The Strange Case of Me and Me

“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?

 

“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.

Inevitable Conflagration

 “I had the shit till it all got smoked
I kept the promise till the vow got broke
I had to drink from the lovin’ cup
I stood on the banks till the river rose up
I saw the bride in her wedding gown
I was in the house when the house burned down” — Warren Zevon

By the time I was diagnosed with a mental illness I had already blown my life up.  It was difficult to believe that I wasn’t the person I thought I was, that everything I had done in my life may have been a result of a disease.  How did this happen?  Where did this come from?  How did I get it?  Why did it take so long to be problematic and noticeable?

My bipolar diagnosis came very late in life. I was 44 years old when I was finally diagnosed in 2012. Bipolar can be triggered by many different events or types of stress. No one is certain what causes bipolar disorder, but there are several theories. The obvious beginning of this is genetics. Bipolar disorder tends to run in families. About half the people with bipolar disorder have a family member with a mood disorder. I have a pretty good history of mental illness in my family. My father suffered from anxiety attacks when I was younger and looking back on his behavior, I’m fairly certain he was also bipolar. His mental issues were exacerbated by my mother’s death in 1996. My maternal grandmother also suffered from mental illness and spent time in a psychiatric hospital. I could never find out what her exact diagnosis was because “we don’t discuss those things” was the family mantra. All I could ever learn was that at some point there was an incident in which she destroyed all of her household furniture and both my parents helped clean it up. I now regret not getting the full story.

Also, a person who has one parent with bipolar disorder has a 15 to 25 percent chance of having the condition. As I mentioned, I’m pretty sure my dad was bipolar. Between that and his anxiety disorder my diagnosis feels like it was inevitable. Until my mother passed away, I never realized how much of a support she was for him and kept him from exhibiting symptoms.
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A mood episode can be triggered in a person who may be genetically predisposed to bipolar disorder. I remember several distinct episodes of depression when I was younger. I had a serious suicide attempt when I was 16 years old and another episode when I was a sophomore in college. That was more self-harm than suicidal. I considered suicide at several other points in my life, especially during the episode of depression that led to my three weeks at Four Winds. I can also remember distinct episodes of hyper-sexuality going back as far as high school and continuing in various forms until recently. If you’ve read my previous blog entries, my activities in strip clubs is pretty well documented.

In my own opinion, the biggest trigger, and the one that led to my diagnoses and self-awareness occurred in 2011. I’ve never discussed this in my blog before and outside of a close circle of friends and mental healthcare professionals, I’ve never discussed this at all. One day at work I discovered a flash drive sitting in the computer I was using. I opened a file to see if I could discover who it belonged to. That was the worst mistake I ever made. What I found was a coworker’s photo collection. Suffice it to say the subjects and material were highly illegal. I will not go into any further detail, as this is already a trigger for me and I can’t dwell on it any more. The coworker was removed from the premises and later prosecuted. As a result I started drinking more than usual, but as the saying goes “What has been seen cannot be unseen.” I tried to drink so much that I would, hopefully, retroactively drink myself blind. No such luck.

In addition to an increase in drinking and depression, I started to spend time in strip clubs where I discovered cocaine. This was quite the discovery, because I had a substance that made me feel slightly better than alcohol, a depressant. Now I could really self-medicate by mixing and matching my drug of choice to my mood.

I found out later on that in addition to genetics, the event of discovering that flash drive, use of alcohol and drugs, combined with a lack of sleep could also prompt an onset of bipolar disorder. It was a perfect storm of crazy. Everything I did effectively was a trigger for my mental illness. For months I experienced an unbelievable hypomanic state. Every symptom was present.

Then the money ran out. The lies and excuses ran out. Then my family left.

The crash was unbelievable; the depression and suicidal thoughts lasted eight months until I finally got to Four Winds. There was a brief period in those eight months when I felt better. I was diagnosed as bipolar, taking my medication, and in therapy. Once I began to felt better I quit treatment because, well…I felt better. I think we all know by now how that movie ended. I really hope there’s not a sequel in the works.

Mea Maxima Culpa

“Guilt is cancer. Guilt will confine you, torture you, destroy you as an artist. It’s a black wall. It’s a thief.” – Dave Grohl

Let me give you a brief insight into my character. Everything is my fault. If it’s not, I will still find a way to make it mine. This is my default mode. Everything has been my fault for the last three years. Every stupid mistake, every terrible outcome, every bad idea, and every lousy situation that has occurred has been my fault.

Ok, maybe not everything, but I have come to believe it. I have so thoroughly beaten myself up for all the terrible things I actually did that I automatically assume guilt for everything. If my son does or says something wrong or out of line, then, in my mind at least, I am to blame. I am a terrible role model and an unfit parent. Anything that goes slightly wrong at home is because of me.

Part of being bipolar is dealing with constant self-doubt and self-hatred, especially while being depressed. When anything goes wrong I can and will find some way to blame myself. Another reason this happens is because bipolar causes not only mood swings, but an intensification of emotions. Where most people may feel a slight twinge of guilt that quickly abates, my world crashes. Guilt and anxiety are multiplied and unstoppable.

Naturally there are things I am guilty of and I accept responsibility for: my financial mess, my family situation, and living situation are all a direct result of my faulty judgment. Even though I say I’ve accepted responsibility, it doesn’t make me feel any less guilty or make me hate myself any less when I’m dealing with the repercussions of my actions, or when they trigger depression.

This guilt and self-loathing are particularly harsh because it they drive my suicidal thoughts. The thought process is this: every shitty thing is all of my own doing and I can’t do anything to stop it because I’ll simply fuck that up too, so the only sensible solution is to kill myself. Not so much to end my pain, but to stop me from hurting everyone around me. I have no doubt that world would be a much better place without me.  In my mind there is no doubt that this situation can only end with me dead.  These thoughts are not an everyday occurrence, but in the midst of depression they surface fairly often.  Usually they are fleeting, but occasionally the idea sticks and I will ruminate on it for an extended period of time. It was this kind of rumination and suicidal ideation that led me to my three week outpatient stint at Four Winds in Katonah, NY.

Like I said, I’ve spent so much time hating and blaming myself that assigning myself the guilt is an automatic reaction. In my house it’s even become a running joke. If something falls or breaks, or whatever accident occurs, there is a race to see if someone can blame me before I yell out that it’s my fault. This actually helps. I can laugh at it and own it in my particular way. Humor is how I cope. I will make a joke of anything, no matter how inappropriate or morbid. Sometimes I won’t verbalize it because I know how awful it will sound, but it still amuses me, and that’s enough to get me by.

I’ve tried to ease up on myself, but it’s a difficult process to undo such an ingrained reaction rooted in real disasters. Especially your grandmother’s gout. Yep, that’s my fault too. I’m sorry and I feel awful about it.