My Peers

Hello faithful blog readers,

I am not going to apologize for this lengthy absence because I have been having a wonderful and, in my opinion, well deserved vacation before starting medical school. However, I hope to write more in the upcoming months because I have a feeling that medical school will provide lots of fodder, both in terms of my own mental health management and exposure to mental health professionals and patients in the system.

Privacy

**Note: This is my first post using Blogsy, an iPad app -- hopefully everything works OK!!**

 

This morning, I had to go to the doctor's office for a simple blood test. I was fasting and hadn't had any coffee so was a little on edge. The lab tech didn't help when she looked over my file and loudly asked, when was the last time you took your lithium?

Modern Love

Maybe this post is part 2 of 2 with my previous post, because it deals with similar subject. As I've thought about the pros and cons of sharing my stories, it's started to dawn upon me that they aren't my stories alone: they are our stories. I own my life and many things have happened exclusively to me, but many things have also happened, because of me, to other people.

Our Stories

Writing this blog has been a tremendous experience for me. I've found an outlet to process and express complex and evolving feelings and I've been touched beyond expression by the response from friends, colleagues, and strangers who emphathize and sympathize with the comments I post here.

As I've received positive feedback about my writing, I've started to think about other projects. There is a whole genre of topics that I can't write about in this forum, particularly related to relationships, that I could share in other formats: short stories, newspaper articles, maybe a book. Why not spend more time writing, both improving my craft and building something worth sharing more broadly? Last week, I remembered why not.

Maybe This Time

Apologies for the delay in posting - there has been a lot going on in my life, related to bipolar symptoms and otherwise, and I feel like I'm in a bit of a craeative black hole. However, I thought I'd pull together a post about some recent events.

One of the worst things about this illness is regretting actions I took and choices I made before diagnosis and treatment. To an outsider, I was a healthy and even highly functional human being but to those I allowed close to me I was a mess. My decisions were driven by fear: fear of something that I couldn't identify (until later, when it happened and a cruelly honest part of me was relieved to finally understand what it was I had been trying to avoid for all this time). I clung to people I thought could protect me and I pushed away those I thought might bring me closer to the edge. These were often the same people.

Next time I'll be braver

Over the last week, I've shared a lot of changes happening in my life with those close to me: my upcoming move, change in career, and changes in living situations. The fnalization and fast arrival of these changes is starting to cause me a little bit of stress - where am I going to live in a few weeks? Am I going to be successful on my new career path? Why am I leaving behind something so good? I'm also in a blessed spot with my illness; while it affects everything I do, I am managing it through medication, lifestyle choices, and love. By the grace of God, the universe, my family, lithium, and sheer, beautiful, shimmering luck, I am in this blessed spot.

Meditation

It's been a long time since my last post, mostly because I went on a 10 day silent meditation retreat. The experience was transformational and much needed. During my ten days there, I learned a lot about how little I am able to trust my self and yet, on the other hand, I gained a great deal of trust in my ability to cope and handle difficult situations.

Building Character

Lately, I've had a lot of opportunities to build character. I actually feel my character getting taller, adding inches in the right places and toning her physique.

I build character when I set limits on the access that unsupportive people have to me. I build character when I emotionally disengage from people, however loving, who cause me stress and cause my symptoms to be exacerbated. I built character last night when I told my good friend that I had to go home and go to bed because I needed some down time. I build character when I run through my depression, through my mania, when I run like the act of putting one foot in front of the other is my new lifeline. Over the last few weeks, I've built character by getting up in the morning and going to work. I've built character by letting each hour follow the previous one, without disaster.

Two years ago, the last month would have put me into crisis mode. I've had a very intense and long lasting (for me) hypomanic period and then a crushing depression. There's a lot of change, and consequently stress, on the horizon, which makes my typically narrow bipolar tightrope shrink to thread-like proportions. But I survived. My psyche didn't disappear behind her symptoms, my body didn't get sick or shut down, and my mind remained focused and cognizant enough to complete the tasks needed to keep me moving forward. I kept moving forward, and now I feel, for the first time in a month, that a fog has cleared, that I am happy but not too happy, that I am tired but not too tired, that tomorrow will be a little bit easier than today. Two years ago, I fell apart, but today, I survived. I built character.

I'm currently reading "An Unquiet Mind," and it is having an unbelievable impact on me that I'm not yet prepared to discuss. I'd like to highlight one passage, though, that sums up my current sentiments, with that bit of humor I try to inject into these conversations: "[This was] character building, no doubt, but I was beginning to tire of all the opportunities to build character at the expense of peace, predictability, and a normal life". After a tough month of training, I think my character could use a taper.

What Prescription?

Every month, I pay $35 for three prescriptions for pills that make my life better. I have been going to the same pharmacy for the same three prescriptions since September, and there are three pharmacists who work there. I'm not asking that they remember me, but I would have expected better than the following.

Sweet Dreams

We tend to like things that we're good at, and I've always been good at sleeping. I fall asleep on airplanes before takeoff and wake up as we touch down. When I get emotionally overwhelmed, I get tired. When I faced my first real professional disappointment about a year ago, I overcame it by sleeping 10-12 hours a night for a week. Sleep hits me like a ton of bricks when other things in life are getting me down and I'm always grateful to seek solace in its chubby, lazy arms.

Last night, I slept for 10 hours, passing out fully clothed on my bed at 8:30pm and waking up groggy at 6:30, dozing for another hour. Today, I felt so sad and depressed at work that I took two small breaks to cry, for no apparent reason, in the bathroom. I felt overwhelmed by the smallest of problems and had dark, scary thoughts. Looking back, my desperate need for sleep was a harbinger of my depression, an indicator of the switch from one mood cycle to another.

Sleep is one of the most reliable predictors of my moods, and one of the best ways I have to regulate them on my own. Last week, I slept an average of six hours a night, and this week I will average ten and crave more. Inexplicable, during both weeks, I will be tired most of the time. I'm staying up tonight because I know that if I limit my sleep, I'll feel more awake tomorrow, that adrenaline will kick in and help avoid those bathroom breakdowns. This is arguably not the best long term strategy, but it's tremendously effective.

I Can't Read

FIRST, some boring housekeeping matters:

1) I'm not sure if my RSS feed works, but I know that if you subscribe via email, you'll get an email everytime I post. So I encourage you to do that if you want to follow me - it's quick, easy, and unobstrusive.
2) I appreciate the comments, emails, etc. that both help me improve the blog and motivate me to continue writing - so if you read and appreciate this effort I'd love to hear from you.

One of the themes I've noticed as I look back over my blog is acceptance. How and when does one accept, and even embrace, her mental illness? When is acceptance giving up and when is it the ultimate victory? When is it a crucial step in recovery and when is it a paralyzing blow?
I've been thinking about a simple question: If I could go back in time and undo my bipolar disorder, would I?

Run Run Run

Two nights ago, I decided to make a dramatic life change in the next three weeks. I was so certain it would work out and I knew I would make the right decision and I just knew and everything inside of me knew and it was so exciting and the world was so exciting and et cetera and et cetera. Hypomania was terrifying, a voice inside my head pushing me over the edge, to places I wouldn't normally go, lurking in broad daylight with theories and beliefs and worldviews quite unlike those I hold in a less manic state. Thankfully, I recognized that I was hypomanic. I feel sad, reflective, and angry when I have to censor myself in these moments, as though part of me will always be Peter Pan, flying off to Neverland with no wings and inadvertently leading the Darling family straight to a gang of pirates.

Sacred Cows and Hamburgers

Earlier this week, my company hosted an event for the Do One Thing campaign, which encourages individuals and organizations to do one thing for diversity and inclusion. A worthy goal, and the structure holds everyone accountable in a small and meaningful way.  One brief moment, however, mitigated the power of the event and is a poignant metaphor for our struggle for acceptance and understanding for mental illness.

One panelist concluded her comments by asking everyone to examine their latent stereotypes and prejudices, referring to them as “sacred cows,” an idiom for “something considered (perhaps unreasonably immune from question or criticism". According to Wikipedia, the term “is based on the popular understanding of the elevated place of cows in Hinduism, no matter how inconvenient,” and in my opinion is very non-culturally inclusive to begin with (why not call them “sacred Saturdays” – keeping Sabbath is far more “inconvenient” than revering cows). She decisively crossed the line, however, when she said that we should “make hamburgers” out of our sacred cows.

Horrible, No Good

Today I feel bad. I made a bad decision or two this weekend and I feel guilty, ashamed, and bad. It’s not just a horrible, no good, very bad day: when you’re managing a mental illness, every bad day can come with a paralyzing, tummy lurching fear that this day could be the start of something much worse.

Am I going to feel depressed all week? All month? All year? Am I going to stop working out and gain weight and withdraw from society? Is this going the feared bout of depression, looming on the horizon from which I do not recover? Will the fog ever lift? Will I ever be happy again?

For me, bad days are more than bad days. They are a trigger. They remind me of being depressed, of the trauma of self destruction, of the great tragedy in my life. I revert to attitudes and actions that bring scant comfort: I withdraw, I eat, I play defense. I act like a trauma survivor, less that last word.  I turn into a scared animal, cringing at a lifted hand.

Someday, I will act like a survivor. Someday, I will play offense: I will eat foods that make me feel healthy, see people who make me feel strong, and do activities that force me out of a stupor. Someday, bad days will not scare me: they will not snowball into flashbacks and fear and the horrible belief that the past has not disappeared. Someday I will not be afraid. Someday.

My Body, My Drugs

I am an intelligent human and my memory typically serves me all too well. I’m fastidious and detail oriented, as evidenced by the two, large white boards, one at work and one in my room, that chronicle my to-dos, trending thoughts, and schedules. Despite all this, I struggle to remember to take my daily medication.

I’ve tried setting alarms. I’ve tried carrying my medications everywhere I go. I’ve tried placing the bottles in my closet so that I have to look at them when I get dressed. I still manage to forget at an alarming rate, forcing myself to turn around on my way to work or take my medication hours late.

Why can’t I remember my medicine? My most recent theory is that I’m passive aggressively, subconsciously protesting my drug dependence. For I depend on these medications: without them, my life was harder, unhappier, less tenable. So despite the fact that their side effects can include weight gain and thyroid and kidney problems, to name a few, I take my three pills every day. Why is it called addiction when it’s a cigarette and medication when it comes from an orange hued bottle? I feel like I’m doing something intrinsically harmful to my body for the sake of my mind. There’s a profound disconnect between the person I want to be and the person who needs these medications, and, of course, there’s not.

First, Do No Harm

The New York Times broke a story yesterday asserting that “nearly one in seven elderly nursing home residents, nearly all of them with dementia, are given powerful antipsychotic drugs even though the medicines increase the risks of death and are not approved for such treatments”. A few other highlights from the article, and my thoughts, after the jump.

Just Me

On Thursday, I got some exciting news. The news made me feel. First I felt relieved, then I felt happy, and nervous, and terrified, and jubilant, and all sorts of things. A year ago, this would have been awful and uncomfortable. I would have worried about why I was feeling a certain way, whether it meant my medication was at the wrong level, whether I was headed for unsustainable highs or a crash. I wasn't able to trust any of my own feelings and emotions, and my world was volatile and uncomfortable if not stable and dull.

Born This Way

This post is inspired by a conversation I had driving to the airport this weekend. Someone asked me why anyone would pay $80-100 for a Glee concert ticket, to which I responded that I had in fact paid $107 for the privilege of attending a Glee concert and eagerly awaited my chance to do so in just a few weeks. For the ignorant in my readership base, Glee is a very popular musical comedy show on Fox, starring Lea Michele as a self centered high school student leading a band of misfits to unimaginable musical heights. On Glee's last episode, mental health was part of a major storyline.

Bunnies

I was sitting at work the other day when I received a mildly humorous email about my blog. I chuckled. A coworker, who is likely to turn into a friend, inquired about the source of my perceived pleasure. I told him that my sister wrote me a witty comment about my blog, and he responded by saying that I should monetize my blog using Google AdWords.


In a perfect world, I would have said, well, I would, but I'm worried that all the ads will be for medications because the blog is about mental health. If he was interested in the content of the blog, he would have asked more questions and made more comments, and if not, well, maybe someday he'd meet someone who is and pass it on. Msybe he reads my blog already and would have said a nice thing or two. But I was afraid, so I didn't discuss the ocntent of my blog. I didn't use this perfect opportunity to share something I'm proud of. Instead I laughed, my defensive laugh, and said, "well, I don't know. It's not like my blog is about bunnies."

This peron might know what my blog is about. I haven't made the blog a secret; I've shared it with individuals and on my Facebook page. I have already chosen to make this blog public, so why skirt around an issue, too polite and uncomfortable to address the elephant in the room? I don't know, but I think that's how a lot of conversations about mental health go.

Coming Out

All week, I've kept a list of potential blog posts on my cell phone. I've gotten really excited thinking about my new project, and I have scribbled notes about the man I saw at San Francisco General today, the article about a "trend" of bipolar celebrities these days, the difficulty I have making decisions. There is so much to say about this illness, about the humor, the sadness, the small moments of triumph and despair that this albatross brings as it swings inexorably around your neck.

Then I read this blog post. The post explains how important anonymity is for someone blogging about his or her mental illness, and how a failure to protect your identity can adversely affect your work life and your personal relationships. Just like bipolar disorder. She compares mental illness to minority sexual orientation, but says the stigma is currently worse for the mentally ill in most situations.

This is something I've thought a lot about. There is heavy stuff to write about here: heavy feelings, heavy experiences, heavy stories. But sharing it lightens the load, because I know that if I had found a resource like this when I was first learning about living with this disease, it would have made my life very different. I remember the few times I've met someone with this diagnosis and how relieved I felt: not happy, not joyful, just relieved. Relief is such a sweet thing sometimes. My memory fhat feeling makes me want to share this blog with everyone I know, in case they know someone who might feel that way when they read it. Or maybe that's not why - maybe it's because I want to break the silence and because I need to share, because writing is what I do when I feel scared and alone and because writing is the only thing I can do that makes me feel like I can leave something in this world, something real and maybe even beautiful.

On the other hand, it's scary. Coming out is scary. People are ignorant, and these things are personal and hard. Do I want my coworkers to see this? My boss? A guy who might be thinking about asking me out? Why is it that it is less scary, and more liberating, to share this blog with strangers than with those closest to me?

These questions scare me. They make my tummy hurt and they leave me with a sense of loss, as though if I shut this down, if I don't share this blog, I'm losing something. Because I'm passionate about this blog, and this topic, and anyone and anything out there help me this illness. But that doesn't mean sharing is the right thing to do. Or does it?