Let's Talk

The other day a mother posted on my daughter's fifth grade class page urging parents to have a talk with their children about the misuse of the word "retard".  It was both sad and infuriating.  It got me thinking about how callous and insensitive our attitudes are toward mental illness and how misinformed we are as a society regarding mental health issues.  We throw around terms like schizo, psycho, bipolar, crazy, mental, retarded as if they are interchangeable and as if it is acceptable to categorize people as such.

  

As most of you know if you follow my blog, I have bipolar disorder.  I don't want to lay out the clinical criteria for a diagnosis of bipolar disorder (BPD) or "educate you".  Instead, I want to share with you my experience living with BPD.  I'd wager a bet that it's probably different than you might think.  And although this is my own personal experience, I don't think that I am an exception to the rule or outside the norm of people that have BPD.  I hope it will open your eyes to a different view on those of us living with a mental illness. 

I know that many of you will think I'm brave for talking so openly about BPD.  And you know what?  I am.  Because the stigma that comes with mental illness is real.  And it's harsh.  It's isolating and demeaning.  In true stereotypical fashion, it lumps a diverse collection of people into one misunderstood group that is looked down upon and feared.  And that makes us afraid to talk about it or even admit that we have a mental health issue.  But why should talking about  bipolar disorder be an act of bravery?  Why shouldn't we feel free to talk about mental illness without the fear of being judged?

 Screw society and it's messed up, uninformed beliefs.  Let's talk.  

When I was first diagnosed, I was so embarrassed.  I had so much shame over something I had no control over.  I was afraid that people would think less of me and that as a result they would treat me differently. I labeled myself as crazy and weak.  I felt that I wasn't emotionally or psychologically strong enough to handle the ups and downs of life, that I had succumbed to a diagnosis of BPD because of some inadequacy or defect within me.  I felt that I was screwed up and had failed at life.  Irrational thinking, but it speaks to the power of the societal stigma surrounding mental illness.

People who have BPD have periods of mania and depression.  I have been diagnosed with bipolar disorder type 2 which is marked by episodes of hypomania and depression.  (Did you know that there is more than one type of BPD?  Because I didn't)  Hypomania is like mania, but to a lesser degree.  I have not been shy about sharing the fact that I have BPD, and yet I can only think of two people in my circle of friends and family that would be able to recognize when I am in a manic state. 

My mania mainly manifests outwardly as irritability.  I am internally less tolerant of, well, everything.  I usually keep it more to myself, but my overall mood is on-edge, akin to how a toddler acts when they are overstimulated.  On the plus side, I am also more productive.  I have more energy and am able to get things done.  Little things like laundry, making dinner, cleaning the house; they don't seem to take as much effort when I'm manic.  On the not-so-plus side, I have trouble sleeping.  I just don't have that tired feeling at night.  I want to sleep, but my body isn't ready and my thoughts keep going, and going, and going... not really about any one thing in particular, they're kind of bouncing around like a ping pong ball and I can't find the off switch.

I can be impulsive, but as a whole, I am a pretty conservative person.  So my impulsivity doesn't really involve any huge risk taking behaviors.  Instead my version of being impulsive means I'm a little more self-indulgent.  That $30 item on my Amazon wait list that I don't need but have beem trying to justify - move to cart, place my order and guaranteed delivery in 2 days - or by the next day if I order within 6 hours and 37 minutes.  That shellac manicure that always seems like such an unnecessary luxury with 4 kids and a tight budget - I'll take OPI color 013 please.  But that's usually about as far as it goes.  I'm just a little freer and I don't overthink every little thing.

I am also less intentional about how I react to certain things.  I don't hold myself to the standard of compassion I usually do and am instead more apathetic.  I just don't care as much; situations that I am usually passionate about taking the high road, I find I don't really care about doing "the right thing" in those moments.  I fall into a teenage rebellion-esque state where I feel that doing good and being a good person is futile, not recognized as valuable by society and therefore, I am going to stop trying so hard.  

So how do I manage my mania?  Not very well right now.  Three years later and I'm still learning.  Sometimes it takes me a few days to recognize that I'm heading toward (or right smack dab in the middle of) a manic episode.  And sometimes, by the time I recognize it, I'm at the point of not really caring and I'm not motivated to do anything about it.  I'm enjoying that "freedom" that not caring gives me.  It's a freedom I don't usually give myself, the option to be apathetic and selfish.  Honestly, I can empathize with people who have BPD that stop taking their medication.  Because even though I don't feel anything like myself when I'm manic, I don't necessarily want to stop feeling that way.  Life doesn't require as much effort and intention when I'm manic.

But I take my meds anyway, because BPD has taken me to some very dark places that I do not want to revisit.  And I talk to trusted friends that can help me keep my perspective and help me see the bigger picture.  I try to remember decisions and consequences I have made during a different manic episode and try to get through the current episode without repeating those same mistakes.  Often times, one of the first signs I'll recognize is my inability to fall asleep and I'll take some Benadryl or melatonin to help me get the rest I need because I know that mania is exacerbated by a lack of sleep.  But so far, those are about all the tools I have in my "manic toolbox" right now.  

And although the mania happens less frequently (2 episodes in the past year) and for a shorter duration (usually somewhere between a week or two for me) than my depressive episodes, I find mania more frustrating because I don't know how to manage it.  I don't know how to make it right.  And maybe there is no "making it right".  I really don't know.  What I do know is that I am doing what I can.  I'm reading books on BPD, trying hard to reflect on my behavior, write about it, talk about it, and learn from each episode.  I take my medications, keep in contact with my therapist and just generally try my best.  I have a whole life yet to live with BPD, I don't have to have it all figured out right now.  

My depression varies from mild to severe.  I've written about my severe depression before.  It is awful.  It is by far, the worst part of BPD and it scares me the most.  Scares me to my core.  At the depths of my depression, not even the love for my children was a strong enough force to keep me from wanting to leave this earth.  And that is absolutely terrifying.  It was all encompassing and completely debilitating.  All of my energy was spent just being.  It was a constant battle to overcome feelings of worthlessness and thoughts of suicide.  I've only experienced that severe of a depression once, and it was a long, dark year.  I hated that year.   And ven though it was 3 years ago, I am still terrified that somewhere in my psyche lurks the ability to be taken to that place.  I always say that I need to make friends with my demons and embrace them as part of the fabric that makes me uniquely me.  But not this.  I have not become friends with this monster.  I will do anything to never have to be in that place again.  Even as I write this, I can feel the desperation and sheer panic those memories bring up.  

Thankfully, since then, I have only had episodes of mild to moderate depression.  My depressive episodes are usually longer in duration (lasting a few weeks to a months) and more frequent than my manic episodes.  But I have some really good internal and external resources to help me through those times.  Outwardly, it's more apparent when I am depressed.  At baseline I am a quiet person, but even more so when I am depressed.  Sometimes not only close friends, but even just acquaintances will notice that I am down.  I want to be alone, but not really, because deep down what I really crave is human connection.  But for some reason it's not something I can do when I'm depressed. Mostly I spend the days having internal conversations with myself, trying to speak affirmations to myself that are stronger than my doubts and feelings of inadequacy.  Sometimes I get sad, even tearful, but depression is not synonymous with sadness.  I think it's closer to hopelessness and defeat than sadness.  Most of the time when I am depressed, I feel overwhelmed and tired.  So tired.  Everything feels so obligatory.  Wake up, make the bed, brush my teeth, get dressed, eat breakfast, take the kids to school, every little thing requires intention and so much effort.  It is exhausting fighting off the urge to isolate and hide from life.

But I know my depression better than my mania.  You might even say that we're becoming friends.  I can recognize when it's coming on and I've learned to just go with the flow.  I don't fight it, it's a-comin' regardless,  and resisting only causes me anxiety and panic and that only serves to make it worse.  I've come to recognize the familiar thoughts and feelings that come with my depression and know that those are not my truths.  They are just part of this disorder and something I will have to continue to learn to manage and combat.  So I just ride the wave with faith and assurance that it will pass.  

It sounds simplistic, but it's not.  It's work.  The key to managing my depression is staying connected.  To know that my circle loves me and is there to support me, to remember and believe that I am not a burden to them in my times of need.  I need to recognize that it is much harder, and more dangerous, if I try and manage my depression on my own.  I have to ask for help.  If I keep reaching out to people who love me, release my thoughts through talking or writing, rest when I need to, keep my therapy appointments, continue taking my medications, and just overall be intentional and diligent, the storm will pass.  And it inevitably does.  Sometimes, I can feel the fog lifting, slowly, day by day.  And other times, I just wake up one day and realize that I've been feeling pretty good for several days and that somewhere along the way, the depression has lifted.  

So those are the ups and downs.  But I don't cycle through them in a day's time or within a single conversation or encounter with someone.  I can be moody at times, but that's more attributed to my hormones (sigh) or situational stress.  Every time I experience an emotion, even if it is closer to the extremes of the spectrum, it is not always attributed to my BPD.  I'm just being human in those moments.  Between the ups and downs, I strive for balance.  And with balance comes peace, clarity, and rest.  That's really where the majority of my days are spent; seeking, and practicing balance. The ongoing quest for balance in a chaotic world.  And I think that's something we can all relate to, not just those of us with BPD.  

I hope you can see that even though I have mental health issues I'm really not that scary.  I'm not crazy.  I'm not schizo, or psycho, or even bipolar.  Because I am not defined by my disorder.  I am not bipoar disorder.  I am me.  Just me.