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.

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

Memory and the Bipolar Showcase

Drew Carey, Price is RightAfter a week of fast and furious rapid cycling, I’ve made a new discovery.  Finding these little jackpots at the end of the game makes playing almost worthwhile.  At least I don’t have to leave the studio audience completely empty-handed.

My consolation prize this time was seeing how the illness affects memory and, in turn, how that affects suffering.

The first layer of this memory game is realizing that I forget what it’s like to be manic or depressed when I’m not in those states.  Maybe it’s like when women forget how painful labor is—the mind wants to gloss it over so they don’t live in fear of the next time.  But I think something else is happening, too.  I believe the extremes of depression and mania are altered states of consciousness.  The brain is altered chemically.  Thought processes and perception are altered.  When a person learns new material in an altered state, that material can’t be retrieved until the person is back in the altered state.  This is called state-dependent learning.

So any ah-ha moments I have while I’m cycling, any new tools I put in place, any comforting words of wisdom I hear from my therapist or friends get locked away behind Door Number Two until the next time.  Also, I forget what the symptoms are, how they manifest and what course the episodes take until I’m back there again.

The flip side of state-dependent learning is that when I cycle I forget what I’ve learned in a stable state.  I’m blank when I try to think of what I wanted to do differently this time.  I don’t call my friends for help because I’ve forgotten that’s what I’m supposed to do.  I forget that I just bought groceries (in a stable state) and go get more.

But aside from state-dependent learning, the stress of cycling wipes out my short-term memory.  I forget appointments.  Even if I write them down, I forget to look at my datebook.  Last week I needed to drive my mom to a doctor’s appointment.  I had Post-it notes on my computer, my bathroom mirror, and in my car so I wouldn’t forget.  As we got out of the pool one day, my friend offered me some of her fresh tomatoes.  By the time I reached the locker room, I’d forgotten what she said.

Stress focuses the attention on the immediate.  Only the details necessary for survival get any brain time.  If actions and thoughts aren’t part of a deeply-grooved routine, they get jettisoned.  Even some of those go if it takes too much effort.  I have to think that’s what happened when I forgot about my meditation group last week.  I’ve been co-facilitating the group for nine months now, but I was in such a high state of crisis, my brain dumped it.

I know lots of people my age start experiencing memory slips—names, dates, a particular word.  It’s part of getting older.  But when I’m stable, these memory storms don’t happen.  I know the difference.  At least I do now.  I probably won’t when I start cycling again.

What seems clear is that journaling and posting visual reminders are key to reducing the stress and panic all this forgetting causes.  I go back to my journals all the time to see what happened, how I felt, what I did.  Now I need to add a Memory Board.  I have a blank bedroom door that will serve.  I’ll tack up phone numbers of the friends I should call, reminders from my therapist, new things to try.  I’ll be able to send messages from one state to another—Dear Manic Girl, Remember to slow down or you’ll crack your hip on the desk again.  Dear Depressed Girl, Remember that eating a whole bag of Veggie Straws will give you a gut ache.

The biggest benefit of a Memory Board will be the reminder that I Forget.  When the cycling starts, I forget that I forget.  As Winston Churchill said, “…it is a riddle, wrapped in a mystery, inside an enigma.”  But maybe this riddle has an entryway.  Maybe I can find one if I keep working at it.

Wayne, I’ll take Door Number Three…

doors

A Break in the Weather

handmade greeting card, Rumi

Cooler temps, clear skies, wafting breezes with the scent of milkweed blossoms—this seems to be my internal weather as well.  And like those breaks in the heat and humidity, they seem to come out of nowhere.

Earlier in the week I had a Come to Jesus meeting with myself.  When the depression bottoms out, all my demons swell up like roadkill on a hot day—gassy and explosive.  Out trotted All the Reasons My Life is Shit.  I won’t bore you with details, just to say there it is an unholy pantheon of gremlins.  And when said pantheon gets gassy and explosive, the splatter perimeter is vast.

So I sat down with my iced tea and toast and journaled until I spewed every vile thought onto the page.  All the self-contempt and whingeing, all the tar pits and road blocks, all the fist-shaking at the Universe lay exposed to the air and the light.  Then, I took a breath and said, “Now, let’s start ripping out the lies.”  So I spend another hour untwisting warped logic, adding gray to a black and white perspective, and challenging every assumption.  A few of the carcasses burst and disappeared.  Most lost volume and deflated into desiccated mats of fur—still there, still yucky, but changed.

The next hour I looked at what I could DO to start turning this rotting meat into compost.  What one small act could I implement to make one aspect of my life better?  What could I do that day?  That week?

By the time I left the cafe, the stink bomb had been disarmed.  I felt triumphant in being able to do that in and of itself.  But I also carried with me a plan to move my health, finances, and purpose in life in a positive direction.  I shared my success with my support group the next day and got nods all around the circle.

I’m not a dilettante at this process.  I know I have a narrow window to do some of these tasks and maintain a different outlook.  But the point is that I can do these things now. And I will do them as long as I can.

This is what we do.  We learn what has to be done every day to manage the illness, then we do it.  It’s the hardest work I know, and it never let’s up.  There are no vacation days and no time off for jobs well done.  There’s just the Work.  It’s not fair.  It’s not easy.  But too bad.  This is ours to do.

And then, after getting off our butts or out of our beds and doing the one thing we don’t want to do, a break in the weather comes.  We look up from whatever sweaty task we’ve been muscling into place, and all of a sudden we catch the breeze and feel it ruffle our hair.  We take a deep breath, one that loosens the belly from the clench we’ve kept it in all this time.  And we see the Great Work we’ve been doing, and it looks fine.

And we know that we’ll forget how this feels, this lightness, but if we keep coming back to the Work, keep doing all that we need to do, it will find us again.

It always does.

Inside the Distortion

handmade cards, collage art, Leonard NimoyJournal Entry:                   Monday December 3, 2012

I’m in a weird purgatorial place, full of angst and thrashing against my life.  Yesterday, Penny rescued me.  We went to Des Moines after Fellowship—shopped, went to Hu Hot, laughed and had real conversation.  She talked about what a gift I was to her and Karen, how much I benefit their lives and what I give to others.  It made me cry.  Makes me cry now.  I feel so lost.  It’s not that I think I’m worthless.  I know I’m skilled and offer something of value.  And I know that’s important and necessary for my own wellbeing.

But, it’s not enough.

It’s not enough to beat back the darkness.  It’s not enough to stop the wanting.  It’s not enough to fill the hole.

Last night before bed, I ticked off my blessings for the day.  When I came to Penny, I was thankful for this honeymoon period of friendship—before I screw it up like I have all my other relationships.  I haven’t hurt her too badly yet, broken her trust or lied to her.  I haven’t scared her too much yet, or dragged her through a suicide attempt.  I haven’t strangled her with neediness or used up her generosity.

But it will come.  It always comes.  The craziness goes a little too far, my ability to rein it in slips a little too much.  The balance sheet tips and there’s a realization that the price of keeping me in a person’s life is too high.

How do I keep living this life?  How can I keep losing everyone?  I know my thinking is twisted now.  This will pass as the moods always pass.  But what’s left?  What’s underneath?  What’s constant?  Is there something in me that does more than survive?  A part that does more than just hang on to the guard rail?  How do I keep living like this?  How do I keep wanting to?

Too Much of a Good Thing

There’s no doubt about it.  I am in a manic phase.  The flood of ideas and potential projects keep washing over me, each one more brilliant than the last.  What I’m trying to do is stay aware and stay focused.  I’m journaling to capture the ideas and get them out of my head.  When the mania lets go of me, I’ll be able to look at them objectively.  Often I find the ideas are still good ones, but not practical or timely or worth pursuing.

For example, yesterday I envisioned a new soft art piece—a Winter Solstice banner using a cloth-charring technique and quilting with used dryer sheets; revisited an idea for a novel about a bipolar woman living with her gay best friend in a conservative small town; and party favors for my Callinda party using cloth, beads, stamps and quotes from the story.  Swirled among those ideas are the details of the day today.  Get to the Y. Remember to take my food journal to TOPS.  Remember to take items for the silent auction at TOPS.  Strip the bed to do laundry.  All thoughts, all details, carry equal weight and flash in and out of my mind.  So writing them down and making lists helps to drain some of the wildness out of them.

I’m also trying to watch what the giddy energy brings up in me.  So far, I’m not feeling the compulsions.  Yesterday, I went shopping with my friend, Cheryl, and only indulged in a magazine (The Writer, for research purposes, of course) and craft adhesive (which I needed).

I have less of a desire to eat than usual, which may be part of the mania and the energetic spin.  Since I don’t have mania nearly as often as depression, I’m not familiar with this symptom.  Or I don’t remember it.  I’ve always been so identified with being a compulsive overeater, that the idea of not being hungry or even caring about food seems freakishly alien.  So I will watch this and mark it.

But, there is definitely an urge to GO, and I catch myself spinning around starting to do one thing, stopping, starting another, stopping.  I feel the nervy, acidic churn in my stomach.  Last night at our weekly Criminal Minds get-together, I noticed that Tom turned up the volume on the TV several times, so that told me how much more I was nattering.

Management today will be a constant returning to my breath, reminders to stop and relax.  Thursday is a busy day for me, and that will help use the energy my mania generates.  So will more exercise.  Our TOPS group plans to walk around a lake after our meeting today, which is perfect.  As always, the Observer must be in the forefront, monitoring the impulses and flurry of thoughts, creating a space between them and me where I can find myself, creating a space to rest and slow down.

It’s all part of the Bipolar Dance.  One cha-cha at a time.

30 Days of Gratitude: Day 19

One of the main reasons I went to Pittsburgh was to get my teacher’s input about the next step in my spiritual work.  As I journaled on my way out there:

It’s more than being on the road and on my way to Melanie.  I’m fine.  I haven’t had an episode in three weeks.  That’s a new record.  Truly.  What’s happening?  Are the drugs finally out of my system?  Has my brain started to manufacture the chemicals it needs again?  Is my practice working?  Is it the energy of the group coming together?  Is it the work with the Gratitude Journal?  Could it be possible, can I dare imagine, that maybe now I can actually work on the food compulsion?

Melanie and I discussed the nature of compulsion, how it’s the complete absence of Will.  She suggested I read about Will from authors like P.D. Ouspensky and G.I Gurdjieff to get a sense of what compulsion is not.  And, like Geneen Roth, Melanie believed many clues to riding the compulsion will come from attending the sensation of it in my body.  Where do I feel the drive to eat in my body?  Does it rise and fall?  Does it expand and contract?  Does it have edges or boundaries?  Does it change as I bring attention to it?

I thought I had come a long way in paying attention to my body, but I realized I’d just begun.  Now it’s time to let my body be in control.  My job is to pay attention to the signals and give my body what it wants.  I love ice cream, but it gives me diarrhea.  My body is telling me something.  I love coffee, but it makes my stomach bloated and gassy.  My body is telling me something.

Another piece came to me one morning as the group sat in meditation.  I became aware of my body as separate and also part of the group.  I was Group.  In that state, the Group Will became accessible to me, something more subtle and more powerful than my little will.  I realized that to work with my compulsion I would have to connect with and call on this larger, higher Will.  This was a key piece for me.  As with any Twelve Step Program, the process of relying on a Higher Power opens up the psyche to all manner of possibilities.  What my little will cannot do, a larger Will can.

When I came home, I looked at habits and practices that set me up to ignore my body and went about making some changes.  For the past few days, I’ve sat in meditation before making supper, getting in touch with the Group Will and concentrating on the signals my body sends me.  I make choices on what to fix based on those signals, then check in several times in the evening to see if my choices were received well.  I’m finding that the signals are very clear.  I’m also finding that it takes energy and my little will to keep making good choices, though I can sense the greater Will at work weaving a new matrix.  My intent is to keep reinforcing this new pattern for three weeks until it becomes habit, then continue to draw on Group Will to maintain it.

That’s my plan.  We’ll see what happens.

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