Friday, July 3, 2009

Bipolar Yin-Yang



softly treading thoughts
slip through giving the slip to
thoughts treading softly



Monday, June 29, 2009

Dazed, Confused, and Ornery as Hell

A few months ago I added a little unsolicited advice from my Bottomless Well of Helpfulness for those of us with mood disorders at the end of a haiku. In typical Sophie fashion, the P.S. was four times longer than the original post. (Grin) just part of my charm. Here is the unsolicited advice again:

...if you have a mood disorder and you get any sort of lingering upper respiratory infection (flu, cold, etc.), please take extra good care of yourself because these sorts of infections can create a bit of short-term mood instability. It's a bit complicated, but it has to do with the way the body breaks down calcium on an intracellular level to fight off the cold only to leave the mood regulating cells a bit topsy-turvy.

I'm bringing this up because I have learned something new about infections and bipolar disorder: it's not just upper respiratory infections that can cause mood instability, other infections can be problematic as well. YAY!! More random fun in Bipolar World!!! Exactly what I needed. Thanks, mood disorder. You are so thoughtful.

Ooops, sorry. Dripping sarcasm there. Let me wipe it up.

I'm not a doctor so I can't answer all infection questions here, but in the last 4-6 weeks I've been hammered with infections and now I'm visiting Mixed State. It's a purple state in case you were wondering, but the weather patterns are severe and erratic. As a result there are more visitors than locals.

Mixed State (definition provided by Healthy Place: America's Mental Health Channel)(wait, doesn't that make Healthy Place the antidote for Fox News?)
Symptoms of mania and depression are present at the same time. The symptom picture frequently includes agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. Depressed mood accompanies manic activation.

..."frequently includes" does not mean "is always accompanied by" - I'm not psychotic or suicidal. However, I am agitated. I fall asleep as I'm sitting up reading or typing, yet can't fall asleep when I go to bed. I'm cranky & my thoughts are scattered, as a result I can't speak properly, therefore, I get frustrated and I feel stupid. I cry when no one is looking and I can't seem to figure out what the intentions are behind other people's words. I hear the words, but I can't discern their meaning. I get a little paranoid, not about Big Brother or anything goofy like that, but when I'm in these godawful Mixed States I worry that my typical self has it all ass-backwards and that folks who know the real me don't like me because I'm, well, me. I've got parenthetical statements coming out my ass and I'm leaving them all in here so you can really stare at the freak in the window that is Miss Mixed State and see what bipolar's nastiest state o' mind looks like.

My current frame of mind started its deteriorating spiral last Thursday. Because I'm big on the whole Constant Vigilance mood management technique, I took a good look at myself Friday morning and said, "there is a glitch in my Matrix." I mentioned it to Bowser and told him I was feeling a little down and the Thought Monkeys were banging on my door, but I was aware of the problem and wanted to hear his observations. He said that there was the teeniest tiniest bit of fluctuation, but he was hearing rapid speech and scattered phrasing. He's my puzzle buddy. We look at all the pieces together to solve the riddle. I found that there's a link between strep infections and neuropsychiatric disorders. Like the upper respiratory infections, the mood changes are a side effect of the autoimmune system's response to the offending cooties.

Huh, he saw a smidgen of mania and I was feeling a bit blue. I told him I hoped he was right and it was a bit of mania that I could fight off - AFTER I used it to clean the house, which is plain dirty 'cuz I've been fighting off infections. A little mania can be helpful sometimes, other times - not so much. I wasn't actually looking forward to a cycle, but I'd rather feel up than down and I was trying to look on the bright side of an impending mood disruption.

There isn't a bright side to a Mixed State. The only thing to do is to ride it out and practice as much self-care as I can muster. I make myself say nice things when there is a lull in the conversation (to try to compensate for the irritable touchiness that erupts most inconveniently), I practice my Four S's, I sit in the sun & take fish oil supplements for holistic attempts at mood regulation, I don't watch the news (to avoid triggers of all sorts), and I give Bowser the daily Mood Report. However, I refrain from telling him, or anyone else, what I'm actually thinking. No one wants to be in my head right now in the same way no one wants to be around a dozen 2 year olds just getting off a sugar buzz from snack time in the park, whilst all simultaneously melting down because it's nap time, and throwing huge fits because they've realized someone forgot their lovies. Each and every one.

So what mood altering infections can I add to the previously mentioned (and scientifically proven) mood de-stabilizing upper respiratory infections? In my case, I think my brain got tired of trying to juggle an immune system working overtime to keep the good things in and the bad things out and decided something had to give and, since my moods have been pretty stable for a while now, the moods could fend for themselves. Yeah, great plan there, Brain.

I had surgery a little while ago and got a big infection that took a while to resolve, then I had a couple of TMI sorts of issues for a week after that, then (if you follow me on Twitter, you know some of this already) I got hit with kidney stones - five in one week - and my doctor ran a zillion lab tests and discovered I have (had) a strep infection in my kidney. Not my throat, my kidney. I had been feeling like dog poop for a week and a half by the time they discovered an underlying infection: chills, fever, nausea, vomiting, fatigue - the kids watched a lot of TV that week. They put me on Super Antibiotics 'cuz if the strep is allowed to do whatever it wants, then it results in renal failure. It took a full week to get any relief from the antibiotics, but by then the old brain was done. The strep infection was the last straw and now I'm living in Mixed State.

Don't try this at home.

The Thought Monkeys are having fun, especially "I'm Not Enough (__fill in the blank__)" and "I'm a Failure." I always end up kicking them to the curb, but fighting intrusive negative self-talk is tiring. It's a constant effort. I'm currently resorting to the tried and true, "because I said so!" argument.

This will pass. I feel better than I did on Saturday. Saturday was one of the rare days in which I give in to self-pity and say to Bowser, " I HATE feeling like this! There is nothing wrong. Absolutely nothing wrong in my life other than a kidney infection, which is now well on the mend. Yet here I am having conniptions, crying jags, unexpected happy bouts of playing with the boys, then utter self-loathing followed by a round of seething as I take out my low self-esteem on anyone in my sight line. I look in the mirror and my skin crawls at what's in front of me. I look in my mind and I want to run away from myself until my mind has decided to move back to Normal (for me) State. I fucking hate this."

And I do.

What I am not liking most at the present moment is that I've been given an award by the lovely Mim for and I'm too scattered and flustered to do what it takes to accept the Love My Friends Award graciously and then pass it on to those more deserving than I. I already know those with whom I want to share my good fortune, but I can't seem to pull it all together at the moment. Thankfully, Mim said this when she gave me the award, "Sophie shares her stories of being bipolar with great generosity. My father and possibly my sister are bipolar and I have learned much that helps me understand them from Sophie's writing." so I'm hoping she'll understand that the mixed state thing wasn't planned and give me some time to get back to my usual self in order to accept the award properly. Thank you so much, Mim.

Now I'm off to brush my teeth and take my meds. I'll crawl into bed and dream about being an unlovable, brutish, fat old cow with terrible table manners who is trying to drink tea from a trough with Dick Cheney while plotting for the moment when she can kick him over. When I wake up, I'll think it means that Bowser hates the very sight of me and if I'm lucky the bat shit codie crazies will kick in, 'cuz really, I have nothing better to do than deal with emotional baggage that has zero, zip, nada relationship with this Here and Now.

Starlight Star bright.
First star I see tonight.
I wish I may, I wish I might,
have this wish I wish tonight:
Please, please, please, don't let me dream about Dick Cheney. I'll take the cow with bad table manners, but not Dick. Thank you, Star.

Goodnight.

P.S. I'm going to wait to get out of this before I write again. Should (fingers crossed) just be a few more days 'til the meds kick in. I normally wouldn't have written a post because I prefer to turtle when I'm down or mixed. However, I thought it might be an interesting exercise to share my Mixed state with everyone who has access to the internet as well as be a record for self-reflection at a later date. You know, when I'm Me again. The True Me might find something useful in this bitter ramble to mold into some little self-soothing technique. True Sophie is too damn perky and optimistic for her own good. ;)
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photo credit "Mixed State" by Jsome1 on Flickr
licensed under Creative Commons

Wednesday, June 24, 2009

I Choose to Belong

The following is my 'anonymous' submission to The Reasons to Go on Living Project. I can't even remember where I first learned about this research study, but the link has been in my bookmarks bar waiting to be clicked for weeks now. Here is the website's explanation of the study: We are doing this research project, The Reasons to go on Living Project, to understand how people’s thinking changes after a suicide attempt. We do not understand the thinking processes that occur for people who choose to go on living after an attempt and there is very little research in this area. We believe that if we had a better understanding of how people found the strength to go living after an attempt, we might be able to better help people who are thinking of ending their lives, before they make an attempt.

Today, I finally sat down and wrote my submission. The submission is anonymous for the purposes of the study (from what I understand, they don't want any demographical info to dilute the relevance of the stories) and mine may or may not be shared, published, edited, distilled.... who knows on their end. However, their mission touched me quite a bit, so I'm sharing my story and all my Reasons here in the hopes that it might help someone somewhere rethink the fallacy that suicide is an option.


Hi, my name is __(Sophie)___ and I’m a suicide survivor. Depending on how you count them, I’ve made 4-7 suicide attempts.

I was 16 when I made my first attempt (pills); six months later I tried again (slit wrists) and ended up in a wonderful juvenile psychiatric ward for a month where I learned some real coping skills to get through the trauma-induced depression that resulted from my trauma-filled childhood. After I got out, I went to an excellent therapist for a few years. She wanted to put me on meds because of my “hyper-ness”, but I refused because meds were for crazy people, not me, and I didn’t want to be medicated and somehow changed from who I was to someone the drugs created. She respected my wishes and instead we worked through talk therapy for two years. I worked very, very hard, got significantly better, graduated from high school & therapy, and then moved on to college.

When I was 21, I went on a suicide binge and made 3 attempts in 3 days (razor to a bigger vein, pills, and then MORE pills). I was hospitalized, put on suicide watch, and then released after 3 days because I didn’t have insurance. However, I thought I had finally learned my lesson. I really hurt and shocked my friends when I had the binge. I crushed my boyfriend at the time – his brother had committed suicide. I never told my family about it (they were on the other coast – it wasn’t hard to omit this little detail). I just told myself I could never harm myself again and I didn’t… for almost a whole decade.

During my respite from suicide attempts, I worked with a teen suicide prevention program, facilitated peer discussions on how to handle depression and thoughts of self-harm, and attended the funeral of a friend’s sister who had killed herself. Seeing the dazed & mourning throngs of family, friends, co-workers and loved ones at her memorial service reinforced my commitment to ignore the thoughts of self-harm that occasionally tormented my mind. Yet, I remember writing a letter to someone and telling them “once you’ve tried to commit suicide, it is always an option. It never leaves the table.” And there was the problem. Despite my many serious attempts and recoveries, I still thought suicide was an option. It was still a viable choice. I was still sick.

When I was 30, a year after the birth of my first son, in the raging throes of postpartum depression complicated by undiagnosed bipolar disorder, I considered my options and tried to kill myself again (pills). My son was beautiful, pure, happy, and healthy. My PPD/bipolar led me to think I was an unfit mother and needed to remove myself from his life so I didn’t ruin him. In a moment of clarity, I called 911 and they talked to my husband who had no idea why I was handing him the phone. I remember my husband holding our baby boy in one arm while dragging me into the ER with his other. I stayed in the psych ward for 4 days. The psychiatrist asked me if I was bipolar. I said no. I’d never been told I was bipolar so he treated me for depression and PTSD. In retrospect, I’m baffled by that conversation. Wasn’t it his job to tell me I was bipolar so I could get fixed? Oh, well.

My last attempt, my very last attempt, happened a year later. I was still struggling with PPD. I was taking anti-depressants and trying to find a therapist in our new town, but anti-depressants only worked for a little while and then I’d have to try a new one. That happens to bipolars, if only one pole is treated, the whole system goes into a tailspin. A month before my last attempt, I went on a long-acting birth control, which had hidden mood-destabilizing side effects and my tailspin turned into a tornado. I suffered a psychotic break. In my psychosis, the thought that guided every second of that break was that I was a terrible mother and would end up destroying my beloved son, he who is first in my heart, just as my mother destroyed me. I needed to die to make room for my husband to find another wife and mother for our child. Dying was the only truly maternal thing I could do for my son. If I really loved him, then I had to remove my damaged presence from his life. So said Psychotic Break.

My husband found me three hours after my attempt sitting in the garage with the car on & covered in vomit from the 100+ pills I had taken with a few glasses of wine. I was barely breathing and unconscious. When I was brought to the ER, they had to put me on life support; my husband was bewildered by all of the equipment attached to me.

“Why do you have her on all of this?” he asked as more tubes were stuck in my unconscious form.
“Her body is too tired to breathe. If we don’t put her on life support, she’ll die.”

I woke up in ICU a day later scared and confused. I had no idea WHY I had done what I had done. I did know that I had permanently damaged my husband and my friends. His anger was palpable. Their faces were drawn, saddened, angry and bewildered. Even though I survived my very lethal attempt, my marriage almost didn’t survive it.

After 4 days in the hospital, I was released because the crisis event was clearly over and the psychotic break had done its damage and left. Before I left the hospital, I actively applied for the Partial Hospitalization program they had. I was interviewed and accepted and began Partial a week and a half after my attempt. I was basically alone except for my friends - my amazing, loving, accepting friends. My husband took our son to his parents’ house where he could regroup and re-evaluate the danger his wife represented. During their absence, I worked my butt off to figure out what had happened to me, why it had happened, and how I could get fixed so it would never happen again.

The psychotic break caused by the medications I was taking as prescribed ended up being the turn signal for my life. While I attended Partial, dutifully taking notes & practicing the lessons in emotional intelligence I was learning, I connected with a therapist a few towns over and began seeing her twice a week in addition to the four 6-hour days I was spending at Partial. Getting well became my full-time job. The first time I met her, I came to the appointment with papers. I had written out my psychiatric history, my family tree, a timeline of the more pertinent events in my life, and a copy of a legally binding document I had drawn up a few days prior declaring to the state that I would never attempt to self-harm again – to do so would be perjury and punishable by law. I knew she needed my history as part of the intake, but I also told her it was my past and I wasn’t interested in rehashing my past. I wanted to start from Now and do whatever it took to get better. I had also been researching mental illnesses, taken several online assessment tests, compared them with my personal and family history, and told her that I thought I might be bipolar. I didn’t want to be bipolar, but I didn’t care about labels anymore, I just wanted to be well.

She agreed with my approach and, after talking with the psychiatrist at Partial, agreed my self-diagnosis. She actually showed me her notes from our first meeting. She had written “Bipolar?” on the top of the page. She and I set to work reprogramming my brain. It was she who figured out what caused my psychotic break. She practically leapt out of her chair when she discovered the medications I had been taking. “Of course you had a psychotic break! You were on an anti-depressant, which removes your inhibitions and falsely elevates your mood, and a long-acting birth control with mood destabilizing effects! I never ever let my patients take that birth control. You are not the only one who has attempted suicide after taking it. Furthermore, anti-depressants alone create chaos in bipolars. You need lithium and a mood-stabilizer as well to balance out your poles.” (
Note: lithium is often called the anti-suicide medication. There’s something in it that makes death from suicide three times less likely and suicide attempts two times less likely.)

And so my journey to Wellness began. It took 4-7 suicide attempts, 13 years in and out of therapy, and a psychotic break to figure out I was bipolar and therefore, treatable. My teenage reluctance to take meds was replaced by a determination to do and take whatever was needed to calm my inner chaos and earn back my husband and son. My diagnosis set me free. It wasn’t all peaches and cream, I struggled with my own prejudice against mental illness and I didn’t particularly enjoy med changes, but here I am 6 years later with my husband, my son, and our second child who is almost 4 years old. I manage my illness. I work hard to manage my illness. Early on I adopted a philosophy of constant vigilance. I do not let any self-defeating thought go by unchecked, I watch my sleep patterns, my moods, my level of energy, continuously looking for glitches in the Matrix that indicate possible mood changes. When I see mania or depression on the horizon, I take steps to prevent them from occurring. I’m not 100% effective, but my vigilance has averted or lessened many cycles. We teach our sons emotional intelligence and I’m open with them about how Mommy’s feelings get sick sometimes, but I take medicine that is sort of a vitamin for feelings, and I have a feelings doctor, and just like getting a cold isn’t anyone’s fault, it’s nobody’s fault when my feelings get sick.

Which brings me to my Reasons:

Visceral Reaction: my primary care doctor summoned me to his office a week after my last attempt. I went quaking in my sneakers. He came in the room and hugged me for several minutes while I snotted on his shoulder and promised I would never do that again. He told me that suicide is an act of self-murder. It is the murder of one’s soul. There is no afterlife when one has killed his or her own soul. His words rang true in my heart. I’ve never thought about suicide in the same way since. He also told me about his discussions with other patients about their depressions. “I ask them if they have thoughts of suicide and they say, ‘NO! Oh my goodness, I could never do that to my family!!’ It is a visceral reaction in them. You need to develop that same reaction.”

I have. I was almost there after surviving my suicidal psychotic break from reality, but I thought and thought about our conversation and gradually came to a point when I realized that, no, just because suicide was once an option for me, that option is no longer on the table. I find it spiritually abhorrent.

My family & My Friends: The aftermath of my psychotic break tore down all walls and revealed all truths, not just my own, but the walls and truths of everyone around me. The truths were equalizing in their revelation of commonalities in our humanity. The bonds that were forged as I obsessively recovered and retrained my brain are unbreakable. I watched the looks in their eyes go from fearful, devastated, and furious to accepting, willing, and embracing. I am so grateful that they stood by my side (some with conditions) and gave me the chance to prove myself. Not everyone with a chronic mental illness is so blessed – to both have loved ones like these and to know what a treasure they are. Our relationships are filled with joy & supportiveness and for once the balance is equal and I’m not sucking out everyone’s energy; I’m contributing lots of positive energy. On the days they struggle, I’m there. On the days I struggle (and bipolar makes sure I do every now and then), they are there for me, too. Balance.

Also, when someone commits suicide, they are spreading the myth that suicide is a viable, reasonable answer to overwhelming turmoil. Children of parents who commit suicide have a 500% greater chance of committing suicide themselves. I. Will. Not. Pass. On. Such. A. Fallacy. To. My. Sons.

Personal Responsibility: I don’t mean to sound all New Agey, but as I came out of my fugue state from my last attempt and realized the extent of the damage I caused, I clearly recognized that the Universe had given me another chance, maybe my last one, to Live. I felt a great debt to the Universe for giving me an opportunity that I wasn’t sure I deserved and I spend every day paying back that debt. I do it by writing, by mentoring others struggling with mental illness, by being available to the needs of my family and my friends, by taking care of myself and loving my soul and its connection with every other living thing. I pay back the debt by caring and advocating for the environment and all of its fantastic flora and fauna. I do something every single day to pay it forward and practice love, really practice the concept of love. Random acts of kindness, along with a lot of letter-writing to my congressional representatives urging them to take better care of the world and pass laws of love, not war and hatred, have become my specialty.

My best girlfriend, who has been my friend since before attempt #3, tells me my debt has been paid back in full, but I don’t ever want to stop paying it. I don’t want to become complacent and take Life for granted. I like feeling responsible for pulling my weight in this Universe; the more I give, the more I feel I belong. My soul belongs here with all of those I hold dear and with the dear ones I haven’t yet met, surrounded by the glorious beauty of Mother Earth. Yes, I know that sounds TOTALLY New Agey, however, knowing my soul belongs somewhere and that I am worthy of breathing the air I share with everyone else has given me a calm centeredness that eluded me back when I thought suicide was always an option. I belong because I want to belong, no one had to give me permission; I needed to embrace the life I was given, the hand I was dealt, and commit to walking on my Wellness Path without too much complaining.

I did give myself a gift as I recovered from bipolar chaos and suicidal ideation – I gave myself permission to be good enough. Letting go of ridiculous self-expectations of perfect parenting, of being an “ideal” wife, and of being just exquisitely flawless in general, freed my mind. As long as my kids know they are LOVED unconditionally and thoroughly, fed, watered, cared for, and cherished, I’m doing my job. Everything else is gravy. Not only is my husband my best friend, but he thinks of me as his best friend, too. Clean house and a hot dinner 5 days a week ? Gravy.

Life is good. I’m honored to be living it.

 


If you have a story you'd like to share with the Reasons Project, click on the link up top and follow their instructions. It's a very simple process, but I suggest being in a good mental space before you start writing. If you are able, please add your voice to Hope, Understanding, and the Scientific minds that are trying to put hope and understanding into quantifiable forms. You never know who you might help.

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Friday, June 19, 2009

June Morning Haiku



Coffee brews in time.
Sun rises on clean dishes.
Come back and spoon me.




Thursday, June 11, 2009

Two words




Two words: Kidney Stone.

See you tomorrow. Haiku should be interesting.


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