Into the Lion’s Den

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“I’ve seen desperation explode into flames
And I don’t want to see it again” – Dire Straits, “Telegraph Road”

Something bad is coming. There’s something pulling me under that I can’t control. I see my patterns and routines changing for the worse. I’m not sleeping. I don’t want to interact with anyone. I don’t have any energy or tolerance for routine annoyances. My temper is short and I’m frustrated, anxious, angry, and above all, scared. Of course, if anyone asks, I’m fine. I don’t go into detail, and I don’t want to talk about it.

I wake up and don’t even have the desire to take my meds; any of them, not just my psych meds. I’ve been missing two or three doses a week for the past two weeks, including medications for heart problems, ulcerative colitis, and diabetes. These are all signs that depression is setting in. I’ve been kind of waiting for it to happen because of several recent stressors and triggers.

I had major oral surgery two weeks ago which left me with four teeth in my mouth. It will take several weeks for my gums to shrink and I can be fitted with dentures. I can’t chew any real solid food and I can’t speak properly. I am angry and frustrated. These are two simple, basic, everyday needs that I can’t perform. I’m embarrassed to say anything, smile, or laugh. When I do, I keep my hand over my mouth. I refuse to trim my moustache because it further prevents people seeing my lack of teeth, although I know full well they can hear the difference. I don’t want to speak to anyone, especially on the phone because I’m difficult to understand. I’m embarrassed to go out in public, but I have to because I have to take care of my son while his mother is at work, and that includes taking him to the park, his martial arts class, and starting soon, swimming lessons. I have to interact with people. There’s no way around it.

There have been several domestic arguments. I’m not going to air dirty laundry and go into to detail, but they have led to a deafening silence at home. The silence is broken internally by that voice in my head, the one that tells me I’m alone, unloved, worthless, unnecessary, and broken. I hurt, mentally and physically.

These have all contributed to an uncontrollable sadness. I want to break down. I want to give up. But I won’t. I have to dig in and try to find a way around the depression. I’m seeing the nurse practitioner this week and will discuss a change in medication. I’ll keep my weekly therapy appointment and try to figure out how to handle this. Unlike previous episodes of depression, I’ve been tracking my moods and patterns, and I can see this one coming. I don’t want to be pulled under like I have before. Because of this, I feel almost like I have an advantage and, despite the lack of a support system, I can still make it through this. I am cautiously optimistic. I’m not broken, not yet anyway. I’ve been through this before and survived, despite what the statistics may say. I may very well wind up being overwhelmed, but not yet. The depression doesn’t have a full hold of me yet, and I’m doing my best to keep it that way this time.

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When Normal Isn’t Normal

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“The only normal people are the ones you don’t know very well.” – Alfred Adler

I dislike using the word normal in reference to mental health. There is no true normal. Everyone has their own quirks and idiosyncrasies. I prefer to use the word “average”. I have average days. I feel like I fit in, like I’m not struggling against myself and my brain and I actually get along. I’m not antsy, irritable, or depressed.  I sort of miss the energy of hypomania, but average is nice.  Sometimes I get a few of these days strung together, maybe even a couple of weeks.   It happens between hypomanic events and depression. It’s still not normal.

On my average days I can enjoy life. I can be happy; my moods are stable and not as magnified. I still have breakthrough moments of sadness and anxiety, but I recover quickly. It’s still not normal, though; there are drawbacks. I still feel like I’m waiting for things to go bad, for the other shoe to drop. I feel better, but I’m still nervous about trusting my own judgment, that there is still something lurking inside that will turn a seemingly simple decision into something horrendous. Overall, I feel good, but never entirely carefree.

Since these average experiences occur between hypomania and depression I’m somewhat leery of what’s going to happen next. This is the main reason I do not refer to my periods of feeling average as normal. I know at some point the average feeling will end and something will eventually replace it . I don’t know if it’s going to be depression or hypomania. If it’s hypomania, how far up will my mood go? It can range from being slightly euphoric and energetic to completely out of control. If I move into depression, how low will I drop? Will I become suicidal again? Will this be the depression I don’t survive? This is my worst fear, that I’m one mood swing from taking my own life.  The statistics make it a coin flip that I’ll attempt it.

There is a positive side to this, especially these days.  I’ve been in treatment for eight months, the longest I’ve ever lasted before going off my meds and I feel better more often and for longer periods.  Although the fear of relapse  occasionally rattles around in my brain, I don’t sit around and ruminate or try to hide from it.   Being afraid of the depression and anxiety cause me to be more depressed and anxious.  I now have reason, however, to not see this as a stressor or trigger.

My most recent hypomanic episode passed without any major incidents. I felt a bit more energetic and occasionally irritable, but nothing unmanageable.  The medication and therapy are working, so although I’m concerned about the next mood swing, I’m not trying to hide from it or lock myself away in fear. I haven’t had an episode of depression since early this year, so I remain positive.  It’s possible that I may be in a sort of remission and the average days will continue.

That’s about the best I can hope for and as close to “normal” as I can get for now.

Myth and Madness

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Possible trigger alert:  The following contains descriptions of my experiences with depression and suicidal ideations.

There has been a great deal of talk about depression and suicide lately because of the death of Robin Williams. There also seem to be many misconceptions about depression and the rationale (for lack of a better term) behind killing oneself. Clinical depression is hell. It’s not just feeling sad for a day or two and staying in bed and eating ice cream. It is debilitating. It is soul-crushing. It is never ending. It isn’t a battle because depression is the absence of everything; happiness, hope, coping, it’s all gone. You can’t fight what isn’t there.

Numerous times I’ve read “everyone gets depressed”. No they don’t. People become sad and upset and can recover. Major, recurrent depression affects 6.7% of the U.S. population. 2.6% of the population has been diagnosed as bipolar and almost 83% of those are classified as “severe”.

These numbers seem rather small when looked at as percentages, but the actual numbers represent millions of people. Bipolar actually has a higher suicide rate than depression: 20% (1 in 5) for bipolar patients and 15% for sufferers of depression.

Those are the numbers; here is the thought process I’ve experienced. Depression is crippling. I can’t sleep, I don’t eat, I can’t think rationally, I have no attention span, and I completely and utterly despise myself. I have hurt almost everyone around me, and those I haven’t I have pushed away. I cannot function and I want no part of the world around me. I mutter to myself. I repeat to myself out loud phrases such as “I want to go home”, “I can’t be here anymore” and, “I wish that heart attack had killed me.” When I say “I want to go home” I mean the home I grew up in, someplace warm and comforting where someone else was responsible for my well-being because I can’t take care of myself.

I try to hide myself from the world.  I bury myself under blankets, I hide my face under hoodies.  I stay awake all night and sleep all day because if I’m asleep while everyone else is going about their day and awake while they sleep they can’t reach me.  The world can’t hurt me in the middle of the night like it can in the middle of the day.

I have internal conversations with my brain. I’m not schizophrenic, I don’t hear voices, I hear my own voice telling me I am worthless, useless, and toxic to those around me. This is when the suicidal thoughts creep in.

I cannot describe my anger and rage at some fucking asshole playing armchair psychiatrist and saying that suicide is selfish and cowardly, or even more ludicrous is the idea that it is somehow related to political beliefs. My suicidal thoughts are not selfish. I’m not looking for a way out or to end my pain. I want to prevent myself from causing others pain. I’ve done enough damage and I am hated by those who were closest to me. I can’t continue to cause them any more suffering by being in their lives. My son needs a better, more positive role model and I can’t provide that. He deserves better.

This is depression. I’m not upset or sad. I’m fucking helpless and hopeless. The only way this can end is with me dead and out of the way, unable to disappoint anyone ever again. I won’t be free but everyone else will be.

Depression is harsh and cruel and I truly hope people never experience it. There is nothing worse than being afraid of yourself. I wanted to be left alone, but I wanted someone there so I couldn’t be alone. Depression is desperation. It’s the need for help, but the inability to seek it.

If you know someone who suffers from depression, how can you help? There are no magic words to take it away, but you can help them know that they are not alone.

Let them know you’re there for them.
Tell them they are loved and that they matter.
Tell them you are not frightened of them.
Ask if they’ve seen their doctor or therapist.
Tell them they do not have to be ashamed or apologize for their illness and emotions.

I would not wish the dark thoughts of depression on anyone. I try every day through therapy, medication, and just normal everyday contact to keep myself feeling average. It’s exhausting, but I know I’m worth more than what I think I am. Keeping that in mind when I am in the throes of depression, however, is a different matter.

If you feel you are depressed, or need help, or generally overwhelmed, please, PLEASE, reach out to someone. If no one is immediately available, call one of the suicide hotlines. There are many and they specialize in various areas. Here is a fairly expansive list of phone numbers. Help is always available.

O Captain! My Captain!

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“I’m moving through my personal life like a hemophiliac in a razor factory.”
– Robin Williams

This week’s blog is a little late and a little short. I wasn’t sure what to write about; as I had nothing planned and didn’t get to write much during the last week. I was looking for topics, but I saw some of them appear on other people’s blogs and I didn’t want to be seen as copying. Then, early this evening I heard about Robin Williams’s apparent suicide. It’s the first time I remember crying over the death of a celebrity.

Why am I so devastated by the death of Robin Williams?

Aside from being a tremendous fan of his acting and stand-up comedy, Williams was a sort of personal hero for me. He was bipolar, but more importantly for me, he seemed to make the illness work for him for so many years. His mania brought forth some of his greatest moments and his depression and addictions provided him with material. He had overcome his addictions to drugs and alcohol, but eventually relapsed and went into rehab shortly before his death.

I saw him as someone who overcame his bipolar disorder and became a success. He rode the wave of his mania to a brilliant career, not only as a comedian and comic actor, but as a dramatic actor also. He could move people from laughter to tears, sometimes in the same film.

Granted, there are better actors and arguably better comedians, but his work and his success continued after he had battled through his addictions and his personal problems that were certainly related to being bipolar. I don’t know if his talent was despite his illness, or because of it, but I saw him as a success story. Maybe I was wrong. Not that he was success, but that he had somehow tamed his illness. The more I read about him, the more I found out how he constantly had to deal with his depression. In the middle of a brilliant career, at the age of 63, he committed suicide. Someone I thought of has a success story could not defeat depression.

This is why I’m devastated by the death of Robin Williams. It’s something to which I can relate. I’ve made it personal.

After so many years and so many successes and so many accolades, it still wasn’t enough to keep his demons at bay, to stave off that same dark depression that haunts me as well.

Here’s the truly devastating part for me: If Robin Williams finally succumbed to that depression, how do I ever stand a chance?

The Sins of the Father

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“It’s a sad affair
When there’s no one there
He calls out in the night
And it’s so unfair
At least it seems that way
When you gave him his life”
– Tears for Fears “Suffer the Children”

Last week when I wrote about dealing with the symptoms of irritability and anger I talked about my son and how I was trying to avoid letting my symptoms affect him. It isn’t easy and it isn’t always effective. I try to shield him from my outbursts, but he will see me when my anger takes over and I yell and curse. I try desperately to avoid him becoming the brunt of my anger. Part of my daily cycle usually includes being more irritable at the end of the day, usually around the time he has to take a bath and go to bed. If his mother is home she will handle this part of the routine, but lately she’s been working late so it’s been my responsibility.

When it comes to certain things, my son does not move quickly. Things like getting dressed for school or to go out at all, getting into the car and putting on his seat belt, and walking through stores, all seem to take forever. Now I know this is not specific to him and a lot of children do this, so I deal with it and I good-naturedly tease him a little, although he did not know what the phrase “slow as molasses in winter” meant. He uses his same time-consuming process in his night time routine, taking forever to get in the bath, getting his pajamas on, brushing his teeth, trying to con me into giving him one last snack or glass of chocolate milk. Again, none of these are unusual, but by this time of day I have no patience. I need him to go to bed so I can have my time to calm down and go to bed. I spend a lot of time muttering under my breath that he should hurry up and move his ass to get into bed. When he asks what I said, I can respond, “Nothing, just talking to myself,” and carry on. I keep telling myself that it’s not his fault. I have to try to keep calm. Deep breathing and occasionally leaving the room for two minutes to collect myself usually works.

At the other end of the mood swings is the depression. This is the most painful part for me. I completely withdraw. I sit on the couch with a hoodie pulled down over my eyes and avoid all communication. He knows Daddy isn’t feeling well. I lie and blame one of more physically tangible illnesses, usually that my stomach is bothering me. This can only work for so long. He knows that something is up. He’s six, not stupid. One day he asked me outright, “Why are you so sad all the time?” I just wanted to break down and sob when he asked. Not only did he figure it out, he had questions that I’m not ready to answer. How do I explain bipolar depression to him at his age?

It isn’t only his observing my symptoms that bothers me, even though I wonder how he processes the behavior he sees. I worry that he may suffer these symptoms himself. Children with a bipolar parent run a 15-25% chance of suffering the same disorder. I hope each and every day that he isn’t part of that number, that he will escape dealing with these uncontrollable emotions and the cycling mood swings. I am horrified by the thought of him suffering through the pain of depression.

I try not to dwell on these thoughts. He is a very happy, funny, and adorable child. I want him to be nothing but happy. Despite my mental illness, he is a source of incredible joy for me and the reason I’m alive. When I was at my lowest and seriously considering suicide, I stopped each time because of what it would do to my son. It would have been a violently selfish act that would devastate him and cause immeasurable pain, the one thing I’ve been trying to avoid. When my irritability slowly creeps up by the end of the day, it is his laughter and happiness that ultimately see me through.

The Strange Case of Me and Me

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“Well when the game is over, I won’t walk out the loser
And I know that I’ll walk out of here again
And I know someday I’ll walk out of here again
But now I’m trapped”
–Bruce Springsteen, “Trapped”

Yesterday wasn’t one of my best days. I’ve previously written that one of the symptoms of bipolar is mood intensification. Another is irritability. The combination of the two is unbearable. I woke up in a truly foul mood for no reason and it proceeded to get worse as the day progressed.

Imagine the anger that sets in when you’re in a supermarket or on some other shopping excursion. The checkout line is too long. The person behind you keeps pushing and bumping into you with their shopping cart. The person in front of you has two full shopping carts and a screaming child pulling candy off the shelf. At the front of the line is a person old enough to have sailed on the ark with Noah and is taking forever to get the groceries on the conveyor. Then they have an envelope full of coupons. Then they have the nerve to pay by check. You know this feeling. A temporary hatred for humanity, all of whom seems to have gathered with a 20 foot radius of you as you are simply trying to buy some milk and thinking this would be a quick trip. These feelings of consuming anger build until you exit the store, take a deep breath, retreat to your car, and head home.

On this particular day, this how I feel when I wake up. Except there is no deep sigh of relief or quiet place where I can calm myself. There is no relaxation. There is no reason for this irritability and anger. It merely is; and I have to deal with it. I try to sit and use deep breathing but it doesn’t work. I keep bouncing my heel off the floor, shaking my whole leg. I can’t sit still, which makes relaxation impossible. This is psychomotor agitation at its finest. I want to claw my way out of my own skin. I want to scream and throw a tantrum like a child, do anything I can to exorcise this rage until I can collapse, thoroughly exhausted, and finally rest. I can’t. I have to manage myself responsibly. I have to watch my six-year old and not lose my temper with him.

My son isn’t making it easy. As we sit on the couch watching TV, he insists on lying right up against my arm. Normally I don’t mind and I take comfort in it. Not today. Every time he moves and accidentally kicks or elbows me, I become angrier. I am able to maintain composure and ask him to move over. He does – for about five minutes – then he is back to leaning on me yet again.

I take a hydroxyzine, a non-narcotic I was prescribed for both anxiety attacks and mania, to calm down. This is the equivalent of throwing a brick in the Grand Canyon. Utterly useless, but I can’t take a second one for fear of falling asleep or being too groggy to watch my son. Everything culminates when my son accidentally breaks my glasses. I let out a “GODDAMMIT!” He bursts into tears. It takes almost ten minutes to calm him down. He apologizes repeatedly and promises never to play with my glasses again. I feel awful for yelling like I did and try to rationalize it by saying I wasn’t yelling directly at him, merely yelling in frustration, but it doesn’t ease my guilt. We forgive each other eventually and move on.

The worst part is that as this anger festers and grows, I recognize clearly what is happening, but I am unable to do anything about it. It is beyond my control and I am powerless to stop it. Anything I do to calm down doesn’t work and psychomotor agitation makes it worse. My wife asks several times what I’m upset about, but I can only tell her, “Nothing.” There is no specific event that has set this off. I feel completely helpless and trapped inside my own brain. I understand what’s happening and I can think rationally about it, but I’m locked away inside myself while the monster tries to get out and play. I feel as if some bizarre version of Jekyll and Hyde is being played out and I desperately want Jekyll to win. I want this day to be over.

Later that night (technically, early the next morning) I eventually get to sleep. I’ve never been so grateful for feeling tired.  Yesterday is finally gone and today, so far, has been very different. Yesterday’s crisis is over and I feel relatively average again. The next test is seeing what I can accomplish while the better mood lasts.

Good Without God?

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“Where e’er we go, we celebrate
The land that makes us refugees
From fear of priests with empty plates
From guilt and weeping effigies”
– The Pogues “Thousands Are Sailing”

I’ve mentioned before that I’ve read several posts and blogs about how different people cope with bipolar disorder. Some turn to god, prayer, and religion. Some turn to twelve step programs to deal with addiction and self-medication issues which include turning oneself over to a higher power. I’m not going to dismiss or belittle these beliefs and ideas. Whatever helps a person maintain a decent emotional baseline and helps them through the emotional roller coaster of being bipolar cannot be all bad. For me, however, the real question is how does one manage without these supernatural ideas?

I’ve been an atheist for several years now and I’ve gone through several phases. Initially I was very much an anti-theist. Religion was bad. End of story, discussion over and done. I was angry. I’ve since moved towards what’s referred to as agnostic atheism. I don’t believe in any deity, but if given empirical evidence, I will happily change my tune. My problem lay with people using religion to infringe upon the rights of others. I’ll leave it at that, as, once again, I do not wish to use this blog as a soapbox for religious or political views. I’m merely trying to ask, and figure out for myself, how does one cope without belief? I think, thus far, that I’ve done ok. I mean, I’m still alive, I’m in treatment, and somehow I’m managing.

I haven’t joined a twelve step program for drugs or alcohol, not because I refuse to believe in a higher power, but because of my therapy and treatment, I no longer feel the need to self-medicate. Do I miss cocaine and drinking? Certainly, but I no longer feel a need for it. My moods have been more constant and there is no need to either raise myself out of depression or attempt to nullify my mania. Therefore, I haven’t felt a need to turn anything over to a higher power. Apparently, I’m not alone. Other bipolar people have mentioned that their desire for drugs and alcohol were dependent upon their moods. Some drank to stifle their mania and did drugs to stave off depression, or vice-verse. It often came down to refusing to deal with the mood swings and also trying to numb themselves against these same highs and lows.

I understand people’s need and desire for belief. I have several friends in recovery through AA and similar programs who by their own admission never would have survived without them. I respect their choices, their beliefs, and their desire and ability to cope. People turn to many different ideas and beliefs for comfort and support. To some, mine may seem more difficult because I do not believe in god or religion. We all have different ways of coping and I don’t think any one is better than the other. My path is slightly different, but it’s the one I’m comfortable with.