Monday, December 24, 2007

A Time to Cry, A Time to Rejoice

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.

Sunday, December 02, 2007

Doped Up and Ready to Rock

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.

Tuesday, November 20, 2007

When Friends Slide Over the Edge

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.

Thursday, November 15, 2007

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

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.

Saturday, November 10, 2007

A Year and a Few Tears Later

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.