Tuesday, February 28, 2017

10 Ways I Manage to Keep Going With Bipolar Disorder

Living with bipolar disorder isn't easy. I have ten rules that I have to keep me going when I'm struggling with bipolar depression, but there are times when those ten rules are not enough to keep you afloat.

I recently discovered that, since I had an epic relapse and had a rather serious near miss with a suicide attempt, and scared the numerous people who care so much about me. I realized that my original ten rules are great, but they are truly lacking when I start to go downhill and find myself in a crisis situation. So I have discovered that I have a new set of rules for crisis management, and I think they are also great for preventing crises as well.

1. Don't stop taking your meds! I think this could be my only rule and the end of this article, honestly, because if I hadn't quit my meds, the rest of these rules probably wouldn't be necessary. This is a common problem for many people with bipolar disorder usually because of side effects, or because people feel better and think they don't need the medication anymore. This was my first mistake. I stopped taking my best line of defense because I was feeling insecure about my weight, even though I was doing phenomenally mood-wise. I know not to quit my meds usually, but I was just so tired of feeling hopeless about my size. This leads me to rule number two.

2. If you are going to quit your meds, at least do it with the doctor's blessing. I saw my doctor and talked to him a couple weeks before my attempt, and he understood my frustration with my medication side effects, and was supportive of me doing a trial run of being off my meds as long as I had a game plan in place if I became unstable. The problem was, I'd been off my meds for several weeks before I got my doctor's blessing, and was already spiraling downhill, only I didn't see the signs in myself. I couldn't be honest with my doctor because I wasn't seeing the signs in myself.

3. Utilize your support system! I did not utilize my support system at all correctly during the last 6 weeks leading up to my attempt. I talked to my therapist about quitting my meds, so she knew, but my husband didn't know I'd quit them until the week I started to really go downhill. I think if he'd known earlier, he could have pointed out the warning signs of my instability to me sooner, and I probably would have never pushed my doctor so hard to stay off my meds even longer. My husband is the one who encouraged me to go back on them ASAP, thankfully, but by then it was just too late for much to be done. I didn't call my doctor when I started spiraling downhill to see what he could suggest as emergency options. I didn't reach out to my friends for support, I just isolated myself more and more and got worse and worse.

4. Don't shut your therapist out. I shut down and stopped working with my therapist for a couple weeks before my attempt. I knew something was getting to me, and I was feeling more and more down, but I couldn't express what it was exactly, and instead of telling her that, I just put on a show and pretended everything was fine. Part of my biggest problem the last couple of weeks beforehand was that we were going to start a new therapy approach that I was absolutely terrified of doing, and I didn't voice just how scared of it I was, and it was stressing me right out. That, mixed with work stresses, and home life, really got me down. I did try reaching out a couple of times in the days leading up to my attempt, but I denied feeling suicidal right up until I sent her my final text saying goodbye. Not such a smart idea.

5.  Accept that if you send goodbye texts to people, you're probably going to be admitted to a psych ward, and embrace it for what it is; an opportunity to get help. There's no shame in getting treatment. Repeat that mantra over and over to yourself, especially if you're having a hard time coming to terms with possibly being 'labeled'. Labels aren't always a bad thing. I'm lots of labels. Mom, Wife. Teacher. Advocate. Writer. Storyteller. Bipolar. Unfortunately, I didn't use my first three days there to my advantage, I was too angry at the world, and too despondent about my life to really appreciate the therapy groups available to me. It took a lot of patience on the nurses' and therapists' part for me to come out of that bitter shell and start working on me to get myself in a good place and feeling better.

6. Recognize that treatment doesn't end after the crisis has passed and you're relatively stable again. You're going to need aftercare. A good doctor and a therapist is going to be crucial to keeping you stable. You might even need more than just a good therapist and doctor (preferably a psychiatrist if you've got a serious mental illness, in my humble opinion). Using me as an example, this has been my fourth hospital stay in the last 2 years. I've made lots of progress, but I've finally realized that I'm not progressing enough with what I'm doing when I get out of the hospital.  I've decided to do IOP, which is intensive outpatient treatment, meaning I'll be doing group therapy as well as a education group 3 times a week for 3 hours a day for 6 weeks, in addition to meeting with my individual counselor once a week.

7. Practice self compassion. This is so important. I made a lot of mistakes. I burned some bridges with this last crisis. Thankfully those bridges were built with something stronger than wood, and I was able to extinguish the fires rather quickly, but I hate letting people down. I broke a lot of my original rules for staying stable that could have probably kept me out of the hospital in the first place, like getting enough sleep, leaning on my support system, doing the have to's, not the want to's, among others. That all being said, I'm still trying really hard to tell myself that I'm good enough. Eleanor Roosevelt once said "No one can make you feel inferior without your consent", and that includes yourself. I'm not giving myself permission to beat myself up.

I wish I had a silver bullet for dealing with bipolar disorder. I wish I could say that doing all of this is cake, and since I could say ' Since I can do it, you can too'! No one in their right mind is going to say that to someone living with bipolar disorder though. It is truly hard on everyone involved. Everyone who cares about you doesn't want to see you suffering, they want to see you thriving. And if even one of these rules I have for myself can help just one person, then I'll have not suffered all this for naught, and I'll have considered my time spent learning these rules the hard way time well spent. 

Tuesday, February 21, 2017

What doctors fail to tell you about bipolar disorder

What does the DSM V say about bipolar disorder? 

It says many things, like you must have at least 3 behaviors from a list of symptoms in mania, lasting a week or longer. It says you must have 5 behaviors from a list of symptoms for depression lasting 2 weeks or longer. These behaviors include a markedly diminished  diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day with depression, and an inflated self-esteem or grandiosity (ranges from uncritical self-confidence to a delusional sense of expertise) for mania. 

So once you've displayed these behaviors, you're diagnosed and treated. The doctors tell you side effects of medications, and how often to take the meds, but they rarely explain what your diagnosis means, perhaps offering you a handout on bipolar disorder, or advising you to check a reputable website. 

That's all well and good, but they don't tell you what to really expect with your disorder. 

They rarely tell you that mania doesn't always look like a euphoric high, that it can look like your worst nightmare with major irritability and lashing out to loved ones, and you not knowing why. 

They don't tell you that you can have mixed episodes, which is a mixture of depression and mania. 

They don't tell you that the minimal effects like weight gain or drowsiness affect more people than usual, and are real and life altering. For example drowsiness is a side effect of Seroquel, and it doesn't just make me tired, it turns me into a non-functioning zombie for days at a time.

They don't tell you that there's no silver bullet when it comes to meds, that rarely what you try first will work. That you'll be paying medication roulette until you find the right combo. That's right combo, it's not often that you're only put on one medication to control your symptoms. 

Nowhere is it mentioned that you might miss your highs, and struggle to stay medication compliant because your creativity is gone and you hate it. 

This sounds gloomy af, I know, but there are benefits to being bipolar that they don't tell you. 

They don't tell you that you're joining the ranks of awesome people, like Carrie Fisher, Vincent Van Gogh, Catherine Zeta-Jones, Russell Brand, and Demi Lovato - oh, and myself. 

They don't tell you just how awesome it can be to finally have a name for what you're going through.

They don't tell you how wonderful a night of sleep can be once you're on the right dose of medications. 

They don't tell you how wonderful life can be once you're free of the demons in your head that are ruining your life. 

They don't tell you that being bipolar is not a death sentence, that you can live and thrive with it, no matter how you feel at the time of diagnosis. 

They don't tell you that there is hope of recovery, and remission of your symptoms. Well, maybe they do tell you that, but you might have missed it, reeling from everything else they told you. And, it never hurts to be reminded of that. 

So those are some things that your doctor might not mention. 

It never hurts to do your homework and research your diagnosis, because knowledge is power. The more informed you are as a patient, the best advocate you can be for yourself. And that's really the best thing a person with any illness can be. 

Tuesday, February 14, 2017

Loving someone with bipolar disorder

How do you love with someone with bipolar disorder?

It's hard af.

I struggle to love me, and I have bipolar disorder.

I've got friends who love me though. I asked them what makes me so appealing, and they had some surprising answers,

One of my friends told me she loves me because I'm funny, I'm creative, and I'm kind. She loves me because I genuinely want to do good in the world.

My other friend had similar answers; I'm funny, honest, and compassionate.

I was once told that even though I'm a difficult person, there's still something innately likeable about me, and well, my friends' answers prove that's true.

My daughter loves me because she relates to the mood swings, and understands when I'm struggling.

My husband shows his love for me by being kind, compassionate, and understanding.

What does that compassion look like?

He knows I love Robert Downey, Jr, so when I'm in a funk, he'll turn on movies with him in it. I just recently watched Sherlock Holmes, and snuggling my husband and enjoying the movie really helped me know I'm loved.  He forces me to talk when I want nothing more than to clam up. He takes me out on dates when I want to curl up in bed and sulk, He surprises me with trips for just the two of us, to help me get out of my head, and to have something to look forward to.

So loving a person with bipolar disorder isn't easy. We're unpredictable, there's a chance we might hurt you when we're hurting too. I inadvertently hurt a good friend of mine with my last suicide attempt, and I'm having to suffer the consequences of that right now. But I'm still innately likeable. I'm still a good person, even though I do have mood swings, even though I have rages, even though I cry and sulk.

I also delight in making people happy, and serving others. And people see that about me.

I'm loved because I'm quirky.

So to love a person with bipolar disorder, you have to be willing to be hurt, you have to take a chance, You have to be prepared to roll with the punches (not literally, I hope). But there are so many good sides to loving a person with it. We're usually quite creative, and can help you get your house beautified, or help you with a DIY project you're stuck on, We can chatter your ear off for hours, and yet we can also turn around and listen when you need someone to lean on too.

Loving someone with bipolar disorder is chancy, and can be scary, but the person behind the disorder is usually worth the trouble. Like an ogre, (and an onion), there are layers to a person. And peeling back the layers and starting to love someone with bipolar disorder is a beautiful thing.

Like people say, if it's difficult, it's usually worth it. And a friendship with someone with mental illness can be difficult, but is so worth it. 

Tuesday, February 7, 2017

What is Mania Like?

I think many people relate to depression. Lots of people have been sad before. Many people have fallen into the dark pit of despair and managed to climb out of it. But I don't think people really have a grasp of what mania is like.

Mania is incredible. Mania is destructive. Mania is the highest high of your life, yet it's also a cliff and you just jumped off into the abyss.

People think mania is just happiness, giddiness, and euphoria. While those emotion can happen at the beginning, it doesn't stay that way.

Mania also includes psychosis, grandiosity, and delusions.

The less commonly noticed symptoms include less need for sleep, rapid speech, inflated self esteem, poor concentration, racing thoughts, risky behaviors, and excessive energy.

I've suffered from mania, and I've done incredible things while manic. I have created amazing things, yet while in the throes of mania, I've destroyed relationships.

You become another person while manic. You're high, you feel like you can control the world, you're going to accomplish great things. You become delusional, and can't see reason anymore.

You might feel like creating an online business and spend your life savings buying things for it. Or you might decide you need a brand new wardrobe for the new you. You might decide your partner isn't enough sexually, and go on the prowl for a new one. Or you might just become promiscuous when you're usually not.

The worst thing about mania, is the hypo-manic phase, when you truly are amazing. When you can still listen to reason, when you feel on top of the world, and you have ideas that are brilliant. This phase usually doesn't last long, and before you know it, you're into full blown mania.

And then there's the crash. It usually feels like you've literally hit a brick wall going 100 mph. You might wake up in the psych ward, you might wake up on the streets, you might not wake up at all. But it's there, and there's usually the deep depression that follows, where you're in a shame spiral because of all the incredible things you did while manic.

I remember the last manic episode I had, I was convinced I was going to start a jewelry making business, and sell my wares to my friends. I bought necklaces, and lockets, and trinkets with money I really didn't have. I was obsessed. I was crazed. I was fixated on this one thing. I felt amazing. I was in control. Until I wasn't. I couldn't tend my kids because I'd flown into psychosis, and wanted to kill myself because I wasn't a size 6 anymore. I was barely holding onto reality, and it was terrifying. I finally went to my doctor sobbing that I needed help, and I was admitted to the hospital.

I know a lot of my bipolar friends miss the mania, and struggle with medication compliance because of that. I miss the hypo-mania, but not enough to risk full blown mania. It's fun for awhile, but it becomes horrific very quickly.

Mania is an uncontrolled beast that resides inside every bipolar person (well, bipolar I person), and it is something that will never be tamed, at least, not without proper medication and therapy, IMHO.

So although there is some 'fun' included in mania, it's doesn't stay grins and giggles, which is an excellent reason to try and keep it tamed. Even when it's hard because you miss the euphoria, you have to remember that it's not just that, there's also usually a side of remorse and embarrassment included with it.