Category Archives: mental health

For Caregivers Everywhere

I have bipolar disorder. My husband is my caregiver. He didn’t sign up for this gig when we met, except for later vowing the part about “in sickness and in health” when we married. I could not negotiate life without him. I try to thank him daily.

My mother was my father’s caregiver when he was dying of multiple myeloma. She knew she was doing a good job of taking care of him, but she asked me to tell her that. She needed someone to tell her she was doing it right.

So this is for my husband and my mother, and for caregivers everywhere.

Thank you. Good job. We need you and we know it.

Some of you are unpaid caregivers who help loved ones for the necessity of it, for the obligation of it, or for the love of it. All of you deserve our thanks.

Some caregivers receive pay, and you deserve our thanks, too. There are many other professions or jobs you could be doing, but you chose to help those who needed it most.

All parents are caregivers, but the parents of special needs children are extra special. You share a task and a worth that few others recognize. You didn’t ask for the job, but you step up to it every day.

You work in homes, rehabilitation facilities, hospitals, schools, and group homes. Your work matters more than most people realize. You help not just the sick, but the struggling, the frail, the dying, and the trying.

Respite care workers deserve recognition too. You allow caregivers to continue their work refreshed – give them a space to catch their breath and recharge their spirits. You are caregivers as well.

The care you all give is not easily definable. It involves the physical, spiritual, mental, and emotional needs of the medically, mentally, or emotionally fragile. It provides sustenance, both literal and figurative. It keeps the people you care for going, or helps them lay down their struggles.

Recently I wrote a blog post called “Caregivers Need Care Too,” specifically about people who care for the mentally disturbed (http://wp.me/p4e9Hv-wh). It talked about what caregivers need in return for the attention, care, support, assistance, and love they give.

In it I said that those who care for others need something from those they care for, and from the rest of society. They need appreciation, validation, time away to refresh and re-energize themselves, understanding, support, and recognition. Not all of the people you care for are capable of giving back, for whatever reason.

So, please accept this from me, one who has known caregivers and benefited from caregivers, and loved caregivers. Your work and your devotion do not go unnoticed, Even if the ones you care for are not capable of saying “thank you,” I say it for them.

You are appreciated. You are worthy. You are loved. You are respected. You make a difference. You have value. You are valued. Even if you never hear these words from those you care for, please accept them from me.

I am grateful.

 

 

The Weather Is Not Bipolar. I Am.

Yeah, I get what you’re saying. The weather changes a lot, and sometimes drastically, so you say it has mood swings. And what’s more associated with mood swings than bipolar disorder?

I know, it’s a metaphor – a shorthand way of comparing things to each other, like comparing a choice to two roads diverging in a yellow wood.

The problem is, there are people on one side of this comparison, and they have a mental disorder. Bipolar literally means a neurochemical disorder of the brain that a person cannot control.It isn’t warmth in December and snow in April. It’s not just a matter of feeling happy one day and sad another. Everyone gets that.

Not everyone has bipolar disorder.

I do.

I have no control over whether I will wake up in the morning eager to get out of bed and start my day, or unable to get out of bed at all. No, you can’t control the weather either, but that’s nothing compared to being able to control your own moods, thoughts, and even actions.

Bipolar disorder, obsessive-compulsive disorder, and other mental disorders are conditions that affect, inhibit, and even ruin people’s lives and relationships. They are not conditions to be made light of, any more than developmental disabilities are. Bipolar is a disorder – a disease, if you will – that can confuse, terrify, and impair you; unsettle, disrupt, and destroy your relationships; shred your memory; take you to the brink of suicide and beyond, if you’re unlucky or untreated.

So, no. Your picky friend probably does not have OCD. OCD is a psychological condition that inhibits a person’s actions based on a complex series of numbers, behaviors, and rituals. It’s lots worse than simply straightening picture frames. Narcissism is not just being vain. Just like high blood pressure is not just someone who avoids salt or diabetic is someone who just avoids sugar. They are medical conditions. We may joke about needing insulin when a new couple overdoes the endearments, but that’s a far cry from really needing insulin. 

Many mental disorders involve neurons and synapses and neurotransmitter chemicals in your brain, and maybe genes. Can you control those by yourself? I thought not. Neither can I.

What I can do is go to a psychiatrist who gives me medications that help control those pesky neurotransmitters. And a psychologist who shares with me ways to cope with the messiness of the life I have to deal with.

And, make no mistake, those professionals and those chemicals do help. They give me more control over my emotions than you have over the weather.

So if you shouldn’t call the weather bipolar or your picky relative OCD, what about public figures? Aren’t they fair game? Can we say, for instance, that Donald Trump is a narcissist? Most likely, yes. Can we say that he has a psychological condition called Narcissistic Personality Disorder? Or Borderline Personality Disorder? Or Sociopathy?

No. The most we might say is that he displays some narcissistic traits, or that he is, in colloquial terms only, narcissistic. But can we diagnose him, say that he has one or another of these psychological conditions? It’s tempting to diagnose from a distance. That’s dangerous. Actual psychological disorders can be diagnosed only by a professional who has actually spoken to the person in question. Anything else is pop psychology and a disservice to the mental health profession. Not to mention a disrespect to people who actually live with those conditions.

I know that psychological terms get tossed around loosely, especially in everyday, colloquial English. I get that they’re shorthand for more complex ideas. Still, it bugs me when someone says weather is bipolar or Trump is a sociopath. I like precision in language. I like it especially when it hits close to home.

What I have is not like the weather. Oh, it comes and goes. But I can’t get away from it just by going indoors. I can’t lessen its effects by putting on or taking off layers of clothing. I can’t turn on the Weather Channel for a prediction of how I will feel later in the week. I can’t move to a place where bipolar is more pleasant.

That would be crazy.

 

 

 

 

Poor? Mentally Ill? Sorry, You’re on Your Own.

Poverty and mental illness have something in common.

There is a stigma attached to both.

Both are seen as moral failings. If only people tried harder, worked more, improved themselves, they could lift themselves out of poverty. Without relying on anyone else’s help, which would be shameful.

And if only people stopped being so negative, looked on the bright side, smiled more, thought more about others, their positive mental attitude would make all those shrinks and pills unnecessary. They wouldn’t be shooting people with assault rifles and sucking up tax dollars for disability payments, which is shameful.

Society can’t afford poverty and it can’t afford mental illness. Why should we make the effort when the poor and the mentally disturbed don’t?

Why should these two conditions both be associated with such stigma and for such similar reasons? It’s simple. People don’t want to think that poverty or mental illness could happen to them.

The truth, however, is that a vast number of Americans are living one paycheck or one illness away from poverty, and one in four or five Americans will face a mental or emotional disorder at some point in their lives. And they are afraid. So they tell themselves that the conditions only affect Other People. And those people must be stupid or lazy or unmotivated or something, or they wouldn’t be poor or mentally ill in the first place.

And that’s where stigma begins.

And what are the consequences of stigma?

Well, first of all, it means that no one wants to spend money alleviating either condition. If these Other People can’t pull themselves up by their bootstraps and improve, the thinking goes, why should we pay them not to? Job training programs, child care, higher minimum wage, insurance coverage, community mental health centers, treatment programs for addiction, need to be paid for some way, but not with our tax dollars, by God!

And it means we don’t want to look at the Other People for fear of seeing ourselves. Don’t put halfway houses, group homes, unemployment offices, treatment centers, psychiatric hospitals, and other reminders in our neighborhoods. Not In My Backyard!

It’s not just a failure of compassion, though it’s that too. It’s not just a failure of the social “safety net,” though it certainly is that as well. It’s also a failure of the imagination – what would it be like if poverty or mental illness should happen to me? The reality is too unpleasant to think about, so don’t.

And while we’re talking about unpleasant, let’s mention the place where poverty and mental illness intersect – homelessness. Don’t we assume that homeless people are both poor and mentally ill? As such, spending money on them is doubly wasted. Why bother? It’s not like it’s going to help. Poverty, homelessness, and mental illness are incurable, after all. (Unless a person can cure their problems without outside help, of course.)

So what’s my stake in all this? Am I a bleeding-heart liberal do-gooder who wants to cure society’s ills and make us all foot the bill for it?

Well, yeah.

But I’m also living month to month on my income. My husband makes only a bit over minimum wage. We have both, at one time or another during our lives, been on unemployment and/or food stamps. We have no nest egg or emergency fund. It wouldn’t take much in the way of reversals to wipe us out. Even at that, we’re relatively privileged.

And I have a mental illness – bipolar disorder 2. Without insurance, I could not afford to see a psychiatrist, or buy medication (one of mine costs $800 per month), or get inpatient treatment if I ever need it. Right now my condition is moderately well controlled, but if I should suffer a setback, I might not be able to work at all. And there we are, back at poverty.

These two unfortunate conditions – poverty and mental illness – affect me directly, so I can’t look away and say they only happen to Other People. I know that they affect others more severely than they do me, and I don’t know how those people make it through.

But I do know that stigma isn’t helping any of us.

When Your Friend Is Depressed

…And by “depressed,” I mean clinically depressed – the sort that has no apparent reason and lasts for weeks or even months. Your friend is not just sad, but feeling hopeless, helpless, discouraged, defeated. even immobilized. She or he may not want to go anywhere or do anything that used to bring happiness. You may even detect a dullness – called “flat affect” – in the person’s voice, a lack of animation, often combined with monosyllabic responses.

What can you do to help your friend?

At first it may seem like the answer is “not much.” And that’s partly true. What your friend really needs is probably help from a mental health professional and possibly from antidepressant medication.

There are, however a few things you can do to help your friend – and a few things you shouldn’t do, not because they will make your friend’s condition worse, but because they simply won’t help.

Let’s start with the things you can do.

Keep reaching out. Even if your friend doesn’t respond, refuses your invitations or doesn’t show up, know that the simple act of staying in touch says that you like the person even though she’s having a hard time and that you won’t abandon her. Make no mistake, many people will. Even if your friend is unable to respond, when she finally does get some relief from the depression, she will realize and remember who stuck by her during the depths. Surely you can spare a minute or two for a phone call or email a couple of times a month. You may think it won’t make a difference, but it will.

Offer to help with practical matters. If your friend has decided to get professional help, you can make doing that easier. You may not realize it, but the simple acts of getting up, dressed, and out of the house can seem insurmountable to him. Offer to drive him to his appointments or to the pharmacy to pick up his prescriptions. Give him a pill caddy to help him remember to take his meds every day.

Imagine your friend is physically ill. In a way, she is. The depression is a result of a neurochemical imbalance in her brain. What would you do if a friend were recovering from an illness or perhaps surgery, or even the death of a loved one? Bring her a hot meal once in a while or pick up an extra sandwich if you’re getting one for yourself? Offer to do laundry or another household chore? Enlist other friends to help? Pray for her healing and tell her you are doing so? None of this will make your friend magically well, but they can help her through the worst phases of a depressive episode while she’s waiting for medication to take effect (which may take as long as six weeks).

There are also some things that you shouldn’t do for your friend because they simply will not work. Here’s a brief list.

Don’t try to “fix” him. As much as you may care, you do not have the power to make it all better. Trying to do that will only frustrate both of you. Leave your psychological theories and miracle cures at home.

Don’t give “pep talks.” Telling your friend to snap out of it or to smile more or to think of others who have it worse will not alter his brain chemistry for the better. He most likely won’t be able to appreciate jokes and humor, either, even if he did before the depression.

Don’t expect quick results. Clinical depression lasts for weeks or months, or in some cases even years. It’s frustrating to see your friend suffering for that long, but if your friend sees you give up, she may too.

Don’t ignore suicidal talk. Suicide is a real risk for a depressed person, even if he is getting professional help. Most people who kill themselves give warnings – they talk about being better off dead or give away their possessions. Stay with your friend. Make sure he has the number of a suicide hotline. Call his therapist. Take him to an emergency room.

My advice for someone who lives with a depressed person is similar: Do what you can and realize what you can’t do. If you truly care about the person and stick with him or her through the bad times, you may find one day that you have your friend or loved one back – maybe not as good as new, but on the way to getting better.

That’s when you’ll find that all your efforts have been worth it. Helping a depressed friend survive and heal is an accomplishment not to be taken lightly.

Seven Reasons I Hate the Bloggess

Red heart, studded with apins isolated on a white background. 3d render

First, let me say that I read the Bloggess all the time. I have her books and I read them all the time too. But secretly I hate her, and here’s why.

1. She had a weirder childhood than I did. She lived in a small Texas town full of farm critters and wild animals, and weird characters, including her father the taxidermist, and has interesting poverty stories, like the one about the bread-sack shoes. I lived in a nondescript middle-class suburb with a stay-at-home mom and a dad that went to work every day smelling of Vitalis and Aqua Velva, rather than deer blood.

(This was also the problem I had trying to write country songs. You can’t get very far with “I was born an industrial engineering technician’s daughter/in the Central Baptist Hospital of Lexington, KY.”)

2. She had more interesting pets, with more interesting names than I did. She had a raccoon named Rambo that wore Jams and a delinquent turkey named Jenkins. Later she had a dog named Barnaby Jones Pickles and has cats named Ferris Mewler and Hunter S. Thomcat. We had dogs named Blackie and Bootsie and rabbits named Christina and Mittens. Our recent dogs have been Karma and Bridget, and the only eccentric cat names we’ve bestowed have been Django and Dushenka.

(Ordinarily, I don’t like cat names like Baryshnikat and F. Cat Fitzgerald. I think cat names should be something you wouldn’t be embarrassed to yell out the door if one of them wanders off, like Louise or Garcia. But I suppose the Bloggess’s neighbors are by now used to anything.)

3. She has more interesting disorders than I do. I have a bad back and bipolar disorder type 2 (and a blog about it, bipolarjan.wordpress.com). The Bloggess has generalized anxiety disorder, anti-phospholipid syndrome, rheumatoid arthritis, depression, and, apparently, an obsession with chupacabras and vaginas. This gives her much more to write about. Although I do have two blogs. Two! In your face, Bloggess!

4. She’s less inhibited than I am. The Bloggess would have ended that last paragraph, “In your face, motherfucker!” I didn’t learn to cuss till I was in my 20s and no one I meet ever believes I swear until I do. Then they’re shocked. Also, I swear all the time, except in my blogs, where I’m afraid I’ll offend readers, all of whom I assume have tender sensibilities. The Bloggess knows her readers better than that.

5. She has way more readers than I do. And she’s published books and has another coming out. I have 495 followers and I think most of them want to sell me books on how to publicize my blog. I should probably study a book like that, but I’d rather read ones about emerging viruses, cloud cities on Venus, and mostly true memoirs. On the other hand, I have the distinction of being the only writer ever to have articles in both Catechist and Black Belt magazines. So take that, moth . . . Bloggess!

6. She and her husband have more interesting arguments than my husband and I do. We never even talk quietly about whether Jesus was a zombie.

7. She has a stronger voice than I do. I mean her writing voice. I had no idea what her speaking voice was like until I saw a video clip of her on the web, talking about vaginas. But when I’m going to write in my blogs, I have to lay off reading her for a day or two, because her voice takes over my weak, tiny mind and it wants to sound like her. I wish I could write like that. Or at least as well as that.jennyme

But, like the Bloggess, I am a strangeling. And that’s a start.

I Want My Blankie!

Linus’s security blanket. Radar O’Reilly’s teddy bear. That kid in Mr. Mom‘s woobie (which seems to be where the term “woobie” was invented). (See https://www.youtube.com/watch?v=vSVCQ-NmTac.)

What do all these things have in common?

They’re what psychologists call “comfort objects,” or as Wikipedia defines it, “an item used to provide psychological comfort, especially in unusual or unique situations.”Morgenmuffel

But look again at that list. What’s different about one of the names? Radar O’Reilly is an adult, or at least grown-up enough to be a corporal in the U.S. Army. Some of the characters on the show and in the audience poked fun at him, but most understood – Radar was in a strange and dangerous place and needed a comfort object to remind him of his childhood home in Ottumwah, IA.

And Radar isn’t the only adult who needs a woobie of some sort. Alabama journalist Anna Claire Vollers wrote:

Last year, the hotel chain Travelodge polled about 6,000 people in Great Britain and found 35 percent said they sleep with teddy bears. A surprising 25 percent of men admitted to bringing their teddy bears with them on business trips.

So now I have a confession to make: I own an array of comfort objects and sometimes take them with me on trips. Once I even took a stuffed bunny with me to a sleep study. (Let me be clear: It was not a taxidermied bunny, but what I believe are now called plushies. For taxidermied animals as comfort objects, you should check out The Bloggess.)

My habit started in childhood, when I preferred plushies to Barbies. Every year our Easter baskets contained, in addition to candy and fake grass, a plush bunny. One year I won a plush bunny three-and-a-half feet tall in a raffle. It was wearing a blue and yellow checked dress. My mom found the same fabric and made me a matching one.

Now my collection includes, in addition to bunnies and bears, crocheted armadillos, assorted Beanie Babies (including a crab and a spider), a giraffe, Thing One and Thing Two from The Cat in the Hat, and a Raggedy John Denver doll that a friend made me (the little heart on his chest says “Far Out”).

Nor am I the only one among my circle of friends who treasures assorted comfort objects. Two of my friends have plush animals that could be either husky dogs or gray teddy bears (which they call “huskie bears”). Our friend John had a toy bunny (“Lovie”) to sleep with at home and borrowed a bear my mother had made when he napped at our house after Thanksgiving dinner. My sister had a 12-inch square piece of cloth from her childhood that she named “Tag.” She kept it under her pillow at college. Her roommates teased her unmercifully about it, though really it was a miracle Tag had lasted that long.

One friend even received as a gift a plushie called “My First Bacon.” As I recall, it talked, though I’m not quite sure what talking bacon could say that I would find soothing, except possibly “Eat me.” (Like the cake in Alice in Wonderland. Get your mind out of the gutter.)

But now someone has gotten serious about the therapeutic effects of comfort objects. Wikipedia notes:

Inventor Richard Kopelle created My Therapy Buddy (MTB) in 2002 as a self-described transitional object to benefit “one’s emotional well-being”. The blue creature speaks to you when you squeeze it and says any of a number of phrases that include “everything is going to be alright.”

Here’s a video: https://www.youtube.com/watch?v=H6kSqSzWr0w. It shows a pale blue, bald, pregnant Smurf-like object being cuddled by various people to a background on New Age-type lullabies. One clip even shows it in the mouth of a giant, leering shark, which does not comfort me and does not appear to comfort the shark.

I will stick with my Pirate Winnie-the-Pooh, thanks. Or my plush Puss in Boots that makes a sound like a cat coughing up a hairball and says, “I thought we were done doing things the stupid way.” In the voice of Antonio Banderas, no less.

I guess we all find comfort in our own way, even if some of them seem stupid to others.

 

The Ups and Downs of Positivity

The only thing making you unhappy are your own thoughts. Change them. 

When it rains, it pours…but soon, the sun shines again. Stay positive.

I see lots of posts and pass-alongs like these on Facebook: memes claiming that all our problems are in our heads and that we have the ability to change our circumstances by changing our thoughts.

With apologies to Norman Vincent Peale and Joel Osteen, I have trouble with the whole positive thinking movement. My back pain makes me unhappy. My brain chemistry won’t let me control my thoughts (I’m bipolar). Thinking about being rich does not attract money to me. Ordinarily I view positive thinking as wishful thinking.

But I know many people believe in positive thinking and its ability to change their lives. So I set up a little hypothetical dialogue. On one side is Barbara Ehrenreich, author of Bright-Sided: How Positive Thinking Is Undermining America. I have selected quotations from her book, particularly those dealing with health, and juxtaposed them with comments from Leslie Larkins, who embraces positive thinking.

Larkins, a former scientist, has always been extremely rational, so it surprised me that her outlook is informed by positive thinking. And she has plenty that she could be negative about. Larkins has been diagnosed with multiple sclerosis (MS), and had a bout with breast cancer and a surgical mistake that (if not caught) would have subjected her to a completely unnecessary mastectomy. At various times in her life, she has also been treated for depression.

Larkins says that her embrace of positivity came with her MS diagnosis: “When I realized that the problems I had been having at work – trouble with focus, forgetting things – had an actual cause and I accepted that I couldn’t continue to do my job, it was actually a little bit of a relief because I had been feeling out of control for a year or so and couldn’t understand why….I did a lot of research on MS and realized that I could end up in a wheelchair any time, so if I wanted to do something in my life, I shouldn’t put it off. That thought was actually quite empowering to me.”

Ehrenreich, in the first part of Bright-Sided, focuses on the breast cancer movement, particularly the pink-ribbon side of things: “Positive thinking seems to be mandatory in the breast cancer world, to the point that unhappiness requires a kind of apology….The cheerfulness of breast cancer culture goes beyond mere absence of anger to what looks, all too often, like a positive embrace of the disease….[I]t requires the denial of understandable feelings of anger and fear, all of which must be buried under a cosmetic layer of cheer.”

She quotes Cindy Cherry, who stated in The Washington Post: “If I had to do it over, would I want breast cancer? Absolutely. I’m not the same person I was, and I’m glad I’m not. Money doesn’t matter anymore. I’ve met the most phenomenal people in my life through this. Your friends and family are what matter now.”

Larkins responds: “Thankfully I did not have to have the ‘full cancer experience’ because I didn’t have chemo and therefore didn’t lose my hair, so I was kind of a stealth cancer patient and could only tell people who I wanted to know. I wasn’t forced into ‘breast cancer culture.’ I also was in a place where I could handle the emotional issues myself, so I didn’t encounter the support groups and such. I think the ‘Cheer up, it’s good for you’ comes from people who don’t know what to do or say, trying to help when they have no idea what’s going on.”

She adds, “I definitely would not want cancer and I would not want MS, but I do really understand this one. I sometimes joke that being diagnosed with MS was the best thing that ever happened to me. It forced/allowed me to focus on the present, not the sins of the past and not the possible mistakes or failed plans of the future. Once I started doing that and it became a habit, it became much less likely that I would fall into the despair of those worries. It was definitely a paradigm shift for my outlook.”

Larkins’s scientific rationality may have helped her as much as or more than the positive thinking movement. At least it gave her a logical base for embracing positivity. “I think having the medical background and a good handle on statistics and human psychological reactions to probability helped me think clearly about all of it, rather than letting it bury me in despair,” she says. “I think it mostly allowed me to stand back and see what I was doing in my head from an objective view.”

Larkins and Ehrenreich also disagree on the benefits of psychology and support groups. According to Ehrenreich, “Psychotherapy and support groups might improve one’s mood, but they did nothing to overcome [my] cancer.” Indeed, a claim that a psychological uplift can cause a remission in cancer seems (to me, at least) both unwarranted and unprovable.

Larkins, however, swears by Cognitive Behavioral Therapy, not for its cancer-killing results (if any), but for its influence on her ability to deal with her various diagnoses. She does see a distinction between “positive thinking” and CBT (don’t Google the acronym, she warns).

“Positive thinking can be a result of CBT,” she says, “but if you just say ‘I’m going to think positive thoughts’ you will end up frustrated. CBT is the method for changing how your brain functions, and it does, indeed, change your brain physically.”

She explains the process: “The more you think about something – an event or a problem – the stronger the neural connections that make up that memory become. My analogy is that it’s like carving a groove or rut in a path by going over and over it again and again …. As the groove gets deeper, it’s easier to fall into it any time you get close to it. By consciously stopping yourself from treading that same neural path, and actively carving another one that has more positive, pleasurable feelings associated with it, you allow that groove to smooth out and the new, positive one to take its place ….

“It’s not that I never fall into a repeating loop of self-recrimination, but if I catch myself there, I consciously tell myself to go down another path, one that I’ve predetermined so as to have it ready and at hand when I need it. It has gotten much easier with practice….”

Back over to Ehrenreich: “Breast cancer… gave me, if you want to call this a ‘gift,’ …  a very personal, agonizing encounter with an ideological force in American culture that I had not been aware of before – one that encourages us to deny reality, submit cheerfully to misfortune, and blame only ourselves for our fate.”

“[I]f you’re denying feelings, you’re doing psychotherapy wrong,” Larkins insists. “You’re also doing meditation and CBT wrong. It’s not about denying, it’s about experiencing them, evaluating them and deciding consciously if they are doing you good or harm.”

Nor is positive thinking the only method Larkins used for alleviating her depression. “Medication definitely helped!” she says. “When I’ve gone off the SSRIs [antidepressants] entirely, I found myself getting weepy and feeling out of control, even though I could see, objectively, that I was OK and even reasonably happy. The meds allow me to control my brain enough to take control of my brain, if that makes sense.”

What about other areas of life? Positive thinking has been touted as an answer for everything from poverty to relationship issues. Ehrenreich explains, “People who had been laid off from their jobs and were spiraling down toward poverty were told to see their condition as an ‘opportunity’ to be embraced, just as breast cancer is often depicted as a ‘gift.’…In fact, there is no kind of problem or obstacle for which positive thinking or a positive attitude has not been proposed as a cure.”

“This,” says Larkins, “I see as a struggle to make sense of and control an uncontrollable world. The same way that religious people call everything ‘God’s will’ or less religious folks say ‘[E]verything happens for a reason’ as a way to feel better about bad things….I think a lot of the ‘positive thinking’ rhetoric is more [a way] of actively distracting yourself from dwelling on the bad things. If you’re not predisposed to depression, that may be a workable method. If you already have malfunctioning brain chemistry, it’s not likely to help, but concentrated cognitive therapy can.”

As for me, I try to notice positive things in the world (which means not watching very much news); I try to add positivity to the world by thanking servers, clerks, cashiers, my husband – anyone who helps me in the course of a day; I appreciate things that make me laugh; I try to find some little thing I can agree with, even if I disagree with most of what a person says. I give myself permission to feel rotten when I feel rotten, but know that it won’t last forever. I do the best I can.

 

The Other Bipolar Disorder

I have bipolar disorder type 2. This is my story.

First, some background. Bipolar disorder used to be called manic-depressive illness, and many people still know and refer to it that way. The term “bipolar” reflects the concept that there are two extremes to the continuum of mood disorders, and some people swing dramatically from one to the other. According to this definition, clinical depression by itself is “unipolar” – occupying only one end of the spectrum.

Depression is to ordinary grief or sadness as a broken leg is to a splinter. Depression sucks the life from a person, mutes all emotions except misery, denies any possibility of joy or even contentment, makes life seem meaningless or impossible. This is hell.

Mania is to ordinary happiness as diving off a cliff is to diving off a diving board. Mania brings exhilaration, ambition, confidence, abandon, and invincibility, with no brakes. It is hell on wheels.

Oscillating between the two extremes – that’s bipolar disorder, type 1. It is a very serious illness. Left untreated, it can cause destruction of families, careers, and more. It can lead to psychosis or suicide.

The treatments for it are no picnic either. Bipolar disorder that severe often requires hospitalization. If the symptoms can be controlled with medication such as lithium or newer formulations, the patients must have frequent blood tests to assure that the drug is present in the right quantity. Electroshock is also a possibility, especially for deep, drug-resistant depression.

When I was (incorrectly) diagnosed with unipolar depression, I used to wish that I were bipolar, on the theory that at least then I could accomplish something. Boy, was I wrong about that. Plans made in mania never come to fruition. They are started, rethought, abandoned, exchanged for something grander, and ultimately fizzle out when the mania wears off.

My diagnosis actually made some sense at the time, as I never experienced anything like the manic highs. All I got were depressive lows.

This leads us at last to bipolar disorder, type 2. Some people think of bipolar 2 as “Bipolar Lite.” The mood swings are not as extreme, the lows less debilitating, the highs less overwhelming. The person with bipolar 2 stays closer to a baseline of normal mood, but still experiences swings back and forth.

Technically the mini-lows are called dysthymia and the mini-highs are called hypomania. In my case, the lows were just as low as in unipolar depression, but I never got the mini-jags of buoyancy that accompany hypomania. Instead, these feelings, came out sideways – as anxiety.

My brain was still racing with little control but in a different direction. Instead of elation and purpose, I was beset by in worries, fears, and catastrophizing.

One of the difficulties with treating bipolar disorder of either type is trying to find a medication or a combination of medications that will level out the person’s moods. Usually this requires more than one drug, and finding the right mix or cocktail of chemicals takes usually requires more than one drug. It takes a great deal of trial and error. In the meantime, the mood swings continue.

At this point, my bipolar 2 disorder is fairly well controlled on medication. I still have spells of depression, but now they last at most a week, and sometimes just a day or two. Untreated, they could last months or years. I still have anxiety too, but I have the medication I take for that, so that I don’t feel like I’m about to jump out of my own skin.

Most of the time I’m fairly high-functioning. I can write, work, earn a living. I have a great marriage and a number of friends, including some who are closer than family to me. I have never been hospitalized, nor have I had electroshock (though that was a near thing). Before I got my proper diagnosis and treatment, I would have not believed this to be possible. My goal in life was simply to stay out of a psychiatric hospital as long as I could, or at least until I qualified for Social Security Disability.

I’m sharing these experiences with you today because I believe that mental disorders should not be hidden or viewed with shame and horror, as they have been in the past and sometimes still are.

It’s undeniable that there is a stigma associated with having mental illness. Going public with it entails a risk. I’ve seen the fixed-smile-back-away-slowly reaction. I’ve seen sudden turn-arounds in my work performance evaluations. But I’ve also seen the “Me too!” response. There is strength in numbers. As more of us who live with psychiatric conditions talk about it, and share our stories, the more we build understanding and perhaps encourage those who are roller-coastering to seek treatment.

So that’s the nuts and bolts of it: Bipolar disorder type 2 is a mental illness. I have it and live with it every day. I do not go around shooting people or trying to jump off buildings. I take medication for it and know that I will likely have to for the rest of my life. And I’m okay with that. I hope that eventually the rest of the world will be too.

 

My In-Law and My Ink

I expected a total freak out. I really did. So I tried to work it into a phone conversation as naturally as I could.

“Say Mom, did Dan tell you I got a tattoo?”

Instead of the expected shriek, I got a fairly calm query.(1) “Where?”(2)

If I were being a smart ass I would have said “At Monkey Bones Tattoos.” But I took the sensible route for a change and said, “On the inside of my left wrist.”

Then she asked, “What did you get?”

Again, any number of possible responses crossed my mind. But I decided to play it straight and told her the truth: “I got a semi-colon.”(3)

The next obvious question was, “Why?”

I could have said because I’m a huge grammar nerd, which would have been the truth about me, but not about the tattoo.

I explained as best I could. The semi-colon tattoo is a symbol of mental health awareness and suicide prevention. I rushed through the grammatical part of the explanation: In writing a semi-colon is a place where the writer could have stopped, but chose to go on. The idea is that someone will see the tattoo (4) and ask about it. Then you can explain the symbolism and how you are trying to combat the stigma of talking about mental illness. Like I just did.

I wrote about this on my other blog, Bipolar Me (https://bipolarjan.wordpress.com/2015/08/09/a-tattoo-is-for-life/) when I first got the tattoo, so if you saw it there, I apologize for the repetition.

Actually, no I don’t. The message is one that bears repeating, as often as we can and in as many ways as we can. You know someone with a mental illness(5) and that person is afraid to talk about it because of the stigma that still exists around the subject. I have bipolar disorder, type 2, and I talk about it all the time on my Bipolar Me blog.

Talking about mental illness is risky. You often get one of the standard reactions: a fixed, awkward smile; unwelcome advice about cinnamon or apple cider vinegar; outright disbelief; a decrease in contact with that person; sudden bad reviews at work. Perhaps worst of all, you get, “Isn’t that what the guy who just shot up the shopping mall had?”

Ordinarily, I post to my blog on Sunday. But this is National Suicide Prevention Week, so I wanted to post now. You can find out more about the tattoos at http://www.projectsemicolon.com/.

As Mom R. said about my tattoo, “It’s for a good cause.”

 

(1) My father-in-law was a Navy man and sported a few of the more common nautical tattoos, so I guess Mom R. had had a while to get used to the idea. Anyway, at least she didn’t go all, “The body is the Temple of God” on me.

(2) Apparently this is the first required question if someone announces a tattoo. Unless it’s on your face, neck or other readily observable spot. I suspect that everyone who asks imagines that it is located some place at least mildly kinky.

(3) Monkey Bones is locally known for extreme, large, and disturbing tattoos, like zombie cows. (I’m not kidding, either.) I think they must have been so embarrassed at being asked to do a pitiful mark of punctuation that they hustled me in and out in ten minutes.

(4) And if we had been Skyping, Mom R. would have, but Skype has been glitchy lately since I changed browsers. So we have our weekly coffee chats over speakerphone. This prevents a lot of Dan handing me the phone and saying, “Here. Say hello to Mom.” Especially when I’m not prepared with any tidbits of conversation, like a new tattoo. Here’s a picture, if you’re curious:

finished
I guess Mike at Monkey Bones isn’t embarrassed after all.

(5) Depression, anxiety, OCD, ASD, whatever. I guarantee it. Someone you know is struggling, and may or may not be getting help for it. A semi-colon tattoo would show you care.

Mental Illness in the News: Some Questions

One of the notable headlines last week that wasn’t about a celebrity celebrity, ridiculous politician, or even the passing of a great and inspiring actor, concerned mental disorders and how society treats those who have them. Those of us who have or care about people with mental disorders may have noticed this story online:

http://www.rawstory.com/rs/2015/02/truly-barbaric-florida-deputy-drags-mentally-ill-woman-through-courthouse-by-shackled-feet/#.VOyTNKh2Gbc.facebook

For those of you who haven’t read it or seen the video, here’s the gist. A woman, Ms. Rios, was declared mentally incompetent at a hearing for a minor offense and not allowed to say goodbye to her mother. She wanted to sit on a bench and cry for a bit. When she did not go promptly with the officer, he dragged her through the courthouse by her shackled feet. A video was taken on a cellphone camera by a lawyer who happened to be present, but had nothing to do with Ms. Rios’s case. If you watch the video clip you can see and hear her distress.

As the headline says, this was barbaric.

But there’s lots neither the headline nor the story says. I have questions.

What is the woman’s mental illness? Or why is she mentally incompetent? The stories vary, usually calling her “mentally ill,” which is shorter for the headline writers, but so far I have seen nothing more specific. One could get the impression that in the mind of the media – and therefore their readers – that the two terms mean the same thing. Was she medicated or unmedicated or off her prescribed meds? Does she have a developmental disability? An autism spectrum disorder? An emotional or behavioral disorder? We don’t know. But does whatever label make her automatically suspected of potential violence? The woman did not behave like an animal even when she was treated like one.

I think we all know people who have mental disorders but are still mentally competent to conduct their own affairs, up to and including court proceedings. In fact, I know you know one – me. I have bipolar disorder, type 2. But who among us, even the sanest and most stable of the general public, wouldn’t have needed to sit on a bench and cry before going to wherever the officer thought we should go? Who wouldn’t yell and protest and try to hold on to a table if we were dragged anywhere by our shackled feet?

Is that the way to calm someone who’s upset?

No?

Why is the officer’s action called “truly barbaric”? I’m not saying it wasn’t barbaric. But how was it more barbaric than other things routinely done to the incarcerated mentally ill (or incompetent)? Could it be “truly” barbaric instead of just regularly barbaric because the officer’s actions were caught on tape? How many everyday barbaric actions aren’t? And putting aside simple human compassion (which he did), didn’t the officer’s actions create a larger, potentially more dangerous disturbance with someone being dragged and thrashing about?

Why did the other officers present do nothing? You can see them on the video. They are spectators. No one says, “Hey, do you have to do that?” or “Give her a minute to calm down” or “Here, let me take care of this” or “You know, there are other ways to handle this” or even “Are you sure you want to do that with the camera rolling?” Nothing. Nada. Zippety. Doo-dah.

Why weren’t the officers and other courthouse personnel trained to handle situations like that? They obviously happen occasionally. Officers are (supposedly) trained to handle situations involving dangerous felons (which Ms. Rios wasn’t), domestic violence, and how to restrain suspects properly. Some even get sensitivity training on race, sexual orientation, and ethnicity. Where’s the training for interacting with the mentally ill (or mentally incompetent)? For de-escalating a situation instead of throwing gas on the fire? How about anger management before incidents like this one happen instead of after? Shouldn’t every law enforcement official be able to control or channel his or her anger and not take it out on the public?

Why the hell aren’t police officers required to wear body cameras – and have someone whose job it is to, oh, I don’t know, review the tapes occasionally? Certainly when there’s been a complaint, but spot checks might also do some good. Why are civilians subject to increasing surveillance, while law enforcement personnel – who are also civilians, by the way – perform their jobs with minimal oversight.

And why is the Golden Rule suspended when the “others” have a mental disturbance? I’d really like to know.