Tag: depression

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.

Let’s start at the very beginning

I’m going to crack open my heart, peel back the layers surrounding me, and essentially strip down to my bare inner self here. It’s a little unnerving, but I am telling myself this is for the greater good: I hope that things I write will be of benefit to you who are reading this. So here goes.

I have always been a perfectionist. I have also always been a pretty optimistic, cheery, energetic person. I was brought up in a religious home and have always been faithful inside and out, if that makes sense. I have never had alcohol or cigarettes; I even avoid caffeine. I was taught to not take the Lord’s name in vain, and it still bothers me to hear people use God’s name as an expletive. I didn’t use bad language. I earned top grades since my early days and graduated as valedictorian of my high school. Generally, I was considered a “goody-goody.” No problem. I didn’t mind at all.

The summer I was 17 I had the amazing opportunity of spending five weeks at a state program for gifted students. The program itself was great and offered all kinds of interesting activities, but even better was spending that kind of time with students like myself. I felt like I belonged. I also fell in love. Ah, First Love. I had a whirlwind two-week romance with a boy who was smart and cute and who liked me, nerd that I was. I began to see myself as pretty and attractive to guys, an utterly new idea. It changed me.

It also devastated me to have to go home. The Boy lived a five-hour drive away. The romance was over. I saw him one more time, briefly, and we agonized over the distance between us. But that was it. He didn’t even try to keep up a long-distance relationship of any kind. I pined for him and went on with life, starting my senior year.

Several months later, I traveled to a state academic function, and it happened: I was in a crowded room, and all of a sudden space just opened up, and the Boy was standing a few feet away. A choir might as well have been singing and a heavenly light spotlighted down on him. I went to him, trembling. He responded distantly, and that was pretty much it. No happy reunion, no resuming of our summer romance. I was absolutely crushed.

Where is all this going? To what I now realize was my first “breakdown.” I crashed. I cried and cried and acted completely not myself. I don’t remember the details, since it happened 25 years ago and it’s too embarrassing for my mind to keep in my memory bank. I do remember, however, a teacher being called in and me acting out somehow that night in our hotel room, and then yelling and using my first bad language the next day when it came time to board the buses to go back home. Even thinking about the brief flashes of memory that are still there makes me cringe with embarrassment and shame. But in putting together pieces that resemble this outburst, I now know that this was the beginning of moments of not-normal behavior. I felt out of control and completely not myself, as if I’d been taken over by an alien being.

Even so, it was years until I even thought of this event as anything relevant to later incidents. I went off to college and went to see a counselor there, not because I felt compelled to do so by personal demons, but because my younger sister was facing her own demons at a drug rehab facility, and my mother told me that it would be good for the whole family to be involved somehow. I was 2500 miles away, so going to a therapist at college was the best I could do to be involved, I guess. I still felt a bit detached from the counseling, as if it wasn’t for ME, but for a family thing. I didn’t personally need the counseling, but I was contributing to the good of the family in a way. I did recognize that my family was dysfunctional (my parents had had issues over the years and divorced right at that time as well), and it was nice to have someone to talk to about those things. But otherwise, I was going about my own business, living the life I had been so eager to get to for years: being on my own at my dream school.

Oddly enough, I had another incident during that first year of school and I don’t think it still really struck me that anything was seriously wrong. I had boy issues throughout the year, but none really sent me into a tailspin. One evening, however, I was waiting for a date to take me to a very nice event at a theater on-campus. He was perpetually late and I’d warned him to be on time. Even so, he was hideously late and I “lost it” again. I yelled at him and generally overreacted. Again, my mind doesn’t care to let me remember details, but I remember the feeling of the out-of-control anger (rage? fury?) that was disproportionate to the offense, and the shame I felt at how I behaved. The guy was pretty easygoing, so, oddly, it didn’t seem to really damage the relationship. We broke up later, but it was just because it was time for it to be over, and I had realized I was crazy about a guy I was best friends with (who figured in to some later outbursts, a number of them).

I think I really just tried to ignore these events, or I considered them to be weird blips in an otherwise happy life in which I was still the happy, optimistic achiever who admittedly was a perfectionist and consequently a bit anxious, but everyone still saw me as a happy, energetic, bubbly person, so I could kind of skim over these incidents. In hindsight, they’re just signposts that I didn’t recognize for years for what they were.

Three years later, I was in a distance relationship of sorts with the aforementioned best friend. We supported each other through some challenging times in our respective church missionary assignments and felt we would be together at the end of them.

I will probably have to write later about more specifics of what I experienced during my mission time, but I can say briefly right now that it was generally great except for some big but brief blips at the very beginning and the very end. I came home feeling in need of support and shoring up, and I knew it was time to figure out what was wrong. At age 22, I finally realized I was depressed or … something. I came home from my mission to focus on getting myself well. Unfortunately, I expected love and support from the Male Best Friend, who had by that time been a part of my life for about 3 1/2 to 4 years. But I went to visit him, vulnerable and looking for support, and he decided practically within hours of my arrival that our relationship was not going to work out. It doubly devastated me, and when I went home two weeks later, I was in even worse condition than I had been when I’d come home from the mission service and, rather than feeling I had support to help me as I figured out what was wrong with me emotionally, I was even more crippled.

My father had had some of his own breakdowns and had once or twice decided to put himself in a hospital to get care. So I decided that was probably the best course for me. Again, I don’t care to remember the harrowing details, but I’m pretty sure from the snippets I’ll let myself remember I was at that point suicidal. So hospital it was. I went into our small-town hospital’s psychiatric unit voluntarily for what was almost a week, I think. It was odd and a little embarrassing to be inside a locked unit, and I had some fellow patients there who had some real issues that made mine seem small. But over the course of that week, the doctor there decided I was bipolar and began treating me with lithium.

I resumed my life, feeling better able to cope and probably doing better after being on the lithium, so I was able to go about life. I stayed in my small hometown for a month or two but then decided to go back to college early, a couple of months before the new semester would start and I would be enrolled. I just needed to get back with friends and in a place I enjoyed and felt comfortable. I still was absolutely heartbroken over my failed relationship, and that pained me for a long, long time, but I managed.

I checked in with counselors at college again, and I had regular blood tests to make sure the lithium wasn’t damaging my liver. But over time, I came to believe that wasn’t the best treatment, or rather, that it was unnecessary. I knew what the “typical” textbook symptoms were of bipolar disorder, and I just felt that I didn’t fit the profile (I didn’t stay up for days on end or get “manic” in the way that seems to be the “typical” way we hear about with certain cases). Lithium was a serious drug to be on, and I didn’t want to be taking it if it wasn’t completely necessary. So I went off it and seemed to do fine.

In more posts, I’ll share more about what I’ve experienced over the years. For now, this does cover the beginning. Now, I reflect on all that and wonder if I should have stayed on the lithium, and made things a lot simpler for myself, but who knows? Perhaps it was for the best I struggled and learned. I was able to have three pregnancies and give birth to three daughters, which I couldn’t have done if I’d been on lithium. In a way, hindsight doesn’t much matter now. I can’t say I have “clear”, for-sure answers now, but I do have years of experience and I know for certain that my brain chemistry does require me to be on medication of some kind. Again, I’ll share all those things in further posts. But it’s been a long haul these past 25 years, and I hope that in sharing these details of my life, I can help enlighten someone else and make things clearer in this world of mental health that can be oh-so-NOT clear.