. That tells me to write this, even though I doubt its usefulness.

Useless sums up how I feel. Old and tired. Detached from society.

As depression goes, I’m really in a not-terribly-bad place. Which doesn’t make it much easier to live through. A little, though. I still have my support system, and I did get out of bed today (after noon), and I’m writing, even as I doubt my ability. But if I’m quoting The Carpenters, I can’t help but feel just a wee bit pathetic.

The Gray Dog is with me. One day soon but not soon enough, it won’t be.

 

Surviving College While Bipolar

I had two goes at college, and they were very different from each other, based on the state of my bipolar disorder at the time.

The first time I went to college, for my undergraduate degree, I was undiagnosed and unmedicated – except for self-medication. I was away from home for the first time – that was my first goal when choosing a college, being after a “geographical cure.” I ended up in the Ivy League, a scholarship student and a fish out of water. And profoundly depressed.

I did manage to hit the ground hiking, as the university sponsored backpacking trips led by juniors and seniors for entering students. We used to joke that it was meant to lose a few along the way, but really it was for orientation. Campfire chats about college life and the like.

On that hike through the Adirondacks, I met Caren, Roberta, and Cyndi, who instantly became my best friends and were my support system throughout the five years I spent there.

Yes, five, though only four of them were really at the university. After my first year, I took a year off. My depression had gotten so bad that I was given to sitting on the floor in the hallway, staring at a poster for hours at a time instead of sleeping. During my year away, I worked a dreary but educational job as an evening shift cashier at a restaurant. When I returned, I had a new major and the same old depression.

Oh, I did have fits of hypomania. I joined a sorority during one, though I deactivated later in a depressive downturn. And I went through the ups and downs exacerbated by several failed romances, including one total trainwreck.

The only help I got, aside from the support of my friends, was one brief therapy group at the campus mental health center and a brief stay at the university clinic, because of some suicidal ideation that my friends recognized.

Needless to say, I came out in no better mental shape than I went in, but I did manage to snag a B.A. degree. Now I feel that I missed a lot of opportunities along the way. It was just another occasion when I felt that my lack of mental health got in the way of what could have been a more productive time, as a well as a happier one. When I left college I was still almost as ill-prepared to function as when I went in.

By the next time I gave college a try, I was, if not mentally healthy, at least mentally healthier. And being back in the town I had been so eager to leave, I had a larger support system, now including a therapist, parents, close friends, and a husband. This time I had help.

I was still a mess, but less of one. With my depression lifting, I was able to teach introductory courses and manage my own course load. I remember my first semester teaching as a blaze of hypomania as I adored the subject and thought I was sweeping all the students along with my enthusiasm. Then one of the students gave me a bad review and I plunged again, never to recover that soaring sensation. I plodded through the next three semesters of teaching.

This time I came out with an M.A. and better job prospects. The day after I graduated I was working as a temporary editorial assistant, a job I kept for 17 years, moving up to editor along the way.

What did my experiences with college teach me (aside from modern poetry and how to swallow aspirin without water)?

  1. Making it through college is possible when you’re unmedicated and have minimal support, but I don’t recommend it.
  2.  Even with diagnosis, medication, and support, it’s still not easy. You know how hard it is to get out of bed and take a shower some days? Now think about going to a class on top of that, where your work will be critiqued. Taking a year off was one of the best things I ever did.
  3. Being bipolar isn’t your only identity, though it looms large in your life. I was also a student, a teacher, a friend, a daughter, a wife, a poet, a cashier, and so many other things. I may not have enjoyed them as I should, gotten as much from them as I could, but they were as much a part of me as bipolar was.

I can’t see myself at this point going back to college and getting a Ph.D. Which is not to say I’ve never considered it. But I like to think that, were I to try, this time I would have a better chance of getting through, sanity intact, with something more to show for it than a piece of paper to hang on the wall. This time, I tell myself, I wouldn’t let Bipolar Me take the experience away from Me.

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