So some real talk about Mental Health and Bipolar Disorder

CW: Suicide attempts and ideation

So some real talk about Mental Health and Bipolar Disorder:

I get more suicidal ideation while manic or in mixed states than when I am depressed. Don’t get me wrong suicidal ideation visits me while depressed but I am more likely to act on it while in a manic rage.

My last suicide attempt happened thus. I was in a mixed state, but the main emotion I was feeling when I got in the car in a closed garage and turned on the ignition was anger.

I have been suffering my most severe manic swing in years for the past couple weeks, and I went there again today. I was enraged and making a plan. It involved either stopping taking my medication which is keeping my immune system from up and killing me, or taking all my medication at once (It probably counts in the hundreds of pills and probably would have taken an hour to ingest them all).

Moved by the Force or His Gods a dear friend checked in on me right after my plan gelled in my head. I did not tell him I was suicidal when he contacted me, but his love for me walked me back from the edge. At the end of the conversation, I did tell him and told him he probably saved my life.

Living with chronic illness has me despondent quite often, there is a very good chance that it will kill me sooner than later, but it won’t kill me today. And neither will my mental illness. Not today. Here that, God of Death? Not today.

The state of my condition

I am something like 30 months stable. This has never happened since my mental illness first started to manifest in earnest in adolescence. My usual pattern of severe episodes is usually 18 months apart on the outside, either something life-wrecking, life-endangering, or needing hospitalizations.
 
I joked last night with a friend that maybe my brain has taken a break from trying to kill me because my immune system is doing such a good job at it (I am currently battling interstitial lung disease likely due to an autoimmune disorder). But I am grateful for the stability. Can you imagine me being in an episode and not being able to breathe right?
 
For a long time, I have felt like I was sitting under the Sword of Damocles just waiting for the next episode to happen, and when it became overdue, the anxiety increased. But I no longer feel that way. I think for the first time in 32 years my illness is well managed and I am not at risk.
 
But it is times like this that I need to be careful not to fall into Bipolar Pitfall #1 which is “Oh I am doing so well, I guess I don’t need my meds.”
One of the symptoms of an imminent episode, however, has begun to manifest, I am crying easily.  Crying at media I am watching or reading.  I just cried reading Quora answers.  Usually, this meant that my emotional control was slipping a bit.  But I have to wonder if I am not just now more emotionally open and aware and that my propensity to cry is more being in touch with deep emotional awareness rather than some lapse of emotional regulation.
For the most part, I am hopeful.  But I can’t be complacent in the management of my illness especially since I am doing so well.

I don’t think this is you

“I don’t think this is you.  This is your pathology, not your personality.”

 

This was told to me by a psychiatrist when I was going through a particularly rough patch, and my behavior was less than stellar.  The thing with mental illness is that our symptoms are not just seen as something apart from us.  The way mental illness manifests, is that it affects the very way we think and feel, the way we perceive the world around us, and the actions we take.

Sometimes corrections a person who is mentally healthy can take are actually impossible for a person with mental illness.  Then there is the added stigma of that if we were just “better”  more compliant with our treatment, or choosing different treatment that our illness would be better mitigated.

 

Being mentally ill is not something we “do” to other people, but unlike many other illnesses, it can get a bit messy, and affect not only we who are suffering, but affect those around us as well.  I don’t know how to avoid this.  And the longer that we do manage to hold things together the more it seems like a betrayal when things finally go off the wheels.

 

Mental illness is damaging.   It destroys one’s careers, one’s relationships, one’s perceptions, thoughts, and emotions.  In my case, any mitigation is always ephemeral. Sooner or later, it will become evident that I am ill.  Things will be done that are out of character for me, but they will still be me doing it.  While I get dissociated and see my pathology take the driver’s seat while my personality is taken along like a passenger.

 

Mental Illness is a hell of a thing.

Origin Story

This was from a poetry prompt in a group I am in and decided to share here.

Origin Story:

I’m five. I am under a table and crying during recess.
The pretty girl tries to comfort me with words that are not comforting at all.
It is the first time I cry in a classroom but not the last.

My school career is punctuated with extreme emotions.
I get help that is no help at all.
I continue to cry in classrooms, while teachers and principals try to explain to my peers why this happens. I don’t hear the words.

Before long school is interrupted, not with crying but with hospitalizations.
I’m given medicine that is not medicine at all.
I’m given gifts of comic books, and discover four-color passion.

I am no longer in school, but I still cry.

When my illness feels close to the surface

Most days, under treatment, the symptoms of my mental illness can be mitigated.  My symptoms are always there, but some days they are further from the surface than others.  Today is not one of those days.  I feel very aware today that I am mentally ill. It makes me feel fragile somewhat.

Treatment even at its very best is imperfect. And my current treatment regimen is far from ideal.

I always try to do the best with what I got, and not see myself in competition with those around me, but right now I can’t help but see how deficient I am compared to folk who do not suffer as I or others do.

Part of this itching feeling of my illness being so close to the surface has made me more aware and sensitive to stigmatization of mental illness.  Deficiencies in mental health seem to be constant fodder for jokes about how crazy or insane someone is, or off handed comments about someone being off their meds.  When I am feeling more well, I can more easily brush these things off, but on days like today, they hurt.  They seem to cut deeper than most days. Where someone can apply a label in jest, there is nowhere I can go where I am not mentally ill.

Mental Illness in the Magic Kingdom

009

They call it the Happiest Place on Earth for a reason.  Within the span of a week, I have found myself in a psychiatric hospital after a suicide attempt for five days, then a few days later five days at Disneyland, in Anaheim California.

This is not the first time this sequence of events has happened.  When I was a teenager in 1987 I went from a psychiatric hospital to Disneyland in a span of days.

During my medicine respite in 2014,  I self-medicated with pixie-dust. My fiancee and I made frequent trips to the theme park which we jokingly called Disney Therapy.

I have had my medicine adjusted recently during my hospital stay, and am no longer suicidal, however suicidal ideation (and attempts) are just one of many symptoms of my mental illness of bipolar disorder.   The fact of the matter is, I have had a malaise of depression during this visit which has put a bit of a grey haze over what should be one of the most enjoyable things I can do in public.

I’m not exactly sad, though it seems to present as sadness.  What I really feel is frustration. Frustration that I cannot seem to have a genuine emotional response to something, but rather have to filter things through the symptoms of my illness.  Now there have been times approaching joy here at Disneyland, but it seems in general happiness is being held in reserve for something.  I don’t know what that would be, and I am sure that this articulation of my emotional landscape falls short of the actual experience.

A trip to Disneyland should not be an exercise in perseverance, pushing myself forward, and working hard to not give in to depression and just retreat.  Now as far as environments go, it is one that is easier than most to persevere in the face of depression, but no amount of Pixie Dust actually negates a mood swing.   We have been leaving the park early — often before or during the fireworks display, and my partner has taken pride in how well we are pacing ourselves — not pushing ourselves too hard.  Thing is, most of the time, I am pushing through an undefined malaise and the desire to just retreat.

I don’t want to make it sound like a Disneyland vacation is a chore — it is certainly not, but neither is it really the escape that the planning video claims it will be.  There is nowhere I can go where I will  not be mentally ill.  There is no amount of fun that will mitigate my limiting neurochemistry.  Rather than escaping my mental illness for a few hours, this trip just puts it in sharp relief.

I sincerely believe that Disneyland really is the Happiest Place on Earth.  I am not at all unhappy, I am just ill.

The continuing saga of Mental Illness is a hell of a thing part 43

I have come to the recent realization that I treat my emotions with suspicion. The nature of my illness means that emotions arise for no discernable reason other than my brain not acting in the manner that a healthy brain acts.

Part of my coping mechanism has been to develop a sense of emotional awareness.  Through introspection and self-honesty, I tend to dig down and analyze not only the emotion I am feeling, but the why of it.  It is only when I can understand why I feel a certain way that I can feel the emotion is genuine and not part of my pathology.

Mental illness is a hell of a thing.  I have lived with a diagnosis for 28 years now, but honestly the illness has been a lifelong presence for the 43 years of my life.  I have gotten pretty good at navigating it for the most part, but I also know it is probably inevitable that my coping mechanisms, support, and medication will not be enough and things go tits up again. I have built these survival strategies over my life, and it is sobering to realize that there will be a day when they are insufficient and I will need to learn new ones.

But for now, I am doing the best I can with what I got, and strive to keep moving forward.

Fernando Therapy

In the 1980s Billy Crystal had a character on Saturday Night Live that insisted that it was better to look good than to feel good.  With a cyclic mood disorder, there will be days, many more than I would like, that I won’t feel good.  Even with medicine and therapy, I will find myself in a depressive mood swing, and there really is nothing for it.  No amount of positive thinking or will power will allow me to not be depressed.

But even in a depressive episode, if i is not severe, I still have some control in my life.  I express this control by making the choice to look good.

Today is one of those days.  I have had mild depression for a few days now, so I indulged in a little self care.  I showered (something I am prone to neglect when depressed), and spent a goodly amount of time on grooming.  I’ve recently started shaping my beard in such a way that I get to wear a full beard, but also get to engage in the ritual of shaving regularly which I enjoy.  I got dressed in a shirt and tie, with the addition of a small lightsaber pin as a tie-tack.   I finished the outfit with bright red shoes to contrast my black pants and shirt, and to coordinate with my black and red tie.

I am still in the grip of depression, but it is balanced somewhat with pride in my appearance. It is a small victory, but I will take it.  Mentally ill, but still MARVELOUS.

There is no escape in this life

I am feeling a general malaise today. I think I am having a slight mood swing to the depressive side of things.
 
I am generally pretty accepting of my disorder which causes moods to manifest for no environmental reason, but just the whims of my brain chemistry. I accept it, but today, I don’t like it.
 
I am bipolar and there is not much I can do to mitigate that. I have medication. I have my coping mechanisms honed over a lifetime of living with this illness.
 
I recently had a discussion with a friend if I ever wished I could have a brain that works in a healthy manner. I said that I did not, not really. Mostly because I do not want to wish for something that simply is not possible. I am resigned that my illness will be a lifelong condition, and there is no escape from it.
I cherish my periods of stability, but I know they will always be brief respites between the hills and valleys of my cyclical mood disorder.
If there was an escape where I could continue living I don’t know if I would take any cure.  I mean practically, I probably would, but I have to wonder, if I lose my illness, would I also lose my creative fire?   Because my illness is manifest in my very mind, any treatment, and if there is someday any cure, would alter who I am.   And I generally like the man I am.  I have done a lot of work on myself, and I continue to do so, to shape myself in the person I want to be.  Well, that is, the person I want to be within the confines of my illness.
There is nowhere I can go, nothing I can do that will stop me from being ill.  Part of my life philosophy is to not form attachment to the way I want things to be.  I learn to recognize what is within my power to change, and what is not.  There is not any benefit in giving time in my thoughts to ideas that begin with, “If only I were not mentally ill, I could…” so I do not give my own mental resources to such exercises.   Rather I subscribe to a philosophy featured in one of my favorite Disney films, So Dear to My Heart. Namely, “Doing the best with what you got.”
Being mentally ill does prevent me from living the kind of life that many enjoy.  But that being said, I strive to do the best I can, with what I got.  Many times I fall short of what many people feel is “acceptable” yet with a at time debilitating illness many of my life activities are disrupted to the point of disability.  That being said, when I do fall, I at times just let myself lie there for a while, but I always get up eventually.   I keep moving forward.  I strive for small forward progress. Because I know even the smallest of steps, over a long period of change can effect a profound change.

The (lack of) joys of rapid cycling.

One of the aspects of how I suffer from Bipolar Disorder, is that I occasionally rapid-cycle.

 

I am having one of those episodes right now.   I was fine an hour ago,  took the garbage cans from the curb and back up against my fence, I walked my dog, and I chucked a blu-ray from Netflix (that I got in October) in the mail.   Things were fine,  I felt fine, nothing seemed out of whack.

Then… there was a sudden transition.  I could feel an even mood nosedive into a heavy sadness or slight depression.   Quite literally I was fine one minute, and the next I just felt the weight of a mood swing come across my body, my shoulders hunch, my head goes down, and I just hold my head in my hand and sigh.    Writing these words now feels like Sisyphus and the boulder.   This is a slight depression, but it is still depression, and that means even simple things take more effort.

The transition from “normalcy” to depression happened as quickly as the transition of walking from the outside to indoors through a door.  It did not creep up on me or build overtime.  Quite literally I was fine one minute, and the next, struggling, the feeling of slowly drowning or being buried, with no vector for these feelings to be addressed.  I am pretty sure there is no environmental cause, but just what my brain does.  Have I mentioned my brain is an asshole and entirely unreliable?

I was having a very difficult time with recall yesterday, I was worried about my brain acting up (I have a not quite small amount of anxiety about the reliability of my brain), I wonder if it was a precursor to this sudden mood shift?  Any answer would be guesswork.