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.

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.

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.

Inevitable Conflagration

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 “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

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“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.