Tag: bipolar disorder

Backtracking here … some official words about mental illness

I realized the other day that though I started this blog in part to share my experiences with mental illness, I haven’t necessarily given some good definitions of the term or the different kinds of illness that people may experience. As I have written about how I feel and continued to get feedback from friends, I realize that I haven’t made clear enough what exactly “official” mental illnesses do, and how they are different from the regular ups and downs that everyone experiences in normal life. So here goes.

From the National Alliance on Mental Illness comes this information about depression:

Unlike normal emotional experiences of sadness, loss or passing mood states, major depression is persistent and can significantly interfere with an individual’s thoughts, behavior, mood, activity and physical health. …

Depression occurs twice as frequently in women as in men, for reasons that are not fully understood. For more please visit NAMI’s section for Women and Depression. More than one-half of those who experience a single episode of depression will continue to have episodes that occur as frequently as once or even twice a year. Without treatment, the frequency of depressive illness as well as the severity of symptoms tends to increase over time. Left untreated, depression can lead to suicide.

Major depression, also known as clinical depression or unipolar depression, is only one type of depressive disorder. Other depressive disorders include dysthymia (chronic, less severe depression) and bipolar depression (the depressed phase of bipolar disorder). People who have bipolar disorder experience both depression and mania. Mania involves unusually and persistently elevated mood or irritability, elevated self-esteem and excessive energy, thoughts and talking.

Now for a definition of bipolar disorder, also from NAMI:

Bipolar disorder is a chronic illness with recurring episodes of mania and depression that can last from one day to months. This mental illness causes unusual and dramatic shifts in mood, energy and the ability to think clearly. Cycles of high (manic) and low (depressive) moods may follow an irregular pattern that differs from the typical ups and downs experienced by most people. The symptoms of bipolar disorder can have a negative impact on a person’s life. Damaged relationships or a decline in job or school performance are potential effects, but positive outcomes are possible.

Two main features characterize people who live with bipolar disorder: intensity and oscillation (ups and downs). People living with bipolar disorder often experience two intense emotional states. These two states are known as mania and depression. A manic state can be identified by feelings of extreme irritability and/or euphoria, along with several other symptoms during the same week such as agitation, surges of energy, reduced need for sleep, talkativeness, pleasure-seeking and increased risktaking behavior. On the other side, when an individual experiences symptoms of depression they feel extremely sad, hopeless and loss of energy. Not everyone’s symptoms are the same and the severity of mania and depression can vary.

More than 10 million Americans have bipolar disorder. Because of its irregular patterns, bipolar disorder is often hard to diagnose. Although the illness can occur at any point in life, more than one-half of all cases begin between ages 15 and 25. Bipolar disorder affects men and women equally.

As I do believe I have mentioned, it seems apparent (as much as is possible with these complex brain issues) that I have a form of bipolar disorder. One doctor, who has written a fine book and puts information on a website as well, has a great explanation that is quite detailed showing what a broad “spectrum” of symptoms people can experience anywhere between the “unipolar” extreme of clinical depression and the other extreme of “bipolar I,” which includes manic episodes and full delusional mania. For a really detailed explanation, visit Dr. Phelps’ site on this particular topic. In other words, I’m somewhere in the “middle of the spectrum.”

I’d say I’m typically a fairly “normal” person. When I’m feeling pretty normal, I manage to weather ups and downs of life with maybe a little complaining and some irritability. I think most people understand what THAT’s like! But when I’m pushed outside of those “normal” chemical boundaries, then I find it either impossible or much more challenging to weather the regular ups and downs with my regular coping tools. I am on medication that makes it much easier for me to stay in the “normal” frame of mind most of the time. But even so, medication doesn’t put me in that “normal” place 100% of the time. I still end up in an extreme irritable state or depressive place every so often.

One point I’d like to make clear is this: as Dr. Phelps says:

Depression is Not a Moral Weakness.

It Has a Biological Basis. 

He shows there are real proofs to back up this statement.

A view of the hippocampus from Psycheducation.org

The other point to make clear is this: doing the normal things that “normal” people do who are facing some sadness or frustration won’t kick someone who has a brain chemistry problem back into healthy chemistry and normal ways of seeing things. Trying to put a smile on your face or just counting your blessings or looking at all the positives won’t do the trick entirely. I’m not saying they’re not worthwhile, but if someone has gotten into clinical depression, those “tips” won’t fix it.

That’s why I am writing about this topic. I’d like more people to understand what it feels like, what it means, to grapple with a mental illness. If you haven’t grappled with it yourself, it’s hard to grasp what it’s like. So I hope that by writing here, I can bring more understanding to those of you who know me or someone else who does have a chemical/biological issue. I’d like to feel that when I say I’m getting depressed, I’m not just complaining about how life is a little extra hard. I’m actually saying I’m struggling and I need support. I’m asking for help. (And honestly, I don’t do that very often, I think. I like to go out and help other people, but I hate feeling “weak.”) And I think this is what many others in my situation are trying to express as well. I don’t want to be seen as a whiny complainer who needs to just buck up and get a stiff upper lip and understand that life can be hard. I just want to be understood a bit more as someone who has a particular biological problem that sometimes makes life a little more challenging to deal with than usual.

I don’t know how successful I’ll be. I just hope that I can reach a few people. If I do, I suppose that’ll be success. Thanks for trying to learn more and understand!

Too depressed to think of a name for this post

Sometimes the depression end of the mental illness that I get to enjoy hits me like a nice thick fog with claws. I can hear it coming but still can’t quite escape its nasty grip. It grabs on and envelops me, surrounding me in a dark cloud no matter which way I try to turn. But pretty soon I don’t try to turn any way anymore.

This ugly depression erases companionship out of my life and surrounds me with a dark cloud, and, to add insult to injury, it zaps me of the motivation to make a nicer-looking illustration with Photoshop.

It’s sadness and frustration and hopelessness all rolled into one entity. It’s wishing all that feels wrong could just wink out of existence, that somehow I could wave a magic wand and have everything better. On extreme times, it’s wishing I could wink out of existence. The cloud allows me to see out, and I know others can see in just fine, but they can’t tell that anything’s happening. It somehow eerily makes others blind to my inward suffering. I end up feeling alone, isolated, and misunderstood.

I want to scream and cry sometimes. I want to talk it out. But talking doesn’t help because there are no solutions, and the people around me have nothing to say that can change the stark reality of the dreary fog. I want someone to have answers. I so desperately want that. I want someone to fix it. When I’m pushed into the depression it’s usually because circumstances in my life have become a bit too much for me to be able to handle anymore. This time around, it’s all the things I wrote about earlier in the week. It’s not having any time to myself to think or write or just care for my inner self for the whole summer. It’s having huge expenses and a bunch of seemingly nonstop little ones drain my bank account this year and make me nervous about spending any little sum, so I don’t even want to take all of my kids to see a full-price movie for a nice change of pace (even at matinee prices, it would cost almost 40 bucks for the five of us to see “Brave.” I mean, come ON!). It’s this darn broken foot. It’s the frustration of having no control over almost anything in my life lately. So many things have conspired to drain me of my resolve and my strength, and now I am down to the level of near-hopelessness.

Oh, I wish a miracle would happen. I wish my blog and website could be wildly successful. I wish I could get some time and inspiration to write the book I’ve been planning and researching for months now: and to feel that it’s even possible to get it published if I do manage to get that mythical time and inspiration together. I wish that I could find the motivation in myself to lose some weight. But with a broken foot, the exercise part of the equation is more than challenging: the recumbent bike sessions I’ve been doing this week aren’t going to cut it.

I wish that I could feel comfortable enough with more people to really say how I feel, but I don’t trust many people to do so. I’m pretty much afraid of how people will respond. My husband at least has learned over the years to stop saying anything that I could remotely construe as platitudes (because those make me go from 0 to 60 in angry miles almost instantaneously), but now he just says nothing. That’s only a slight improvement on the cliches and pep talks; I just wish he could say something that would really comfort me or encourage me. I wish I could find it in me not to feel at all resentful that he can’t do this for me, because it’s really not his fault. Very few people are very good at dealing with someone who’s laboring under the fog of depression and that utter hopelessness. That’s what’s so frustrating: it isolates so quickly and easily. No one knows how to respond. I know. I get that. But it still makes me feel alone, and angry, and doubly sad. I am deathly afraid of people’s judgment, of their fear, of the possibility that they’ll think I’m weak or that I am just a complainer. (I usually feel fairly strong. That’s the problem: I’m too strong. So even when I feel weak and hopeless, everyone else still thinks I’m fine and just leaves me alone.)

I’m afraid. I’m tired. I’m exhausted. I’m actually just overflowing with “sick-and-tired”-ness. I’m at wit’s end. I’m utterly sick, sick, sick of feeling like this on a somewhat regular basis, of feeling that life has me cornered, that I have no control over my own destiny, that I’m Sisyphus pushing, pushing, pushing on that rock. I’m SICK of looking at that rock.

That’s the thing: I’m not the type of person who expects to have anything handed to me on a silver platter. I don’t think the world owes me a living. It’s the opposite, really. I work hard all the time to take care of myself and my kids and my husband. I work hard in volunteer roles to help other people. My heart goes out to everyone else I hear about who’s in need in any way and I wish I could help. I am always doing something that’s practical in some way. But when I get into this down mode, I wish that all of my efforts would finally bear fruit, that the rock on the hill I constantly am climbing would just sprout some legs already and MOVE, dammit. My arms are tired.

Again, I guess that’s why I’m writing this blog. I want to put into words what I experience, in the small hope that what I say can be of help to someone else out there climbing their own hill, pushing on their own insurmountable, immovable rock. Man, I wish I could just pick up your rock for you and toss it away, let it crumble into a million pieces as it rolls down and hits the valley floor. I wish you could do the same for my rock. And I wish that I could help everyone out there feel more comfortable talking to someone in my position right now, make you feel able to say something encouraging, able to sit it out and not run away cringing. I want to feel less alone. I want others like me to feel less alone.

It might be another thing that’s impossible, but like all the other goals in my life that seem impossible right now, I just have the tiniest hope that they might, might, MIGHT be possible, in some other universe in which I am happy and capable again.

The best moms … know their limits

Much talk has been made over the years and even recently about “good moms” or moms who “do everything for their kids” and so on. The Time piece titled “Are You Mom Enough?” stirred quite a bit of controversy and buzz. But there are clearly as many ways to parent out there as there are parents. I would venture to say that a number of those methods employed by some parents are probably not so great, but in general, most parents get the job done passably well. But I think what bugs me the most is when people make judgments about parents whose kids are doing just fine and start saying that their parenting style is lacking. About a month ago, right around the time I was in dire need of a little me time, a Facebook “friend” posted that she was so disappointed in all the mothers who were complaining that their kids were driving them crazy. She ended by saying, “It’s about attitude!” I gently responded with a couple of kindly worded comments to the effect that just because some of us mothers were rightfully saying our kids were making us nuts (this is summertime, people!), it doesn’t make us bad parents. Just normal. A few hours later, my comments (which were completely appropriate) had been deleted. What the heck, man?! But that’s a whole other story.

Let’s just say that I consider myself in many ways a pretty normal, typical mom. For years, women have dreaded the summer months in which a passel of kids would be constantly underfoot and looked forward to school starting again (even a popular Christmas song refers to the relatively short winter break: “And mom and dad can hardly wait for school to start again!”). So feeling nutty here at the end of the summer does not make me an unusual mom, let alone a bad one.

I will say that what makes a good mom, I think, is knowing your limits. I figured out long ago that, given my personality and my mental health issues, having consistent and dependable time alone, preferably weekly, can keep me going at my best. I’m a gas-guzzling, large-capacity van, let’s just say, at this stage of my life, and I need frequent infusions of gas, oil, and water to keep me running effectively and continually transporting my load of children through their lives. I also need good quarterly maintenance.

Unfortunately, the summer months disrupt my fairly well-planned and nicely balanced routine that keeps me at my mothering best. I know this going in and start feeling a little nervous come May. But I do the best I can to plan and make allowances. And then I still end up running low on gas and oil and burning out at least once, sometimes twice, usually in the middle and at the end of the summer. A month ago, I felt myself snapping, stretched to my utter capacity for patience and sacrifice, and I scheduled a Saturday for myself. I hadn’t had more than an hour to myself in about two months. I hired a niece to babysit for the day and I went for a lovely bike ride and then had lunch and manicures and facials at the beauty school with a friend. It was wonderful. And not nearly long enough. I was not ready after merely seven hours to get back into the grind. The timing the next day of that Facebook post of my friend (unnamed here) was very unfortunate. I thought it was insensitive and judgmental. After having my comments deleted, I deleted the friend (this was not this person’s first “offense” at overreacting to innocuous comments, either). At the time, I felt it was the simplest and quickest solution to help reduce the negative influences in my life. Again, I suppose that’s a whole other story.

Mama’s stretched to snapping: it’s not a pretty picture.

A month later, I am back at snapping point. Having four children with all their demands (and whining and fussing amongst themselves, which can just grate on one’s nerves) around nonstop; then having to make sure the two older ones get to a girls’ camp; then the oldest, who can actually babysit, be gone for an entire week at band camp; then breaking my FOOT and being unable to do the things I need and want to do; then not having any time or brain-space for thinking clearly in order to work on the writing projects that mean a lot to me personally; having other big responsibilities on my plate that still need to be taken care of, broken foot or not (band boosters [the band director needs us to raise $150,000 for new instruments over the next three years?], being in charge of my university’s local alumni chapter, other volunteer things); then throw in PMS, and it’s a recipe for burnout. (Not to mention having all kinds of large and small expenses pop up until the point of ridiculousness this past four or five months, and the astonishing number of things that have kept breaking down on me the past few months till where I’m begging the financial universe for mercy…) It’s the rubber band being stretched entirely too far. It SNAPS.

I wish I could be the kind of mom who enjoys every single moment with her children. I wish I could savor every moment during the summer with them. I have done some fun things with them here and there. I just haven’t been their everything for every moment. (Nor do I think that is good for them, anyway.) I am still absolutely ASTONISHED at the amazing journey a dear friend took this summer with her seven children. They drove in a pop-up camper all the way from the western United States to Alaska and spent two months making the trip. I would have gone nuts probably on the second week, the third at the latest. How she did it is beyond me. But I am in awe and I tip my hat to her. What an amazing experience for them all. But me, I’m just getting my kids through the summer at home, barely gripping on to my sanity.

I am still trying to figure out right now how to just survive the next eight days until my children start school. It sounds silly now that I’ve managed to get through a whole summer, but the last days are seeming like an eternity because I’ve already snapped. I have no spring left. I pretty much want to curl into a ball in my bedroom, take some kind of sleeping pills so I can coast through the next days mostly unconscious, and lock the door.

I would probably be a slightly more “normal” mom if I didn’t have my mental health issues. But I do the best I can to stay on top of them. I take medication, check in with my psychiatrist, and have regular visits with a therapist. I try to be reasonable in my expectations. I’ve been trying to repeat all kinds of useful and inspirational mantras the past weeks to keep myself positive enough to survive until I have some time alone to just regroup in pretty much every way. I just don’t know who or how to ask for help. And unfortunately, when I mention my feelings and am aware that I am being stretched too far, I end up with mostly unwanted advice (one-sentence cliches that too often start with “just”… if you’d just do X, Y or Z, you’d be fine. Or just “let go and let God.” Yeah, I know all that. Doing it is really the battle, isn’t it?) I don’t want advice. I want support and practical help. Someone want to take my girls on a vacation for a few days? That would be most welcome. No mantras, no judgment. Just support and caring.

As you can see from this long post, my manic side is coming out a bit. Sorry ’bout that. But it’s my reality. I am who I am, and I’m daily trying to improve the parts of me that can be improved, and manage the things I can’t change (genetics, brain chemistry: I’m talking ’bout you). But I’m still working on it. I’m going to fall down a lot and fall short a whole lot. I just wish I were better able to figure out ways to practically deal with the snapping of the rubber band before it stretches too far. My aspirations for being a great mom are simply in knowing my limits and not pushing past them. I’ve given my children so much and taught them so much and love them a great deal. Yeah, I need some time alone, away from them, sometimes in order to be able to continue to be a good mom to them. I just want to be able to stave off the snapping.

Spirituality and mental illness

As a faithful follower of Christ my entire life, my spirituality and connection to the divine have always meant everything to me. My life would not be what it is without my knowledge of and faith in God, my Heavenly Father, and His Only Begotten Son, Jesus Christ. I have always depended on the great gift of the Comforter that Christ left with his disciples, the Holy Ghost or the Holy Spirit. I’ve been taught since I was young how to understand what the Spirit is trying to communicate to me through his still, small voice. It is explained to people in various ways because it can affect and teach each of us a little differently, so each of us must learn exactly how he sounds to us. A scripture in my faith’s canon says that the Holy Ghost will speak to me in my mind and in my heart, and that really rings true in my experience. I can often just feel ideas popping into my head, and I can feel in my heart a good feeling that confirms they are from a trusted source.

But my challenges with my mental health over the years have thrown wrenches into that beautiful process off and on, in various ways. The depression, irritability and anger I’ve felt have blocked that positive flow of messages from a loving God, leaving me to feel adrift and alone and cut off. I’ve sometimes felt that there are just no answers coming to prayers, and I’ve given up asking. I’ve even gotten angry at the heavens then for leaving me in that isolated state, with no communication coming my way. All of it leads to me feeling that I’m alone and undeserving of God’s love, that for some reason he just isn’t paying attention.

Even medication I’ve taken has caused difficulties of its own. As I wrote in my previous post about my long list of medications over the years, when I tried Abilify for a few months about a year and a half ago, I felt absolutely numb. It was unnerving because I’m usually a bubbly person who often sees the bright side of things and, in terms of faith, relies on (even might take for granted) the wonderful peaceful feeling that comes from turning to prayer and scriptures and other messages of a spiritual nature. I know that when I listen to good music that reminds me of God and Christ or when I read a scripture or an inspirational magazine article, I’ll feel uplifted and recharged. I’ll feel the influence of the Holy Ghost, a marvelous gift. So for the few months I took that medication, I didn’t feel anything, including those spiritual feelings. I didn’t feel bad, but I didn’t feel good. I didn’t feel peaceful or Spirit-filled whenever I did all the things that would normally make me feel that influence. It bothered me a great deal. It was a strange feeling to go to church, where I would normally feel happy and inspired, and just feel … nothing. A black hole where there would normally be gardens in bloom with all colors of gorgeous flowers of faith.

What got me through that time was just the knowledge I had still in my mind about all the experiences I could remember. My brain had stored away the memories of knowing that God had answered my prayers at specific times and that I knew that the Holy Spirit had usually been in my heart. I couldn’t feel it then, but I trusted in my head that it had happened before and would come back to me, no matter what wacky tricks this medication was playing with me. And sure enough, when I got off that medicine and got to mostly myself again, I did feel that peace again. The black hole was gone, filled again with light.

So the wrong medication can play tricks on faith. Depression and other mental illnesses can do their own brand of damage. I’ve been through that emptiness before and am kind of feeling it again, and I’m sure I’ll keep experiencing it throughout this mortal existence. It’s not pleasant, and I’d rather not have to go through this. But my feeling is that this is my cross to bear, so I’m doing the best I can to handle it gracefully. Saying I’m doing my best is the truth, but even then it feels silly to say because “my best” can sometimes not be a whole lot. I feel alone inside of myself and that God isn’t sending me answers or the positive feelings I need. But I know in the part of my brain that’s not “messed up” somehow that he’s still there.

I think what I want most to do here is connect with other people who experience these feelings. I think that faith communities are slowly doing better at directly and publicly addressing matters of mental health in the context of religious belief, and that’s wonderful. But depression and other mental illnesses work hard to isolate their sufferers. Those of us who know in our minds and in our hearts that God is aware of us and loves us but sometimes don’t really “feel” it the way we should because of neurochemical vagaries can talk to each other to buoy each other up not just in our specific trials but in our faith. We’ve been given a great gift to have a Savior and the good news of the gospel he has taught. I believe there are still miracles today. Honestly, though, some days, amid the clouds that create a darkness of despair in my heart and head, I don’t feel a conviction that God will work a miracle in my life. And since I know that isn’t true, deep down, I have to work hard to combat the feeling that is false. A dear, dear friend of mine told me a couple of times that she and her mother were able to talk to a well-known Christian writer of our faith after he gave a talk they attended. She wrote me to remind me what he had told them: “He suffers from depression and told my mom and me that being faithful means that you remember the Lord is with you and mindful of you even when the depression doesn’t let you ‘feel’ it. He is still there!” I just cling to that like a little round life saver thrown to me in an ocean of big waves. Eventually the waves die down, and I’m still clinging on for dear life: alive and well yet again. Still.

Medications and me

Having a mental-health concern (that seems most likely now to be a bipolar disorder) for the past 25 years or so has naturally led to my being on various medications to try to improve my quality of life. I’ve already discussed a bit how it’s been a challenge to figure out exactly what I’ve been up against over the years (just some depression? anxiety? postpartum depression or PMS? bipolar disorder? nothing at all?), so I’ll try to go back and address what kinds of medications my doctors and I have tried to use to help me feel a bit more “normal,” or, more accurately, just better able to cope with the usual stresses and strains of life.

The first I ever took some kind of an antidepressant was toward the end of my LDS mission when I was feeling serious stress. The resident older missionary/retired doctor prescribed me a medication that would supposedly help with that. At this point, I honestly don’t remember what it was he gave me. What I do remember is that I was in pretty bad emotional shape and just going about my regular busy schedule just with a new medication didn’t help me feel any better. Besides, it usually takes a few weeks for those kinds of medications to even start making a difference, and in the meantime, I just kept feeling stressed — and guilty or bad about being stressed while I was supposed to be happy and spiritual and serving God and my fellow beings. It just wasn’t a good recipe for success as a missionary or a happy human being. So I ended up having to leave the mission behind and go home to seek help in a different environment (already talked about how that went).

I was next put on lithium when hospital doctors decided I was bipolar. I took that for a bit less than a year, I think. I felt better as time went on, mostly, but I also went back to college, where I felt more at ease and myself and had my friends around me. I am sure that the medicine must have helped though, looking back, because otherwise I probably still would have been seriously depressed/angry/stressed. But the change of environment did contribute, and after a time, I just felt that 1) the diagnosis of bipolar disorder couldn’t really fit me because I didn’t fit the “classic” signs of the “full-fledged” disorder and 2) lithium is a serious drug to be on: it can potentially damage the liver. I was having my blood tested every few months to make sure my liver was fine, but it was still a real concern. So I went off the lithium. During all this I was seeing a counselor at school, so I didn’t do all this just on my own without any professional support, but I don’t know if I had a psychiatrist on my “team” at that time.

After I married and moved to California with my husband, I know I ended up seeing a psychiatrist regularly, but I cannot remember if she had me on any medication. I know I didn’t go back on lithium. She might have put me on some kind of antidepressant, if anything, but I don’t remember for sure, and I have no idea what it was if I did take something. I do know that the first year of my marriage was very rough for me emotionally, and I prefer not to think about the way I acted. It’s too embarrassing. Luckily, my husband stuck it out with me. I also know that I was on hormonal birth control pills for the first two years of our marriage, and I am convinced that fiddling with the sensitive balance of my hormones was not a good thing for me emotionally.

I know that there were months and years I didn’t take any kind of psychiatric medicine, and there were other months and years that I did. It was always some kind of antidepressant. I took Zoloft and Wellbutrin at a few different times off and on after and between pregnancies. I took them together for a year or so, mainly because Zoloft did take away my sexual response. That’s something that’s a warning when you take that and various other medications, such as Prozac, and it’s definitely true for me. It can seem like a small price to pay, but it’s actually a pretty big sacrifice when it comes to a full intimate life with your spouse, so it bothered me greatly. Taking the Wellbutrin with the Zoloft took that side effect away.

After probably my third pregnancy, my gynecologist prescribed me a new medication, Lexapro. He said it worked well and had no significant (definitely not sexual) known side effects. I was eager to sign up. The morning after I first started taking it, I got out of bed in the morning to use the bathroom and then ended up passing out on my way back to bed. I was so scared about the weird feeling I had during that few moments that I told my husband to call 911. The paramedics came out and pronounced me fine. They said I’d most likely rubbed the back of my neck or something and had some kind of vagal episode. OK. Fine. Unfortunately, over the next 5 or 6 days that I took the Lexapro, I still felt weirdly faint and out-of-body-ish, and I figured the only thing that had changed in my life was that new medication. I visited with my general doctor, who told me that was ridiculous. But I decided it was the cause, and I stopped that Lexapro. I instantly felt better, well, fainting-wise. (The lesson here: even if your doctor says you’re being ridiculous, you still should trust your instincts.) So I went back to Zoloft or something similar, I think.

I started going to a psychiatrist again, which I hadn’t done for quite some time, just getting antidepressants from my gynecologists or general physicians, although I had still gone to see counselors for talk therapy more regularly. The psychiatrist I saw at that point, probably in 2007 or so, put me on Effexor eventually, which worked well for me for a while. He did suggest I might be experiencing bipolar disorder and might benefit not from lithium, but Lamictal (lamotrigine). He even gave me a sample pack. Even though I did consider that option, I told him that since I was feeling pretty good taking the Effexor, it seemed silly to stop taking something that was working just to try something else. He thought that was reasonable and kept me on the Effexor.

Then in 2008, my family and I moved to California from a long stint in Alabama, and life became unbelievably stressful. I’d also been taking the Effexor for probably a year or maybe a little less. At any rate, I’d probably only done well on an antidepressant for a year or so at any time I’d taken one, either because after a while, my life had settled down and I’d gone off a medication and been fine, or the medication had seemed to stop working. In this case, I just kept taking the Effexor, but my new general physician upped my dose. Shortly before another momentous, life-changing event for me, the death of my beloved dad, I started trolling the Internet and found the site I’ve mentioned already by Dr. Jim Phelps, which made me start to seriously consider the possibility that I really did have a bipolar disorder. But this psychiatrist was making the point that there was a wide spectrum of bipolar disorders, not just the “biggie” in which people stay up without sleep for a few days at a time, go on wild shopping sprees and spend tons of money, and do otherwise really foolish things they wouldn’t otherwise do. So I found a psychiatrist in my new town who was on my insurance list and made an appointment. He put me on Lamictal, which my previous physician had suggested a couple of years before. It did seem to slowly make a difference, and I was happy to be off the Effexor, although it did take a solid two or more months to very slowly wean off of that very addictive medication. (If I didn’t get a dose, I’d start feeling kind of headachy and light-headed, in a distinctively Effexor-less way.)

So I think the Lamictal gave me some relief and some hope that I was on the right track, but a couple of months into that, my dad died and sent me spinning. My psychiatrist asked me at the first appointment after Dad’s death (merely two or three weeks afterward, mind you), “So, how are you feeling?” Uh. BAD. My dad died. I’m miserable. Hard to say how the medication is working. I’d feel rotten no matter what. And that’s how it went.

A few months after that, I mentioned to some people in my church congregation that I was struggling with mental illness, and a few recommended I try a different option, a natural formulation called EMPower that was sold by a company called Truehope. The company says that the formulation contains micronutrients that are found to correct the imbalances found in those with bipolar disorder and other mental issues. I have always felt that ideally, it would be nicest to treat the actual cause of a problem rather than just the symptoms, if at all possible. This sounded like a very reasonable option, and Truehope has actually been doing scientific studies showing the benefits of EMPower.

I felt that I needed to at least give this option a shot. If I didn’t, I would never know if it could have helped me or not. So I went in to my psychiatrist, who naturally told me he didn’t agree with my decision and that he couldn’t continue to see me if I went off my prescription and took EMPower instead. I knew he’d say that, and I was ready to say, “OK. I won’t be back.” He said he knew I’d be back in a few months in even worse condition.

I tried the supplement, which is actually pretty expensive (probably about $100 a month, and not covered by insurance, of course), for about six months. I felt at first it really did help, but after a few months, I was just not feeling good enough. I tried a few adjustments and options after some phone calls with the company’s support techs, but I finally had to make the decision to end my own personal “drug trial.” I am sure that the supplement truly does help lots of people, but as with anything, nothing helps everyone. I did struggle, however, with what to do next. I firmly did not want to go back to my previous psychiatrist. He was too abrasive, and I felt I couldn’t work comfortably with him to find the best options to treat me. I finally decided to go see a nurse practitioner working in psychiatry 45 minutes away from my town because my therapist had heard good things about her from several other clients. I felt that it was going to be best for my mental health process to work with a psychiatrist who I felt comfortable with, that we were really a team, that she would be supportive. So I made the appointment. This new person, who I still see almost 2 years later, turned out to be a really good fit personality-wise, which I think makes a big difference in getting the best care possible. The only drawback is that my insurance doesn’t cover her, so I have had to pay entirely out of pocket. Luckily, I have had the spare funds to be able to pay for the visits, and it has been a good choice for me.

I’ll just call my nurse practitioner by her first name for ease of writing. Susan really went into a lot of detail with me, talking to me about the options and what she thought might work to help me, even explaining why she felt that way. I personally have really liked her approach. I like to feel that we’re on the same page, and knowing her reasoning helps me to feel more confident that is happening. We tried probably four or five different medications over the course of probably four to six months, during which time I’d go back every month to see her and check in. We tried Abilify, Prozac, and maybe Celexa. I can’t remember exactly. I did notice Prozac didn’t make me feel any better, and it just made me feel completely dead sexually, which was super-frustrating for me. So that was a no-go. I also know the Abilify didn’t do it on its own, and it actually made me feel, rather than “more normal” or “more like myself,” just kind of numb emotionally. I wasn’t stressed, kind of, but I was just dead. I didn’t feel anything. I felt like a zombie. I absolutely did not like that. She ended up adding in Cymbalta, which felt pretty helpful. Eventually, we took out the Abilify to see if that would help me feel less numb. And it did work. The Cymbalta, at the time, on its own, was a good fit for me. I’ve now been on that for perhaps 18 months.

Unfortunately, I’m afraid that now we’re getting to a point we need to tweak again. I’ve been on just antidepressants before, and I’ve either just gone off them or they’ve stopped working, and I fear this is happening now. I’m just feeling unhinged. The stresses and huge demands on my time are taking a huge toll on me, and I’m not proving up to the challenge of dealing with them in an appropriate manner. I’m coming up in a few weeks on another check-in with Susan, and I think this time we’ll have to address now how to change my dose or try something else. It’s been nice, though, for the past year, feeling pretty good and “myself.” Descending back into my “crash” mode is a scary and upsetting thing, for me and my family, and it’s nerve-wracking for me to ponder how much trial-and-error it’s going to take to get me back to happy. Will it take a couple different medications again and weird feelings of numbness or just not-effectiveness (so I’ll just feel unable to cope for a few more months? Yikes!)? My main fear is looking ahead at a few months of not being myself, far from it, especially with summer months coming on and my kids being out of school and all the stresses that places on me every summer. It scares me.

So that’s where I am, medication-wise. I’ve been a bit of a guinea pig for the past 20 years. It’s difficult because treating any kind of illness can be tricky and require some finesse. The basic stuff is kind of straightforward (infection? take an antibiotic; cold? take some antihistamines and Sudafed and wait it out), but other health issues take some trial and error. Then when it’s mental health, which is still a kind of slippery creature in the early 21st century, and every person’s needs and body chemistry is unique, it’s a science that’s more art than anything else. Being the doctor is probably a challenge, but being the patient is truly difficult. Being that guinea pig, the one on different kinds of medicines, is tricky and frustrating as all get-out. I’ve said for ages I wish there were a control group for me. But there isn’t. Good science requires a control group and an experimental group, and in this case, giving just me a medication and seeing what happens isn’t truly good science. And the onus is still on me as the patient to make the judgment calls, to figure out what’s changed, what to tell my health-care provider, about what might be significant. Do I feel better taking Lamictal even though my dad just died? Can I possibly separate out the effects of that from my normal stress reactions? Can I say I feel better on something even though a bunch of stuff has been happening in my life? If I could put myself in a quiet room without any interference from outside sources, I could judge better. But that’s never possible. (And if I could be by myself in a quiet place — resort, maybe? that would be amazing — I may very well be able to get to feeling better without the medication. Maybe. At least I wouldn’t be bothering anyone else.)

This post is incredibly long; perhaps I should have separated it into a few parts. But it’s the best answer to those who would like to know what my experience is with medications. I hope it might be of some use to those of you who struggle with similar problems and need to figure out how to look at your own situations with more clarity. Perhaps it will just make some of you more sympathetic with those in your lives who have challenges similar to mine. Or maybe those who know me but don’t know all these details about me will feel more empathetic with me. Either way, I hope this is of use to someone out there. This is an ongoing story, so I will need to update as the next few months come along and I visit my nurse again.

A shout-out to the blog that started this conversation

Early last month, I saw this lovely post linked from a friend’s Facebook page. It got me thinking about my situation, and I decided it would be useful to start a blog that talked openly about mental illness. So here we are, about six weeks later.

Being Sunday, I will focus today on some faith-related observations. I don’t necessarily intend this blog to be focused entirely around faith and my religion in particular, but from time to time I’d very much like to address belief because it is very important to me and how I experience life.

I am of the opinion that my church, the Church of Jesus Christ of Latter-day Saints, has done a nice job bringing some of these more sensitive topics to the attention of the church membership worldwide. The official magazine of our church is called the Ensign, and it comes to homes monthly with lots of wonderful inspiring articles and first-person experiences of how the gospel of Jesus Christ has changed people’s lives. The magazine has featured over the past decade more and more articles that address special situations like how to parent and teach people with disabilities, for instance, and how to tackle the problem of pornography. It has featured articles about mental illness, as well, from the viewpoints of licensed therapists and from those who have struggled with it personally.

So in no way do I think our church has tried to sweep the issue under the rug or act as if it isn’t a challenge to many people. I have definitely enjoyed the articles about mental illness in the official magazine, and I have appreciated books that have been published about the topic that are aimed at the LDS audience.

But I do think that more can be said, more can be done to bring what was once rather a taboo topic out into the open. I’ve already written about how more people seem to understand physical illness, and I liked how this blogger mentioned the same feeling. Our church women are known for providing meals to those who are sick or who have just had babies. We’re great at delivering casseroles. But while I have been given some meals over the years postpartum, I haven’t been provided much sustenance when it’s come to my mental recoveries. I think that there are basically two reasons for that: 1) few people even know when someone’s suffering from mental illness (in general or a bad episode of it) and 2) our society as a whole still just doesn’t talk about it enough so that it’s something people all feel comfortable with. Sure, not everyone is even good about talking about physical illness, shying away from the “C” word, for example, but even so, I think that the more a topic is addressed, the more people can become comfortable with it and the less it will feel like a taboo.

So here I am, again writing these words out in public so they can feel less strange, less taboo, less “other,” less misunderstood. The topic of mental illness is extremely personal to me, and I could continue being very private about how it’s affected me, or I could do what I’m doing now: just speaking out loud. I think this whole blog has that same purpose: to contribute to a conversation, to raise awareness, to increase sensitivity and understanding. I think that in our day we have been blessed with the gift of technology, and if we use it to improve and uplift people’s lives, we will be giving a gift to others.

A tribute to a one-in-a-million man

Since he turned 45 yesterday, I decided today would be a good day to recognize the superhuman support and love of my husband, Marce. I met him when he was 25, and in a way it doesn’t seem possible we’re in our 40s now, that nearly 20 years have gone by. I’m quite sure when he fell in love with me and decided to propose he had no idea what his married life would have in store for him.

We did have some discussion while we were dating about my mental health. I had returned from my mission, gone through the heartbreak I did with my longtime friend, and been started on lithium after a diagnosis of bipolar disorder. One evening we took a drive to visit my mission president, a man I love a lot and greatly admire, and who was sensitive to my needs. He and his wife sat and chatted with me and Marce; we had only been dating about two weeks at that point, and I didn’t really expect it to get serious. My president asked about how I was doing emotionally, and I told him so far, so good. His dear wife whispered to me, “He is a good young man. Hold on to him!” (She was more right than I could possibly have known that evening.) On the drive back to school, Marce asked me, “What did he mean about taking your medicine?” That gave me the opening to just tell him everything about what I’d experienced and where I was at that point. He listened quietly as he drove, held my hand, and seemed very reassuring and nonjudgmental, which meant a lot to me.

Sometime in the few months after that, I decided to stop taking the lithium because I just didn’t feel I had bipolar (I just didn’t fit the symptoms of the “bipolar I” or the typical disorder, as I think I’ve written about already). The medication could have dangerous side effects, and I needed to have regular blood tests to make sure it wasn’t damaging my liver. I felt since I wasn’t sure about the diagnosis taking a possibly harmful medication didn’t seem like a good idea. Unfortunately, around that same time I got engaged, finished college, and started my new life, and got so busy with a new full-time job and a marriage and new place to live and everything else that I neglected to consider my mental health. If I remember correctly, I didn’t do anything about it immediately (though I know I did find a psychiatrist sometime in that next year). I also started taking birth control medicine, which is chock full of hormones, which I have also learned was probably not a great addition to the cocktail of my personal chemical makeup. Again, unfortunately, I didn’t know any of this at the time.

My sweet love on our wedding day.

What my dear groom experienced in the first year of our marriage was a number of occasions of me flying off the handle at nothing. I remember one trip on a day off to an amusement park, where I went ballistic over something someone near us did and shouted at them. I don’t remember the details, and honestly, just thinking about the idea of it anymore and writing it down mortifies me. But it’s what happened. I was a mess. On that occasion and others, Marce would just quietly try to divert my attention and take me away physically. He rarely made any comments or judgments.

The two of us have very different temperaments and backgrounds. My family was very open and didn’t hold back our opinions. We argued and yelled and were loud. His family was a strict Asian family, and the children did not talk back. There was no argument between children and parents, and yelling wasn’t tolerated. On top of those differences, I had a background in speech and some debate and a need to win. Marce played basketball and never debated. I’m sure it mattered to him if he won basketball games, but he just wasn’t (isn’t) a competitive type. Put that together, and you have no arguments, sure, because it takes two to argue. But I’ve certainly hankered for it over the years. If he had been the arguing type, we’d have had some doozies. As it was, I’ve yelled and screamed and done wacky things, and he’s listened in silence with a nearly emotionless face.

I’m not writing any of this because I’m proud of it. Very much the opposite; I’m embarrassed as all get-out. In many ways, my yelling and anger doesn’t fit with what I consider almost my “real” personality. But it’s happened, and it’s impossible to say that it’s __ percent my hormones/brain chemistry and __ percent my personality/upbringing/etc. I’ve already written about how it’s not possible to separate my “true” personality from what’s been caused by my mental disorder. I just am who I am; what I’ve done and experienced makes me who I am now. I hope that all of my flaws (chemical or not) have at least helped to turn me into a better person over the years, rather than cement me into place as a meanie.

It could be accurate to say that Marce may have needed to be more assertive or actually discuss issues with me more rather than just be silent. But that’s an issue for his blog, if he were ever to write one. What’s important and relevant is that over the course of being together for 19 years, he has never yelled at me; he has never left. He has always loved me and been supportive. I don’t think he’s judged me harshly, despite my giving him good reason to do so. He has done that from the very beginning, up until now, when we can at least put some good labels to what we experience together. Because at this point, it’s not just MY mental health issue; it’s OURS. (Although I have said at times when I’ve had the worst moments that he’s lucky he can at least go to work or somewhere else and get away from me for a while, whereas I can’t get away from myself and what’s happening in my head.) We are in this together; we’re a team. What’s his problems are mine and vice versa; what are his strengths could also be mine, and vice versa. I’ve known from fairly early in our dating days that I just felt comfortable, myself, with him, that I didn’t have to pretend to be something or someone I wasn’t. I was at ease; I felt loved. I’ve also known that we complement each other perfectly. We have truly made a great team.

Many other men may have bolted long ago from what I’ve put my husband through. But he is not other men. Sure, he has weaknesses, but he is an unconditionally loving husband who is dedicated to the institution of marriage and to me, personally. He and I believe that our marriage can last forever, and we’re working on it so we can be happy together for eternity. I now have confidence that is truly possible because I have 18 1/2 years of knowing for sure that my husband is committed to that. I am very blessed. His support has made all the difference in what have been some really challenging times. So, happy birthday, my love. I hope that my strengths and commitment to you have shown you how much I love you and appreciate all you’ve been to me.

Latest discoveries

It’s going to take a whole lot of posts to cover my life and experiences in this department. So I started at the beginning, but I’ve been jumping around since that first post. I’m going to try to explain a bit where I am now.

We moved to California in late summer of 2008 from Alabama, where we had lived in one town for 10 years. We were pretty well settled there, even though we hadn’t expected to stay there for so long. But our children’s needs, primarily, induced us to move cross-country. Though I had some time to plan and prepare for the move, the whole thing didn’t go nearly as smoothly as I would have liked. It took ages to get into a house of our own, during which time we lived with family and had all of our possessions in a storage unit. Then we waited and waited for our house in Alabama to sell, and after a year of waiting and one very low offer that fell through, we decided to rent it out. The stress of all those things, combined with the financial stress of paying two mortgages for a year, made life very difficult. I just felt depressed and frustrated and irritable pretty much all the time.

I had been seeing a psychiatrist in Alabama for a year or two, during which time he’d put me on an antidepressant that seemed to help fairly well. But with the move, it just wasn’t doing enough. So I started surfing the Web one morning and found a site that turned out to be very useful. It’s just a very simple-looking site by a psychiatrist who has shared many of his insights online. He also wrote a book called Why Am I Still Depressed? I pored over the site and then ordered the book. I decided that it was time to see a psychiatrist in my new town, rather than having my general doctor keep writing scripts for the old antidepressant.

The site had really struck a chord with me; its information led me to believe I was experiencing what this doctor (James Phelps) describes as bipolar II. Armed with this bit of information, I found one of the two psychiatrists in town that my health insurance covered and made an appointment. My new doctor and I talked, I shared my opinions, and he prescribed a new medication; he called my condition “atypical bipolar disorder,” but it’s just a slightly different name for what Dr. Phelps called bipolar II. The new medication seemed to work fine, and just knowing I had new information and a new medication gave me hope.

Three years later, this is still the diagnosis I’m working with. I’ve tried some different meds and a different doctor (I’ll write other posts on those topics), but we’re still going with that. Honestly, though, I still wonder how many other factors are at play. Dr. Phelps’ website talks about how thyroid disorders are sometimes tied in with bipolar II, and since I’ve been hypothyroid for about 12 years now (well, that’s when my doctor and I discovered it), I can’t help but think it may play a part in what I experience, even though I have been on thyroid replacement medication for all that time and it’s supposedly controlled (according to blood tests that my current doctor administers every year: and THAT, again, is a whole other topic). I also have noticed that I feel particular sensitivity to hormonal fluctuations, during pregnancy and postpartum and my monthly cycles, and those must be factors as well. I’m fascinated by how things work, and the complex interplay of hormones in the body is so interesting to me (I even wrote a paper about hormones for a research project in English in high school before I knew how personal it was). So I would love to figure out exactly how all these things work together to create my particular issues. Doctors, however, basically don’t seem to care about this (How could they not? Do they not have any curiosity?), at least when it comes to treating me. They just want to know that they’re finding a good medicine to treat me, and that’s all that matters. They have a point, I suppose, but I’d just love to know how all this works inside me. As far as we’ve come in being able to treat mood disorders, it still feels like we’re kind of living in the 19th century treatment-wise compared to all the other feats of medicine that exist.

So I could say now, “Well, this is it. I’m almost 42, and I’ve finally figured out what’s going on with me.” But even though I feel fairly confident that I’m on the right path — and it’s a big relief, I must say — I still wonder if in 10 years my diagnosis might change and I’ll look back and say, “Gee, we were close but not quite there.” At any rate, this is the best we have right now, and we’re going with it. It’s something, and something is better than nothing. I suppose, when it comes down to it, this is really just an extension of my previous post, “What’s in a name?”, because we have a name but that name could very well change. It’s just nice to have a name; it helps me to wrap my mind around what I experience, it helps me on occasion to explain to others if I feel so inclined, and now it might help you.

What’s in a name?

So I’ve thought a lot about how difficult it is to just put a name on what I experience. For years, I really wasn’t sure what I had, as I mentioned before and will need to write more about. So if it was hard for me and doctors to label my condition, then explaining it to others is even more of a challenge, even now. Then, even if there is a name, communicating correctly to others so they will really understand is even more challenging.

For a comparison and introduction to my thoughts on this topic, I have a daughter who has Down syndrome. Over the years as I’ve been involved with organizations that advocate for people with disabilities and have spent time talking with other parents, I have been actually very grateful for the fact that my daughter has a very straightforward diagnosis. I’ve met people whose children obviously have cognitive challenges but who have spent hours and hours in doctors’ offices and with other specialists, trying to determine just what their child is dealing with. It’s vital to have some kind of diagnosis in hand in order to effectively move forward with some kind of treatment and/or (especially) educational plans and specialized services. It’s no doubt sometimes a challenge to have a child with a disability (again, whole other topic here), but it seems to me that it’s even more difficult when you can’t put a name to it. I’ve had 14 years of knowing I have a child who has Down syndrome. She’s received the services she’s needed, by and large, over the years, and it’s been relatively simple to make those happen.

What makes her situation simpler also is that her condition is easy to observe on the outside. The physical characteristics that are signature Down syndrome traits are literally written on her face, and pretty much everyone knows by looking at her that they should have some types of different expectations from her. I don’t want anyone to think that I want people pre-judging my daughter or having low expectations for her because that’s not at all what I’m trying to say. But when she behaves a little differently than most people and hugs everyone and talks with a bit of a speech impediment and so on, I can feel fairly comfortable knowing I don’t have to try to explain away what she’s doing because many people will already know there’s a reason to cut her some slack behavior-wise.

A similar “rule” applies to people who have physical disabilities. Many of those can easily be observed; if someone is in a wheelchair because of paralysis or uses a cane because of a limp or even has a seeing-eye dog because of blindness, that person instantly can communicate without needing to say a word that he or she has a particular challenge to which others might need to be sensitive (although they generally just want to be treated like everyone else, their situations are at least fairly clear to others, and then others can choose how to be most sensitive and kind to them). But mental health issues are completely invisible. No one can tell by looking what someone who struggles with mental illness is having to cope with.

The companion issue is that mental illness simply is not as readily understood as physical illness. Each individual in this world has a package of trials and difficulties (as well as talents and skills and interests) that is unique. Some face tremendous trials in this life. Some are open about some of the things they face, and others prefer to be quite private, sharing details or even basic information with very few others. So some people who are diagnosed with cancer will talk readily about their illness, their treatments, their prognosis, their fears and frustrations. Others will keep quiet. But those who do share more, for instance, a cancer diagnosis, will likely be quickly understood. “Cancer” is a word that is easily communicated in our society; listeners will think “chemo,” “surgery,” “radiation,” “sick,” “death” or “remission” when they hear it. They will feel compassion and a desire to help, perhaps with meals or rides to a doctor or something similar.

On the flip side, however, is mental illness. Mental illness today, with its various diagnoses like schizophrenia, depression, bipolar disorder, and so on, is coming out of the darkness in a way; more people talk about it in society, but it’s still not as easily understood as physical illnesses. There is generally no stigma associated with illnesses like cancer (although, frankly, there can be a bit with some illnesses that can be linked in part to unhealthy habits), but there is lots of misunderstanding, confusion, and stigma associated with mental health. Either people think that mental illness really doesn’t exist and a sufferer is “making things up” or trying to get attention or something else, or they think that their mental problems are bad habits that just need to be broken. Someone with depression could be told to look on the bright side or to just force themselves to get out and about, for example. Or others may simply recoil a little bit from someone who has a mental illness; they may be seen as weak or “crazy” or “scary” or unbalanced. Mental illness can make others feel uncomfortable and nervous, rather than compassionate and eager to help and lend support.

So back to the name. When I have chosen to share with someone, briefly, that I deal with issues of mental health, first, over the years, I wasn’t sure what I did have, and now that I (basically) do, I still can’t just say, “Well, I have atypical bipolar disorder or bipolar II.” No one knows what that means. Communicating requires that both people understand the meaning of a word. Like I said before, if I say, “I have cancer,” I can pretty much leave it at that and someone else would know what I meant. But if I wanted to briefly mention, “I have bipolar disorder,” half of people wouldn’t know what I meant. Even if they did, my version of this “spectrum” is practically unique to me, so it would require several more paragraphs to get across a basic meaning that one or two words couldn’t convey, as “cancer” would for that illness.

What’s the upshot? It’s just a lot easier not to ever tell anyone what I deal with. One, I can’t say it quickly and move on to other topics. Not possible to communicate what I need to quickly. I might find someone who is very sensitive and eager to talk to me about it, but it’s going to lead to at least a 15-minute conversation, and sometimes there’s no time for that. Two, if I do say what I have, and someone else basically understands what I’m talking about, there’s always a possibility they may have a negative connotation in their minds that will lead them to make judgments about me that I’d rather them not make.

On my bad days, I’d be happy to stay at home, keep to my bed, and refrain from human interaction so as not to offend or cause any problems. But many of those days, since I do have four kids and lots of responsibilities, I still have to be out and about, getting things done. I’m then more likely to be impatient or super-irritable or sometimes just want to cry over something dumb that wouldn’t bother a normal person (or me at some other time) at all. It’s those days I wish I had a sign on my forehead that just says, “Please excuse me. I have a mental illness; I do my best to deal with it constructively; I take medication, I see a therapist regularly, I try to relax and take care of myself as much as I can given my limitations. But I have a family; I have responsibilities, and life goes on. I’m standing in this line that has taken forever and it’s making me feel completely at the end of my rope. I’m valiantly doing what I can here, but my best on this kind of day isn’t too great. Please give me some leeway and smile at me encouragingly or just try not to judge me.” But my forehead isn’t as big as a billboard (thank goodness), and this sentiment wouldn’t fit on it.

So no, there is no outward sign of my inward distress to give people around me (strangers or friends) any indication of what I deal with regularly or if I’m having a bad day in particular. (Very close friends will understand if I just say a few words because after years of talking and explaining, some shorthand will work. But this only applies to a handful of individuals in my life. You know who you are.) There are no physical indications, no typical characteristics to tip anyone off. And if I were to say something to someone else, I couldn’t really capture the essence of what I want to convey in just a few quick words. It’s frustrating. Again, this is all part of why I’m writing on this blog. I’d like to extend to others who don’t have my particular challenges the kindness of helping them to see more clearly from my viewpoint, all at their leisure whenever they’d like to read this. And for those who experience similar feelings, I hope you can feel a kindred spirit.

Balancing act, part one of many

It’s pretty common for women to talk about the tricky proposition of balancing the many elements of their lives. In fact, I know few women who don’t worry about getting a proper balance, let alone maintaining it. But having mental health issues just makes that balancing act that much more difficult. I can say from years of experience that it’s a razor-thin line; right on one side I might feel a little overwhelmed but still OK; on the other side, I’m far past overwhelmed: I’m stressed, I’m drowning, I’m angry and lashing out at whoever comes too close. The latter is not a pretty picture, and I don’t like thinking about the times I’ve been pushed too far on that side of the line.

What my psychiatrists and I are currently calling bipolar II or atypical bipolar disorder causes me to experience a kind of hopeless feeling in which I rarely feel that kind of depression that makes me not want to get out of bed. It’s more of an angry depression. I feel isolated, alone, abandoned by all who should love me and somehow care and know me well enough to be able to see what’s happening and help. When I feel that way, in the very extreme times, I feel that life won’t possibly get better, that I can’t take the psychological pressure that seems to be pressing in on every side of me. I just feel angry at everyone who could possibly be blamed, including God. When the anger kind of dies out, I feel depleted and in despair. So I “swing” back and forth between a sad, hopeless depression and an angry depression, if that makes any sense. I’ll try to explain further in later posts. Suffice it to say, yes, I am a type-A personality, but I’m also typically a fairly cheery, happy person who always has a smile on my face. So when I get backed into these corners where I feel trapped and angry, the rage that almost flares up out of nowhere feels so at odds with who I feel I AM that it upsets me even further.

That brief introduction to my moods is just to somehow try to explain that I can quickly get out of balance. After years of this kind of yo-yo-ing, I can feel when I’m getting close to the brink, and I start feeling desperate. I know I need some down time, alone time, unwinding time to try to swing myself back to a more stable self. The problem is when I feel I don’t have the choice to just say no to activities or pressures or expectations from others.

Some people are more sensitive about this than others. Again, finding balance is always a delicate proposition, and many people understand this for themselves and that it’s the same situation for others. Some are just more empathetic about others’ needs as they bump into their own needs. I admit I get a little irritable when I say, “Well, I can only do ___ because I am pretty busy.” In my mind, that’s me being responsible enough to know my limits and exercise my personal choice to lay down those limits and work around them. When someone else responds, “Well, yes, sure, but we’re ALL busy,” I know they’re not really going to be too respectful of whatever line I’m going to draw for myself. Or they may say, “Yes, well, but (____ organization) really NEEDS you.” Sure, every organization that relies on volunteer help of any kind always needs help and never has enough. But I cannot possibly do enough to fill in those gaps, for that group or any other. Or I might just say flat-out, “No, I simply don’t have the time and energy to do that right now,” and rather than saying, “Oh, of course, don’t worry about it. We’d love your help, but we understand that” they keep pressing on in some way. These responses essentially tell me that these people value their needs above mine. And sure, we tend to be selfish beings and that’s natural. But I certainly appreciate it when someone else rises above those human tendencies and tells me, “That’s fine. You do what you need to do.” I so greatly value when they have the kindness to respect my choice, my right to make decisions for my own life and that of my family.

You see, I know what my limits are, and I’m constantly doing the balancing act. I am a softie at heart, and I want to give my money and time to a whole lot of worthy causes, worthy people. My heart goes out to them. I may even sometimes foolishly say yes or maybe when I should have said no because I’m biting off more than I can chew or even get in my mouth at one time. But when it comes down to it, my mental health must stay intact, so I can be happy, so I can take care of my family (which is paramount in my life above all the other things that matter to me), and so I can in the future continue to give to others. Simply, it rankles me when others don’t respect that I should know best for my own life and my own well-being and continue to push me when I say no. It ticks me off. Big-time. But on the flip side, I feel respected and cared about when someone is kind enough to take me at my word and wish me the best. Perhaps I expect too much out of people, but I would love to see more sensitivity in how people treat each other. There’s just no way of knowing what someone else is going through. I’m being open here on this blog so I can help others understand what I’ve experienced, but I simply can’t go through my whole personal history every time someone demands justification for me saying no. Thank you for being understanding, those of you who have been and continue to be so with me.