Another Train


So, nobody said I was particularly wise.

In my desperation to tame the Binge Eating Disorder beast, I regularly cycle around to doing stupid things—things I know in my adipose-caked heart won’t work.  Like diets.  But when an authority figure (aka my new doc) blamed all my physical woes on obesity, and my trusted nurse practitioner suggested a ketogenic diet, I jumped like water in a skillet of hot bacon grease.

I learned two things:

  1. A ketogenic diet made my gut unhappy in violent ways.
  2. I will binge on anything, so changing the type of food doesn’t change the behavior one iota.

So, now I’m back to mindfulness and paying attention to my triggers.

All this food-stress didn’t help my bipolarness.  I’ve been roiling, inside and out.  My thinking is still in desperation mode, so I need to be careful not to jump on every thought-train that pulls into my station.  Another train will come.  And another.  Sooner or later, this anxiety and agitation will shift.  The urge to hop a train out of town will ease.  Eventually, I’ll be able to leave the station and go home.

But, I’ve got this ticket in my hand…

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Catching Up

the-captive

After almost three weeks of Clear, Calm Mind, weeks when I made art with quiet joy and dug into the second draft of my book about being bipolar, weeks when decisions made themselves; after weeks when the Dark Times of last autumn faded, the inevitable shift came.

northern-exposureFirst, just a melancholia set in as I  watched the last season of Northern Exposure (like getting weepy over Hallmark commercials).  Mopping up with Kleenex, I would have called myself hormonal if I still had any Girl Parts.  But after the final episode, I felt bereft.  I’d binge-watched all six seasons of the show, and now it was over.  I have a bad feeling about this, my Inner Han Solo muttered.

Later that day, I shut down during therapy.  We hit something big, and it blew all the circuits.  My therapist talked and all I could hear was the teacher from the Peanuts cartoons (Wah-wah-wah).

lala2Yesterday I met my friend at the theater to see LaLa Land and cried through the whole thing.  Not that I was paying attention to what was on the screen.

It takes me a bit to catch up with the shift.  I have to find a little spot of compassion and mindfulness where I can change gears.  What do I need?  What do I have to take care of and what can wait?  I will stay home today and do art at my table instead of going to church and the Writing as a Spiritual Practice group that I love.  I can make this decision without guilt or self-loathing.  It’s what needs to be today.

Tomorrow I will focus on preparing my apartment for the new bed-bug prevention regiment.  There’s a lot to do—vacuum, get everything off the floor, pull the furniture away from the walls.  I don’t quite understand what will be done, some kind of silicon mist, so I need to get as much stuff under cover as I can.  Then, on Tuesday, the cats and I will camp out at friends all day while this procedure takes place.  I’m not sure what kind of clean-up will be required once we get back.  All I know is that I can’t vacuum for three days.

no-need-to-hurryStuff like this is stressful on my best day.  I had found a rhythm with the quarterly bug-sniffing dog’s visits, but I guess Radar wasn’t as accurate as advertised.  Now management has decided on this annual preventative hoo-haw instead.  It’s so disruptive and worrisome.

So, I breathe and try to turn my thinking.  I don’t have bedbugs, but if my neighbors do, I’m at risk.  So this is a good thing.  Proactive.  And only once a year.  I can do this.

And if it’s all I do this week, it will be enough.

The End of Gratitude

Gratitude U

At least in collage form. For a while. Frankly, it was exhausting to summon up so much gratitude when I was hospital-worthy.

Gratitude V

Negative thoughts yoke themselves to negative emotions. One can trigger the other, strengthening the connection, creating a wider, smoother highway for each subsequent episode.

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Forging new neural responses through mindfulness and self-compassion takes time and lots of practice.  It feels counter-intuitive at first.  For years, perhaps, we’ve berated ourselves for not being strong enough, disciplined enough, grateful enough.  These core beliefs feel so true, we don’t even question them.

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You, yourself, as much as anybody in the entire universe, deserve your love and affection–Buddha

Science now supports what that old bodhi tree-sitter knew–mental illness must be embraced with love and awareness from those who suffer from it.

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It feels impossible only because it’s a path waiting to be created.  But I’ve found over the years of making my own trail through this bramble that it gets easier to remember the way back to it.  And once I remember to treat myself gently and with exquisite care, I find I can breathe again.

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And then, I can be grateful for the air, and my lungs, and this day.

Take-Aways

anton/compassion

…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.

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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Unknowing

Listen, she saidThe only thing I know for sure about my flavor of bipolar disorder is that I know nothing for sure.  On days like today, when my mind feels cool and friendly, I can marvel at the potential this unknowing offers.  Living without answers keeps me in the questions.  It makes me curious, willing to experiment, and to move on if the experiment fizzles.

Unknowing can be a great relief.  When mixed with mindfulness, there’s an untethering that happens.  My attachment to being functional, to plans, even to my concept of Self loosens.  Unknowing helps me accept whatever is in the moment.  Unknowing allows me to accept all of me as my mood, energy and cognition rise and fall.

kingsmountainThese rapid cycling, mixed states plant barriers that force me to cut a new path.  The first step is to sit with the beauty of the barrier.  I imagine touching the rough, unyielding surface and see an Irish megalith—part of my DNA and a complete mystery.  It requires respect and acknowledgment.  If I don’t see the barrier, I can’t dream a different trajectory.

This weekend I came down with a bad cold.  Over the course of a day, I lost my voice and terror drowned out all other sound.  “I just got over pneumonia.  In a couple of weeks, I’ll be driving across the country.  I can’t get sick now.

And the monolith rises up, demanding attention.

Card DisplayI am sick, so I need to tend that.  I leave for ArtFest in three weeks, and I’m ready.  As I sit with this old stone, I can see that I’ve been pushing too hard.  Because I was accepted as a vendor, I’ve been cranking out my most artful, most outrageous cards.  I refurbished a display unit my friend loaned me.  I wanted ArtFest to see a particular side of me—professional, laid-back, confident.

And the craggy rock cannot be moved.

I am all those things, but my illness makes me much more.  My moods, my energy, my capacity will swing on my trip.  I could keep my fingers in my ears and pretend it won’t happen, but then I’ll crack my head on this immovable menhir.

I need to be quiet now and listen to the silence of my DNA.  As I breathe in the mystery, I can feel my grip loosen.  Expectation.  Ego.  Fear.  Judgment.

I’m fine.  And now it’s time for a cup of tea.

Melancholia

Aches to FeelOriginally one of the Four Humours in ancient medical practice, the word melancholia comes from the Greek for “black bile.”  Someone with a melancholic temperament presented as despondent, quiet, analytical and serious.

Whole eras could be melancholic (The Dark Ages).  Movements in music, literature and philosophy grew around it—Germany’s Strum und Drang, William Blake’s art and poetry, Edgar Allen Poe in general.

Later, melancholia became synonymous with major clinical depression, but went out of fashion as a medical term.

My personal experience of melancholia contains a wistful element—a hole that can’t be filled, an undefined longing.  There’s a nostalgic flavor to it, an almost remembering.  It’s that feeling of waking out of a dream right before an answer is given, before arriving at the destination, before the consummating kiss.  Something very important slips through my fingers, only I can’t remember what it was.  I miss someone terribly, but I don’t know who.

Across the wide spectrum of my bipolar mood swings, this is the place I can tolerate the best.  I’m not surprised that poets, painters, musicians and philosophers created from this saturnine state.  I experience it as deeply romantic and full of movement—Catherine in Wuthering Heights, crying out for Heathcliff on the moors.  For me, this mood easily attaches itself to story, character, fictional angst and all things heart-wrenching.  I can use this form of depression.  I can’t say that about most of my other states.

It still requires mindfulness.  Melancholia’s longing draws in sorrow and angst from outside of me, be it real or fictional.  I dare not watch The Road or Atonement.  And after I finish that intense reunion scene with my short story characters, I’d better go watch funny kitten videos on You Tube.

Having a hole that can’t be filled creates incredible vulnerability.  The longing to fill an aching, raw void leads to desperate acts.  So, while this humour visits me, I will feed it art and words of love and belonging.  If I’m very lucky, I might even start to remember that nothing is missing at all.

 

The Price of Insight

F

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.  Even then, moments of awareness are 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 with many online groups like Askyourguide and BeHere. 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.

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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