Disquietude

get-back-up-artistMy computer came home today, perkier, but still not firing on all cylinders.  The tech-docs did their best and will continue to monitor vitals.  At least I don’t have to create posts on my phone anymore.

Perhaps now my vague disquietude will ease up.  I feel like I’m constantly patting my mental pockets to make sure I have my keys.  What am I forgetting?  I start out the day with my gym bag and art tote, then forget my purse.  Once back in the car, I realize I’ve forgotten the letter I need to mail.  Then, my coffee.  Or like yesterday, I left my coat somewhere and still haven’t found it.

I’m discombobulated, constantly ticking important stuff off on my fingers.  Cats alive?  Gas in the car?  Shoes on?  I check my calendar, then look at it again because I can’t remember what was there.  I’m guessing my anxiety is a little spiky.

I’ve been getting about two hours of sleep at night for several months —even taking Xanax, which is usually all I need.  So, my med provider switched me to Clonazepam—same pharm family (anti-anxiety), but with a longer duration.  I still wake up three or four times a night, but go back to sleep, which I wasn’t able to do on Xanax.  And I’m not waking up furious.  That alone is a huge relief.  Any morning I can get out of bed not pissed off or in PTSD flashback-mode is already a success—no matter what else follows.

hen-in-charge1116Before Anthony, the tech-surgeon, made his house call this afternoon, I vacuumed and dusted a little—something I haven’t done since summer.  I told a friend, “You know it’s time to vacuum when the carpet is crunchy.”

Like my computer, I’m still not firing on all cylinders, but we’re both making progress.  Two addled brains are better than one, I guess.  It’s a good thing the cats are in charge.

Next?

TMy computer is in the hospital, gasping its last, I fear. So I’ll try to create a post with my phone. Technology–heh, heh–ain’t it sumthin’?

I finished the outpatient program and am trying to figure out what’s next. How do I re-engage with the human race? Aside from that being psychologically required, why would I want to?

No more Vyvanse, for one thing. It may have curbed some of my binge eating disorder, but gave me headaches and aggravated an old TMJ  injury. Aggravated seems the operative word here. The general consensus is that it also upped my “All People Stink” core belief, which may have contributed to a crankier-assed attitude this past year.

Mad Maxine

All I know is that it took weeks in group therapy before I could sit through the whole session. It was either bolt or punch some sap in the mouth. Not violent by nature, this impulse scared me a little. But I’d be lying if I didn’t say it also felt good. Which was scary in a whole other way.

Everyone in the group had issues with irritability (a common symptom of just about every mental illness), so we worked with it. A lot. So now I have a folder of “anger management” handouts in my Bipolar Badass arsenal.

Speaking of which, I designed myself a business card for my art show in December. Quite happy with the results.

Business Card 2016

Another “what next” was asking two of my friends who also suffer from depression and anxiety to form a Sanity Support group. We met last week, and the prognosis looks good for more get-togethers. This one stone could kill so many Crazy Birds for me that it’s hard to keep my WANTING in check. Patience, Grasshopper.

And since my computer is likely on its way to the Tech Morgue, I treated myself the day I discharged from the hospital with a 32 inch TV and a DVD player. No more incantations, Reiki treatments and uncomfortable yoga positions to get a disk to play in my wheezy computer. Now, all I need do is push a button. Pure Heaven.

New TV

The final “next” for now is working through the book Seeking Safety: A Treatment Manual for PTSD and Substance Abuse with my therapist. I’m sure the next “next” will rise from that.

Take-Aways

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…be attentive to what is arising within you, and place that above everything else… What is happening in your inner most self is worthy of your entire love; somehow you must find a way to work at it.

—Rainer Maria Rilke (from the cover of an IOP handout on PTSD)

•Mindfulness and Self-Compassion change the  physical structure and chemistry of the brain.  Now there is scientific proof.

•Books I’ve ordered on the studies and effects of neuro-plasticity that have been referenced in IOP:

  1. Seeking Safety: A Treatment Manual for PTSD and Substance Abuse by Lisa M. Najavits
  2. Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom by Richard Mendius and Rick Hanson
  3. Bouncing Back: Rewiring Your Brain for Maximum Resilience and Well-Being by Linda Graham
  4. Into the Magic Shop: A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart by James Doty
  5. The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark G. Williams, John D. Teasdale, Zindel Segal, John Kabat-Zinn and John Teasdale
  6. Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind by Kristin Neff

I’ll be in the program one more week.

Putting the Libra to Sleep

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I’ve completed six days in the Lutheran Hospital outpatient program, and I can’t tell yet if it’s making me better or worse.

There are two designations—IOP (Intensive Outpatient Program) 1 and 2.  None of the literature explains the difference between the groups, but, basically IOP1 is for more functional, more acutely symptomatic folk.  IOP2 is for more severely ill folk who maybe require other services (home care, rehab, medical, etc.).

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The first two days I attended IOP1.  The group was HUGE, 14-18 people with the usual one or two who dominated every conversation and folks talking over each other.  I thought I would lose what little mind I had left.

I watched my intolerance and irritation skyrocket.  My Libra penchant for fairness blew up into a neurotic need to silence the blabbermouths so that the silent suffers might get a second to squeak out a comment.  But I also realized this was all my shit.  If the facilitators felt no need to shut down the usurpers or redirect the tangential wanderers, then it wasn’t my place to step in.  Instead I clutched my purse to my chest and took deep breaths.

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After the second day (and no sleep that night), I knew I needed to talk to my designated handler.  I told her through bitey, frantic, tear-and-snot laden spew that I couldn’t take another day of it.  She listened with a beatific smile and commented in a gentle don’t-spook-the-Tasmanian Devil voice.  Perhaps I should move to the other group.  And feel free to find a quiet place to breathe whenever the desire to punch a talky-talker in the face arose.

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My first day at “the other end of the hall” felt restful in comparison.  There were only five of us in group, and I learned things about PTSD—one of my diagnoses, though something my therapist and I have never really explored.  We usually have other immediate shinola to deal with, so we’ve only ever just touched on it.  THIS was what I was hoping for—some new information, some new tools, a direction.

But, the next day the group expanded to 13, and the whole issue of blatherers and time-sucks reappeared on a crazier level.  I tried to be compassionate, but that well seems to be dry at the moment.  I know folks talk out of nervousness, insecurity, etc., so I tried to reason with myself.  I still ended up out in the hall with my earbuds firmly in place, listening to Billy Joel sing “Innocent Man.”

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I blame the insurance industry and our butt-head Governor, Terry Branstad.  Most insurance coverage only allows three days a week in outpatient care, so Mondays, Wednesdays and Fridays end up with twice the group size as Tuesdays and Thursdays.  It’s stressful to go from a small, intimate group where folks feel safe enough to open up, to a mob where everyone talks at the same time.

And because our Governor closed most of the mental health hospitals, took away funding for behavioral services, and basically told folks with mental illness to “get over it,” the programs that are left are bursting at the seams.

I watch the kind and knowledgable staff at Lutheran run around like headless chickens, trying to accommodate everyone’s needs, shore up folks enough to leave so that those who have been waiting a month for an opening in the program can take their place.  The nurse practitioner who talked to me about medication laughed long and loud when I called it “a three-ring shit show.”  This seems to be my new favorite phrase.

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I came home every day more exhausted and people-avoidant than ever.  I feel like an Introvert In Extremis, only able to function after hours of silent cat time, a couple episodes of Fringe and a frozen pizza from Costco (they have the best thin crust sausage pizzas…).  Even then, “functional” may mean taking a four-hour nap or washing the dishes.

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Yesterday I did my laundry at 3:00 in the morning, because I couldn’t stand the thought of going to the laundromat on the weekend when everyone else goes there.  So, because I was already awake at 3:00, I did laundry for the first time in my apartment complex’s washer/dryer.  Granted, one is not supposed to use the machines until 8:00 out of respect for the tenants who live next to the Common Room.  But since I hate people right now, I didn’t care.  And I tried to be quiet.  No one came after me with a knife, and no one slashed my tires later, so I think I got away with it.

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In between tippy-toeing, I sat at the nice dining table and worked on my journal.  Along with my wheeled laundry hamper, I brought my traveling studio (everything should be on wheels) and a big mug of hot chai.  I sat at my own little coffee shop with my earbuds in and the smell of clean wafting around me, and even through the itchy buzz of being up at 3:00 doing something illicit, I could feel my mind smooth out.

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The same nurse practitioner who laughed so hard with me suggested a new strategy for next week.  Bring my wheely cart and when group bugs me too much, take it to this out-of-the-way lounge I found and do art until I feel like coming back.  I tried that on Friday, and I left the hospital less drained.  I met my two meditation buddies for lunch and lasted about 30 minutes before I completely faded.  My well is dry.  That’s all there is to it.

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I think the trick is to not panic.  I feel myself considering the new drugs this kindly nurse practitioner suggests, even though I sat with my own NP before I started IOP and recounted my long list of Drugs Tried and why they didn’t work.  She reminded me that there really is nothing new in psychotropics, just tweaks to the same old formulas.  If they didn’t work then, they won’t now.

I’m grateful that the Lutheran staff is so willing to work with me.  It’s ironic that the adaptability and flexibility I need from them is part of what makes me so irritable there.  It’s a very loose, laissez-faire set-up for people who have different special needs.  I must try to give my Libran craving for fairness, order and rules a rest.  Maybe I can give her a Xanax.

Mean and Scary

mousy-ladiesSince my last post, words of love and encouragement, texts, phone calls, offers, cards and funny videos poured over and through me.

Part of it is Facebook. This was the first “I’m thinking about suicide” post that I put on Facebook, so some of this kindness comes from people I’ve not seen in decades—junior high school friends, relatives, etc.  They don’t know that, while serious, this is a side of the illness that comes around every few years.

Part of it is the word.  Suicide.  It brings out the panic in people.  It ignites folks like other incendiary words—God, Abortion, Trump.  And fire requires action.

Part of it is that kind people need to do something to help.  And they’re used to sicknesses that get better.  A little chicken soup, a little gift, and the icky stuff goes away.  They don’t understand that I’m always sick—more or less—no matter how sane I sound or look.  It’s a matter of degree.  A little chicken soup-kindness everyday would be lovely.

It’s been difficult—teaching about mental illness, resetting my boundaries, and reaffirming what I really need—at a time when I want to punch most people in the face.  This is not how one thanks everyone for kindness and thoughtfulness.

I isolate when I’m “unwell,” but this is something more.  I can’t seem to navigate the niceties of social interaction.  I can’t pretend to listen to other folks’ three-ring shit shows (and I normally do a grand job at that).  I can’t tolerate the nattering of voices or the pressure (albeit internal) of protecting others from my illness. I’m scary at present.  And mean.

The last thing I want to do is hurt kindhearted folk.  It’s one of my nightmares—shoving away everyone who loves me with this illness.  It’s such a huge disconnect—hanging on every kind word and pushing away the people who speak them.

All I can say is Thank You and I’m Sorry.  Don’t stop asking questions—not about what you can do for me, but about the illness.  I am a font of knowledge on mental illness and if you need to understand, I’m your gal.  That’s one interaction that won’t get you punched in the face.

Trick or Treat

werewolf-girlOne of the earwigs of my flavor of bipolar disorder is passive suicidal ideation.  I’ve learned that thoughts of death, the desire to be dead, and fantasies about my funeral are all just symptoms of my illness, not some conclusion or solution I arrive at on my own.  I’ve come to understand them as just one Tootsie Roll in the party favor basket of worsening depression.  I can root around in my stash to see if the other treats are there—insomnia, social isolation, hypersensitivity, lack of interest in things I usually enjoy, persistent hopelessness and despair.  This is not the Halloween candy I want, but it’s the loot I’ve been given.

One of the ways I counter these distorted hobgoblins is by remembering I have the ultra-rapid cycling form of bipolar disorder.  I can count on the witch’s brew of my brain chemistry to shift in hours or days.  All I have to do is distract myself until that happens.  I’ve gotten pretty good at that.

The other thing I can count on is the complete unpredictability of my illness.  My care providers and I have tried to track patterns and triggers.  We’ve charted seasonal changes (sometimes), stress (sometimes), length and depth of mood shifts (no pattern there).  This year has been like no other, but that’s like saying snowflakes are different.  So what?

graph-down-300x2252All I can really say is that last year around this time I got pneumonia.  Since then, I’ve been depressed except for the tempering effect of my cross-country trip out West and back.  I’ve had burps of hypomania, and a few good days, but each dip downward has been lower than the last.  And the good days are rare.

That’s a long time to keep distracted.  It’s a long time to push against the negativity and the whispers of a Final Relief.

Earlier this week I found myself shifting from passive to active suicidal ideation.  That’s a clinical and un-scary way of saying I starting planning how to get the job done.  If it weren’t for the promise I made to my cats, that I wouldn’t abandon them, I might have followed through.  I like to think not, but it was deep and dark in my head.

Instead I called Lutheran Hospital’s out-patient psych department and got on their waiting list for an intake interview.  Since my therapist had called them two weeks ago to get information, they bumped me up the list, and I’ll get that interview next week.

togetherIt sounds so easy when I write it out like that, but it took all the skill, energy, and courage I had in the moment to make that call.  It meant stopping the forward momentum that had been pushing me for months and turning in a different direction.

Once I made the call, the relief was immediate.  I’m still severely depressed, but the suicidal Junior Mints melted—which makes a nice treat for my cats since I’m out of catnip.  They deserve a treat.  Even if it’s only a mental construct, they saved me.  My heroes.

And now, in the spirit of changeability, for something completely different.

Tedious Beyond Belief

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Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t.

― Kay Redfield JamisonAn Unquiet Mind: A Memoir of Moods and Madness

Worth a Much Higher Price

Waiting for…

 

bone-white

The microwave to ding

The movie to start

A phone call

Relief

Me

The Justice League—Bipolar Style

Merely AgogI’ve been in trouble for a while now, mental health-wise.  The amnesia that comes with severe symptoms keeps me from remembering that this is normal.  My brain yammers that I’m getting worse, that my social skills are devolving, that all my tools are useless, and that, maybe, by brain is starting to liquify.  But, the reality is I’ve been here before.

One of the many vital roles my therapist assumes is that of Archivist.  She starts a sentence by saying, “When you’ve been like this before…” and suddenly I can breathe again.  I spend so much energy and attention on navigating the whip-quick changes of the rapid cycling aspect of my illness, it’s very hard to pull focus and take in the larger picture.  Shifts happen in the slow time of seasons.  My Richter Scale rarely registers a catastrophic event, but like earthquakes, the tension builds over time to an inevitable break.

Recovering this broader perspective helps.  I’ve survived 8.9 quakes before, so how do I do that again?  Before, I would check into Mercy Hospital’s Out-Patient program (day-care for the neuro-diverse), but like so many other mental health care programs and hospitals in Iowa, it no longer exists.  The programs that are left focus on folks who need functional help.  I don’t need help doing my laundry (usually).

My Integrated Health Caseworker said something like this yesterday, “You’re so high-functioning, you fall through the cracks.”

It’s a Catch-22, being a Bipolar Bad-Ass.

img_0977Friday, I went early to my therapy appointment.  I brought my wheely cart of art supplies and camped out at their little corner table in the waiting room.  They thought that was a brilliant idea, and invited me back whenever I felt the need.  So, I went again yesterday and stayed all day.

There’s no therapy, no expectation of interaction beyond a quick hello, but it’s a safe place that’s quiet and welcoming.  Sorta like going to a coffee shop, except the baristas love and understand me.  I call it “Out-Out-Patient Care.”

My therapist and I are also exploring alternatives.  What about a Mindfulness class that would provide structure and an emphasis on Doing The Work?  What about some sort of retreat?  These things cost money, so we pulled in my caseworker to help hunt for grants.

I am grateful everyday that I function as well as I do.  AND it’s hard work to find services that fit me.  AND it’s hard to think outside the box when thinking is most difficult. But, I have an actual team helping me now—my own little Mental Health Justice League.  I’m not feeling much like Wonder Woman at the moment, but with a little help, I might be able to find that lasso.

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