Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Sunday, January 29, 2006

My future as a kitchen timer

I have had a tendency to forget things are cooking or forget to check them or the like for a very long time now. My attention span is just not that great and when I'm cooking I usually am doing several things at once. When I first bought this house the oven was not in good shape and heated more than it was supposed to, so forgetting things was really dangerous. To counteract this I always set the kitchen timer to go off every 5 minutes (or whatever) to remind me to go to the kitchen.

I've been doing this for so long now that I am noticing I have learned a new skill. Every time I think it's time to go check something in the kitchen I get there and there are 5 seconds left on the timer.

If therapy ever doesn't work out I can be a clock.

Thursday, January 26, 2006

This is what must change

I just randomly found a message board devoted to people posting negative comments about bipolar disorder. I didn't even get that was the point until I read half of it. Then I couldn't stop. There was one person who tried to defend the victims, but he just wound up saying that bipolar and seriously depressed people are very intelligent but lack motivation, through no fault of their own maybe. Um, I consider it HIGHLY motivated that I get out of bed and work every day even though I take enough sedatives to keep most people knocked out for 3 weeks and I have a disease that makes me exhausted anyway.

The worst comment (and it attacks lots of people, and the rest of the post goes on and on about others in this group) was "The lines beteen [sic] bipolar, retarded, and lazy (expletive) are thinner than ant ****". Um, yeah.

Hence my point, this needs to be maintained as a rare illness, not the social excuse of the month.

Wednesday, January 25, 2006

Please don't judge a blog by it's cover

This is a new blog and as far as I can tell only one person reads it (albeit from 2 computers :) ), and that person knows already. But on the random chance someone else stumbles in here, I started this when I was doing well. Within 24 hours I began something that normally would last a week or so. However, something has occurred in my life which is extremely painful. This means I either won't be feeling like writing or the writing will not be my best. My thinking is not always completely clear at these times, and I'm trying to learn to do this anyway. So please accept that this illness has chosen to invoke itself exactly at the wrong time for a new project, and that soon I will again be able to focus and say the things I really want to say and the things that need to be said. I have thoughts, insights, ideas, and right now I can't stop crying. So if a you exists, let me prove myself with time. I tend to judge what I read quickly and I understand that approach, but consider this the worst of the worst. Not that it won't happen again when this time has resolved, but it's not the best start.

Monday, January 23, 2006

I Object

I read an article stating that 20% of teenagers hospitalized for psychiatric symptoms may have bipolar disorder. This was apparently such an exciting story that it was highlighted and featured on hotmail and was an MSN main story.

Early diagnosis of bipolar disorder is certainly important. I would give anything to have some of the time I lost due to improper treatment back. I have been diagnosed for nearly 4 years. In that time we have gone from having 3 medications approved to having something like 10. There are plenty of others known to help that are not yet approved specifically for bipolar disorder. I am grateful for this, as I need the field of available meds to be as large as possible since I am able to tolerate so few of them. However, it has made bipolar more and more "popular". Suddenly everyone knows someone who is bipolar.

Many of those diagnosed with bipolar disorder have what is called "bipolar spectrum disorder". This is not yet the formal DSM description of bipolar disorder, but it probably will be eventually. It allows for many degrees of bipolar disorder, from the moody person who has little impairment of functioning, to patients with repeated psychotic manias. During the year and half before I was diagnosed formally I was treated by a doctor who did not see that I was as sick as I was because I was able to work. I was not able to function at all besides working, but to her that meant I was not bipolar. In reality I am much more at the worse end of the bipolar scale, but I maintain an ability to work. The areas in which I can't function are more social and doing anything not working related.

A majority of those diagnosed with bipolar disorder in the last few years seem to have the softer forms of the illness. These people deserve treatment of course, and it is a great thing that medications are finally available which can treat bipolar symptoms without the horrible side effects of the heavy duty meds. However, having soooo many people diagnosed with this disorder is resulting in a mis-understood illness being even more mis-understood. I've been told things like I should refuse to take certain meds because of the side effects and opt for meds that are easier to handle. If only it worked that way for everyone. But telling me that in regards to things like an antipsychotic (which is the only choice at times) is much like telling me that Prozac alone can cure me.

The reality is that most teens have serious mood swings and many have behaviors consistent with bipolarity. Many teens are quite depressed. I remember it as being the norm. Certainly some teenagers need mood stabilizers. But if teenagers are assessed for signs of mania and depression using measures that don't factor out that teenagers are normally going to appear quite bipolar at times, many will falsely be diagnosed. There are repercussions to this diagnosis and I think a delay as long as possible is wise. The medications used to treat this are not pleasant and often have long term side effects. At 30 years old I have hypertension and have to be screened for diabetes annually. I've gained 50-60 lbs from the meds. At least one medication can impair fertility. Several are unsafe during pregnancy. Many require monitoring to be sure the liver and kidneys are not being harmed. And it's not easy to come off of the meds. It is very hard to convince a doctor that you are not bipolar after you've been diagnosed. We're notorious for being non-compliant with meds anyway, and then if you are doing well and taking meds it's hard to prove that you're not just doing well because of the meds. There is also vast prejudice against those with this illness. Even a trip to the emergency room can result in a fight to prove you are not there for psychiatric reasons, despite ample physical symptoms. Some doctors will not treat bipolar patients. Others treat us as if we are a guaranteed problem, unable to comprehend instructions, report symptoms accurately, or follow through with anything. Despite laws to the contrary it can affect employment; I have a resume to prove it.

When I was first diagnosed and first treated I was very angry that I hadn't been diagnosed earlier. Looking back through my life there were warning signs all along, and officially my first episode would be as a young teenager. However, I believe that not being diagnosed allowed me to achieve so much more. I could not take these medications and complete college or graduate school. I benefitted from being old enough to not buy the limitations that seemed so obvious when I knew what was wrong with me; I had been working for nearly 2 years while my moods and behaviors were uncontrolled, so I knew I could find a way to do it when I felt better. I was able to see that I was not destined to live like a stereotypical bipolar. Had I been told at the age of 14 that I had this illness, that it would affect my life in such and such a way, I would not have tried some things that I am so proud of. I know this for sure because now there are many things I "know" I can't do. Many are realistic, but I know that I choose to limit myself at times out of fear.

I would much rather have been identified as "at risk" (and to be fair I was at times by people who did not follow me long enough to be sure, and probably by those who were afraid I would harm them if they hinted at it because to say THAT WORD invoked great wrath for many years), than to have been diagnosed before there was any doubt.

I also would much rather this be kept a "rare" illness than the illness of the week. I know what it does to me. I know what it does to my patients. That is true bipolar. If everyone suddenly wants to be bipolar then it becomes casual, and that is like saying any potentially fatal, life-changing, non-curable, treatable only with things nobody wants to deal with, illness (say viral pneumonia) is as common as bronchitis. When "everyone" is bipolar in some way, then I have to deal with physicians who have just been through my medical history and medications in great detail with me asking "but WHY did your psychiatrist put you on an antipsychotic?". Answer: "Um, because I'm bipolar and was having symptoms best treated with an antipsychotic?" DUH. (That's a true story).

I want it both ways. I want acceptance, but I don't want commonality. My bipolar is not your depression. My depressions are more than likely nothing like your deepest depression, medicated though that may be. I want bipolar to be more than "moodiness", as it seems to be becoming known. It's so much more. Call it what it is. Diagnose it only when it's real. Treat it carefully. Respect it. Don't make it what every parent suspects.

Friday, January 20, 2006

Irony of Irony

This has been a terrible week for me. I keep saying that, and really I won't say that every day that I ever write on this thing, but this week really has been bad. My sleeping, which is never even remotely normal, has turned into near torture this week, with 45 minute chunks of sleep separated by awake periods, difficulty falling asleep, and exhaustion. I stayed home from work one day to sleep, which helped somewhat, but I am still very tired and facing another night of probably uneven sleep. I am waking to items thrown around my bedroom, blankets and sheets on the floor, laundry baskets knocked over, and an angry cat. This is not restful.

It is always hard to work during these times. There are obvious reasons, like I'm tired. Plus my job requires me to be extremely patient with severely mentally disabled adults, and it can be very hard to be patient with someone who is being mean to your face when you are exhausted. In fact one of my rules for myself is that when I snap at a patient in any way I need to think about whether I am too tired to be working. At times it can also be emotionally draining to be in situations where I am providing support and education about living a life with a disability. Currently I am helping a young man around the same age as I was when I was diagnosed come to terms with the need to set goals for his altered life, which is very different than his plans. I speak oh so generally of my own losses, and he doesn't know how deep they cut, and the emotions run deep for me. Yet I'm finding a special talent for these discussions, one I'm growing after a few years of experience in this specialty.

However, during the hard times those things are so much harder. I routinely find myself wanting to scream "I KNOW!!!!!" and to reveal much more about my own illness than I really want known. People accuse me of "caring too much" when they just have no clue. I have been known to make sharp comments under my breath when something was attributed to "just being how a schizophrenic is" or "they..." comments which try to establish lines between the "normal" staff and the patients. This time though, it's not been patient relationships that has hurt so much.

This week my greatest challenge has been anger and impatience with a co-worker who is having personal problems and her own psychiatric issues and is not dealing with them. Her life is miserable, she is making life miserable for all those around her, and I am very angry with her. My anger has a lot to do with my own need to strictly be responsible for myself all the time. I don't get to be rude just because I feel bad; if I feel bad I go take a pill, and if I can't see I need one a friend knows to tell me to take one and also knows where to get it in an emergency. As a bipolar if I am to succeed I must be responsible all the time, from the day I managed to diagnose myself because the doctor I was seeing then was an idiot, to the day I realized I needed serious help and got myself to the best doctor in the country immediately, to taking meds that make me sick and fat and tired, to taking time off. And so-called normal people are apparently allowed to act out as much as they want. I made my company aware of my illness long ago, and I needed to. If I did what this co-worker does I would be asked to take time off. I am so angry that being irresponsible about personal problems seems to buy leeway to continue to behave inappropriately.

Thursday, January 19, 2006

The truth comes out

During my months of thinking about doing this I stopped so many times because I was afraid of what would happen when I had bad times. In 4 years I have had one 9 month period that was solidly good, and the rest of the time goes up and down a lot. During my bad times I usually shut myself off even more than I already am from things that are fun, social, or interactive. I don't trust myself to be nice, and I have no energy. And my focus is firmly on fitting in to the "real" world, to keeping anyone from calling me the mentally ill one, and to refusing to let my illness win.

The problem is that sometimes I am sick, and I still do have a real life during those times. I am teary and irritable and angry and often whiny, and I hate being those things. I only let those who are very close to me see these things, and I fear anyone else seeing them. I've been bitten seriously by people I did not tell about my illness finding out about it, and by the misconceptions of those I did tell. I am terrified that if anyone sees what I am like when I am sick that I will face more rejection and humiliation.

What I want most in the world is for people to see that I can be and in fact am seriously mentally ill and yet I am capable of doing all sorts of things. I'm pretty good at the "doing all sorts of things". I am not good at the seeing I'm mentally ill part. So that is the next function of this blog, to be open when I'm sick and yet anonymous. This would probably be more meaningful if I had more than one reader who knows already that I'm not doing well right now, but someday someone may read this.

So, for this week, it's not been the best. I made myself manic by accidentally drinking tea I thought was decaffeinated but was full of caffeine. Thanks to taking large quantities of lithium, which is sort of like ingesting daily doses of pure table salt, when I refer to drink I am not talking a dainty glass, I usually refer more to a pitcher. And so I lost a night of sleep. This is dangerous for me, and since my moods have been out of kilter for many months lately it was even more dangerous. Then I was upset by something at work, and wound up taking a day off to recover because I was too angry and emotional to deal with people. Sleeping for a day helped, but I'm still highly emotional and tired. All this because I didn't read a label.

There will be times I just stay quiet, keeping my not feeling well to my select group of victims. But for today, I feel bad. The end.

Monday, January 16, 2006

And in the Beginning

I fear writing this. In fact writing this has taken nearly 2 months. All my caution says to wait for a better day, an asymptomatic day. But it is best to be as I really am, and today is one of the real me's.

Welcome to a world where nothing is the same twice. Where nothing is the way it "should be". Where some days I will make great sense, and the next day understanding me will require you to sort out the extraneous information my brain can't.

I am Just Me. I live with bipolar disorder. Specifically I have bipolar I disorder, rapid cycling, with severe mixed episodes. (In English, I have the more serious form of bipolar disorder, my moods shift rapidly (often every few days and at times even more frequently), and when I am at my sickest I am both manic and depressed at the same time. Mania for me is not what people generally think of; I am extremely, tortuously anxious, irritable, impulsive with my anger, and I do not sleep. Calming these states require antipsychotics, none of which I tolerate well and so I put off taking them as much as possible.) Combined with a host of medication allergies and meds that do not affect me, I'm every psychiatrist's nightmare, at least on paper.

On the other hand, I am every psychiatrist's dream patient. I have been blessed with some biological gift of functioning in parts of my brain that should not function. I have never done many things bipolar patients are known for. The worst impulsive spending spree was when I bought a tv I wasn't sure I was going to get before the mania hit and then adopted 2 scrawny, sick cats and bought tons of cat toys for them. The vet bills were painful, but compared to a car they were nothing. And that move sealed my diagnosis, made it very real to me that I had to always be careful, and so far I have succeeded. I have never touched drugs or alcohol. I take my medications almost every day, and when I miss I usually have good reason. I often can know what med adjustments need to be made from how I feel. This is a big help when trying new things can begin 6 months of torture for all around me.

But I am so much more than the illness. I live every single day, and every day I get in-your-face reminders of how very blessed I am. Parts of what I write will be about my limitations. They are huge. However, every day I live behind my mask, the mask which hides the greatest irony of all: I am a mental health professional, and I spend all day every day working with 150 of the most severely affected schizophrenic and bipolar patients in this state.

My story is about learning to live with an illness. It's about succeeding despite the "shouldn't"'s surrounding my disease. It's about the experience of learning that faith means not planning for life, but trusting that God's will can be good, even when it is the opposite of what ever seemed a possibility for my life.

I was diagnosed late for someone with the severity of the illness I have. I had to learn to give up many prejudices about the illness I had developed during years of education. Almost 4 years post diagnosis I am a well-educated, succeeding so far, responsible, independent adult, working in a highly stressful environment daily. Through this blog I hope that I can help others learn a broader perspective on bipolar patients than I have faced over and over from healthcare professionals during this experience, and also a broader perspective than I admittedly had myself. My dream is to live in a world where every time a bipolar patient cries those who work with them do not blame it on cycling, but allow them to have normal emotions as well. I also hope to meet others like myself, to gain a wider perspective, as I have never met anyone with the kind of symptoms I have who does what I do. I want to know other mentally ill mental health workers, as well as others.

I will stop now. Today I made myself manic via accidental (really, it's not fun and I would never do it on purpose) caffeine ingestion. I had very little sleep last night and did not stop moving all day. Or talking. A lot. About nothing.