I miss mania.

Well, to be more specific, I miss hypomania. I miss feeling like I can accomplish anything. I miss feeling the burning urge to write.

Since my last post, I have improved on the depression front. I am returning to Alaska, and I have a job there that I start on January 2nd, and I couldn't be happier. I will miss my family here, but I have learned that Alaska is just better for me right now.

My friend H and I are going to be working on the Bipolar project we have going. Its a series of images she photographed starring yours truly, along with personal reflections and facts about Bipolar Disorder. I'm very excited to get this project going, I think it is going to be a positive thing for both her portfolio and my soul.

This has been a brief update, in an attempt to get back into writing on this stupid thing. I am aware, of course, that this blog is akin to me screaming into an empty hallway, with random people leaving their apartments occasionally overhearing my babble. I'm ok with that.

Rock on.

-Z

Let's Discuss Why I Haven't Been Writing...

Hello!

I very much doubt many of those who originally started reading this blog are still following it at all, since I haven't updated since February. Sorry about that. But, that explanation comes later.

First of all, a quick update. I went on a fantastic and wonderful roadtrip journey across the country, starting in Bellingham, WA, going down through California, across to New Orleans, LA, and finally ending up back home in Ohio. It was beautiful, humbling, and one of the best things I have ever done, despite my current financial issues that were not helped by this adventure. I am back in college, and Social Work has officially become my focus for my forseeable future. I am back with my oldest and dearest family and friends, and it is wonderful...it really is.

That being said, I am pretty spectacularly depressed.

It started when I was at the tail end of my journey, then went away for a bit, and then has continued to worsen over time. There are many reasons for this, I am quite sure, and many of them have become obvious to me through self-reflection and the never-ending observations of others (which are so crucial to me staying in reality). I think the worst part about being depressed is the complete lack of perspective that it brings. I AM HAPPY. No, really. I have the people I have loved for my whole life within reach, for the most part. I finally get to see my sister on a daily basis, a part of my life that I have missed so deeply. I feel at peace with my career decision. I'm being more open and honest about my Bipolar Disorder than ever, and I've even been taking the proactive steps to track my symptoms to better assist in my continued existence. (Moodtracker.com is awesome, but that's for another post)

And yet.

And yet I have been sleeping too much (14 hours) or too little (3 hours) at night, only to want to nap throughout the day, regardless. I am currently on the "too little" end of the spectrum, having woken up from a nightmare about an hour ago. I found myself thinking, (a dangerous past-time; I know -Beauty and the Beast ) and then I found myself remembering this site.

Its not that I forgot about it exactly. Its that I've been doing well, so it wasn't on the forefront of my mind. When I started it, I was entering into hypomania, which meant that I wanted to talk, and grow, and expand into the universe to be a part of everything...yadda yadda. I had a lot in my brain, and there was this PRESSURE to get it out. Then, responsibly, I recognized it and got help. Gradually, the NEED to write drifted into a desire to write, then into a mild interest, then into pretty much forgetting why I started this thing in the first place.

I started this blog first and foremost to purge myself of the demons that Bipolar has presented me with, as quite generous gifts. I wanted to educate myself and others about the disorder, and put a human face onto the disorder, as many that tried before and succeeded.

I want to come back to that. It was cathartic, and actually helped me realize that I was drifting into the "bad-place."

I am depressed. I'd go with mildly-moderately. Most days, mild. I am still taking my medications, but I need to change my antidepressant and my sleep medication, I think. In keeping with "needing to change" such things, I have an appointment to see a psychiatrist here. Granted, it was 3 weeks from the day I called to see him, but I'll take it. It was worse in New Orleans.

I cannot promise that I will be loyal in updating this blog again, any more than I can promise that I won't drop a glass full of milk tomorrow morning. But I will try. Being depressed makes it harder to want to dredge my mind for semi-interesting things, but I do end up with a lot of time at 3am to stare at walls.

Answers to a few questions you may ask:
Q. Where are you, on a scale of 1-to-Suicide?
A. Meh, about a 3. Honestly, that's really nothing to worry about. That basically means that I think about it a little more than usual, but do not desire to hurt myself, nor do I have any plans to do so. Still want to be alive. Would like things to be less difficult, but in the hey-I'm-still-breathing kind of way.

Q. Are you REALLY still taking your medications?
A. Yes, really. As prescribed, even. I hope to change a few of them soon, but I am not changing them on my own. Well, except for going back on Seroquel briefly to see if that would help with my sleep, but I was never taken off of it, and was left with the impression that it was on my discretion whether or not I should use it.

Q. Are you self-harming?
A. Except for the urge to smoke an occasional cigarette, no. I have put in measures to bring that down from about 4 a day to none, though. My sister has my pack, and I get one per day. Since I have no money, there is no concern about me buying more.

Q. Does anyone know?
A. Well, I hope you can keep my secret, internet...Shhhhh. Of course people know! That was the point of "coming out"! Silly internet. My sister, her mate, and many of my best friends are on the daily roster for checking in and processing. I feel horrifically guilty about this, but a majority of that is the depression talking, and I actually hope to get on that topic later.

Q. How's school going?
A. Fine, actually. I am taking the fewest credit hours of any semester/quarter in the history of my life (12 hours), but I'm enjoying it. The stress is both good and bad, but way more in the good than the bad.

Q. Where are you working?
A. Don't talk about that. Really, I might start getting upset. Suffice it to say, I don't have a job right now, despite many applications and an actual job offer that got rescinded by corporate because the company went into a hiring freeze. I hate, hate, hate not having work. This is the first time I've been unemployed since I was 15, and I am not handling it very well.

I think that about covers it for now. Thanks for being here for me, internet. And thank GOD you are not my only place to seek solace and help.

Be safe,
Z

Depression

Depression is a creeping thing. It slips under your doorframe and crawls into bed with you.

I have had moments of sadness that hit me like a semi-truck. But in general, depression for me has started as a quiet dissatisfaction with nothing in particular. Just a nagging feeling that something, somewhere, needs fixing.

My personal depression experience has a lot to do with guilt. I heap myself with it. I blame myself for things that could not possibly be my fault; I take things that ARE my fault and expand them out into holocaust-sized sins. I have a Catholic upbringing, and we're second only to the Jewish people in guilt mastery. My mother, (wonderful woman by the way, only ever really punished us through guilt. I wake up and feel crippled by it. Bills that I pay late make me feel guilty--"I'm not a functioning member of society!" Not answering texts and calls right away--"I'm neglecting my friends and family!"...I once stepped on the cat while walking down the steps and wept for nearly an hour.

Depression is an over the top experience. People witnessing it from the outside are usually appalled and embarrassed for the depressed person. THEY HAVE A POINT.

Depression is completely absurd! It takes your emotions and reactions and ramps them up to hyperbolic extremes. But depression is not that person's fault. We all have days of being melodramatic and feeling sorry for ourselves--don't lie, we all do it. But depression lasts for weeks and months. It effects mood, sleep, food intake, concentration, and other aspects of health. Depression is physically painful at times. Depression is not a personal failing or a choice, it is a series of unfortunate brain chemistry actions, and often, it takes serious work to get out of depression.

It can take months to get into a really deep and pervasive depressive state. Every aspect of your being is colored by it. Therefore, telling someone to "snap out of it," or "cheer up" is downright insulting. Trust me when I say that the majority of depressed people do not want to be depressed. It sucks. It hurts, and it completely destroys relationships and self esteem. Some of them don't even REALIZE that they're depressed.

Being supportive of these people is important. Getting them professional help is huge--but they have to make that decision for themselves. Another thing that is important is not to martyr yourself. The man I loved during my severe depressive episode brought himself very very low trying to drag me along. He tried to get me help, and I fought and ignored him. I took his well intentioned criticisms and heard them as a complete rejection of everything that I was. I very nearly dragged him down with me, because he loved me. Don't do that to yourself. Don't ask me how to avoid it...just...don't.

I personally believe that it is possible for most depressive episodes to be broken by a person without medication, if they are given the right tools. I believe that meditation, goal setting, strictly regimenting your day to include sleep and exercise, as well as balancing your diet and cutting out the alcohol can help pull you out of a depression.

I also know that for me, those things did not work on their own. I needed medication to help. And I am not alone. Many people find themselves in holes so black and deep that they cannot crawl out without a lamp and a bit of rope.

Medication is not a sign of weakness.

(I should have to write that on a board 9,000 times. "Medication is not a sign of weakness...medication is not a sign of weakness...Medication is not...")

I had a very hard time accepting the prospect of medications for my depression symptoms. Additionally, it never even occurred to me at the time that my hypomanic times might have benefited from a few little white pills. But hitting my personal rock bottom in a severe depressive episode taught me that sometimes, you just need more chemical help than you can pump into your brain through willpower alone.

I am a damn stubborn woman. To a FAULT. I can outargue most people, and have challenged myself in more ways than I can think of, and I generally come out at alright. But being stubborn about not getting medical help was not a good decision.

I barely remember the first 36 hours after I went into the inpatient psych facility. (yes, I have been inpatient, more on that later, I promise)

But around day 3...my world was completely different. Life still kinda sucked--I was still getting dumped, for example, but I could see the other side. I still had about 4 months of hard self-reflection and work to do to get to a healthy head-space, but I can tell you for certain that medication started me on the right path.

I didn't know where I was going with his post, and it shows. Sorry about that. But I felt the need to try and...process my depression experience. I am no longer depressed. I look back on that time and feel ashamed and embarrassed for past-me. I am angry and feel guilty about the time that was wasted, and the relationships that I damaged, some irreparably. But it is in the past. I am not the same person as I am when I am depressed. That guilt doesn't need to follow me every day.

It feels good to know that. Believing it is still hard. But I do KNOW it. And that's enough.








tl;dr version?

Depression is real, and it sucks. You can get better on your own sometimes, but other times, you may need medication to help you, and THAT IS OK. It will get better. One day, you'll look back and not even know how to imagine being this sad. It. Will. Pass.

Vocab Quiz?

It has been brought to my attention that I’ve been throwing around some terminology that many people outside of the mental health experience may not be familiar with. I will attempt to define some of these words in simplified language. It you want to understand them better, I suggest the following websites for further information, try the following links, or just ask me:

http://bipolar.about.com/od/glossary/Glossary_of_Bipolar_Disorder_Terms.htm

http://www.healthcentral.com/bipolar/understanding-bipolar.html

http://www.nami.org/Template.cfm?Section=nami_connection&template=/ContentManagement/ContentDisplay.cfm&ContentID=67728

Bipolar Disorder I- The most severe form of Bipolar Disorder. According to the DSM-IV, Bipolar I is “characterized by one or more manic or mixed episodes, usually accompanied by multiple major depressive episodes.” Bipolar I is the kind most often depicted in the media. (See: Mania)

Bipolar Disorder II- Right now, this is “what I have”, but diagnosis can change as more symptoms develop over time. According to the DSM-IV, Bipolar II disorder is “characterized by one or more major depressive episodes accompanied by at least one hypomanic episode.” The main difference in the two is that those with Bipolar II have hypomanic episodes, but no manic episodes.

Cyclothymia- Sometimes called Bipolar III, it’s known as a “mild” form of Bipolar Disorder. In cyclothymic disorders, the patient will range from mild depression to euphoria and excitement, but stop short of the extremes of the disorder.

Off-Label- The FDA approves medications for specific uses. If a medication is prescribed by a doctor for another use, it is called an “off-label” use. For example, I used Trazodone and Seroquel off-label. Trazodone is usually a depression medication, and Seroquel is for psychosis. But when used in lower doses, they work in different ways in the body.

Baseline- The range of emotions and actions that make up what you, doctors, and support people (family/friends) find to be “normal.” Everyone’s baseline is different. My baseline is high energy, upbeat, and sometimes confrontational. Suzy might be withdrawn, pessimistic, and conflict-avoidant. Both of our individual “baselines” are normal, even though they are different.

Depression- All encompassing low mood, low self esteem, loss of interest in activities usually enjoyed, low energy level. Can be accompanied by insomnia or hypersomnia (too much sleep). Can impact work or relationships.

Severe Depression- Same symptoms as above, but higher severity and longer duration. Suicidal ideation and attempts are usually found in severe depression. There will be negative effects on work, school, relationships, hygiene…pretty much anything you can imagine.

Hypomania- Literally meaning “below mania” is generally a period of persistent elevated or euphoric moods. It can also be a period of high agitation and irritability. Racing thoughts, pressured speech, and an idea of “the rest of the world moving too slow.” People in a hypomanic state have little need for sleep, are outgoing, competitive, confrontational, and usually have a higher productivity. Hypomania is separated from mania in that it does not have the psychotic symptoms, and doesn’t tend to impair day to day function. Classic symptoms: “mild euphoria, a flood if ideas, endless energy, and a desire and drive for success”

Mania- A state of elevated or irritable mood, arousal, and energy levels. All of the symptoms found in hypomania can be found here, with the addition of psychosis. Mania is also associated with gambling, shopping sprees, affairs/sudden divorces, unprotected and dangerous sex, and other excesses.

Mixed Episode- An episode that no one wants to have. It combines the worst parts of hypomanic/manic with the worst parts of depression. Basically, you can be high energy, insomniac, suicidal, depressed, creative and driven all at the same time. Not a good combination.

Suicidal Ideation- Thoughts of suicide. From “wishing to die” to making a plan, this simply means that suicide is on the mind of the individual. There are varying degrees of severity.

Successful suicide attempt- Results in death.

Unsuccessful suicide attempt- Does not result in death.

Racing Thoughts- I found this on Wikipedia and thought it was a great explanation, so I’m just going to copy it verbatim. “Racing thoughts may be experienced as background or take over a person's consciousness. Thoughts, music, and voices might be zooming through one's mind. There also might be a repetitive pattern of voice or of pressure without any associated "sound". It is a very overwhelming and irritating feeling, and can result in losing track of time.”

Pressured Speech- “Rapid, loud and difficult-to-interrupt speech characteristic of the manic phase of bipolar disorder. The person may be extremely talkative and continue to talk even though no one is listening.” This is not just being chatty. I’m a chatty person by nature. But this is me to the ^10th. I will babble on incoherently, often having to force myself to stop to breathe. I will also flit from topic to topic more than I usually would, or talk more about my feelings than I usually do.

Psychosis- This is a generic psychiatric term for what most people would just call “crazy.” The actual definition is more along the lines of “having lost touch with reality.” Hallucinations, delusional beliefs, sudden personality changes can all be aspects of psychosis.


I hope this clarifies some of these ideas. These are merely my summation of these terms, and I do not pretend to be an expert. Addtionally, my definition is colored by what I have personally experienced.

-Z

Breaking the Taboo- Oh look, I'm talking about suicide!

Suicidal ideation is an interesting barometer for my mental health. (SPOILER ALERT: I will not be killing myself today. Sorry. Try back tomorrow. This is merely a philosophical musing)

At the best of times, suicide is still disturbingly present on my mental radar. I remember an incident at a waterpark, where it became astonishingly clear to me just how unstable I actually am. While in line for one of those terrifying tube rides, about three stories up, I commented to my companion something along the lines of—“Huh. From this height onto those rocks? That would almost definitely be fatal.”

Deafening silence.

What I had interpreted in my brain as a perfectly normal conversation starter, he had found disturbing and frightening. I was not feeling suicidal. I was simply being observant.

Since I was very small, I have always been aware of what options I have in terms of fatal occurrences. Standing at an intersection, my mind often wanders to what vehicle out of those in my line of sight would kill, rather than maim me at the speed they are currently going. Being at high altitudes during hiking has me observing sheer dropoffs instead of gradual (if dangerous) downward slopes. Don’t even get me started on the myriad options available to me when I worked on the ambulance. These thoughts are not abnormal to me, but they aren’t pressing. Its just…something I look for.

I have decided to compare myself to a bird watcher. They may well be at their cousin Susan’s wedding, but they’ll still notice a Harris’ Sparrow hanging out in the trees flanking the arch and altar. Its not that the bird is more important to them than the vows (I am not imagining an obsessive bird watcher), its just that they can’t help but notice a detail that has become a big part of their life.

Is that what suicide is to me? A pleasurable hobby? That is the thought that stopped me dead (heh) earlier today, and lead me to writing. In conclusion: no, I don’t think so. It’s merely something that I keep track of. Is that disturbing and a little frightening? Absolutely. But what it IS is occasionally comforting, in a way, to know my options.

So, to get back to the barometer aspect of suicidal ideation—

My normal baseline notices suicidal options. That isn’t something that I think I can change. I don’t long for them, and I don’t seek them out. I just notice them when they pass me by.

At the very beginnings of my descent into an unhealthy place, I start grading the suicidal options as they come across my path. Hit by a bus? Not definite enough. Jumping off a cliff? I might get found by innocent bystanders, even children, if I land too close to the hiking path I came up on. Gun? Messy, but definitely effective. Again, this level of awareness usually doesn’t happen at the time. I notice it later, once I’ve started to come back to what I have established as baseline.

The next step is planning. I start contemplating the logistics of my death. I found myself searching for crematoriums on the island where I live not too long ago, and in realizing that there WASN’T one, made the completely logical decision to not kill myself here. I’d have to at least travel down to Bellingham first. It’s just too darn expensive to ship a body.

At this point, I am STILL not actually planning on or truly having suicidal ideations in the classic sense. Yes, I know that a textbook will tell you that picking a method and “planning” is a major danger sign…but for me, I have learned that it really isn’t.

(Here be dragons.) Somewhere after the “planning” stage in my lovely descent into a very personal hell, I start realizing I’m contemplating suicide, albeit in a very general way. There is a fork at the road at this point. I either turn right, and start trudging back up the hill, paying more attention to myself along the way, and letting a few friends and professionals know…or I turn left. I can’t explain what happens when I turn left. It’s only happened a few times in my life, and I can’t honestly explain why. Despite all of this rambling about suicide, I really do not want to die. I love my life. I love my friends, my family, and what I consider to be a valuable step in my eternal spiritual path. I honestly do not understand how I could have ever been suicidal in my current state of mind. It just doesn’t compute. I may notice suicidal options—but I really never actually plan on acting on them.

Until I do. Then, like a trapdoor being pulled, I “turn left”…and suddenly find myself honestly planning on dying. I start judging myself for what I haven’t yet done. Circular logic leads me to “well, I’m going to kill myself, so I don’t deserve to live,” as well as other equally idiotic places.

This has happened two times in my life. I will not go into details of these times right now, though I feel like it might be educational to others to discuss it at some point.

The next step, which I have never yet sunk to, is actual suicide attempt. I have had plans. I have waited until those who loved me weren’t around, and I have had my finger on the trigger, both literally and figuratively.

But I have never done it. And God willing, I never will.

This is what mental illness looks like. It’s not flashy visions of Green Lantern telling me that I am the chosen one. It’s rarely panic attacks and homicidal rages. It isn’t something you can see at a glance when you meet someone—and it certainly isn’t something that people can always see in themselves.

It is this. It’s realizing that the way I have always thought is seen by many (now including myself) to be not only terrifying, but dangerous.

But that’s part of healing too. Because for the first time, I’m not only realizing the parts of me that are wrong and scary, I’m accepting them as the quirky little beasties they are. Like a dog that pisses on the carpet a little when he gets nervous, my brain is not always the best companion. But I’m learning to anticipate his excitement—and realizing I have to clean up afterwards. (Sooner rather than later)

I don’t think I really have a conclusion to all of these thoughts. I don’t think I’m there yet. I’m doing all the things I’m supposed to do to be healthy, and I’m starting to really look inside myself and really see who I am. I don’t want to die. I’m firmly in the “life is good” camp.

And I guess the point is that I’m learning that I can’t take that for granted.

Alright. Time to go make oatmeal.

Coming Out Bipolar

Never let it be said that my madness has not given me gifts.

Glorious highs have come from my disorder. Though I have not yet experienced a true manic episode, my hypomanic phases have been some of the happiest times of my life. I have felt like a superhero. I have gone days without sleep, aced tests that I couldn't get a C on now, worked shift after shift without feeling an ounce of burnout that should have been piled upon me...

I have had some of the best moments of my life because of my illness, as pathetic as that might be to some.

But the places it has taken me have not always been good. I have looked into a mirror and hated myself with such passion that it has terrified me. I have been suicidal. I have contemplated strange and dangerous pursuits like prostitution with as much forethought as some people take when deciding to stop by Barnes and Noble on the way home from work. I have harmed myself. I have been physically aggressive towards those I love. I have lain in bed for days and considered it a triumph that I hadn't yet got up the energy to end it all.

Coming out of the closet has many connotations, both socially and personally, for me. I identify as a heterosexual female, but much of my life I have shoved and pushed into a small corner of my mind, and prayed no one noticed. Well, they have. Bits and pieces here and there.

And they have loved me anyway. Not everyone, of course. But enough. Oh, enough.

I am mad. But I am not alone.

This will be the outlet for some of my thoughts and musings on my madness, and explaining, both to myself and possibly to others, what the true reality of Bipolar Disorder can be, for me.

Thank you.