I’m the Wrong Demographic

I’m mourning the cancellation of two of my favorite shows from this TV season.

forever  battle creek

 

 

 

 

 

 

 

 

 

I know—the Black Rhinos are nearly extinct and the human race as a species seems to be eating its young, but if I think about that stuff I’ll never get out of bed.  So I focus on something inconsequential.  Like how My Shows always get cancelled.  I have a history of being the wrong demographic.

alphas_wallpaper

Alphas (2011-2012)

dollhouse

Dollhouse (2009-2010)

Men of a Certain Age (2009-2011)

Tara

United States of Tara (2009-2011)

moonlight

Moonlight (2007-2008)

daisies

Pushing Daisies (2007-2009)

Joan of Arcadia (2003-2005)

carnavale

Carnivále (2003-2005)

firefly

Firefly (2002-2003)

millennium

Millennium (1996-1999)

beautybeast1

Beauty and the Beast (1987-1990)

TV_Guide_04March1967_cover

Well, you know… (1966-1969)

I hate when interesting, well-acted, well-scripted shows go belly-up.  I hate when fake dating, fake celebrities and humiliation get all the air time.  Because that audience buys more stuff.  Economics sucks.

Geeks can sometimes make a difference.  Star Trek resurrected nicely.  And Firefly got a feature movie.  But mostly we have to grab these sweet berries before the corporate crows pluck them for good.  Yes, I whine and howl, but I also sorta like holding this end of the spectrum.  It’s my lot in life to be weird.  Shiny.

The Price of Insight

I'm OK A prominent feature of  schizophrenia and bipolar disorder is anosognosia, a sick person’s unawareness that he is sick. — Algis Valiunas, New Atlantis, Winter 2009.

No one really understands why those of us with serious mental illness struggle with insight.  Current medical theory holds that it’s actually a core feature of our neurobiology.  It’s not that we’re in denial or stubborn—we simply can’t see.

This seems ridiculous to those observing from the outside as our behavior becomes more risky and disjointed.  But those are the times when our insight is most impaired, because anosognosia is also a symptom. We lose insight just when we need it most.

Lack of insight is relative.  It fluctuates as the illness fluctuates.  When we are in remission or in a more stable state, we can often see that we were ill.

Lack of insight is listed as the leading cause of non-compliance with medication (I’m not sick, so why should I take these drugs that make me feel lousy), and in another paradox, compliance with one’s medication regime can improve insight in some cases.

Aggression and violent behavior are also linked to lack of insight.

So, if insight is important to recovery and functionality, what can we do to foster it?  Unfortunately (and not really a surprise), the mental health delivery system has little to offer:  Take your meds.  Go to therapy.

I’ve been told by most of the professionals I’ve worked with that I have a high level of insight.  Even when my symptoms are at their worst, I retain some awareness, though it becomes harder to access and trust.  But very few of those therapists and psychiatrists ever asked me if I do anything to strengthen my awareness.  The fact is I work very hard at it.

I started meditating and working on mindfulness years before I was diagnosed with bipolar disorder, and those practices continue to help me “wake up” in the middle of an episode.  Meditation is the only “exercise” I know that builds the muscle of insight.  And like any muscle, the more it’s worked, the stronger it becomes.  We can build insight by using insight.

It’s not for weenies, this practice.  Ask any neuro-normal who sits meditation or suddenly realizes he’s projecting his fears into the future instead of living in the Now.  Most people are asleep.  To be anything else requires dedication, courage and sweat.  It also requires forgiveness, tenderness and a willingness to observe rigid beliefs with gentle curiosity.  And then, those moments of awareness are still fleeting.

Insight is a Big Ticket item, and most people would rather spend their hard-earned psychic cash elsewhere.  I get that.  I’ve taught meditation for fifteen years, and most people don’t stick with it.  Sitting with oneself can be uncomfortable.  It can be frightening.  Why not practice golf instead?  At least that’s fun.

That’s been my experience with neuro-normals.  Now I’ve been asked to teach meditation to folks like me with serious mental illness.  I’ll introduce it gently next week, then see if anyone wants to continue.

Because these are people who will recognize the price tag.  And they might decide it’s worth it.

I Think We Need a Bigger Boat

boatI found out today that my therapist and the nurse practitioner who provides my medication supervision are leaving to start a private practice of their own near Des Moines.

If you’re in the mental health delivery system, you’ve probably experienced this kind of trauma.  It takes years of searching to find a therapist who gets you, to find a psychiatrist or NP who works with you, only to have them leave, or the clinic closes, or whatever kind of insurance you have doesn’t work anymore.  The most essential piece of your recovery drops out of existence.  So you flounder, and in that vulnerable state, have to start searching all over again.

I’m lucky in that they will only be an hour away.  After talking with my therapist today, my plan is to stick with them if they can get Medicaid-certified.  Lots of “ifs.”  So, it doesn’t seem like such a big deal.  Except it is.

I hate how stuff like this confounds and unmoors me.  Even with a solution in sight, I feel hysteria crawling up my throat.  Just when my support system seemed to be jelling, just when it seemed safe to go back in the water…

I have to watch my catastrophizing—I see sharks when it might just be tuna.  I have to keep breathing.  I have to remember I’ll be fine no matter what happens.  I’ve been here before—back when my boat didn’t even have a motor.  So, I’m okay.  I just wish there wasn’t so much chum in the water around me.

bigger boat

Unboxed

In a Box.

The Darkest Hour is Just before the Box Pops Open. —Ancient Feline Proverb

Last Thursday was the third day in a row of fighting suicidal thoughts.  Fantasies of death consumed me.  My therapist scheduled extra sessions.  I sent lots of SOS texts to friends.  It was the worst of the worst.

I took a nap that afternoon and woke up different.  I couldn’t understand what was happening.  Was that sunshine coming in the bedroom window?  When did the grass get green?  What was this weird feeling in my body?  Energy?

I washed my face and put on my shoes.  Could I actually, like, go do something?  I ran errands.  In my car, driving to the auto parts store to get a windshield wiper I’ve needed for months, delivering the cards I made for the school district, I felt the sun, smelled the flowering trees, took deep breaths.  No intrusive thoughts.  No darkness.

Over the next few days, that sense of being normal continued.  Story ideas started coming back.  I made dates with friends and kept them.  I vacuumed.  I ate a bowl of vegan chili and felt something weird.  Full.  I could actually feel that I’d eaten enough and stopped—which started a conversation with my support staff about the correlation between the brain chemistry of bipolar disorder and binge eating.

Such an odd feeling of transition, to have the box of depression spring open after months of darkness and containment.  Like most cats, I don’t immediately hop out.  The eyes must adjust.  Safety must be evaluated, trajectory calculated.  And I must remember that this rush of freedom will not last, at least in this brilliant form.  I will be hopping in and out of the box all through the summer.  But I know that the lid is off.  The Mean Season seems to be over.

Something New For My CV

Louis CK

º

The DSM (psychiatry’s Bible) came out with a revised and updated version in 2013 with oodles of controversy.  Along with weird restructuring, the Powers that Be (think Nicene Council with prescription privileges) dropped some diagnoses and added others.  One that gained full blessing of the Holy Order was Binge Eating Disorder (BED).  It came with criteria and suggested treatment.  No one paid too much attention.

But in the two years since, more and more providers are taking BED seriously.  Drugs used to treat ADD and ADHD have been somewhat successful in treating the compulsive/impulsive aspects of BED.  Cross-training has always been the drug companies’ bread and butter.

In a casual conversation last week with my nurse practitioner, I mentioned how I gave up trying to lose weight this year.  She asked a few questions, then said I met every single criteria in the BED diagnosis:

  1. Recurrent and persistent episodes of binge eating
  2. Binge eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal
    • Eating until feeling uncomfortably full
    • Eating large amounts of food when not feeling physically hungry
    • Eating alone because of being embarrassed by how much one is eating
    • Feeling disgusted with oneself, depressed, or very guilty after overeating
  3. Marked distress regarding binge eating
  4. Absence of regular compensatory behaviors (such as purging).

She knows I’ve managed bipolar disorder without medication for five years, but she wondered if I might want to try Vyvanse, the current darling drug for BED.

Vyvanse is, basically, Speed, so we both knew mania and insomnia could be side effects.  Great.  But, since I’m sensitive to medication, I’d probably know right away if the spin was more that I could handle.  We also talked briefly about self-monitoring and keeping charts (I’m boss at keeping charts).

So, what the NP and I decided was to wait until I was out of my Mean Season and more stable, then start Vyvanse mid-May.

All my life I’ve dreamed of a magic pill.  I doubt this is it.  But, what have I got to lose besides a few nights sleep and some mad spring cleaning?  At least I get official credit for something I’ve known all my life—I have little to no control over what I put in my mouth.  No diet, motivational bestseller, or cognitive therapy ever touches that wild and mindless drive.

Not that I’m looking for more craziness to add to my resume, but there’s comfort in being recognized.  I’m not lazy or lacking in willpower.  I’m not weak.  My brain just works differently than most people’s.  Funny how that keeps coming up.

I’m on an Adventure.

Give Me a Reason

It’s been a bad day.

It’s one of those days when thoughts of death and fantasies of how seep through the cracks.  It’s one of those days that demand a reason—any reason—to keep on going.

Like the push of a kitty’s paws against my side as he settles me for a nap.

Or a job that needs to be finished.

So, I left Emmett to sleep under the covers and finished a project—cards for the people retiring this year from our school district.

Retirement1

This is the third year I’ve been hired to make these cards.  When I think about it, even though I ended up in partial hospitalization the last two years, I still got the cards made.  They nudge me toward life, these pieces of gratitude.  My hands remember beauty even if I can’t at the moment.  As I work the sun swings around to my westward-facing window, giving Henry his chance to bask.

Another day nearly done.  And I made it to the other side.

Behind the Curve

True Blood

♦ ♦

HerveauxIn desperate need of distraction from my flippity-floppity brain, I rented Season 5 of True Blood to see Robert Patrick as a werewolf.  And… well… kept going.

I’m really late to this party.  The show ended after seven seasons last year.  But there’s so much fun to be had.

Alcid, for one.

And the way Vampire Bill injects so much sexy smoke into Sookie!

So, if you’re not easily offended (everyone, even the tele-evangalists, say f*ck every other word.  It’s HBO.  They do it because they can), and you’re not squeamish (tanker trucks full of blood for every f*ckin’ episode.  Oops.  Sorry.  It rubs off), then you might enjoy this campy show.  Or maybe you were one of the five million die hard fans who found it ahead of me.  Or you got bored with it (how many ways can you have sex with a vampire? Yawn).

It’s Disneyworld compared to what’s playing in my head.

Ooo, new theme park idea…

Kind, Gentle and Generous

Give Him the Moon

Earlier this year I set a goal to stay out of the hospital or a hospital program this spring.  Three out of the last five years, I’ve ended up there.  It’s a good thing, really, to know when to make that call.  Lots of folks with mental illness aren’t able to do that for themselves, so I feel lucky and proud of the work I do to hang onto a little insight during the worst of times.

However, the program I’ve used in the past was eliminated, like many of the behavioral health programs across the state, because psychiatrists fled Iowa like rats on a sinking ship (some problem with Medicare reimbursement).  If I needed serious help now, I’d have to drive across the state and admit myself into one of the few psych wards left.  I’d rather not, really.

I needed to change things up—not just my perspective, but what I do to manage this transition from winter to summer.  I found some new resources this year to help—Intensive Psychiatric Rehabilitation (IPR) and Integrated Health Services (IHS).  Both are new state programs trying to fill the gaps left by the psych docs.  Also, with my mom’s passing last summer, I now live frugally instead of crushed by poverty.  It’s a huge difference.

So, with this new net under me, I started to address the critical and disapproving voice in my head.  I started to wonder if my drive to do more and be more was actually another facet of that mean voice.  I watched how I withheld comfort, left no room for rest or rejuvenation, and squeaked by on the least.

I wondered how it might feel to do the opposite—to be kind and gentle in my self-appraisal, to be generous with my time and money.  I wondered how that voice might sound.  I wondered, for instance, what my grandma might say to me when rapid cycling ruined all my plans for the day.  Or what my friend, Lily, might say about me going to Ireland next year.

Whenever I started to hate on myself, or rail against the unfairness of living with bipolar disorder, or scold myself for going to Des Moines twice in one week, I tried to stop and conjure the people who love me.  Their kind and gentle voices filled my mind.  Their immediate generosity helped me breathe.

Over the course of the spring, I’ve tried to make those voices strong in my mind.  This is some of the hardest work I’ve ever done.  I’m steeped in self-violence.  Recognizing the lie in that voice when it slithers into my thoughts takes time.  Then, countering it with petal-soft, open-armed sweetness is like speaking a foreign language.  But, I’ve learned a few words.  And my vocabulary is growing.

Being kind, gentle and generous to myself doesn’t alter the course of my bipolarity.  Rapid cycling fogs my brain and leaves me exhausted.  Emotions flip and tumble like Olympians.  Chores overwhelm me.  But, today, I have hope that I can navigate the hard road through Spring.  In my mind, I’m holding a warm, gentle hand.  It fits perfectly in mine.  Because it is mine.

The Healing Time

Finally on my way to yesStrange & Terrible Sights

I bump into

all the places

where I said no

to my life

all the untended wounds

the red and purple scars

those hieroglyphs of pain

carved into my skin,

my bones,

those coded messages

that send me down

the wrong street

again and again

where I find them

the old wounds

the old misdirections

and I lift them

one by one

close to my heart

and I say    holy

             holy.

© Pesha Joyce Gertler

Trust the Next Breath

Trust the Next Breath

May all your endings turn into beginnings.

Previous Older Entries

Blog Stats

  • 103,826 hits
Follow

Get every new post delivered to your Inbox.

Join 1,144 other followers

%d bloggers like this: