Sunday, October 7, 2012

Trigger Happy.

Stability was fine, I guess, while it lasted. Neither WAY up nor WAY down, my new therapist wants me to keep track of my moods on a scale of 1-15, with 15 being like almost despondent-depressed, and 1 being hypomanic. When I went to see her on Friday morning, I told her I was about an 8 on the depressed spectrum. I explained to her (and she understood why) I felt that a hypomanic episode, given midterms and the amount of work I have ahead of me, would give me an enviable edge. While I might be scattered enough to start 18 projects with grandiose plans to finish them all, at least they'd jump start and perhaps I'd be able to complete them as I stabilized.  But Friday wasn't happening. Books out, syllabi earmarked, case studies in front of me, drowsiness despite an entire pot of coffee knocked me out. For five hours. In the middle of the day. (SuperJuls was like, "That was QUITE the nap!") That's not a "nap." That's a "night's rest."

Some fellow bloggers who write about their experience with bipolar disorder will agree: no one will look at you and *think* that you're sick. You're not covered in boils. You haven't had a measurable heart attack. Your nose isn't running and you're afebrile. Mental illness is covert. And if you're good, really good at it, as I am, you can convince just about anyone that there's absolutely nothing wrong with you. (And besides, nobody likes a buzzkill.) I try not to fault people who say things to me like "Keep on plugging along!" or "Concentrate on what you have to do!" as if this condition was something I could just shake off and press forward. Look online and you'll find literal lists of WRONG things to say to someone who's bipolar. A popular one is "Just forget about it...only you can change how you feel." Another great one? "Go out and get some fresh air." (Because of course, it makes perfect biological sense that an alteration in the imbalance of brain chemicals is remedied by an influx of fresh oxygen to the lungs. Right?)

The truth? No, as a matter of fact, I *can't* change the way that I feel. If mental defect was all a matter of an adjusted attitude, none of us would be handcuffed to a lifetime of psychotropic medications. If my moods were as easy to reverse as changing a dead light bulb and screwing in a new, bright one, don't you think I would have, you know, DONE that a long time ago?

What I've personally found to be true of both bipolar disorder and PTSD, having both conditions simultaneously, is that they're largely trigger-based in addition to (at least bipolar) being chemical interruptions. A super-positive experience or achievement can flood your head with feel-good dopamine, not unlike having an orgasm that goes on without ceasing for days, or being high on drugs. Mania is getting up at 5 am after 2 hours of sleep, taking a shower, getting dressed, eating breakfast and flying off on errands before hunkering down and cranking out 3, 10-page papers in a few hours. Apart from the scatter-brainedness of trying to engage in conversation as you jump topics like a relay runner, the average person will simply think that you're really happy, or over-enthusiastic. The downside? It eventually ends, pretty badly.

Conversely, negative triggers (disagreements, icky stress, insomnia, bad dreams, or the anticipation of major life-altering events or decisions, other medical problems, work, hell, $1000 in unexpected car repairs) can precipitate an episode of major depression, or in the case of PTSD, disabling fear and anxiety during which everything and everyone is scary and dangerous. Put simply, it really, really sucks. Why I even bothered to shower and put clothes on yesterday is anybody's guess. It's not like I went anywhere. Cloistered in my house, my car which won't be ready until Monday, once again I set out to crank my theories midterm paper. Don't get me wrong--ideas and direction are in my head, but I lacked the capacity to follow through with the project. What'd I do instead? I took another long nap. 

When I'm chock full of negative triggers and in a depressive state, though in contact with loved ones, I disregard positive self-care. (My school is HUGE into the concept of "self-care.") One might argue that sleep is a positive self-care mechanism, but neither too little nor too much sleep is recommended. But it's at these times, I'm typically not eating, pumping anti-nausea  and diarrhea medication, stuck in the bathroom more than a dozen times a day, in lounge clothes all day, un-showered and with the exception of brushed teeth, I'm not exactly socially presentable. I chain smoke. About the most I look forward to is the time of the evening when I can take all of my sense-numbing psychotropic medications and await the wave of malaise to guide me towards my bed, though half the time, I'm not sure how, exactly, I made it there. 

The roughest? A mixed-mood episode. Rapid cycling. Those are the nights I fall asleep writing at my desk, my head churning zillions of ideas but my body shutting down, usually culminating in waking my family up by the sound of the loud thud of me, having been asleep for hours in my office chair, finally slumping to the floor with the imprint of my keyboard spread across my forehead. I think my family is finally so used to it, they've stopped coming in my room to check and make sure I didn't break any bones. The thud awakens me enough to, again, guide me to bed, usually *after* I figure out where the hell I put my eyeglasses, which I've not-so-mysteriously busted no fewer than a dozen times in the last 6 months, in my sleep.  (Lenscrafters, who repair my glasses at no charge, ask me every time I come in how in the hell I broke my glasses in such seemingly inexplicable ways. I'm out of excuses. Now, I just say, "Hell if I know.") If Luke's home, after I thud, or even while still in my transient dream-state, sometimes I'll seek him out in his room, interrupting his sleep. He gently walks me back to my room, cracks my window open, uncovers my bed, tells me I'm making no sense whatsoever, (reminding me the next morning of what I was babbling about) and puts my ambient music channel on, kissing my forehead goodnight. We try and do this as quietly as possible. When he's not home and I go looking for him, and I can't find him, I panic until I am awake enough to logically deduce that he's at his dad's. Yes, his therapist, father and I all realize this is a grossly unhealthy familial pattern.

Speaking of unhealthy patterns and dynamics, I'm in a relatively serious, cross-generational fight with a much-older friend. (Yeah, if you read me enough, you'll figure it out but I'm purposely not glaringly calling attention.) As to which I eluded like 2 years ago, being friends with someone who's a Baby Boomer is sometimes really difficult. Me even mentioning here that we're *having* a disagreement will be enough to tick him off further. In the course of conversation the other night, I suggested that it's, perhaps, more typical of his generation to sweep feelings, opinions and events under the rug, and pretend they don't exist. He argued his offense at my friends and I, for lack of a better term, publicizing our lives in detail, when in his view, it's a mark of disrespect and dishonor of privacy and confidentiality to expose the aforementioned, never mind that  at least a couple of my closest friends are closer to his age than they are to mine.

I never got the chance to explain, amid him implying that he has lots of friends (a sudden bumper crop of divorced and widowed female friends he's never mentioned before, as if to say, "You're the most high-maintenance, childish girl in my life and I frankly don't have time for any more of your bullshit") and family members who all keep sensitive matters to themselves, that I grew up in a house full of secrets, between my parents, my grandparents, my aunts and uncles. Anything that brought to light cracks in the pavement of our nuclear existence were hush-hush and nobody's business. 

When the male grownups argued, it was in Polish, so the women (except my Nana, who was fluent) and children wouldn't understand. I can't tell you how many times my brother and I were shepherded to either a neighbor or another un-involved extended family member's house for the evening while a "family meeting" was being held at our house between my mother, my father, my paternal grandparents, my dad's older brother and his wife...matters of unheard-of, unspoken, non-revealing skeletons chiefly (as I'd find out after I grew up) centered around my father's fores into misadventure, or failure, or shenanigans; or at worst, jeopardizing the very core of our family with his perpetual drunkenness and poor decision making and lack of impulse control, his moods unpredictable. Whenever I knew a "family meeting" was being held, it struck fear and anxiety in me when I was a little girl. I was tiny but smart. I knew somehow that my Daddy was in trouble for some reason or another.  

Other members of my immediate family can refute my clinical opinion until they're hoarse. Scientists, geneticists & psychiatrists all conclusively agree that bipolar disorder presents as a chiefly inherited illness. It's not "the luck of the draw." I'm not an unfortunate mutation of the combination of mental disease and addiction. My mother disagrees with me because she, to be honest, didn't know what to look for, nor was mental illness (even worse than alcoholism) made public knowledge, treated or openly discussed, all in favor of putting on airs. The way I see it, from what I've understood, my father began drinking in his teens and by 20, was an alcoholic. His manic impulses manifested themselves much in the same way mine did, only more severe and devastating; his depressive episodes all drunkenly fought. (He had to have Bipolar I, whereas I have Bipolar II, which is slightly milder.) He started to drink (read: self-medicate) right around the typical time bipolar begins to exhibit symptoms. I'll bet if I could psychologically interview him now, he'd liken triggers that affected his moods (in either direction) and the puzzle would be arranged pretty quickly going back to his life events. Keep in mind, most of what I know about my father is anecdotal; my concrete memories of him ranging from about the age of 2-3 to when he died when I was 11. I don't have a lot to work with. Hence, I rely on what other family members tell me. My father wasn't in treatment long enough to  have doctors "figure out" what was behind his addiction, never mind that the tools by which to diagnose and treat in the early 80's didn't exist. While my elder friend is busy "reconciling" his feelings of anger, betrayal and God knows what else with regard to my big mouth, I'm still left trying to reconcile why nofuckingbody at the hospital knew how to safely detox someone who's drank every day for 22 years by using medications to prevent delirium tremens, while my father's cardiac system completely exploded in 24 hours, instantly killing him with my elder friend's own father at the helm of pronouncing my father utterly and completely DEAD. 

Taking *that* into consideration, my Boomer friend, I would hope, at the very least, understand exactly WHY I loathe secrecy and under-brushing or not honestly expressing emotions or feelings. Sometimes respecting confidentiality (and I think friends my own age would agree), while perhaps some colorful, detailed stories are indeed best kept out of the public eye, kills. It kills your heart--either metaphorically or physically. Forced to internalize or disregard extreme changes in mood, or expressions of either love or hate, does everyone a disservice. 

My friend views Facebook, Twitter, etc as a ridiculous, time-wasting exercise in too-much-information and futility, once again, airing one's dirty laundry or that of others when nothing is anyone else's business. To a certain extent, I'll agree with him when it comes to inane status updates about people eating pancakes, or the weekly "Go Bears!" inundation. Sometimes Facebook updates are so banal, that I'll cut/paste them and post them over on Twitter, citing them as the "stupidest thing I read all day." What he doesn't get, because he's averse to the openly online culture, is that there are gems hidden in between insipid congratulatory wishes on Yo Yo Ma's birthday. There are those on Facebook who do what we deem "Vaguebooking," or posting confounding status updates purposely to alienate or express passive-aggressive diatribes. While superficially annoying, it's in updates like that, or other, more blatant expressions of present-in-time emotions that someone working with a psychologist's brain (with experience as a patient) can truly dissect and assist someone who otherwise wouldn't raise a "help me" flag. It's kind of like the online, mental version of, say, visiting your doctor complaining of heart palpitations. And I've experienced this with a wide variety of people--friends I've known for decades, people from church, down to names I barely remember from my teens. I find that if I'm open and honest about myself and my struggles, the more I can give back armed with a wise history, a perspective missing from most conventional client or patient/doctor relationships, which is WHY I DO WHAT I DO. Yes, sometimes the solicitations for advice or help couldn't come at a more inopportune time, like being on call 24 hours a day. I have my own shit to manage, which isn't easy. Yet, do I turn away anyone? Never. That is not my nature. It's also the manner by which I would (hope) to be treated by people with at least a minimal, vested interest in my well-being.

Not being in daily physical proximity to my Best Male Friend, how did I piece together his behavior coupled with what he was posting to Facebook and Twitter multiple times a day? By reading between the lines. By comparing what I knew of him versus the subjects and details about which he posted online. Was that time ill-spent? Was it inane? Was it too-much-information or the divulging of too much detail? A reflective "No." Had I not been paying attention to his tiresome online missives, I'd never have picked up on his patterns. In doing so, yes, I helped save his life. While I didn't make the ultimate decision for him, nor did I gather together an intervention (blech), calling him out on his posts led to his personal revelation that he was slowly killing himself and needed help, and I guided him as best I could. For that, he owes me nothing. He is not indebted to me. It's the same thing I would do for anyone else I loved or even cared about.

The medium of electronic communication, by its very nature, plunks shitbombs in peoples' laps which they didn't ask for, have little time for, don't appreciate, are irritating (sometimes) but are NO LESS valid or worthy of attention or care than a private discussion between 2 people over dinner. And it's public--and I'm part of it. While termed self-aggrandizing or egocentric, the tale of my life in print, subject to criticism and harsh dissection by even strangers on other sites, could be considered my own rebellion against the shame and secrecy of the culture in which I was raised. I don't sugarcoat. I don't hide. I'm crazy and a drunk junkie. My father was crazy and a drunk. My friends are embroiled in complicated situations. I have feelings that aren't reciprocated that eat away at my heart, that are interfering with my concentration, which my BMF, as politely as possible, addressed one-sidedly with my elder friend because he didn't know what else to do and he knew I was hurting, that route being a lengthy email. I'm also loved passionately in what's seemingly also an ill-fated situation. We're all colorful figures. The characters in my blog are real people with their own real feelings, which I guess I need to do a better job of respecting. 

If being part of my life is embarrassing or shameful to any of you, or inappropriate, I apologize. I'm used to it. My last boyfriend harbored such disdain of the public acknowledgment that we were a couple, he quickly would remove himself from any photos of the two of us on Facebook, and continued to tout himself as being on-the-market even when he was (supposedly) exclusively mine. Being sorry and apologetic about myself and my life, however, wears me out. I'm not saying "My way or the highway," but nothing can be resolved or reconciled unless open dialogues and frank honesty, which includes time expelled, are fostered. A blithe "Yeah, see you around..." is a larger slap in the face than any of us should be expected to bear.

I mentioned in a previous blog having had dinner with my aunt and uncle recently, and the subject of bipolar disorder came up, upon which I poked my son's leg under the dinner table after my mom announced off-handed that I had it. My aunt asked me what it was and how you "get it." Knowing brain chemical disturbances would go right over her head, I simply said that it was "largely genetic." GASP! That implied, as is typical with my family, that ultimately, there's someone to BLAME. While I categorically hate being equated as being "just like" my father, seeing as I'm *not* dead and am recovering from addiction, when I piece together our lives side-by-side, they're remarkably similar, behaviorally. Why I'm the only one who recognizes this or sympathizes with it, I don't understand. A-ha! That brings us to the next Baby Boomer characteristic du jour, denial. 

The physicians at my former place of employment would get aggravated at the lag in their schedules caused by patients whose agendas of problems and issues surpassed the scope of a 15-minute allotted appointment. (The patient base being largely elderly, or late-Boomers.) While their compassion and patience was no doubt appreciated by their patients, and while they would take extra time to listen, it seemed as if the ticking clock or the sand in the hourglass rang more loudly than the words and feelings iterated by the patients. Time management in medicine is a dumbar's struggle, especially in the advent of electronic-based charting, detailing and notating. In my aspired-profession, we refer to something called "core competence." My opinion is that, if the doctor, who's time is limited, cannot (either by virtue of his specialty or time), cannot spend an hour listening to the problems and issues of the patients, the ethical, compassionate, sound thing to do is to refer the patient out to a psychologist. Easier said than done with that generation, who by and large deny that they have emotional problems or issues that would benefit from the listening ear of a therapist. Certainly that's the case in my own family, and would've been the case in the course of treatment of my father, had he survived. The dichotomy of people reaching out versus their senses of pride and stigmas fascinate me to this day. 

Ask me when, where and why my depressive episode began, and I'll tell you. Unlike my family, I'm not assigning blame to whom I believe to be responsible. That's unfair. My mental illness is my own situation to manage. 

My mom is leaving town until the 11th and Luke is with his dad until then. Scheduling some free time with my friends has proven futile, with the exception of a friend who's doing a psychological survey for one of my classes. My elder friend wants nothing to do with me. I have school--midterms--work to do. Unless I reach out, which I certainly will if you hear from me, I'd prefer to be left alone to do my work and yes, my work tires me severely and no, I don't want to spend my scant free hours at AA. My phone lines are 24/7 open to two people, both of whom know who they are, BMF and my best girlfriend. I'm thinking of going to the Tattoo Factory alone, potential mugging be damned, though my friend who recently went plead with me not to go nuts in there permanently marking myself with something I'll later regret. I'll eat if I feel like it, but I'm really kind of a GI mess right now. I'm a little scared, and apprehensive about the solitude, though welcomed and freeing. Hopefully, in between depression-induced extensive napping, I will get my work done without the aid of too much Pink Floyd. 

Barring other coping mechanisms, there's always Neil Diamond:


Anonymous said...

Neil Diamond's discography is extensive. I know you enjoy all of his work, but I find it interesting that you'd choose "Red Red Wine" to post on your blog.

Andrea Miklasz said...

परेशान मत करो कृपया

Anonymous said...

What's with the Muslim bullshit?

Andrea Miklasz said...

If you're so fucking stupid that you can't run a set of characters through an online translator, how could you be expected to know that "Muslim" isn't a "language?" FYI, it's Hindi.

best male friend said...

Anonymous Ignorant Person: I asked Annie what the characters meant in Hindi. It means "Please do not disturb me."

Please respect that with her and don't hassle her.

Annie, you DID save my life. Don't discredit yourself. Without you....

True, I thought "Red Red Wine" was an unusual choice, but I get it.

If you're not up to writing papers tonight, don't on your vitae, that's easy enough, or your dictation, which yeah, is a pain, but again, doesn't require much brain power. I tried buzzing you a couple hours ago...did you pass out again?

Andrea Miklasz said...

BMF, you saved your own life. I merely guided you towards hope by practical example.

It was a toss-up between "Red Red Wine" and "Solitary Man," so I picked the drinking anthem. Glug glug glug.

best male friend said...

You had on "Hot August Night." I would expect nothing less. Other than perhaps "Soolaimon."