Monthly Archives: April 2014

The Trough of the Wave

Things were good for a few days. Now they are not. I want to wait and write when they are good again, but this site is about authenticity, so I’m going to check in now.

I try to tell myself that it’s the way of things: summer is followed by autumn, the moon wanes after waxing, and what goes up must come down.

I try not to be afraid of it any more. I try not to have unrealistic expectations. I try not to let the knowledge of what will come interfere with enjoying the good times while they are happening.

The operative word, of course, being try.

I get so tired of running these calculations all the time. Of constantly observing, diagnosing, and analyzing myself. Of collating the data and crunching the numbers until I can estimate how much of a situation is biochemical and how much is psychological. Estimate whether I’m suffering a worsening of my condition of just a worsening of my attitude. Whether I need professional help or just some tough love.

I’m tired of spinning the wheel and having to try to guess where it landed. I’m tired of constantly evaluating whether I could be justified in asking for help or in declining a task. I’m tired of questioning my own honesty.

I’m tired of being in pain all of the time. Of having disturbed sleep and feeling fragile and hollow all day. I’m tired of hearing lectures about how fucking important sleep is and how I should be getting more of it.

I’m tired of looking at everything I’ve done wrong, every way I have harmed or failed those I care about, and every way I have failed to do and be whatever I could have done and been. I’m tired of making plans to try to do better in the future when I feel as if I am barely hanging on now.

I’m tired of getting advice about great classes, physical therapists, massages, and countless other things that I can’t have from people who don’t seem to grasp the fact that I have no money. I’m tired of feeling guilty every time I write a check to my therapist and asking myself if this is the month I should quit and how likely is it that I’d end up inpatient if I did?

I’m tired of trying to have normal conversations with people. Tired of monitoring my tone, vocabulary, facial expression and body language. Tired of trying to make small talk when I want to grab them and pull a bit of their soul out. Trying to keep from asking who are you really? What makes you weep? What makes you laugh like a child? What do you need right now? How do you cope with the fact that you’re going to die? What would you do with me, right here, right now, to fight the darkness inside us? Could we play? What would happen if I broke the rules?

I’m just tired, and that mercilessly compassionate spiritual thing I try to use as a guide will not lie to me even though I kind of wish it would.  It/she/he/whatever will not tell me that there is relief from this cycle coming, or that my shoulder pain will go away, or that food will stop being a struggle, or that I will ever be totally free of craving the drug that offers temporary relief.

Soon–most likely in a matter of days–I will feel better. Recently–less than a week ago–I had some good times and celebrated. It really is the way of things, for all of us and only emphasized by my condition. I live it, whether I always accept it or not; I write it here, and I know I am not alone.

“Black Box” Has Red Flags

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I just got finished watching the first episode of the new series Black Box, which features a bipolar lead character, and I’ve come to the conclusion that I must be doing a really terrible job of being bipolar: I’m not attractive enough and the last time I wore thigh-high stockings didn’t end well.

First, I want to acknowledge that the show does portray some points with honesty and realism, such as the protagonist promising she won’t go off her meds again and her brother replying that it isn’t a promise she can make. It makes an attempt to capture the conflicts of someone who really feels that her unmedicated self is such an important part of her she doesn’t want it gone, but risks dire consequences when she chooses not to comply with her meds.

In that sense, it gives heart and emotion to one of the most difficult issues present in mental health treatment today.

That being said, I want to draw attention to what I feel is an important misrepresentation of bipolar disorder and mental illness in general.

In a conversation about Dr. Black’s condition, it is stated that she is “fine” as long as she takes her meds. It’s a very clearly drawn line, in fact. Taking the meds equals fully functional neuroscientist. Skipping one dose sends her into the stratosphere, and restoring them brings her back to her fully functional state in a matter of hours.

Seriously? Am I the only one who rolled my eyes at this point?

I take my meds religiously, and I am not fine. My condition ebbs and flows, my meds need monitoring and adjusting, and I have a variety of symptoms even when the meds are as good as they can be. And I am certainly not working as a freaking neuroscientist, despite a high IQ and some good education.

The oversimplification of Dr. Black’s condition is a disservice to many sufferers. It implies that those who are disabled by their mental health problems are always responsible, when in fact there are many who are fully compliant with treatment and work hard to manage their condition.

Psych meds, as I wrote about in A Bittersweet Pill, are imperfect and full of guesswork. They can take weeks or months to work fully, and the ones that work quickly would probably have side effects that interfere with the kind of job this character is portrayed as doing.

I hope that the creators of the series will continue to make an effort to humanize those who suffer, and I hope they will be aware of the potential harm in glamorizing, trivializing or oversimplifying this mysterious condition.

49 Minutes, 32 Seconds

Several days ago, I challenged myself to celebrate my recovery and my life at the weekend convention I attended, in spite of the old tapes that make me hesitant to do so. In that spirit, I announce that I showed up for my first 5K and crossed the finish line with a time of 49 minutes and 32 seconds. I announce that I cared enough to do the math afterward and find out that my average speed was 3.72 miles per hour.

To a runner, of course, this is not even on the graph. But remember who we’re talking about here: someone who weighed close to 300 pounds for much of her adult life. Someone who was a semi-invalid for years. Someone who, in general, wouldn’t have been caught dead moving faster than one mile an hour unless it was to reach a bottle of pills.

I had two goals when I arrived at the site: not to stop moving and not to come in the very last. I was optimistic about being able to achieve the first goal if I paced myself, but as I looked around at my peers I was not at all sure about the second.

I knew I had gone to bed earlier than most of them. Put a thousand-plus recovery types in the same hotel and hijinks tend to ensue, albeit clean/sober ones. There had still been dancing and karaoke going strong when my overstimulated brain called a retreat, but you couldn’t tell it by looking at them. I saw some serious runners who seemed prepared to do some serious running: stretching whipcord muscles, adjusting iPod rigs and monitors, and pulling on specialized-fabric outfits that probably went for three figures at REI.

I had expected something a little more social–people chatting as they jogged or walked. Camaraderie with a little aerobic exercise thrown in. But one of the first instructions given at the starting line was to get into single file as soon as possible because we were running on a dirt path at one side of a bike trail. Yikes. It’s okay, I told myself. Just have fun. Even if you are last it’s fine. It’s a beautiful day and you’re doing something you never, ever thought you would do.

Ever. You see, jogging and I have never gotten along, almost from the moment we met. Like many, I had my early experiences with running in PE class. We were timed, compared, and assigned extra laps around the track as punishment. It didn’t help that I was in the Los Angeles area and we ran during extreme heat and third stage smog alerts (there are less of these now, and schools are required to respect them more.)

My feelings about jogging also go back to a specific moment when I was thirteen. I was finishing up my laps, hauling my awkward and unfamiliar body along in the heat, when I passed my first ever non-childhood “boyfriend” and he said “You sure jiggle a lot when you run.”

Later perspective suggests he was making a teen-boy reference to my breasts, which was rude enough, but at the time I heard it differently. Excruciatingly uncomfortable with the new layer of fat that had appeared with puberty, I took it to mean that when I ran everything was jiggling, and in a ridiculous way. That my stomach, thighs and body in general were an embarrassment and that I should never allow myself to be seen in any high-impact activity again unless I morphed into a much thinner, denser person.

Even during the times I was active as an adult, I never broke out of a brisk walk. Although I was comfortable with a little more bounciness when dancing, the rhythmic up-and-down bounce of jogging was to be shunned.

So the stretches of jogging I did during the race to make the time I did–as sporadic as they were–represent not only improved fitness but improvement in my attitude. Because here’s a news flash: now I do jiggle a lot when I run. I probably look as jiggly as that embarrassed thirteen-year-old thought she looked. Everything, and I mean everything, goes up and down thanks to the extra skin from my weight loss, and nothing short of a carbon fiber corset and leotard would do much about it.

I can’t picture myself ending up a hard-core runner, or having running be my most preferred form of exercise. I prefer hiking and dancing. But what a gift to even try it; to break into and out of a jog without giving much thought to how I looked. To challenge myself. To compare myself to myself and take pride in having done something new.

There was no such thing as finishing last. That being said, there was also nothing wrong with letting the little kid in me enjoy the fact that I wasn’t the last to cross that finish line. Nothing wrong with letting her enjoy being part of the crowd cheering on the 5 or 6 people that came later.

Kinda Celebrating

Am I the only one who feels profoundly ambivalent about celebrations? Not just the commonly stressful major holidays, but more personal celebrations: Birthdays. Recovery milestones. Achievements. Anniversaries. Any time we say here’s this thing about my own life that I am going to acknowledge as good. What brings out the ambivalence in me?

Theory # 1: I am afraid that I’ll screw up before I get to the milestone. For example, I am going to a large recovery gathering this weekend. Hundreds of people will be celebrating milestones in their recovery, covering from days to decades. Getting ready to go made me realize that I am having a bit of pre-milestone squirreliness, myself. This is an acknowledged phenomenon in recovery groups: that people get restless, anxious and even self-sabotaging as a big date approaches. Well, every May 3 I add another year to my total, so I’m right in the squirrel zone. It’s just good to have some awareness around it.

Theory # 2: I’ve been taught that good things don’t last, and that being content will hasten the inevitable ill fortune. Many of us internalized the same message in childhood and had it reinforced in adulthood by our families, peers, fearmongering media, etc. Celebrating feels like tempting fate, as if we’re in a Greek tragedy and the gods might see our pride as offensive and smite us.

Theory #3: Celebrating any achievement makes me sad because I think I should have achieved the thing earlier, or differently. How wonderful my life could be now if I’d gotten into recovery 10 years ago! Happy birthday to me–but I’m not where I should be at this age. Damn, what if I had never given up writing 25 years ago! (Gazpacho Soup, anyone?)

Theory #4: Just plain bad associations. Someone dear to me died on my tenth birthday. Celebrating present recovery milestones reminds me of past celebrations that were followed by failures. Self-congratulatory shopping for clothes after weight loss tended to end with said clothes going to charity.

So how do I allow myself to get past my ambivalence and honor things that want to be acknowledged? Do I pin disclaimer notes to myself as I sit at dinner with friends? Do I sacrifice a goat or two at the altars of If-Only and Don’t-Count-Your-Chickens before I head to a party? Do I get creative with a hat and some fishing gear to rig myself a portable Damoclean sword?

This convention is a good example. I have a shitload of grace to celebrate and share and give thanks for–but a part of me feels I should have more at the “vintage” I am. That my life should be more organized, my finances in better shape, and my career, well…existent. Mental disclaimer notes, all over my cool T-shirt.

How does that serve anyone? Do I really think that I am only allowed to celebrate something if I know it’s perfect and permanent? Of course I, as a whole, don’t. But this is a case of me rooting out a hidden “core belief,” as the cognitive-behavioral folks would say, and talking back to it.

For what it’s worth, I am stating an intention to celebrate at the gathering. I will dance at least once, bad shoulder or not. On Saturday morning I’m doing my first 5K with my fellow addicts–on what planet is that not something to celebrate for a person who could barely walk up a flight of stairs? And when, at the largest meeting, I join hands with over a thousand of my peers, I will try to send myself the same love and support I am sending each of them.

Where’s the Pony?

“If you keep digging, you’ll find the pony under all the horseshit.”

I heard that saying for the first time yesterday, and loved it. You’d think I would have heard them all by now, but no. This one brought a badly needed smile to my face.

The trouble with coming out of a depressive episode is that you return to find life waiting for you. If life happens to be full of some problems that are worrying or stressing you, there’s a part of the brain that wants to retreat back into the cloud rather than face them. Right now, I’m facing my family’s financial issues and some other things with a distinct lack of aplomb. I bravely opened a stack of mail and found that the deluge of bills from my appendectomy, as well as some others, has begun.

I would like to tell you that I rolled up my sleeves, called about each one, wrestled the insurance company into paying what they are supposed to, set up a payment plan for everything, and finished my day with a celebratory kale smoothie.

The truth is that I rolled up my sleeves, punched holes in all of them and put them into a nice red binder, then backed away from it as if it were radioactive. I called my sponsor and burbled about how overwhelmed I was for a while, then spent the rest of the day munching on carrots and sugar free popsicles so I wouldn’t hit the high carb foods while compulsively solving Sudokus.

I’ve written before about feeling overwhelmed by life showing up, and by so many aspects of life showing up at the same time. Money. Marriage. Parenting. Health. Family relationships. Creativity. Sexuality. There are things I don’t write about in detail because too many of the details are someone else’s story, but believe me when I say that there is activity in all of these areas.

So when do I get my pony?

Well, the mature, recovery-oriented part of me (annoying twit that she can be sometimes) reminds me that expecting any kind of reward for living in recovery only leads to trouble. I can reap great benefits, but the only reward I can really expect for living life on life’s terms is more terms. And I won’t always like them.

Also, I’m pretty sure the pony is a metaphor.

It’s also important to remember that I am very Jungian in my outlook. Which means I love alchemy. And in alchemical terms, the horseshit would be seen as the prima materia, or base material, which gets transformed and worked on in various ways to yield a final product of great worth. So perhaps I need to alter the saying:

“If you work with the horseshit enough, you’ll make a pony.”

Doesn’t have quite the same ring to it, does it?
 Oh, well. The point is process, and a belief that the process has a desirable goal. Belief that even if life gets harder it’s still leading somewhere, and staying present for it is worthwhile. I need that, and sometimes I need a dozen different metaphors for it in a day. Realistically, it is unlikely that certain parts of my life are going to get easier. Several of them are quite likely to go through tough transitions.

But I believe there is something being created. I just don’t get to know what kind of creature it will be–all I’m really sure of is that it will need a bath.

To Turn Will Be Our Delight

You’d think I would have enough experience admitting failure to be totally comfortable with it by now. It’s easier than it used to be–and the failures I need to admit are often not as severe as they used to be–but I still don’t enjoy it.

Yesterday I mustered up the courage to go to the weekly meeting of the support group for the weight loss program I did. I had missed two weeks, and knew that my weight was up considerably as a result of my disordered eating during this latest episode. I dreaded revealing this, and dreaded sitting through the group, which is composed of and facilitated by people who don’t share any of my other issues. I sometimes feel self-conscious when I talk about my recovery and my mental health, but they are so intertwined with the food issues that there’s no way around it.

To live with food issues is to ride shifting waves of success and failure. To be an addict in general can require admitting to having a problem in the first place, or admitting a relapse once, or admitting a thousand relapses a thousand times. To live with a mental health condition can require admitting lapses in meds, lapses in self-care, or many other imperfections.

In each of these cases, the admission has to come before the turning. It has to come and it has to get to a deep enough level for internal change to happen. I can’t count the number of times I’ve said “I need help” and then proceeded to continue the same behavior or ignore offers.

Sitting in the group, I hoped that I had reached the right point for a turning. Not the first turning, or the last, but this turning; a turning I need to stay on the path I need right now. I admitted that I need to eliminate some foods that have been triggering my cravings, and hoped I would have the willingness to do this.

When I need help with an episode, or support during an attempt to change my behavior, it’s really hard for me to ask. As an addict, I hesitate to give any impression of asking for sympathy because I don’t think I will get it. I also feel that someone will see the turning I am attempting as pointless or trivial because there have been so many others. “Oh, she’s on another diet.” “Oh, there she goes on an exercise kick again.” “Oh, she cleaned the kitchen. Isn’t that cute. I give it two days.”

But it isn’t cute, and it isn’t trivial. My life is made up of turnings. Big ones, little ones, and medium ones. Huge ones like the last time I went to rehab, and tiny ones like when I chose my breakfast wisely this morning. This aspect of the human condition is magnified in cases like mine, perhaps, but we do all share it. Everyone in this world is in the process of screwing up or repairing some aspect, big or small, of their life.

Anyone who is waiting for me to “get it” and arrive at a consistent way of living–never again to fall or fail–will be waiting a very long time indeed. I remind myself of this so that I’ll learn to let go of my desire for the approval of someone like this. Letting go of that longing isn’t easy; I would very much like anyone I admire to admire me too.

Some of the bravest moments I’ve ever seen have involved addicts standing in front of their peers and admitting that after months, years or decades of recovery they have relapsed. In some cases, they also admit that it happened a while ago and they have been lying and pretending about it since then. This admission often heralds a new and deeper stage in their recovery, or a new approach to it.

I hope the turnings I make during this stage of my life are teaching me and making me more willing to do what is necessary to keep growing. I write about them because I want to be a little bit brave too, and because I never, ever want my readers to think I’ve got this. Or that I think I’ve got this.

A Bittersweet Pill

I’ve been thinking about how lucky I am. Okay, I can’t claim it’s been in the forefront of my mind as I navigate through this depressive episode, but I’ve been thinking about it for at least the last two minutes. That counts, right?

I’m lucky because the meds adjustment is beginning to help. I think. I’m lucky because the medication I take for my condition has far less side effects than many others. I’m lucky because I am able to obtain and pay for it.

Many people are less fortunate; including myself at times. It took years and many, many trials of different medications before we settled on this one, and I endured a dizzying spectrum of side effects: anxiety, sleeplessness, grogginess, nightmares, nausea, weight gain, intestinal problems, loss of libido, worsening of hypomanic symptoms, dissociative symptoms, intrusive thoughts of self-harm, and on two occasions a near-fatal desire to walk into traffic or turn the wheel sharply while driving.

My experience is not unusual. A lot of trial and error is often necessary, because both the biochemical nature of the problems and the biochemical action of the remedies are still so poorly understood. We’re reduced to the basic method of doing something and seeing what the results are, then doing the next thing. Some people say that the meds don’t work at all, or aren’t ever worth their cost in side effects, or that our culture is drugging away our individuality.

I’ve been told (not by doctors) that I don’t really have a form of bipolar disorder; that I’ve just been diagnosed with that because bipolar II is the trendy diagnosis right now. I’ve been told (not by doctors) that taking psych meds will interfere with my spiritual development and my “kundalini awakening” and I should let just my condition do what it does and follow the energy to where it wants to take me. I’ve been told (not by doctors) that I should stop taking bipolar meds because taking them means that I am not really abstinent from drugs and thus not fully in recovery. (More about this idea in Medications and Judgments)

I used to feel more defensive when faced with these kinds of opinions. The degree of brokenness that led to my recovery has left me not caring so much: my obligation is to stay in recovery and participate in life, no matter what I have to do, and whether it makes me look good or not.

The truth is, even I don’t understand what my meds do for me. Their action is so subtle that I feel nothing; am aware of no changes at all. Only in hindsight, days or weeks later, do I see that my symptoms have decreased. It caused me trouble in the past because at some point I would say, “Great! I’ve been doing better for a while now; I obviously don’t need these anymore. Toodles!” With antidepressants, a trial of going off them can be quite appropriate in that situation. With a bipolar person, and bipolar meds…not so much. If it’s working, it is usually best not to mess with it, and I learned that the hard way a few times.

There are people who must make much harder choices about their meds than I have to make. If their clinical condition is more extreme, the meds that help are more likely to have obvious side effects–feeling dull or groggy, weight gain, sexual impairment, even risk of neurological problems.

I’m not an authority on all of this. I’m a statistical universe of one. I’m just drawn to say how much I admire, and feel for, those who are going through these issues with their meds. I’m drawn to encourage anyone who hasn’t been there, or who has had a bad experience and is tempted to judge widely from it, to open their perception. I’m feeling a desire to acknowledge that it can take courage, and humility, to take psych meds. In some cases, it takes a willingness to give up some quality of life in exchange for being a safer and more productive member of their family or community. And I’m lucky that I don’t currently have to give up much to take mine except a little money and pride.