Swing Time

Resurrection!

noreply@blogger.com (Anonymous) — Mon, 25 Jul 2011 20:12:00 +0000

It's been two and a half years since I've written this blog. Why? Because at the time, I felt that writing about bipolar disorder was perhaps not a healthy thing for me to do.

I was wrong. Lately, with public figures displaying the sad symptoms of the disorder, I started thinking about Swing Time again. I had hidden it from public view and yesterday, I reopened it after writing my other blog, The Knitting Curmudgeon.

Throughout the past two years, I have been doing fairly well, although symptoms occasionally break through. Nonetheless, I'm functional, although working as a consultant makes me unemployed far too often.

My latest sadness is over the death of Amy Winehouse, the newest member of The 27 Club. What upsets me are the comments made from friends and the media: "Oh, no surprise!" If you do not have bipolar disorder, clinical depression, or addiction, it is hard to understand that these are brain disorders. As I always say, "PHYSICAL!" If Amy had suffered from a brain tumor and died from that, you know that there would have been far less "I knew this would happen" comments and a greater understanding. Cancer is socially acceptable. Amy, who wrote her hit song "Rehab", clearly denied her illness and addiction. Who let her down? When people are mentally messed up, they have to be hammered sometimes until they see the light. And sometimes, they do not, as Amy didn't.

Mental illness is still viewed as a personal weakness, even though TV is full of ads for Cymbalta (a hideous drug that I once took for less than two weeks and dumped), Seroquel (my lifesaver), and Abilify, amongst others. These drugs are not cures. There are no medicinal cures for addiction, for depression, for bipolar disorder, for schizophrenia, for personality disorders. There is nothing, although research does continue. Because BP and creativity walk hand-in-hand, the fear of losing creativity via medication is huge. I have taken medication for years and have never lost my creativity.

Addiction often arises due to self-medication. People drink and do drugs because they are mentally ill and need something to relieve their agony. As a commentator on CNN said today, addicts can't recover if they don't accept treatment. They don't because they are frightened, because they are convinced that rehab is more like prison and not a cure. Having worked with drug addicts and alcoholics in the past, when I was a psychiatric technician back in the '70s, I completely understand this attitude. Yes, society has failed addicts in many ways by pointing fingers at them and calling them "weak lunatics." Weakness has nothing to do with mental illness. Support from family, friends, and society means everything. But the epiphany of understanding and accepting your illness is the ultimate cure.

I remember when I had my epiphany during my one stay at a mental institution. If you want to get better, you have to face yourself, look at your life, and decide to accept help. It may be the hardest thing you've ever done. Fortunately, my bipolar disorder is not as severe as it could have been. My family and friends were always there for me. However, society still blackballs me. I don't tell my employers, obviously. The stigma of mental illness can ruin you professionally, even if you are successful at your job.

I have always reached out to fellow sufferers and have been told that this blog has helped a number of people. Although I am the Knitting Curmudgeon, I love to help others if I can. I've been through enough shit and worked my way out of it. If I can pass on my solutions, then I have contributed something good.

One day at a time is the true path. I take each day and stroll. I'll be back writing here anon. Stay well, take your meds, and remember that you can help yourself live a good life.

It's 2009. The Year of the Zyprexa Settlement.

noreply@blogger.com (Anonymous) — Fri, 16 Jan 2009 02:55:00 +0000

Been a long time since I've written a post for this blog. Work, a new romance, and the holidays have been at the forefront. But I'm well and happy, even during this miserable time of year for us bipolars. God, winter sucks and this one is just too damned cold so far.

I just read about the Zyprexa lawsuit settlement. I haven't been in touch much with bipolar news lately but having never taken this med, I think I let the news slip through my brain when the lawsuits were first filed.

I have a real problem with pharma companies, although I work as a consultant for one of them that makes only vaccines. The advertising on TV is obnoxious and frankly, often misleading. The ads for bipolar medication, such as Abilify, have one positive affect--they do help bring bipolar disorder into the mainstream, which "normalizes" it to some degree. As with the depression medications, depression became more acceptable as an illness once the drugs were advertized and celebrities such as Brooke Shields and others discussed their problems with it publicly.

Still, pushing drugs to be used in situations where they have not yet been proven useful or safe is unethical, to say the least. Yes, I take an anti-convulsant, Lamictal. However, there is much evidence these days that bipolar disorder is related to epilepsy. And God knows, for me it works. So at times, a little drug creativity done with thoughtfulness on the doctors' part may be beneficial.

But the question is, how deep is the love fest between the pharma companies and doctors? I know that my doctor hates the TV ads and refuses to be swayed by drug salespeople. He prescribes medication based on what he knows about psychotropic drugs, which is vast. Dr. B keeps up with them all. I hated the Cymbalta he put me on last November and I stopped it within a week, before I had taken enough so that I would have had to been weaned off of it. He was fine with that. As he says, I know how I feel better than he does.

Of course the drug companies are in it for the bucks. And with the economy nosediving, people can't afford to have their prescriptions filled and are stopping medications. It's time for the pharmaceutical companies to stop the bullshit, get a little more ethical, and realize that they could go the way of Detroit and Wall Street if they don't wise up. I'd be lost without my meds but I'm also concerned about the nature of this business. I'm not going to be some drug company's guinea pig, for sure.

When the Insidious Dark Mists Spread Their Vaporous Poison

noreply@blogger.com (Anonymous) — Mon, 17 Nov 2008 01:43:00 +0000

No matter how religiously I've taken my meds, sometimes a situation derails them.

My job, a continuous stressor, finally broke me into pieces. Pieces that screamed, cried, grasped out for help. A jigsaw puzzle of a human being, frantically trying to put Tab A into Slot B before the world swallowed her up.

Not in 13 years have I had such a depressive episode. Even the death of my husband almost 7 years ago didn't send me into this kind of tailspin. I ran to Dr. B in tears. He upped my meds and told me I had to step away from the job, for at least two weeks, or I would end up in the hospital. I leaned on Mim, my therapist. She reinforced what Dr. B said and told me I had to get out of the job. I couldn't face going on disability but the prospect seemed certain.

Drugged to the gills, with doubled Xanax, increased Lamictal, I sat in silence in my chair, knitting day after day, sleeping when groggy. And then, two special things happened. Two shining moments that cleared my head and my heart.

The first was a reconnection with a man whom I had gotten to know through a dating site and then pushed away, because I was afraid of being hurt again. But Jerry and I found each other again. I let him back in. And he made me laugh, night after night on the phone, and then in person a week ago. Funny, smart, caring. Just what I needed. He brought me roses, took me to lunch, we went for a long drive in the country, and then out to dinner. And he's called me almost every night, teasing me lovingly and making me happy. I'll see him tomorrow again and I can't wait.

The second wonderful moment was a call from a recruiter with whom I had had contact last January. This time, she had a perfect job offer for me with a pharmaceutical company, doing the technical writing and procedures analyses that I can do so well. A week and a half ago, they took me out to lunch for my interview, I managed to pull my ass together and smile and be personable. The two people, Rick and Katy, were incredibly nice and I'd be working with them. Three days later, they made me an offer. With more money than I've ever made in my life.

It's funny how my higher power works in mysterious ways and watches over me. I was close to losing my faith but when push comes to shove, if you hang on, life does get better. I've always believed that I have the strength to overcome whatever gets thrown in my face. Once again, I've pulled myself out of the well. But not without help from He who always loves me, my family, and my friends.

This disorder that we all share can be a curse to some. To me, it's the fount of my creativity and the life challenge that has built my character. When it threatens to take over, I take no prisoners. Ever.

Through a Glass Darkly

noreply@blogger.com (Anonymous) — Sat, 27 Sep 2008 05:43:00 +0000

That has always been a favorite of mine. Because being manic-depressive often means just that: Seeing life through a glass darkly.

It comes from the New Testament, specifically 1 Corinthians: 13. "For now we see through a glass darkly." Supposedly this actually refers to mirrors.

In the midst of a manic episode, I can oddly step outside of myself, an almost spiritual detachment, where I see the behavior and cannot stop it. This is generally when I put out the call for help and go to see Dr. B, which I did this past Wednesday. There's much to be said about the aura that precedes a manic episode. He compares it to an epileptic aura. I believe this to be true.

So, what are my manic episodes like? Not unlike driving a car with bald tires full tilt boogie down an unpaved country road, with my brain pounding like the engine's pistons. Thoughts flit here, there, around the top of my head, and then disappear, only to be replaced by more unconnected ideations. The only thing that will stop this racecar is a tree. Splat...

During a manic episode, there is much energy to be put into projects. Like a whirling dervish, I operate brilliantly (or so it seems at the time). I climb the peaks of performance, thrilling myself by peering over the dangerous precipice. If I willed it to be so, I could fly. I actually believed that as a child. As an adult, it takes on a more nuanced cloak. I fly, indeed, through my writings. You could say that my writing is my sanity keeper. As it has been for so many others.

Once I'm at the top of the peak, the paranoia sets in. People really don't like me and they're talking about me behind my back. I become frustrated, highly irritable, and with those very close to me, often verbally combative. My impulses are out of control. I get into the car at 1 a.m. and drive around aimlessly, waiting for the medication to work its magic. Sometimes it does, sometimes it doesn't. I'm hypersensitive to all things that touch me, both physically and existentially.

And then suddenly, I rappel rapidly down the slope.

Like a love-starved puppy, the inevitable depression begins to follow me, panting, a deluge of anxiety, sorrow, fear, and morbid thoughts. My world comes to a standstill. Yes, I can still work but I can no longer focus on minor details, so that work becomes the battle to stay intact. Somehow, I always manage, if barely. And hide the severity of my illness as best I can.

These are the warning signs that I've come to know and fear. As of this writing, I am on an increased medication dosaging schedule. Besides being ready to pass out from the extra Seroquel, I've had Xanax added to the cocktail. I will take it sparingly but it's there to help. And I have faith that I will once again overcome the demons that rage inside of my head.

If you are in the midst of what I call fighting the good fight, go back and read both of Kay Redfield Jamison's books--Touched with Fire and An Unquiet Mind. Jamison is my heroine and through her research and writing, she has done more to help me stay on the straight and narrow than any other writer.

Stay well, my friends. And keep fighting the good fight, side by side with me.

More on Baby Bipolars

noreply@blogger.com (Anonymous) — Thu, 18 Sep 2008 11:46:00 +0000

This past weekend, the New York Times Sunday Magazine featured an article on bipolar disorder in children. This remains a controversial issue but I'm very glad that it's getting increased publicity. Awareness leads to solutions, eventually.

Whether or not these children are in fact bipolar is moot. The fact remains that they have distinct behavioral problems, as I did as a child. I frequently had rages, temper tantrums, acted impulsively, and was then branded as a "naughty little girl." Of course, that was the '50s. When child psychiatry was virtually unknown and certainly not known to my parents.

In the meanwhile, as a rapidly aging bipolar, there has been more research on my age group, 50+. The disorder does not get better with age, that's for sure. However, staying on medication will actually improve your brain, apparently. Fine with me. Although I don't always like the fuzziness my meds cause, I've found that with a little extra effort, I can overcome it.

I'd like to hear from over-50 bipolars. Do you find that your disorder has worsened? Are your manic periods more out of control? I do see that I have to have my meds monitored far more closely than when I was younger. It would appear that their effectiveness wanes much faster than previously. That's simply my observation of my own situation. I have been going through yet another dysphoric period, so Dr. B will see me next week for a review. Fortunately, my dosages are on the low side, so we have plenty of room to play.

Dysphoria Rears Its Very Ugly Head

noreply@blogger.com (Anonymous) — Sat, 06 Sep 2008 21:10:00 +0000

When I say I'm cranky, that's part and parcel of being manic depressive. It's the double-edged sword. Dysphoria. Not depression. Two different things entirely. Dysphoria is that part of mania that's not fun. It's savage, nasty, and destructive. The polar (pardon the pun) opposite of euphoria.

Today I had a major brain seizure. I saw something on someone else's blog that set me off and I immediately went to town on this woman. I thought she had "stolen" something from my blog, The Knitting Curmudgeon. Um, no. But when I'm in the throes of a dysphoric episode, I can't see anything but red. Bright, bloody red.

When Dr. B told me that bipolar disorder is a seizure of the brain last year, I realized how right he was. Right before I go off the wall, I can feel the pressure in the back of my head. My brain is malfunctioning. You'd think at this point I'd be able to stop myself when this happens.

I didn't. I just went right on and ran my mouth. Fortunately for me, the object of my ire was gracious and understanding. However, I'm sure I left a big bad taste in her mouth. When I "came to my senses," as it were, I was bowled over as to what I had just done. And tried to make amends. I hope I have.

My loving gatekeeper, N, was out today, going on a job interview. He called me from the road and immediately said, "What's wrong, sweetie?" He always knows. And when I explained to him what happened, he told me he had thought I was a bit crabby this morning before he left. I hadn't seen that at all but looking back, he's right. I wish he had said something then but he was running late for his interview and didn't really have the time.

It's time for a medication review, for sure. With the fall coming and the "Danger Zone" of the shorter days, I need to see Dr. B this week before this spirals into something worse. Managing the disorder is always a full-time job but I believe that everyone needs a gatekeeper, someone who knows them well enough to put the kibosh on bad behavior.

N is that person. And I love him for it. I'm feeling better now. But that doesn't mean shit. The dysphoria is back and I'll give it a run for its money.

Life, Death, and Hope

noreply@blogger.com (Anonymous) — Mon, 28 Jul 2008 00:37:00 +0000

I can't imagine that anyone has not now heard about Randy Pausch. I recall hearing about his "Last Lecture" when he first gave it. With his death, it is making the rounds again. I had forgotten how much it affected me. If you have not seen it, here it is for you to view.

His gift to all of us. Whenever I feel depressed, from now on it will be required viewing. I heard tell that his words stopped some people from offing themselves. It's carpe diem writ large.

Thank you, Randy. Dying well is as important as living well. They should be one and the same.

For Irene and Katherine

noreply@blogger.com (Anonymous) — Mon, 30 Jun 2008 01:48:00 +0000

Irene and Katherine,
May this always be the place where you feel free to vent and rant, where you know that someone wants to hear you. I hear you and my heart bleeds for you both.

My oldest daughter has suffered from depression and sought treatment without my badgering her. My younger daughter's first husband was an abusive alcoholic, probably bipolar. Her second husband is bipolar and controlled on meds--he's a real sweetheart. I cannot imagine the excruciating pain that you both live with.

If I ever make a little difference for someone in writing about my struggle with manic depression, then I've fulfilled my promise to myself. When I had my come-to-Jesus moment in the hospital back in 1995, I knew that if I accepted my disorder for what it was, I'd fight for myself tooth and nail. I'd fight against the stigma of mental illness. I'd demand the care that I needed. Your children were victims of our dismal mental health system. We should all fight for those who do not get the care that they need.

You can write as much as you want in my Comments. I would rather see you do that and feel perhaps a little momentary relief because you've opened up and told your story to me and those readers who have walked the walk.

I say that to you all. This is not just my blog--it's yours, as is The Knitting Curmudgeon. I treasure my readers of both and I want to hear those voices, be they in pain or in happiness. Got it? Good. May the higher power guide you to peace.

Jammin' It Down Your Throat

noreply@blogger.com (Anonymous) — Sat, 28 Jun 2008 03:44:00 +0000

Now, you may find this very amusing. I know I do. Did you know that I was a psychiatric technician from 1973 to 1982? Yeah. I worked at a county institution, mostly because in 1973 I had a 4-year-old and a 1-year-old who needed their mommy during the day, so I worked the evening shift while my husband watched them.

No "it takes one to know one" jokes. Even though it's true. I began on the med/surg ward, worked there for about a year, learned to pour medication, give subcutaneous and intramuscular injections (nonprofessionals could do this in New Jersey at that time), and learned firsthand about death and insanity. The things I saw are forever a part of my consciousness and I hope I never forget them.

When I transferred to the short-term 30-day crisis intervention ward, it was there that I met people who were manic depressive. Amazing people, too. An opera singer, a sculptor, a writer, several seductive drug addicts who had immense charm and an unbelievable capacity for self-destruction. All of them brilliant and all of them in the desperate throes of the disorder. We'd all sit and talk for hours. I was their caretaker but they became my friends too. Little did I realize that we had an awful lot in common.

Their mania or depression very often triggered mine, although I was too lost in maintaining bare survival to recognize my own illness. And what was worse? A friend from high school, Becky, was brought into the ward screaming, out of control, trying to climb the barred windows. She was placed in seclusion immediately. And committed. Because I knew her, I was recused from caring for her. But I watched helplessly as she disintegrated mentally. It took five months of commitment before Becky was more or less stabilized. Mostly less but they let her out.

Back then, commitment was fairly simple. You went to your commitment hearing and two doctors had to pronounce you a danger to yourself or others in front of a judge. Then you got the old 60-day commitment order. You couldn't leave and you were forced to take the medication, even if it had to be administered via a shot in the butt.

Then came the public advocates and everything changed. Not for the better, either. Patients now had rights. They could refuse treatment, no matter what. So began the deinstitutionalization of our mental health hospitals. And out the patients went, all too often with no place to go, since their families were sick of dealing with them.

The question then and the question now is, when you are that mentally ill, do you have the right to refuse treatment?

This is a terribly hard moral dilemma. On the one hand, people with manic depression or schizophrenia can be helped with medication. On the other hand, forcing people to swallow pills and spend their days in straight jackets so they won't harm themselves seems to be enormously cruel.

It's not. As someone who has been off the wall crazy and shoved into a hospital against her will, I honestly thank God that I was forced to face my disorder and deal with it. Trust me, I was a hard sell. Maybe in my next post I'll tell you the story. It's in its way funny but also dead-on serious.

I was close to commitment but they didn't go through with it because in actuality, I was not suicidal but rather having suicidal ideations. Now, sometimes those can lead to the real thing but my history was ideations rather than actions, so they let me off the hook. To a point. I wanted to sign myself out but the doctor informed me that if I went out AMA (against medical advice), he'd get me commited. Yikes. I stayed.

When your sense of mental balance is so incredibly warped and out of control, you can't be capable of making sane decisions. Your brain is fucked up. You need someone to support you and maybe sit on you so that you take your meds and do what you need to do to get better.

This doesn't work in many cases. Trying to force someone who's off the wall to take meds is frequently a no-win deal for both sides. But I do believe that anyone that sick can't help themselves. I know I couldn't, when I was at that point. I will be forever grateful to that doctor at Fair Oaks who didn't give into me and made me take what I needed and face my demons.

Incidentally, I saw my high school friend Becky at my 40th reunion last weekend. I could have cried. She barely recognized me and I could see the madness in her eyes. Her hair was done in weird little braids, she wore a dress that was somewhat strange, and a mutual friend of ours, who is a nurse, was staying with her the whole evening. Lisa, the nurse, told me that Becky was very fragile and she was afraid that Becky might act out. She didn't but I could tell she was agitated.

It was then that I realized what I've probably known all along. There are striking degrees of manic depression. Even though I am diagnosed as bipolar I, I am what is known as a high-functioning manic depressive. I haven't been back to the hospital since that time, through the grace of God. I am blessed. I can function, even though it's a daily battle. Becky cannot. And clearly, all the commitments she went through, all the medication she's taken over the years, have brought her scant relief. I grieve for those for whom nothing works. But I don't know if commitment is the right answer or not.

Baby Bipolars

noreply@blogger.com (Anonymous) — Thu, 05 Jun 2008 03:07:00 +0000

Last week, Newsweek had a very interesting cover article on childhood bipolar disorder. A condition that evidently is discounted by many so-called medical experts.

I was most certainly a bipolar child. Perhaps not as severely bipolar as the young boy in the article, whose behavior is so out of control that he frightens his parents, his teacher, his schoolmates, everyone around him. A child who wishes to kill himself? Absolutely. I know. I was that child.

I was "trouble" from the moment I was born. In fact, before I was born, since my mother was in labor with me for almost three days. Once I popped out, I then made her life a living hell with colic, screaming, not sleeping, and generally driving her to a nervous breakdown. She and my father temporarily moved to her parents' house because she could not cope with me. They stayed for three months until I "settled down."

As Mom always says, I didn't learn to walk. I ran. Into walls. Literally. And at 18 months, I perpetrated the first of many "stunts" (quotes are all my mother's). While she was on the phone, I climbed up onto the stove, turned on all the burners and plopped myself in the middle. Stunt #1 was a doozy. Out of control already.

Then, at 3, I pushed an old lady in a wheelchair down a hill at the Forest Hills Tennis Club. My mother was sitting on a bench, talking to her friend Joyce, Joyce's daughter Vivian was not interested in playing with me because she was 5 and much too sophisticated. So I was bored. And saw the old lady, whose nurse was also talking to a friend, and decided she was bored too. So I hopped onto the back of the wheelchair, released the brake, and down the hill we went, with her screaming. Yes, I do remember doing this, very clearly.

Besides impulsive actions, which my mother dealt with by literally leashing me so that I wouldn't run away, I had terrible temper tantrums. Constantly. These seem to have started when I was around 3, or at least, that's as far back as I remember. I would be overtaken by uncontrollable rage, and would throw myself onto the ground screaming. I had to be physically restrained so that I wouldn't hurt myself.

So I was a "bad" little girl, at least to some of my family members. My maternal grandmother was the only one who gave me unconditional love, who saw that I wasn't bad at all. And I rarely had mood swings when I was with Grandma. She was a calming, loving influence. My paternal grandmother, a dour German woman who had her own mental health issues, would chase me around with a stick, yelling that she was a witch who would cook me and eat me. Crazy Hansel und Gretel time. I despised her.

Once in school, it became worse. I couldn't sit still, I fidgeted constantly. My handwriting was illegible because I simply had not advanced enough neurologically to be able to control a pencil. However, in 1958, in second grade, I was considered sloppy and lazy, with my teacher torturing me with handwriting exercises that I could not do.

Throughout the rest of my childhood, I was always being reined in. And I remember lying in my bed at night, depressed, wishing I could die, because I just wasn't good enough and I couldn't seem to make myself better. I had no self-esteem. To give my mother credit, she realized it. However, back in the '50s, a mentally ill child was simply trouble. End of story.

Recently, my friend Marcia, who I've known since elementary school, said to me, "I thought you got sick when your dad died." No, that's when the disorder finally blossomed to the point that I became seriously ill.

I was 17 when my father died of stomach cancer. He was probably bipolar too, a man of great generosity, joie de vivre, and one of the finest impulse spenders I've ever known. But I adored him and his death at 43 was devastating for me. I did not know how to grieve. A week before Daddy died, my brother Rich and I were summoned to his bedroom, where he told us that we should be like Spartans, keep a stiff upper lip, because he was going to die.

We had not been told his illness was fatal. In fact, although we realized Daddy wasn't getting better, it never occurred to us at 13 and 17, that he was dying. Until that day.

Thereafter, my descent into madness, as the novelists like to call it, was rapid. And for many more years, it became a nightmare from which I thought I would never awaken.

So yes. There is such a thing as childhood bipolar disorder. I know. I was one of many children whose mental illness was defined as being a bad kid. There are no bad kids. Just kids who need help. So let's not push them away. Let's take care of our bipolar children. Because it is a REAL disorder.

Getting What YOU Need

noreply@blogger.com (Anonymous) — Sat, 24 May 2008 11:52:00 +0000

It's been awhile since I last posted. Why? Because my life has been a maelstrom of work. And although I've have been taking my meds religiously, the stress of travel, of doing the work of two people, and the inability to focus on myself and my mental health needs, are taking their toll. I fear the slippage back into the maelstrom of illness.

This morning I went to an AA meeting with my friend N. I go sometimes with him, although I am not an alcoholic. I have, however, a very addictive personality, as I have discussed in previous entries, and this week, while waiting for hours in an airport trying to get home, I could feel the pull of oxycodone, my drug of choice. Oh, how I wanted the chemically induced sense of wellbeing, the high that allowed me to stop caring about myself and anything else.

During the meeting, listening to members' stories of their struggles, I realized that every day is a struggle for me too. No, I don't drink, although I came damned close to becoming an alcoholic years ago. And I stopped drinking completely. Big deal. I switched to oxy. Then there was a real problem. One that I somehow managed to overcome without a group because it never occurred to me that I could go to one. Hey, I didn't need the support of a group. So wrong. So very wrong.

What hit me hard this morning was my failure to take care of myself. Yes, I'm taking the meds. No, I'm not getting what I need nor am I making it so. All I can do these days is work myself into a greater danger of becoming ill. And that ends today, thanks to the AA members this morning, and N in particular. When I go off the beaten path, he takes me, shakes me, and tells me to take care of ME. As I do for him, when he sails off into depression.

It's so easy to ignore this disorder that we all share. Yeah, take some pills and you're managing. It doesn't stop there. We have a disease of the brain, one that never can be cured. But it can be managed with smarts. From now on, I will say no to those demands that will cause me to go over the edge. That means that I will insist that my health and wellbeing come before any job requirement.

I missed both my therapy and psychiatrist appointments this past week. Why? Because I put work before my health. A lesson learned. This will never happen again. And if the company doesn't like it, they can kiss my ass. Because they aren't going to help me stay well. I am.

As a reminder, this is Mental Health Month. If you know of someone who needs help, don't be afraid to say that to them. Send them to the links I have in the sidebar. And don't ever let go of them. Love them, listen to them, hug them, and know that they can fight the good fight, with help. And if it's you who has the disorder, please take good care of yourself. Because if nothing else, I care about you, as well as myself. We're all in this together, so let's be good to US.

Mental Health Parity Pared

noreply@blogger.com (Anonymous) — Fri, 11 Apr 2008 19:22:00 +0000

Long time, no write. I've been well, but overwhelmed by work. Must slow down the stress factor because as you all know, stress is ill advised when you suffer from a mental disorder. In fact, stress is ill advised no matter who or what your state of health.

I've been meaning to write on this topic because it's an important one to all of us who either live with mental health problems or have someone you love who's dealing with it. The Mental Health Parity Act, an amended version of the 1996 Act, was passed by Congress in early March. What does this mean for us? Well, for some of us, nothing. The 1996 Act provided enough wiggle room for insurers to limit benefits. They simply limited the number of visits to a psychiatrist or therapist, and upped the copays. Perfectly legal, then. The 2008 Act, which languished in Congress for way too long, has problems.

Did you know that if you are employed in a company of less than 50 people, the Act does not apply to you? Or if you are self-insured? Forget it, you're fucked.

My company employs less than 20 people, at least in the US division. I'm limited to 30 visits a year to my therapist and my psychiatrist. Fortunately, I can get along with that because my bipolar disorder is now well managed and my meds are working for me. But what happens to those who are having acute episodes of mania, psychosis, depression? Those who cannot be covered by the Act, with 30 visits, pretty much the standard, are still discriminated against. This must stop. The only way is a national health care plan that treats everyone equally.

I see this as a civil rights issue. Indeed, who among us have not felt the sting of the stigma attached to mental illness, who have been treated as an inferior specimen of the species, and now, treated unfairly by the government. Again. We have to fight for equal coverage for EVERYONE. I'm sure the Senate is collectively patting itself on the back for a job well done. It was not. If everyone is not included, then it remains a discriminatory piece of legislation.

With an administration that is contemptuous of everything, including this, we'll just have to wait for the change that I know is coming. In the meanwhile, the fight continues.

Crazy Love, Crazy Talk

noreply@blogger.com (Anonymous) — Sun, 27 Jan 2008 00:26:00 +0000

You know, I'm beginning to understand the value of talk therapy. Very much.

OK, so I always had a 'tude about therapy in general. "I don't fucking need to talk to no steenkin' shrink."

Wrong. So wrong. I'm almost ashamed to say that while I would pop the pills the shrink gave me, that's all the cooperation I'd give. Yeah, I'll take the pills and be done with it. For a long time, that's how I saw it. And that's why my treatment was really half-assed. Because I wouldn't open up, to anyone. I kept my dark manic secrets to myself, completely. Nobody, not even my husband, knew some of the things I did and thought.

I inhaled Oxycodone, while keeping my addiction a secret. I spent money and hid it from my husband. I went out and did wild things in the flush of mania. And then, I'd come down. Nobody knew what drove me to depression. I did and I hugged it tightly. I suffered through the horrors of Oxy withdrawal because I was too full of myself to seek help. I wasn't giving up my nasties to anyone. In fact, they were my blankie. I'm a BAD GIRL and I should punish myself for my sins by torturing my psyche. Jesus, how pathetic.

And then, along came my best friend, N, who is a recovering alcoholic, which is why I do not name him. He's known the depths of despair, the misery of life, and the epiphany that one needs to have when you hit rock bottom, whether it's through alcohol abuse, substance abuse, or the agony of mental illness.

When we first met, N told me up front that he was a recovering alcoholic. I, in turn, told him that I was bipolar. And knew then that here was the first person I had ever met with whom I could unabashedly and without any reserve talk about the awful things I had done in the past. He would never pass judgment on me, nor I on him. I would trust him with my life and I hope he would trust me with his.

I started talk therapy again six weeks ago. This time, I went with an open mind, checked my ego at the front desk, and gave myself completely to my therapist, Mim. One of her initial questions during that first therapy session was, "Who's your gatekeeper?"

Huh? What dat? "It's the person who knows you the best, who can tell you when you're getting off balance, the person in your life in whom you can confide" says Mim. Oh. I didn't hesitate with my answer. Yes, I knew immediately. N. He's as sensitive as I am, so he knows when I'm out of kilter right away. "Boy, you're AWFULLY snippy this morning." And he's always right about my moods. (Of course, it works both ways--I sure know when he's out of sorts, too.)

Between N and Mim, I've begun to see the light. For the past two Saturdays, I've gone with my beloved friend to his AA meetings. And today, I had yet another mini epiphany.

It's good to be with people who understand your illness, who've been there themselves. It's past good. It's wonderful. And where I always pooh-poohed group therapy, I now see its value. The group supports, the group loves, the group knows. Although my addiction was to a different medium, as it were, addiction is what it is. Often, it's self-medication to mute the sadness, the insecurity, the agitation. But the lesson I have learned from attending these meetings is that when I open my heart, nobody's going to thrust the stiletto into it.

Tonight, before I began writing this entry, I went to the Depression and Bipolar Support Alliance site to make contact with the East Stroudsburg support group. I will continue to go with N to his meetings, because I love him and I want to support and understand him always, but I will also go to my meetings too. And with an open heart, an open mind, and a giving soul. That's the guidance I've received from my Higher Power.

So stop. Look. Listen. And keep yourself open to all possibilities. You'll benefit endlessly. Life is filled with these epiphanies, if you let life happen to you.

Seizure the Day

noreply@blogger.com (Anonymous) — Thu, 03 Jan 2008 23:06:00 +0000

I must say, I am tremendously thrilled with my new pdoc, Dr. B. Any doctor who would willingly give you an hour's worth of his time (and who is a wonderful listener) is a gem.

And he made a few things about bipolar disorder completely clear, stuff that had me a little confused. This guy is the first doctor who's answered my questions in a direct manner. Perhaps my questions and his responses will help you. Or at least, leave you a little better informed.

Mar's Question 1: Why was I initially diagnosed as bipolar II and then 10 years later, rediagnosed as bipolar I?

Dr. B's Answer: Because sometimes the nature of the disorder changes. Maybe originally you were more depressed and had very few incidents of rapid cycling and mania, hence the diagnosis of bipolar II. Then as the years went by, you became more manic, with dysphoria rather than euphoria, and rapid cycling. This would indicate bipolar I.

Mar's Question 2: What's the connection between bipolar disorder and epilepsy? And why do anticonvulsants seem to work so well?

Dr. B's Answer: Bipolar disorder is really a seizure of the brain rather than the body, which is what epilepsy is. Both types of seizures respond well to anticonvulsants. When you are manic, your brain seizes up and you are subject to impulsiveness, delusions, bad judgment calls, paranoia, anger, and all the things that indicate mania. The anticonvulsant helps to stop that activity and allows the brain to work properly.

Mar's Question 3: I think I finally understand that I must stay on my medication for the rest of my life. But is that really true? Will I ever be able to go off of my meds?

Dr. B's Answer: Yes, it's true. And no, you should never go off your medication. It is believed that multiple episodes of the disorder cause brain damage. Your cognitive abilities become impaired. Without medication, the brain will sustain more damage as you grow older. The medication not only allows you to function but may in fact help repair some of the damage already there.

I left his office feeling more and more comforted that I have a neurological disorder, one that can be controlled. Even though I've always espoused this, there have been times after a particularly bad episode that I've doubted it. When your brain goes haywire, it's hard not to blame yourself rather than the disorder.

Case in point, regarding anticonvulsants being of enormous value in controlling these brain seizures. Last week, I had a terrifying episode, where I could actually feel my brain seize up. It happened while I was driving and suddenly, I felt almost suicidal. I began crying. I felt incoherent. Somehow, I got home safely but suddenly, I felt a wave of sheer anger overtake me, anger directed at a dear, beloved friend and companion. I wrote an angry email but somehow had the sense not to send it. I then hand wrote a note to him, the note being rather incoherent and vague.

Now, I'm on medication but fortunately, I can take an extra Seroquel or two if this happens. Which is exactly what I did. Within a half hour, I was OK. This time, I understood exactly what was going on, whereas before, I'd just get worse and worse until suddenly I felt better.

The next time I seize up, I'll know exactly how my brain felt from the previous episode and maybe I can nip it in the bud. The path to understanding this disorder is becoming less and less ambiguous. Thank God.

A Time to Cry, A Time to Rejoice

noreply@blogger.com (Anonymous) — Mon, 24 Dec 2007 19:19:00 +0000

Christmas can be an awfully lousy time for those of us with mood swings, particularly if we're alone, have had a bad year, lost someone close to us, or we're just plain not controlled on meds.

I had a horrible Christmas last year. Alone on Christmas and New Year's Eves. Continuously in tears, wondering why I couldn't seem to find anyone to share the season with. My friends all had significant others and were busy with them. My kids, ditto. So I was left alone to stare at the TV and wonder why I was even bothering to stay alive.

It seemed such a waste of everyone's time, especially mine.

And then, on New Year's Eve, I sat spinning some yarn, my usual meditative activity. The moods were unstable, to say the least. However, I managed to regain some equilibrium from the rhythmic motion of the wheel. And suddenly, the joy erupted in my soul. No, it wasn't a manic swing. It was the realization that my higher power had given me skilled hands with which to work and give myself pleasure. That I was alive, I could have hope again, and that I was strong enough to overcome whatever blew my way.

After that, I felt comfortable in my skin. I focused on spinning and the overt sadness went away. Focus is everything, especially focus away from self. Too much is not good, as is too little. Balance is everything.

This year, as I was driving home to East Stroudsburg to get some shopping done, I found myself once again meditating, this time in the car. I had some wonderful Christmas music on, music that reminded me of my childhood growing up in a German family, with all the tradition. And how much I loved Christmas then...and now. I saw the face of my Grandma, laughing and carrying presents into our house. Grandpa, with his little smile, eating a piece of crumbcake and letting me pick off the crumbs. My brother, playing with his new Mattel Ack-Ack gun, which he guarded with his life. Oma and Opa and Aunt Helga, coming with bags and bags of toys from FAO Schwarz. Dad cooking the traditional goose on Christmas Eve and then reading Dickens's A Christmas Carol to us.

And then, I saw the smiling, excited faces of my girls when they were little, jumping up and down, begging to open presents while their father dawdled in the bathroom.

So many memories. So many people in my life gone--Grandma, Grandpa, Oma, Opa, Helga, Daddy, my husband. And countless people who made an impact on my life and are now wisps of memory.

I cried a little tear or two for the ones I remember. And smiled a big smile. Because no matter how hard my life has been, there has always been remarkable people surrounding me, then and especially now.

May you have a peaceful Christmas.

Doped Up and Ready to Rock

noreply@blogger.com (Anonymous) — Sun, 02 Dec 2007 06:57:00 +0000

Well, after a fashion. Slowly but surely, I'm coming out of my last, awful bout of dysphoria. I'm hooked up with more Seroquel and a new therapist who is absolutely fantastic. It may seem as if I've been doing the right thing in my pursuit to manage my disorder all along, but one thing that has finally hit home: I need the talk therapy, especially right now. It's enormously important and helpful. Someone truly objective, who listens.

Sue asked some very good questions: Does it matter which types of medications you are subscribed? Do some work and others not? And does it make a difference if you see a regular medical doctor or a psychiatrist?

Um, yes to all. There are a number of medications out on the market for manic depressives: Lithium, the first real medication for the disorder, Tegretol, Seroquel, Lamictil, Depokote, Abilify, Klonopin. These are the most commonly prescribed. Does it matter what you take? No, if it works. And yes, some help more than others, depending upon your individual physiology. Often, it takes time to find the right mix. But you have to be commited to finding that mix and to try what you need to try.

And then, some people never get enough relief from medication. It's a sad truth, but one that must be faced. There are cases of manic depression that are so bad, not much helps. Some bipolars often would rather self-medicate with alcohol, blow, heroin, and whatever than face up to the reality that their health is in their hands. It takes a hell of a lot less energy to do the illicit or the Liquor Store Shuffle than get yourself into a proper care program. It also takes an epiphany about your illness, something that may or may not happen.

Often, medications don't "work" because the bipolar doesn't take them according to directions, stops them as soon as they feel better. We've all been guilty of this, including me. "Oh, I feel great! Don't need no steenking pills." Wrong. My epiphany continues to this day. The first epiphany was in 1995, when I accepted my disorder for what it was. When I understood that my healing must come from within and that there is a higher power than my ego, I was able to submit to the treatment I needed, including admitting to things I had done when manic, much of which I was ashamed of. The second epiphany came when I understood that I will have to take medication for the rest of my life for this. Big deal. As my mother pointed out, look at all the pills she has to take at 84. As ever, she was the voice of reason that I needed to hear. Along with my pdoc's

Seeing a medical doctor, such as your primary care physician, and hoping that's all you need to do is foolish. First of all, most responsible MDs will refer you to a psychiatrist or a behavioral clinic. Psychiatrists understand all the ramifications of psychotropic drugs. MDs can help you with your upper respiratory infection. You wouldn't see a shrink for your chest congestion, would you? Or your bad back? You'd see an orthopedist or chiropractor for that.

Is there hope? Absolutely. Every day, more and more is learned about this disorder. It affects so many people--an estimated 5+ million Americans suffer from it.

When Friends Slide Over the Edge

noreply@blogger.com (Anonymous) — Wed, 21 Nov 2007 02:50:00 +0000

Thanks to Sue from Kannsass for this topic. What can you do for friends who are clearly suffering from depression, mania, or whatever mental illness manifestation?

You want to help but how? Your friend has withdrawn to the point that it's interfering with their life or is so out of control whacked out that you can no longer ignore the behavior. Well, not being a mental health professional but someone who has dealt with a sibling who suffers from depression, here's how I handled it.

First of all, tell the person that you love them. That's it. Don't talk any further, just hold them, give them physical reassurance. That goes a long, long way, especially for depressed people. I know myself that when I have been depressed, having someone who just gave me a loving hug did enormous good.

This can loosen up the toughest cases, I think. Once you feel that the person is receptive--you've built trust with the physical contact--then tell them that you are concerned (not worried, don't use that word) about how they feel and that you will support them in any way possible. You want the person to feel positively about getting help. Don't condemn, don't shame, don't get frustrated with their lack of response, even though it's often hard to avoid these feelings when dealing with the mentally ill. Understanding is huge in getting people to face their illness.

However, if the person is completely over the edge and incapable of making a sane decision, it's time to intervene.

If the person is actively suicidal, do not pass Go, do not collect $200. Contact a family member, if you are a friend, and emphasize the seriousness of the situation. Often the family members are the last to know how ill your friend really is. It is a life and death matter, no drama intended. If your friend has no one, call 911 or the local crisis intervention center, and get them hospitalized. Immediately. Don't be afraid of overstepping the boundaries. This person is no longer responsible for their actions.

Suicidal people can hide their intentions quite well, especially if they are bound and determined to off themselves. I know, having worked in a psychiatric hospital, that oftentimes, there are signs so subtle that even professionals miss them. If this is the case, ultimately the person will be successful and kill themselves, with little warning to those close to them. And therein lies the hideous tragedy--those left behind berate and torture themselves for not having "saved" their loved one. Sometimes, you just can't save someone from themselves. They have to have a glimmer of insight in order to pull themselves up from their depths and get the help they need.

Mania is another kettle of fish entirely. People in a severe manic state can do really dangerous, off-the-wall stuff, especially when the condition is severe. Grandiosity is a key symptom, as is paranoia. If your friend is convinced that they need to go to a casino with their life savings because they know they'll win big, you may or may not be able to talk them out of it.

Manics don't listen well. So the best you can do is gently but firmly suggest to the manic friend that their behavior is inappropriate and could cause them a lot of trouble. Their behavior. Not them. Don't say "You are crazy and you'd better stop this right now!" A more effective way of addressing it would be, "You know, your behavior lately has been pretty reckless. I'm concerned that your actions might get you into big trouble. Is there anything that might help? Can I help?"

By and large, helping someone who is in the throes of mental illness can be at best tricky. You can do what you can, but in the long run, the person who is ill either will accept their illness on their own and get help, or they'll be committed to a hospital. Either way, as a friend, just love them, listen, and be there. If you do that, you're a true friend.

Finally, don't be afraid to ask a mental health professional for some guidance for you. In fact, I would do that without hesitation. Because living with and loving someone who suffers from a mental disorder can be a strain on those who are the support system.

Please, Sir, I Want Some More...Seroquel. And No, I Don't Drink. Really.

noreply@blogger.com (Anonymous) — Fri, 16 Nov 2007 01:48:00 +0000

I was gobsmacked at the response to the Blog Resurrection. Here I'm thinking that I'm being rather self-indulgent and possibly borderline whiney about doing Swing Time again.

Maybe not. Right now, I'm not the best judge of whether I'm "normal" (or Abby Normal, as we say in my family, with credit to Mel Brooks).

Thanks to Matthew for telling me about the new Crazy Meds link. As you can see, I've been redesigning the blog (easier to read, no?) and I'll be putting the old resource links back up. And Ann, you were so right to let Martin's family know what the deal was.

Guzzle. Ralph. Thump.
Well, one thing I've discovered in my psychiatric travels is that manic depressives are often alcoholics. Self-medicating, dontcha know. Recently, when seeing the crisis intervention pdoc, he gave me a sideways look when I told him that I don't drink. I don't. Here's why.

I had a short but seriously heavy guzzle season back in the mid '90s, when I was a hot-shit NYC editor with a big, fat ego, and I managed to drink my way through many Chelsea bars with my drinking pal, Steve, another editor.

And then after finding myself puking in the Hoboken train station at 1 a.m. one too many times, I stopped drinking altogether. Because yeah, it runs in the family, that alcoholism thing. I was one step away from it, no question.

Previously to that little incident, I was addicted to Oxycodone, due to a painful cervical disk condition. My Dr. Feelgood was an orthopedist who later lost his license to practice medicine because he loved to write prescriptions that were at best questionable. I remember that the first time he examined me, he asked me this: "What kind of drugs do you like?"

Well, what did I know? So he got me hooked on Oxy. Now, mind you, this was in the early '90s, when the Oxy problem was not publicized, and all of us addicts had little trouble getting snockered. Boy, I loved the high I got. It acted in lieu of the psychotropic medication I should have been taking.

So the neck gets better--but now I'm craving the Oxy, its splendiferous high that makes the psychic pain, anxiety, and mania calm down. So I keep telling him it hurts and he keeps giving me happiness and sunshine in pill form. And if I ran out and couldn't get to the office, he very kindly put the Rx in an envelope and taped it to the office door. Because you know, these drugs can't be called in to your local CVS.

I finally realized that I was addicted. And went cold turkey. A nightmare, about which I never spoke about. Not to friends, not to family. I did it alone.

And then it was the alcohol, which happened about four years later. You would think, having been on Oxy and then having to kick it, I would have avoided drinking. Who says addicts are smart people?

The final chapter--hospitalization in 1995, with a diagnosis of bipolar II. It's been changed to bipolar I but I'm not sure that means shit. Take your pick. And during that hospitalization, the pdocs put me into an AA meeting because they didn't believe me when I said I didn't drink. I stood up in the meeting and said, "My name is Marilyn and I'm bipolar. And I don't belong here because I'm not an alcoholic." Since then, I've met several recovering alcoholics who suggested that maybe I did belong there. Because having kicked one addiction made me ripe for another.

I suspect that having an addictive personality and being bipolar go hand in hand. Hey, it's cheap and easy to drink to medicate. These days, I've wised up. And get myself to a pdoc rather than immerse myself in something far more dangerous than taking Seroquel and Lamictal.

A Year and a Few Tears Later

noreply@blogger.com (Anonymous) — Sat, 10 Nov 2007 13:58:00 +0000

I stopped writing this blog because I felt that perhaps writing about one's illness might be counterproductive and overly self-involved.

But I was wrong. It is, in fact, productive, and while somewhat self-involved, can put out into the light something that can help other people who suffer from bipolar disorder.

So here we go again.

Rather than dump bipolar stuff on my knitting blog, this is a far better venue. I dislike mixing the two, actually. Manic depression and knitting don't necessarily go together, although I find my color choices often hooked into my mood. Not exactly a revolutionary theory but rather one of a series of epiphanies that I've had about being bipolar.

You know how it is. You read something, it doesn't connect with your state of mind, and then three months later, you go, "Oh, right. That's me."

Now coming out of a nasty bout of dysphoria, I started to think that perhaps keeping this blog alive would add to my need for advocacy.

Let's ride. Not over the edge but backing away from it.

How I Know When The Bell Tolls

noreply@blogger.com (Anonymous) — Sun, 09 Jul 2006 00:37:00 +0000

Lately, it's been creeping up on me. That something's-not-right feeling. And then it starts. The anxiety attacks, the sleep difficulties, the sadness, the mild grandiosity, the up and down and up and down of a mixed state and rapid cycling.

Time for a med re-evaluation. I have a feeling that perhaps lithium is not doing the job. I'm at the right level and it seems to me that it is not taking care of the manic dysphoria that I am seeing once again.

When I was last diagnosed two years ago, as bipolar I, my psychiatrist felt that my dysphoric mania had pushed me from II to I. I believe he was right. And since I began with hypomania back in 1995, clearly the disorder is worse. Still manageable but unquestionably more serious.

I did a search on Google so that I could read what was out there about dysphoric mania. And I came upon something at About.com that really made me think. I'd like to share it with you.

The standard propaganda about bipolar is that it is the result of a chemical imbalance in the brain, a physical condition not unlike diabetes. For the purposes of gaining acceptance in society, most people with bipolar seem to go along with this blatant half-truth.

True, a chemical storm is raging in the brain, but the analogy to the one taking place in the diabetic's pancreas is totally misleading. Unlike diabetes and other physical diseases, bipolar defines who we are, from the way we perceive colors and listen to music to how we taste our food. We don't HAVE bipolar. We ARE bipolar, for both better and worse.

In one way, it's akin to being God's chosen people. As God's chosen - the (un)lucky one or two percent of the population - we are prime candidates for God's wrath, but even as God strikes the final blow - as the old Jewish saying goes - he provides the eventual healing. In a way that only God can understand, God has bestowed on us a great blessing. Living with this blessing is both a challenge and a terrible burden, but in the end we hope to emerge from this ordeal as better people, more compassionate toward our fellow beings and just a little bit closer to God.

For some reason, I found this incredibly uplifting. I'm not religious--spiritual, certainly, but I don't Jesus-shout. Nonetheless, I am guilty of comparing bipolar to diabetes with those who do not have the disorder. I so want people to understand it and I am so tired of the stigma.

I am bipolar. I will never again compare it to diabetes. And despite the struggle, I would never accept a cure that would make me any less than myself.

So I'll be calling the doctor on Monday to make an appointment as soon as I can. Because this thing just don't quit.

The Kiss of Death

noreply@blogger.com (Anonymous) — Sat, 01 Jul 2006 00:29:00 +0000

So, who do you tell about your disorder? And when?

I don't have a good answer for that because even though I tend to be quite up front about it, there are times when less is more and I don't disclose.

At least, not right away. And perhaps in dribs and drabs. Or maybe never.

When you've finally found out that you're bipolar, it's often such a relief to know that your behavior is to some degree quantifiable that you really want to tell everyone. "Hey, remember the time I spent $5,000 on diamond hairclips? Well, now I know why!"

I generally have a pretty good sense of who I can trust to understand. But I certainly don't wear my disorder on my sleeve for everyone to see.

For example, my boss, who is a wonderful person and someone who I consider a friend, knows, even though I've known her for a short time. She's a diabetic and understands that manic depression, like diabetes, is an imbalance. In the short time she's known me, she knows that I am a damned good editor and writer, that she can depend on me to get the job done, and that I never whine when the going gets tough.

My last boss, who was a clueless dork, never got it, even when I was grimly hanging onto my job during a particularly bad siege of side effects. He simply did not understand that medication could cause me to lose my sharpness and could not accept that I missed details due to a reaction to an increase in dosage. He just thought I didn't give a shit. When I finally explained to him that I took this medicine because I had a chemical imbalance and that I was manic depressive, all the good work I had done was worth nothing to him. He only cared that he wasn't getting what he wanted, not that I was struggling.

But bosses notwithstanding, there are other people with whom you may want to be careful. If you're single and dating, do you tell the boyfriend or girlfriend? That really depends on where you are in the relationship. If you've been dating only a very short time, say a couple of months, I'd say hold off until you know if it's solid enough.

Sooner or later, you have to say something, though. And it's taking a huge chance because you just don't know how people will react, really. My feeling has always been, if he doesn't like it, he wasn't worth it anyway.

However, understand this--people who do not have any mental health problems often do not know how to handle us when we're careening over the edge, be it with mania or depression. Erratic behavior, constant crises, anger issues and all the other baggage that comes with manic depression can be extraordinarily wearing on the other person. I know that in the 32 years I was married, I often drove my late husband, the epitome of patience, right to the brink before I was diagnosed and medicated. But we worked through it together and he developed an amazing understanding of the disorder for someone who never had a screwy day in his life. But he was the exception rather than the rule.

So weigh your odds carefully. Be honest when you can but don't spill the beans before you know the terrain.

The Children's Hour

noreply@blogger.com (Anonymous) — Sat, 10 Jun 2006 23:41:00 +0000

How do you handle a family member who's potentially bipolar?

Not with kid gloves, that's for sure. Although I've been accused by daughter #1 of seeing bipolars under every bush, the fact remains that this is a hereditary illness, whether it's been proven scientifically or not.

That said, it runs rampant in my family. Virtually everyone has had something, whether it's been full-blown manic depression or clinical depression. So there have been sessions throughout the years where one family member has been talked to about their particular (or peculiar, if you like) brand of mental illness.

I recently had yet another family sit-down, this time with my youngest daughter, who is exhibiting some signs of bipolar and has, like her mother, been a pro at hiding them until she did something quite destructive. To me, with whom she is very close.

Approaching someone about their behavior is possibly one of the most difficult things any family can do, even if they've been there themselves. If the person is doing something destructive, it has to be stopped. And I found myself in the same position my late husband must have been in when I was at my manic worst.

My brother and I confronted my mother about her alchoholism many years ago. We didn't tiptoe around it, either. We simply told her that we loved her but that her drinking was destroying her relationship with us and we wanted it to stop. She did, and hasn't had a drink since then.

Telling someone that you love them but you hate their behavior is the way to go, always. You can never judge the person but you certainly can judge the behavior. And if you find yourself dealing with a family member, that's the way to go. You may not get through to the person the first time around. It may take more than one confrontation to get them into therapy or whatever it is they need to do. But if you don't try, you are then part of the problem.

Sometimes you will be successful. More often than not, you will be unsuccessful. Because in the final analysis, the person who is ill must recognize it themselves. But if you don't bring it to their attention, they may never know. It's that insidious.

So if you've been avoiding talking to a loved one, stop putting it off and do it. They may or may not listen. But at least you've given it a shot.

To Anti-Depressant or Not...That Might Be the Question

noreply@blogger.com (Anonymous) — Sun, 23 Apr 2006 00:07:00 +0000

Jeez, I haven't posted anything to this blog since February 26th. Little wonder, too, since it was about that time that I was waiting to hear about my new job, which I did get and am fully into now. It's good. I'm well.

Thanks, Matt, for writing about your questions on other kinds of bipolar. It seems to me that it's the kind of disorder that doesn't necessarily fall into one or two buckets. And yes, there are more than just I and II--there are other types as well, making it damned difficult to figure out what you might be.

I also went the same route as you. Depression and anxiety with a large ladleful of insomnia were my prominent symptoms. Or at least the symptoms I told the doctor about. I didn't realize that overspending, crabbiness and other things were "symptoms." Until much later.

The problem for those of us who do suffer more from depression than mania is that the psychiatrists can't always tell what kind of bipolar we are, if in fact we are. I find that Paxil has helped me considerably, even though it may tip my scales a little towards mania. I've found that I function better a bit on the manic side but I have to watch myself closely. Certainly, both depression and mania can be destructive.

It sounds to me as if you are very aware of how you function. That's a good thing. As for information regarding other types of manic depression, there are a few. There are the two major forms, I and II, along with rapid cycling, which happens to women more than men and is defined as having four or more episodes of mania or depression within a year. I am a rapid cycler. NIHM is a pretty good resource for info. Here's what they say about another flavor:

In some people, however, symptoms of mania and depression may occur together in what is called a mixed bipolar state. Symptoms of a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. A person may have a very sad, hopeless mood while at the same time feeling extremely energized.

As far as all the types of manic depression that have been identified, probably the ultimate resource is the DSM-IV, which is used by psychiatrists to diagnose mental illness. Lacking that, there are many good books out on the market and I would encourage you to check into some of them. I did a list of my favorites in a previous post; however, I'm looking into two books right now: The Bipolar Disorder Survival Guide: What You and Your Family Need to Know and Bipolar Disorder for Dummies (I swear to God!). I'll let everyone know if they're worthwhile after I read them.

I read a lot, in any case. And I made it a point to read as much as I could get my hands on about manic depression. The internet is a great resource but having some books on the subject will give you much more information.

So welcome to the club, Matt. It's a good club, really. Because as the Church Lady said, we're "speshul." And I'll start writing more frequently, now that I seem to be adjusted to my new job. Plus, I don't need to put pictures up on this one, which means I can just type. Heh.

Taking My Time

noreply@blogger.com (Anonymous) — Sun, 26 Feb 2006 17:14:00 +0000

It's been a while since I posted an entry to this blog and to be honest, if it weren't for my friend Carol encouraging me to continue, I was seriously thinking about giving it up.

Why? Because there's something in me that says it's not all that healthy to write constantly about your illness. This could be interpreted two ways: First, as avoidance or second, as a sign of health. After all, if you're really mentally healthy, why would you want to keep dredging up the subject?

It would seem that a number of people have benefited by my discussion. And maybe I've benefited, too. So I'll keep writing, when the spirit moves me. It may not be on a regular basis but if nothing else, people use the links.

One of the last comments asked a few pertinent questions that I'll try to answer:

Mar tell us what it feels like when you take your meds. Does it makes you feel sedated? antsy? Why is it so common to stop taking them when a person does so much better on them. How long after you stop taking them do you begin to once again slip back into manic or depression. If you had a teenager would you sit on top of them until they took their medication for the day? Will you listen to someone telling you that you're not on your meds, or do you resent someone trying to direct your?

When I take the right combination of medication, I feel OK. When I went back on medication more than a year ago, it was a bitch. I had terrible tremors, I would fall asleep at any time, which made driving very dicey, and I couldn't focus on my work at all. It took a bit of doing and adjusting but now I'm fine. The anxiety is gone, the depression and mania are kept at bay, and I can still write, knit, spin, whatever.

People generally stop taking medication because they feel good. Duh. It's the medication that makes it so. I stopped my medication only once, in June of 2001. And it was not because I really wanted to or felt that I was "cured." It was a financial decision. My psychiatrist no longer took insurance at all, so I had to leave her. I couldn't afford the $180 a session. My primary care physician refused to continue my medication. So I went off meds. And stayed off for more than three years. During that time, my husband became ill and died, leaving me with no money and a big mortgage. I had to sell the house we built together and move. And still, I managed to stay balanced. I have no idea how.

However, in November of 2004, I again became extremely dysphoric, as is my tendency at this time in my life. Bad crying jags, extreme irritiblity accompanied by anxiety. It's sometimes hard to differentiate between dysphoria, a type of mania, and depression. However, with a true depression, it's very difficult to do anything. With dysphoria, you can still function, get up, go to work and so on. So back I went on meds. I was fortunate to find out that UMDNJ had a center not too far from my work that would take insurance. I didn't need anyone to tell me I needed to go back on meds. I know that better than anyone else.

Slipping back into depression or mania or both happen quickly or, in my case, slowly. It's a crapshoot. Everyone's different. The thing is, you are playing Russian Roulette if you go off your medication. Sure, you might not feel anything right away. But depression and mania are insidious and they can sneak up on ya before you know it.

As far as kids taking their meds, that's one I've never had to deal with. I think that rather than making medication a point of contention, I would work with my child so that they understood exactly how important medication is. And that's not easy either, especially with teenagers. The bottom line: You can't force anyone to take anything, be they adults or teenagers. It has to come from within. And if you force the issue, it becomes worse. Bipolar children are a special case, one that warrants specialized handling.

I do listen if someone says I need to be back on meds. Actually, I know it before it's apparent to my family. In fact, generally they don't have a clue because I tend to keep my behavior steady in public. It's in private that I don't do too well.

I think it's a good thing to feel someone out before suggesting that they need medication. Rather than say, "You need some drugs, your behavior is ridiculous," I think a better approach would be "Don't you think you'd feel better if you saw the doctor and see what s/he can do for you?" People with mental illness respond badly to demands, especially manic depressives.

However, everyone responds to love and caring. No matter how off the wall they are.

Have you ever stayed up 48 hours straight? No, but I did 60 once.

noreply@blogger.com (Anonymous) — Tue, 07 Feb 2006 19:45:00 +0000

I've been thinking a lot about Birdie's comment the past week. She asked: can you tell me how you personally proceeded to receive help? You know, that initial step?

I didn't think I was at all sick until 1994, when I was 44. All the years of depressive and manic phases were nicely hidden from all but my husband. My first severe depression was about three months after my father's death, when I was 17 and a senior in high school. My mother was dealing with her own grief and was drifting into alcoholism, so she really didn't notice that I was skipping classes to stay in bed. My grades went downhill but at that point, I was already accepted into college.

My first manic episode began in October of my freshman year of college. I met a guy at a frat party at another college and we proceeded to have a wild affair, with me living in his room most of the time. That ended and I went back to my boyfriend, whom I married a few months later because I got pregnant.

Nice, huh? A real happy story so far. Terrible pre- and postpartum depression, when I tried to cut my wrists, landed me in therapy with a friend of my mother, a woman who had no bona fides other than she had counseled a lot of people in lifestyle management. She was no doctor and therefore, although I benefited greatly from her advice and help, did not see the deeper problem of manic-depression.

For the next 20 years, I managed to be a decent mother and wife, work hard and advance my career from a psychiatric technician (another great story I'll have to tell sometime) to the point where I became an editor without the benefit of a degree. But all along, there were continuous bouts of mania and depression. I don't know how I controlled their severity but I was always good at talking sane and thinking crazy.

One day, my husband Jimmy came home from a visit to the doctor and handed me a pamphlet on manic-depression. "I dunno, honey. This sounds an awful lot like you."

I read it and I realized he was right. Still, it took another two years and a terrible depression, one that I couldn't control, to make me desperate enough to call the local hospital and ask for names of psychiatrists. That's what made me call. I just couldn't stand living such a shadow life, with the ups and downs.

Once I was under care, it took my psychiatrist two years to make a firm diagnosis of bipolar I because I neglected to discuss my spending sprees and my out-of-control rage with her. I was better than I had been, simply because the depression was under control. However, a dysphoric manic episode convinced her that there was much more to the story.

It's critical that you tell the psychiatrist everything. I didn't, and it was the reason I was not diagnosed faster. I was afraid of appearing less than perfect. I was embarrassed that a person of my intelligence would do stupid things such as spend money I didn't have and run my mouth when I should have controlled it.

Psychiatrists have heard just about everything. You won't be judged for your behavior. Your behavior is the one symptom you have that will help the doctor make a diagnosis. And even then, it's not that easy. But taking the first step and calling is the biggest one. Once you've done that, you've started to participate in your wellness.