My Experience Only. YMMV.

Posts tagged ‘mental illness’

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.

Mental Illness: Poverty and Privilege

Mental illness is not just an American problem. In fact, it’s a problem around the world, and perhaps much more acute in other nations, especially those plagued by poverty.

There’s no way to know for sure, but many – perhaps most – of the world’s mentally ill are undiagnosed, untreated, ignored. Because what do you do when you live where there’s no psychiatrist? No therapist. No medication. No help.

Your family may support you, shelter you, or shun you, depending on their financial and emotional resources and those of the community. But for many people, there is simply nothing.

Psychiatrist Vikram Patel, one of Time magazine’s 100 Most Influential People for 2015, is working to change that.

As a recent profile in Discover magazine put it, Patel and others like him have set out to prove “that mental illnesses, like bipolar disease, schizophrenia, and depression are medical issues, not character weaknesses. They take a major toll on the world’s health, and addressing them is a necessity, not a luxury.”

In 2003, Patel wrote a handbook, Where There Is No Psychiatrist: A Mental Health Care Manual, to be used by health workers and volunteers in poverty-stricken communities in Africa and Asia. A new edition, co-written with Charlotte Hanlon, is due out at the end of this month.

Patel, in his first job out of med school, in Harare, Zimbabwe, says he learned that there wasn’t even a word for “depression” in the local language, though it afflicted 25% of people at a local primary care clinic. There was little study of diagnosis and treatment in “underserved areas.”

Later epidemiologists learned to their surprise that mental illnesses were among the top ten causes of disability around the world – more than heart disease, cancer, malaria, and lung disease. Their report was not enough to spur investment in worldwide mental health.

Patel developed the model of lay counselors – local people who know the local culture – guiding people with depression, schizophrenia, and other illnesses through interventions including talk therapy and group counseling. By 2016, the World Health Organization (WHO) admitted that every dollar invested in psychological treatment in developing countries paid off fourfold in productivity because of the number of people able to return to work.

One objection voiced about Patel’s model is that the real problem is poverty, not depression or other mental illness. The argument goes that the misery of being poor, not a psychiatric illness, leads to symptoms and that Westerners are exporting their notions of mental health to the rest of the world, backed up by Big Pharma. Patel responds, “Telling people that they’re not depressed, they’re just poor, is saying you can only be depressed if you’re rich … I certainly think there’s been a transformation in the awareness of mental illnesses as genuine causes of human suffering for rich and poor alike.”

Of course the problem of underserved mentally ill people is not exclusive to impoverished nations. There are pockets in American society where the mentally ill live in the midst of privilege, but with the resources of the Third World – the homeless mentally ill, institutionalized elders, the incarcerated, the misdiagnosed, those in rural areas far from mental health resources, the underaged, the people whose families don’t understand, or don’t care, or can’t help, or won’t.

I don’t know whether Patel’s model of community self-help can work for those populations as well as they do internationally. This is not the self-help of the 1970s and 80s, when shelves in bookstores overflowed with volumes promising to cure anything from depression to toxic relationships. It would be shameful if the rich received one standard of care for mental health problems, while the poor had to make do with DIY solutions, or none.

But, really, isn’t that what we’ve got now?

 

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.

 

Ten Opinions That May Offend Someone

Recently I noticed that I have been reluctant to offend people, particularly on Facebook. I keep my opinions to myself, especially on social and political matters, and dread being “unfriended” or starting (or continuing) a “flame war.”

This is not just a matter that relates to my bipolar disorder, though it is certainly that too. I have written a number of times about how having bipolar disorder and the behaviors it has brought out in me have cost me friends, even ones that I thought were “forever-friends.” These losses have affected me greatly, at times pushing my anxiety and depression buttons nearly as far as they can go.

Just as I have toned down my comments on subjects such as liberal vs. conservative issues, I have also let pass by posts in bipolar support groups and mental health memes on people’s general Facebook timelines that I’ve disagreed with. Oh, when I see a particularly incorrect or egregiously stigmatizing remark, I’ve been known to smack the person on the nose with a rolled-up newspaper, but often in a soft, “In my experience, you may not be correct” manner.

There are also conflicts within the bipolar world that I have strong opinions about but have not jumped into, for fear of offending someone. And I have to ask myself, what would be the consequences of offending someone in such a discussion?

Yes, I might be unfriended. More likely I would be ignored. Or (virtually) yelled at. In other words, if I offend someone with my opinions, they may in turn offend me with their opinions. And while that’s not a productive state of affairs, it’s hardly the end of the world. In an ideal world, I might cause someone to question or consider or engage in fruitful discussion. Not likely, but possible.

So, if I am trying to overcome my fear of offending people with my positions on guns, abortion, health care, climate change and the like, what am I to do about my opinions regarding bipolar disorder and mental health in general?

Well, first of all, I can state where I’m coming from: straight, white, female, married, childless, bipolar type 2, 60 years old, diagnosed for years and on any number of medications for years as well. Not much controversial there. That’s just facts about me and hard to deny.

But here are some things I believe that I know are sometimes subject to differences of opinion. And for what it’s worth, here’s my take on them.

  1. Psychotropic medications are good things. Yes, they can be overprescribed or improperly prescribed, but when dispensed and used correctly, they help.
  2. The Scientologists are way off base. Mental illness exists, and so do treatments for it.
  3. “Natural” or “holistic” treatments for mental illness are not enough to replace medication and talk therapy.
  4. Sunshine, exercise, and positive affirmations are good things, but also are not enough to replace medication and talk therapy. They do good for a number of people, less for others, and not much at all for some.
  5. We’ve got to change the popular dialogue about mental illness and violence. We must not let it go unchallenged. For that matter, we must change the popular dialogue about mental health in general.
  6. While it’s a good thing if those with mental illness take their medications properly, it is absolutely their right to refuse treatment.
  7. Health care (and insurance plans) should cover mental health care at the same levels as physical health. (Okay, that one’s not really controversial among the mental health community.)
  8. Emergency responders including police should all receive training in dealing with mental health issues, but they probably won’t.
  9. Most people don’t/won’t/can’t understand mental illness until it touches their own life in some way, and maybe not even then.
  10. Education about mental health issues should begin in grade school.

There. If you disagree with any of those statements or feel that I am an idiot for stating them, so be it.

Oh, and while we’re at it, persons with a mental health diagnosis should not automatically be prevented from owning guns, but people with domestic violence convictions should 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.

Andrew Tate Doesn’t Get to Define Depression

“Depression isn’t real. You feel sad, you move on. You will always be depressed if your life is depressing. Change it.”

Now, before you jump all over me, let me say that I never said that. It’s a tweet from Andrew Tate, kickboxing champion and former star of “Big Brother UK.” It caused quite a stir in the Twitterverse and was immediately challenged by, among others, J.K. Rowling and Patton Oswalt.

Obviously, there are a few things wrong with Tate’s opinions. First, the notion that depression isn’t real. To quote Hemingway, “Isn’t it pretty to think so?”

The millions of us with major depressive disorder and bipolar depression would love it if our disorder weren’t real; if we could just move on. If we could only change our lives. Kick depression out of our heads, as we should be able to, according to the kickboxer.

And Tate threw more fuel on the fire. He tweeted “MY DEPRESSION INBOX. Is hilarious. Full of crybabys. . . .”

Admittedly, many depressed people cry. But that doesn’t make us crybabies. Babies stop crying when their needs are met. People in the throes of depression don’t really know if their need for it to stop – their need for, if not happiness, at least not-despair – ever will.

When I first became clinically depressed I was a child and knew nothing about clinical depression. But I knew I was profoundly depressed. And I knew that if I waited long enough, that depression would lift. Being undiagnosed and unmedicated, I had no idea when I would come out of depression. All I could do was wait for it to happen.

Now older and wiser (and diagnosed and medicated), I know some things I can do to shorten that time until the depression lifts. I can practice self-care. I can call my therapist. I can turn to my husband. Now I know – really know and understand – that my depression isn’t forever, even if my disorder is.

And I know that, if I have to, I can push through depression instead of waiting for it to ease up on its own. Meeting my self-imposed blogging deadlines is one way I do that. Paying the mortgage and power bill is another. In some way those are both life-affirming activities, or at least statements that I am still connected to the world – however fragilely – and that I want and need to come out of the depression and get on with my real life.

It’s ridiculous to say “move on” or “change it.” Depression comes and goes when it wills. All we can do is endure it and keep pushing back until it gives the tiniest toehold. Then take that tiny purchase and push some more. It’s the hardest thing in the world when depression has sapped your energy, but believe me, there is more inside you somewhere. It may just take a long while to find it and to recognize it. We can no more change our depression than we can our souls. We can push back against it.

So screw you, Andrew Tate.

And screw you, depression.

 

 

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