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 spiritplantjourneys.org 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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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.

March Madness

TumbleweedPhew!  February is behind us.  Enough, now, of the darkness and bitter cold and on to mud below and sun above.  Historically, March is the time I rouse from my mental hibernation and blink at the mess I’ve made while thrashing around in the dark.  I spend too much money when I’m brain-sick.  I eat compulsively.  Fat and broke, I usually overreact.  Last year and the year before, I put myself on strict money and food diets… and I ended up in partial hospitalization.  Hmmm.  Maybe this is a pattern I need to address in IPR.

The mission of IPR (Intensive Psychiatric Rehabilitation) is to help those of us with mental illness succeed at a goal we choose.  My goal is to keep living in my apartment, not taking sabbaticals in the hospital, so my caseworker, Aly, and I look at any skills needed to do that.

Partial hospitalization gives me structured support, a place to do the hard work of managing my illness when it’s overwhelming, and accountability to professionals who understand me.  One of my new skills is to seek out more structured support outside the hospital setting.

Seeing my therapist and participating in IPR every week are two kinds of structured support.  Recently, I added a weekly meeting with my Peer at Integrated Health Services (where I worked for a time last summer).  Allison and I sit for an hour and talk about doing the hard work of recovery.  The more I can get this kind of help, the less likely another hospitalization.  And since the Partial Hospitalization Program closed its doors last year, my only option now is full admission to a psych ward.  To me, that’s not an option.

So, it’s also important to look at this pattern of deprivation in the early spring.  As Aly and I talked through this, it seemed so simple.  Now is not the time to white-knuckle anything—not my budget, not my diet, not an out-dated version of myself as responsible and in control.  If there was ever a time for my Kinder, Gentler practice to kick in, it’s in March.  Now is the time to acknowledge how ill I’ve been and how well I’ve coped.  Now is the time to gently come back to cooking at home when the depression lifts enough to allow it.  Now is the time to remember that this is what my savings is for—to pay the bills my illness created over the winter and to give me space to breathe.  I’ll be able to live within my means again, but not right now.

This whole idea is radical—not clamping down to pay off my Visa bill or repaying the money I took from savings.  The idea that I can do those things later, should do them later, boggles my mind.  So simple.  So very Kind and Gentle.  It’s lovely to be my own best friend.

Basic Care

Keep CleanYesterday a crack opened in the bipolar depression that’s been at me for weeks.  Enough to let me remember to return to basics.  Because I’ve looked in the mirror every morning and said to that shocked face, “We’re not going to the hospital this year.  We’re not.”

First a call to the group I worked for this past summer—Integrated Health Services.  Their whole mission is to keep mental health clients out of the hospitals and emergency rooms.  I know I need more support now—I’ve been hearing from my providers all year that I don’t have enough in the best of times.  I’m not sure what IHS can do, but I made an appointment for Monday with Rosario, my care coordinator, and with Allison, my peer, to sit and figure that out.  They are both kind, heart-centered women.  I feel safe going to them.  The fact that I was just able to make the appointment helped.  Doing something, anything, sometimes helps.

Daily PlanToday I will start using my Daily Plan sheet, the one I created after my partial hospitalization last spring.  It will help me focus on small goals and remember to do every day tasks that get waterlogged by the swampy emotions.

I looked at how much money I’ve spent this month and cut back to the essentials.  Today I’ll figure a budget to get me through to May (February is just the beginning.  March and April can sometimes be even worse).  I’ll try to make it something I can live with, not something that will punish me for being sick.

HenryI cleaned out my refrigerator of all the liquefying vegetables and bought a few simple groceries.  I swam at the Y.  I sat with my fading bedspread for a while and sewed a blanket stitch around the frayed edges with gentle music playing and the cats behind my head on the chair.  Henry’s belly makes a gurgling, crackling sound when he’s digesting, and I pressed my ear against his fur to listen while he slept.

My apartment is a sickroom now.  No sudden moves.  No grand expectations.  Everything deliberate and gentle.  I must tend to my sleep, get to the Y every day, maintain my journal, plan quiet visits with friends, try to eat fresh food.  I will try to keep the structure sound while the storm carries on inside.  I will treat myself as someone worthy of care and respect, as someone that I love.

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