Showing posts with label shame. Show all posts
Showing posts with label shame. Show all posts

Monday, February 14, 2011

Sinking feelings

"I was more at the point where I felt like I wanted to be dead, but wasn't thinking about acting on it. I didn't have any plans or desire to do it myself. I just wanted to stop existing."  -Me, February 13, 2011

So I off-handedly shared a major crisis in my life on a thread at Crazyboards Sunday.  It didn't even bother me when I wrote it.  Later, when I went back to the thread, and saw it, it made me do a double take.  So blase, this has happened so many times, I think I know just what to expect.

My stomach dropped at rereading this hubris, this nonchalant dismissal of a time when I longed for death, as just "one of those things."  To be clear, I am NOT longing for death at the moment, exactly the opposite.  I would hardly use a forum to announce my impending suicide where people know me in person, and how to find me,   I may be crazy, but I'm relatively intelligent.

It isn't that I am depressed at this moment.  It is more that I am afraid.  I feel like something may be stirring in Crazyland, but I can't tell for sure.  Is it a bad mood? Might it be a side effect of medication?  Or am I just due for a visit from the Mood Fairy?

Or perhaps my DH deserved to have his head bitten off this afternoon.  Yes, I have snapped at him for the exact behavior before.  But this afternoon I was very assertive about explaining what about a particular behavior bothered me so much.  On the one hand, I interpreted in the most negative way possible.  On the other, he admitted given the language he uses, he can understand how I might come to make that interpretation.

But irritability could be a sign of a mood swing in any direction, regardless of our eventually coming to an understanding.  It's the fact that I initiated the discussion with anger that is different and troubling.

I will never entirely know what to expect.  Bipolar is a difficult disease to treat.  Its patterns change over time, confounding previously accepted truths.  Drugs that work for years poop out, and drugs that don't work can make one even crazier than before taking the medicaton.  I blandly assume that I have learned how to recognize a pattern or rhythm to help me anticipate episodes, to cut them off at the pass, so to speak, before they become too bad.

Then, suddenly, my brain decides it is time to clean house, and throw out all the knowledge, patterns, and tips I have accumulated over time, and make a fresh start.  New types of episodes.  More instability.

I can remember the year to which I so indifferently referred yesterday so distinctly.  I had been laid off, yet was still teaching another semester at that school before I left, so that wasn't fun.  The day I was laid off was also the day I had evacuated a busload of teenagers from the school campus, as wildfires raced towards it.  The next day, I heard about the murder of my friend.  Then came the week+ hospitalization for my kidneys.  Followed by very, very severe depression.    I ended up calling a crisis line for the first time in my life.

The first few psychiatrists gave me medications that either sent me into a manic frenzy, or were toxic to me.  I ran out of money. Next stop, a crash landing in my parents' basement.  I was so ashamed, and my mother made sure I knew she was ashamed of me, too.  Her verbal brutality was just one more thing to hasten my downward spiral.  And the headaches.  Never forget the headaches.

Awful.  I remember thoughts: "It would just be so much easier if I died.  If I just went to sleep and never woke up."  I never acted on it.  I think there was only one time I was ever truly serious about taking action to bring about my own death, and that was a depressive episode that turned into a mixed episode.  But that was several years in the future.  This episode's theme was inertia.  Hunger and inertia.  I ate at night, to avoid my mother.  I lived at night, to avoid my family.  My dog, Bess, would lie next to me on the bed all day as I slept and hid, if I needed her to.  She was my best friend.  I never want to be without a dog if I am depressed again, even with my husband around.  No person near me can understand the place I am living when I am so depressed.  I need a dog to just shower me with love and affection when I am wanting to die, because it is such a simple straight-forward love, it is easy to return.  No baggage.

And there's more.  I have been on a new medication, a type of anti-depressant, a tricyclic. I actually am not taking it for depression, but to treat my intractable migraines.  I was quite excited to try it, it was the first drug of this "class" of medications I had ever tried.  I have basically tried multiple versions of all the other classes that my body will tolerate.   Ironically, I seem to have magically stopped my standard rhythm of migraines 2 out of 3 days as soon as I started the new medication.  Sheer coincidence, it actually still needs time before it will start working.  But it has coincided with a 13 day period when I have only had two bad headaches and a three or four of mild ones.  The first 5 days, I didn't have *any* type of migraine (migraine is a disease, the headache is just the worset symptom of it).  I am still suffering from too many headaches.  But less pain is less pain.

But with this exciting new (to me) class of medication, comes a caveat: While the amount of tricyclic used to prevent migraine is quite small compared to the therapeutic dose necessary to treat depression, as a rule of thumb, anti-depressants + bipolar =  not a good thing.  This is one of those rare instances where I have run out of other options to try to stop headaches that are ruining my quality of life.  We are trying to delicately balance contraindicated treatments, hoping we can find the magic amalgam that will help with my head, but not hurt my mental stability.

So while we wait to see if the tricyclic helps, we also are watching closely for signs that it might be activating my bipolar illness:  That is, triggering a mood swing.  My doctors biggest concerns are that I have any lability of mood at all.  My biggest concern is having a mixed episode:  Mixed episodes are kind of like having a pocket-Hell that you are forced to carry around, and you have to negotiate life and cope with the havoc Hell is creating at the same time.  No one else can see Hell in your pocket, you just seem flat out insane.  Which I am.  And part of that insanity is believing that others intentionally try to do everything they can to provoke Hell into bursting out of my pocket, and breaking things, forcing words that I know are dangerous even as they fly out of my mouth to come pourng out, throwing things, berating myself and my loved ones.  Of course, I understand intellectually I am the one doing those things.  But my intellect is being over-ridden by sick brain.

As a reasult every time I feel a petty thought, or am irritated, or tear up, or get overly excited about things, I begin to worry.

Usually, when I talk about depression, it is something in my past.  My last one was a brief one in 2001.  I almost had forgotten what it felt like. But re-reading the sentence I quoted above makes my stomach clench, makes me hyperventilate, makes me want to cover my head with a pillow.  It made me remember a tiny inkling of what it was like, and now I am scared that the reason I can suddenly so closely identify with that feeling is that I am headed in a bad direction.

Monday, December 13, 2010

Body Integration: Where I end, is where I begin. #reverb10

December 12 prompt:  Body integration.  This year, when did you feel the most integrated with your body?  Did you have a moment that wasn't mind and body, but simply a cohesive YOU, alive and present?  -Patrick Reynolds


I thought long and hard about this prompt.  I was beginning to feel as if I was going to have to talk about the same thing I talked about for "Moment," which I had already cited again in my post for yet another prompt.  Next I tried to think of one of my rare athletic moments.  The few times I exerted myself, there was not any particular moment I got into some kind of zone, where mind and body melded.

Suddenly the phrase "mind and body" leapt out at me.   How could I have missed that?

One of the dilemmas of being bipolar is determining the point at which one's personality ends, and the influence of the illness begins.  Mental illness is a biological illness, but it manifests in our behavior and mood.  Are our "real" personalities and our bipolar symptoms, which are, after all, largely behavioral, too intertwined to be teased apart?  It certainly can feel that way, especially when you are in the midst of an episode.  The fact that sometimes a particular mood will really bring out a troubling personality trait fills me with trepidation that I am directed more by my illness, than my own volition.

One of the things I have found on Crazyboards (which I mentioned in the "Community" prompt blog post) by listening to other bipolar patients' experiences, from childhood to the present day, so much of my life is an echo of theirs.  From similar yet unusual childhood mishaps, to relations with our parents, to our delusions and/or hallucinations,  and how they spill over into our day to day lives, no matter how rational and responsible we try to be.

So is the startling similarity of so many bipolar people's lives just a correlation, or do precursors of our first "official" mood episode start appearing way earlier in our lives than one would think?  The traditional age of onset for bipolar illness is late teens, or early 20s.    But while we may not have an acute episode until after our childhood, sometimes it seems as if our early behavior and personalities are strikingly similar.

And because bipolar illness is a genetic one, our parents offer suffer from mental illness of one type or another.  So many if not most of us had unstable and chaotic childhoods.  If anyone needs structure, it is bipolar people, and that kind of tumultuous upbringing often causes us to find ways of sabotaging and undermining ourselves.  Crazy parents are often unable to provide the support and nurturing we need, through no fault of their own. The more regular our lives,  the better we fare from day to day (although I will admit that I am very unlikely to impose structure on myself).  I don't really know how a "normal" family interacts, but our family gatherings are almost always tense affairs, involving a great deal of teetering on egg shells.

Unfortunately, the mood episodes that make me feel most alive are mixed episodes, which are widely accepted to be the worst and most dangerous episodes in terms of the risk of a patient harming themselves or others.  Rages, sobbing, over-sensitivity, self-loathing, sensory overload; the sensation of my body trying to crawl out of its own skin, the pacing, the inability to sleep.  Things taste awful, so I stop eating.  My frustration threshold is non-existent, and I can feel anger coursing through my body.

Mixed states are the most visceral and terrifying periods of my life.  I hope that no one ever judges my overall personality based on my behavior during such an episode.  But I would be disingenuous to tell people that mood episodes are somehow not a genuine part of me.

Just because I haven't added any media for a few days, and this is supposed to be a post of the uniting of body and mind, here is a picture I took of myself during my last mixed episode, in the early summer of 2010.  Most of you of course have no idea how I normally look, but here I am drained of color, my face is set and furrowed with anxiety, and I look exhausted because I had probably gotten about 12 hours sleep in the last 4 days.

Saturday, December 11, 2010

Out of Wisdom Comes Pain and Lust #reverb10

Dec 10 prompt:

Wisdom. What was the wisest decision you made this year, and how did it play out?  -Susannah Conway


The wisest decision I made this year has lead to literally days of pain.  But it was still the right choice for my marriage, and I am glad I made it.

As a chronic migraneur, I am always on multiple medications.  This is in addition to my psychiatric treatments, although the medications for mental illness and neurological disorders share a huge overlap.  Sometimes, I find meds that work to lower the frequency of my headaches.  Unfortunately, once a headache arrives, treatments, even opiates, are hit and miss.

I am not going to go into a long discussion about all my treatments, but one in particular has worked for me on a number of occasions for a few years at a time before pooping out on me:  the anti-convulsant, Depakote.  After several year long "vacations" from Depakote on other medications, I would repeatedly find myself saying to my neurologist that I wanted to try it again. It would always improve the frequency of headaches for a while, then once again poop out.  But when it worked, it was the best medication I had tried.  

Besides the issue of repeatedly pooping out on me, Depakote can cause severe side effects. Excessive weight gain is the most infamous one.   My experience has been a little less straight-forward, but ultimately ended with impressive weight gain.    Depakote can suddenly, after working well for years, destroy one's pancreas, and make one a Type I diabetic.   It can cause severe liver damage.

But the side effect that became the most instrusive and upsetting was that Depakote totally killed my libido stone dead.  I didn't like to even be touched, although of course I was more tolerant of DH's touch than anyone else's.   Still, "wrapped in cotton wool" and "bound in plastic wrap" are the phrases he has used over and over to describe what I was like on Depakote.

People may realize that headaches are incapacitating, but they often do not realize how incapacitating drug side effects can be.  The side effects of the medication become just one more aspect of being chronically ill.  Deciding what side effects you can tolerate, or are willing to put up with, always requires a risk/benefit analaysis.

By February of 2010, given my headaches, medication side-effects, and foot surgery, sex was almost non-existant in our marriage.  Like many people, early in our relationship, sex had been a constant.  But over 10+ years, my headaches have gotten more frequent and harder to treat.  So not tonight, dear.  And then the medication I took destroyed any interest I had at all.  I felt obliged to be active as much as I could, but it was so hard.  I knew DH was torn, he didn't want me to be in pain.  But man, did he hate Depakote.


After watching my husband's misery, I decided that for the sake of our marriage, I would never again take Depakote, even though it still is the medication that has worked best for me in terms of my headaches.  I had begun to feel like I wasn't upholding my end of the marriage.  I am not saying that there is a quid pro quo for sex, but sex is a very important part of a marriage, there is no denying it.  People who know me know that I do not generally talk about my sex life with anyone, but this is not about sex as an explicit act, but instead as a component of married life.  It is upsetting and humiliating to not be as sexually available to your partner as you would like, and feel s/he deserves.


Since we were together 24/7 throughout most of 2010, we were able to delve into this issue in detail, and re-evaluate what our expectations were for each other in this marriage, and check to see that we were still on the same page.  I knew intellectually I wanted to be on the same emotional page as DH, but I just couldn't do it with the chemical chastity belt that Depakote had become.  Most Drs. consider this a completely valid reason for discontinuing a medication, so I knew my neurologist would accept it.  My neurologist is as desperate and clueless about what to do next as I am, and allows me to largely direct my own treatment.  The fact that Depakote is also used for psychiatric treatment of bipolar illness means that my psychiatrist must also be kept on top of what is going on, but Depakote has never had a psychiatric effect for me, and he allows me to raise it and lower it without consulting him first.

Plus I was beginning to wonder whether or not it wasn't already pooping out, anyway.  My headaches were definitely becoming more frequent.

So in June, with the Dr.'s blessing, I began to titrate (that is, change the dosage little by little, to allow my body time to adjust) off the Depakote, and titrate onto blood pressure medication, propranolol, that is also widely used as migraine prophylaxis.  You must always titrate off of anti-seizure medications, or you risk having severe seizures, even if you weren't taking them for seizures in the first place.

I immediately made the rather depressing discovery that yes, in fact, the Depakote was helping.  My headaches increased in frequency and severity the lower my dosage went.  I was prepared for a bad period, there is often a short period where everything gets much much worse when you are titrating onto a medication, even if it ultimately proves successful.  But the bad period didn't end.

And now, I am Depakote free.  I am having headaches more days than not, and this has been the case since July.  At first, while almost daily, they often were not severe, or only lasted a few hours.  The further in time I moved forward from my last dose of Depakote, the more severe the headaches have become.  And they continue to be present more days than not.  The propranolol has been a bust.  In January I will be trying another medication for the first time, the SSRI Cymbalta.  When used for migraines, the dose is so comparatively tiny, there is no real concern of its cross-reacting with my psychiatric medications.

But even with the failure of the propranolol, it has been totally worth it.  I knew that even as I huddled over a waste-basket, heaving for hours on end on Wednesday night, head pounding, eyes streaming with tears.  

Of course, when I am curled up in pain, I am not exactly the most sexual creature.  But when I am pain free these days, I now realize it was if my entire sense of touch had been severely dampened.  The fact that I can tolerate DH's arms around me while I am sick, and enjoy them when I am not, is a shockingly huge and happy change for both of us.  While I am sick too often these days to speak honestly about second honeymoons, we are definitely both feeling a renewed sense of enjoyment and emotional intimacy.  And when I am feeling well, well, I'll be gross, and admit sex is so much better!  Sex actually felt like a chore on Depakote.

So those are my early unexpected gifts for our 10th wedding anniversary this July:  Accepting pain, and regaining intimacy.


Thursday, December 2, 2010

Writing and Mindfulness, #reverb10

I forgot to include December 1st's prompt for my first blog post of #reverb10.   But here is the prompt for Day 2/December 2nd:


"What do you do each day that doesn't contribute to your writing -and can you eliminate it?" (Author: Leo Babauta)

As I suspect it will be for many people, this was a really hard question for me to answer.  Damn you, #reverb10, for throwing a curve ball so early!  As punishment, this is going to be more of a process post, and less reflective.

When I began to ruminate on this question, I realized it was very difficult for me to come up with something I did daily that interfered with my writing.  But I had absolutely no problem thinking of all the things I don't do every day, all the mind loops and stall tactics that I use to excuse the quality of my writing, or not writing at all.  These are some of the things I thought of, when I tried to think of something I did daily:

  • I don't focus enough on my formal, non-blog writing, which harms my development as a writer, and therefore the quality of my blog.  
  • I don't set aside a time, or set a timer at some point during the day, to just bang out whatever comes into my head.  I know this is a good exercise if I want to get serious about writing, but I never seem to just start doing it.
  • I never write down ideas when they pop into my head, even just a few words on the back of an envelope. By the time I sit down later, the ideas are lost.  
  • I haven't sought an outlet for my writing.  I am one of those people who needs a deadline to really get anything polished.  I can't bring myself to complete anything I start, without that line in the sand.  
I have so many half written short stories, articles, and yes, even ideas for a novel, all tucked away in a large wooden keepsake box.  It also holds reprints of the very few things I have actually published, as talismans.  As if the fact of their completion will magically rub off, or positively influence my enormous collection of half-thoughts, and stories ending mid-paragraph.

By the same token, I never pull anything out of the big wooden keepsake box to revise or rethink, or insert into other, longer, writings.  It is like that wooden box is a coffin for my writing.  A coffin stuffed with notebooks, half used; journals with bi-annual posts; copies of legal briefs; and the few articles I have published.  I should be pulling them out, dissecting them, and cannibalizing them for new, and hopefully better, pieces.  It is as if they were lost to the mists of time.

That my approach to this prompt was immediately negative is not surprising to me.  I have a very negative approach to my entire life, I am pensive, intense, and not a very sweet person.  This makes my writing seem very self-indulgent, and inward looking, or at least that is how it reads to me.   Part of what concerns me is that my writing is always memoir-ish, but makes no real attempt to make my experiences seem universal.

How do I turn myself around?  How do I start to feel positive about what I write, and have written?   How do I take my intensity and self-indulgence, and use it to write, instead of angrily ruminate?

One therapy to which I have been subjected is Cognitive Behavioral Therapy (CBT).  I didn't really enjoy it, or the other people in my group. I was enrolled in the sessions as part of my course of treatment for bipolar illness, although it has since been found that CBT is of zero benefit to those who are bipolar.  Nonetheless, it was helpful for anxiety, and to some extent, compulsive behaviors.  But the most important thing I learned about was the quasi-Buddhist theory of mindfulness.

In my life, being mindful means living in the now, and listening to my thoughts, and what questions they raise.  It is about finding the patterns of flawed and negative thinking, and being able to say: "I see I am beginning to follow my old negative thought pattern.  I need to change my orientation."  It is hard to do at first.  No, I take that back, it is always hard to do.  Mindfulness requires a lot of work, and it forces self-knowledge, whether you want it or not.

I am hoping this year to begin to obliterate the negative thought loops that hold me back from writing.  My only weapon may be mindfulness.  But it is a strong one.

Thursday, October 7, 2010

Migraine

I have gotten myself tangled up into some kind of "Mission Statement" post from which I can't get disentangled. I think it is an attempt to fit too many blog posts into one. So I think I am going to keep my Magnum Opus in draft form for a while, and let it steep before I go back to it. And yes, I still have to finish the Lush, makeup, etc. post, because I actually do have pictures and ideas for that.

One thing that has been cutting into my blogging, both in terms of pain-free time, and in terms of being able to think clearly for long periods, is a series of migraines I have had over the last week. It has totally screwed with my sleep, and I am just not a happy camper. But behind the scenes, I was still taking pictures of what I wore.

On Monday, I was still recovering from the migraine that went Saturday and Sunday. But I needed to run over to Lucky to get my DH some medication, and a grocery or two. This is a red velour tunic, with gold detailing around the neck, and my pair of Coldcreek jeans again. I am just wearing my same Navajo inlay pendant, and no earrings, I wasn't feeling too good. No makeup for sure. Oh, and I was wearing black slip-on "penny loafers. The little purse is from It's a Girl Thing, made by one of her few craft consignment people (she usually does just regular consignment). It's really cute, but kind of fragile, I have already sewn a sequin and a shell back on. But I would thrash it whether it is a $20 or a $2000 handbag (and I could easily get $2000 handbags from this place). I do have one expensive purse, that I used to use, until my mother yelled at me because didn't I realize what a nice purse that was? I was going to ruin it. Because why buy something nice, if not to wrap it carefully, and put it away someplace where you will never see it again?



Monday night, I didn't really sleep. It sucked. So by the time it was 9 or 10, I figured I might as well go do something, which usually means "goodwill hunting." Believe me, if you have not done this, this is a cheap hobby. I keep dithering over how much I am buying, and DH keeps trying to figure out what money I am talking about. So I decided to hit the Goodwill right in Santa Clara, which is about two miles (everything here is between 2 and 7 miles away: If I were a good person, I would walk or bike that, but I am not a good person).

So for this mission, I used a satchel I had got on a previous trip. Again, I am trying to be a little more aware of my appearance, and I am guessing that means not using the same neoprene ballistic handbag that you have been carrying for the last two years, because you can wipe dog slobber off of it. So, remember, we are out of sequence, it is now Thursday, but this is Tuesday. That is the brown Nine West (as opposed to the black) tunic, some Venezia jeans I found in the suckiest Goodwill in the area. Even the sucky places can surprise you. Venezia are not quite as good a cut for me as Coldwater creek. I also wore a pair of brown suede loafers I have had for years.

As I said, I also brought a new (for me) hand bag, a Wilson's black leather satchel, listed on their site for 120 (not on sale, I think it was on sale for 80), and I paid 15. It looks brand new. I had to stuff it with tissue paper for a couple of weeks, because it had obviously been flattened behind something in someone's closet, but it is a gorgeous bag.

I went really looking for tops this time. I am pretty set for skirts and jeans, unless something just screams to me. Well, I found a couple of cute tops, and a really nice long grey draped sweater, missing the belt, but the loop holes were threads, so I could cut them. I got up to the register, and couldn't find my wallet. Gah! Where was my wallet! I had switched everything else into the new bag (phone, comb, pen, shopping bag, etc.)! So I apologized, and left the stuff behind. I got home, and it was on my computer. Duh, I had activated a new ATM the prior night, and my insomnia made me space on putting it back in my purse.



So I was annoyed, but fine. Finally at about 2pm, I was able to fall asleep. I woke up with another migraine. That lasted all day Wednesday. I still tried to dress like a reasonable person, although I am clearly deteriorating. That is a black tshirt, with fleece pajama bottoms, and Eggplant heathered draped cardigan. I was cold, which is common with migraine. DH was running around nude most of the evening.



So I debated whether to post this next picture or not. It is of me today, after several days of migraines (with some few hour breaks), and still feeling lousy. I wasn't head-achey when the pic was taken, but it is starting up. October and November are traditionally my worst months. I hate it, because no one believes you can really be THAT sick THAT often, but still look totally fine on the days you aren't sick. I do not deny that I am an inherently lazy person, but I am not so lazy that I like to fake migraines.

Anyway. I decided to post it. The whole long argument I am having with myself in my un-posted blog entry is about this kind of self-image issue. This is a way more hard picture for me to post than of one with or without makeup was. This ensemble is Costco tank top avec Costco fleece pants. The hair is done by my bed.



And my husband still loves me. Who knew?

P.S. Freudian tell of the day: I put "Mothers" as one of my tags. I wrote a half sentence about her in this blog post.