Out-Out Patient

Triggered by a traumatic event a few weeks ago, bipolar depression brought its bags and settled in for a long visit.  This past week I started going to my therapists’ clinic every morning to break up depression’s momentum and build my own form of Out-Patient Care.  I arranged the little alcove they set aside for me—a folding screen and white noise machine to make the patients in neighboring offices feel safe in their privacy plus the high table and chairs.  I brought in my art supplies and a large cushion to sit on the floor, and went about filling the tall, gray walls with words and colors that I needed.  But that wasn’t enough.

Yesterday, my therapist and I discussed how to create a real program that would help me tolerate this depression without resorting to hospital out-patient care.  I find the hospital programs themselves to be helpful, but interacting in the large group model difficult to the point of undoing any good done there.  So here’s what we’re trying first:

My daily schedule will be from 8:30-1:30, five days a week.  Daily, I will work on DBT (Dialectical Behavioral Therapy) worksheets dealing with tolerating distress, read one of Megan’s many children’s books and journal about it, and make art—either for the space or in my journal.

I feel a lot of dread and the usual suicidal litany gallops through my mind.  I’m uncomfortable and scattered.  My calendar empties out as I can’t tolerate most people or the pressure of going somewhere at a designated time.  But I did ask a friend to lunch yesterday, even though I phased out after twenty minutes.  Concentration doesn’t last long.

At home, I’ve put my TV in the bedroom, so the cats and I camp out on the bed as I try to work on my Solstice cards while half-listening to my go-to depression binge, Fringe (I just started Season Three).

I’ve also returned to Pinterest, where I can look at pretty pictures and hoard new photos of my Pretend Boyfriends.

Later today, I hope to go see the new Murder on the Orient Express and do my laundry.  That feels like a lot in my current condition, but I’ll try.  It’s really all I can ever do, keep trying, keep looking for new ways to get through the worst of the illness while waiting for the shift to come.

Some days it doesn’t seem like much of a life.  The distorted thinking makes that view darker and more hopeless.  Even then, I can see my courage at work, even when the list of obstacles grows like a Bugs Bunny nightmare.

This is my life.  Mine.  For better or worse.

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Frail and Exotic Flower

Frail & Exotic Flower

⊂  ⊃

This is one of the flavors of my depression, feeling translucent and fragile, a melancholy scrim of gossamer floating untethered in the sharp October air.  This is when I yearn for deliverance, rescue, capture by warm and gentle hands.  My weepy mind slides into fantasy to protect itself from the hard edges of the world.  It pulls Heroes around itself like cashmere.  And it tries to sleep.

I am here, now, in this place of soft sorrow.  One eye on the Hero, one eye on the rhythm of the Real.  Train whistles in the distance mourn and warn traffic.  The pumpkin colored oak tree across the street paints across gray canvas and readies for winter.  I am both hibernating in the safe corners of my mind and stepping out to do laundry, meet a friend, have a birthday meal with my sister.  I am both insulated and exposed, denying and tolerating this phase of my bifurcated moon.

But, duality is home to me, my nature, and this season will pass to the next.  All I must do is wait.  In the cashmere and in the banging drum.  Both.  Always both.

The Magic of Showing Up

Collage art, Greeting cardsI figured flying to England and back would give me a cold.  And I thought the spotty sleep over there mixed with the inevitable drop in adrenaline might bring on depression.  Check and Check.  What I really hoped for, though, was magic.  Alas, no.

I hoped a break from this weird job I started in July might help me see a clear path.  Stay or Go?  Jump in with both feet and start setting up mental wellness support groups?  Or resign and look for a position with less chaos, less pressure, less ambiguity?  You’d think leaving the freaking country might shift one’s perspective, throw a little light into the shadows, turn the fire up under the subconscious, but no.  I’m still sitting just as squarely on the fence, the pros and cons equally balanced.  I’m still in this Neither/Nor space—not able to fully commit, but not able to back away.

Sick and depressed, the impulse is to quit, crawl back into my safe, old life and nurse myself back to health.  But, I don’t know if going back is the answer.  I’ve spent the last two months pushing my Distress Tolerance envelope, and now I have this new space around me.  When the impulse says, “Run!” I can actually take a step back from it and answer, “Wait.”  And when I do that, the emotion and the thoughts settle down, and I simply show up for whatever is in front of me.  Sure, I could take this skill back to my old life, but I’ve had a taste of more.  I can have more if I just wait and stay present.

Yesterday, I felt too funky, physically and mentally, to meet my friend, but I also knew it would be good for me to get out of the apartment and into the sunshine.  So, I went.  Allison and I get together to write, which is always good, and to connect, which is even better.  We sat in our booth, doing our thing, aware of the noise in the booth behind us—two very young mothers with their combined litter of small children eating lunch—when it suddenly got very quiet.  We had heard the bonk of a little head hitting something hard and anticipated the bawl that would follow.  We both turned and saw that the baby was choking.

Allison asked the mother if she needed help, and she rushed the toddler to our booth.  I picked him up without thinking, and started doing the Heimlich.  One.  Two.  Three.  Four.  Out flew a wad of chewed food.  And he started crying.

The mother grabbed him and the whole crew went back to their booth.

I looked at the baby crying in his mother’s arms.  I looked at Allison.  She looked at me.

“I’m glad I showed up today,” I told her.

I believe in synchronisity and looking for lessons in the moment.  But, this was a little much.  My legs felt like jelly as I walked to my car.

Just Show Up.

Well, I asked for magic, didn’t I?

 

Ghosts in the Fence-Line

She's a FighterA friend once introduced me by saying, “This is Sandy—she has shitty boundaries.”

At the time, he was absolutely right.

I was coerced into a sexual relationship by a doctor who was treating me.  One of my therapists was a sexual predator.  I didn’t see either of them coming.

Since then, I’ve worked hard at keeping control of my own power.  It still takes time to realize I’m being stepped on or pushed, but when the lightbulb goes off, I push back now.  It’s difficult and painful, since the old traumas tend to rise from their graves when I stand up for myself.  I’m told this is a form of PTSD.  Great.  One more acronym for my file.

Like everything else, if it takes too much effort to push back, or the discomfort of it is too much, I bolt.  Run from the danger, run from the past, run-run-run.  But, I’m working hard at that, too—working to stretch my tolerance for distress, which includes the distress of planting my fence posts in the ground and defending them.

I had to do that at work this past week.  I have a set schedule that I can count on now—1:30-4:30, Monday-Friday.  I can plan around it.  I can plan on it.  But some of my co-workers keep trying to undermine it.  “Can you meet with a client at 10:00?”  No.  “Can you come with me at 1:00?”  No.  “If you could flex a bit,” they say.  Or the last straw for me on Monday—”We can wait until you’re ready.”  Ready for what?  To be valid?  To be Normal?

I watched my brain do it’s thing—thrash around with the Ghosts of Boundaries Lost and make preparations to quit the job.  But, then a miracle happened.  I’ve been watching this s-l-o-w shift for a while now.  It’s like my mind puffs out, a little more air in the pink balloon up there, and other options present themselves.  Suddenly, I remembered that my boss is on my side, that she wants me on the team.  So, I sent her a careful email.  “Help.  Do you have any ideas?”

Her response was immediate.  “I didn’t know this was happening.  I’m sorry.  It will never happen again—I’ll make sure of it.”

So, when I met with Luke Skywalker yesterday (my interim therapist), the Ghosts were swirling.  Just walking into his office brings them up anyway—he’s my care-provider, he’s a guy.  The Crypt yawns wide.  He gave me some options—stick them back in the vault for the time being and play a game of Uno with him instead or take them on.  I’m not one for pussy-footing, so I said, “Come on, let’s go.”

Most of that work yesterday was simply staying with the feelings as they rose and fell—terror, shame, guilt, self-hatred, self-recrimination.  There were moments I couldn’t catch my breath, moments I cried so hard it scared me worse than the emotion.  As I write about it now, a sudden swell of despair passes through me.  It’s so strong it washes in the idea that death would stop the pain.  The return of that old impulse, however fleeting, shocks me.  And pisses me off.  How dare those old perverts still have any control over me!

It’s always a restless night when the Ghosts swarm, so I’m heading off to the pool a little bleary-eyed and emotionally hung-over.   But, I’m heading off to the pool.  And then to my new therapy group, and then to work.  Because I’m getting good at mending my fences.  And I’ve got the barbed wire scars to prove it.

Tempest in a Teacup

Don't Know BeansHere I am, finishing up my second week of work.

The stress is enormous, not just for me, but for everyone trying to learn this new program and making up the next steps as they are needed.  The real challenge for me is to moderate the anxiety and pressure.  Under stress, I’m easily overwhelmed.  I’m like a teacup that flattens, slopping out my ability to concentrate and my emotional flexibility.  I lose capacity.

I also become reactive, and my first instinct is to bolt.  I run from the stressor, fling it off and dive into a hide-hole.  So, the words “I can’t do this” fly in and out of my head regularly.

But part of my personal journey is to work on increasing my tolerance to distress.  If I’m ever to make any lasting changes in my behavior and my life, I need to work this work situation like a puzzle.  What do I need to do to stretch my envelope of tolerance?  As always, I created a plan.

The first piece is to breathe.  It’s my starting point.  When the acronyms start flying and I can feel my body vibrating like a tuning fork, I stop and breathe deep into my belly.  It tells me to come back to myself.  It starts the process of flinging off the assumptions and negativity.  Breathing deep, I can remember why I’m doing this.  I can remember I don’t need to understand.  I can remember that I’m not alone.

I also realized that creating more structure would help soothe the anxiety, so I put an After Work plan in place.  I go straight home, change, and go to the Y to ride the recumbent bike for an hour.  That helps burn off some of the adrenaline and agitation.  Then, I journal with a cup of something soothing.  Then, I meditate.  After that, I’m rational enough to eat a sensible supper.  This helps.  Instead of bingeing all night with a movie, I’m taking positive action to stretch my tolerance.

And it seems to be working.  I may be an emotional puddle by the time I leave the office, but by the next morning my teacup is upright and able to hold water.

This is new behavior for me.  It’s also more stress than I’ve endured in years.  I’m proud of all that.  I’m also aware that I could blow at any time.  That’s the unknowable, uncontrollable piece to bipolar disorder.  All I can do is stay as mindful as I can from moment to moment and see what happens.

I’m on an Adventure.

tiny cups

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