On Taking Psychotropic Medications

I missed one of my medications for two weeks. I don’t know I did it, except it fell off of repeat refill, and I didn’t notice it was gone. It was my anti-depressant; I take a cocktail of meds to manage my bipolar disorder. Which means that without them, I progressively got depressed and anxious, curling up in a tiny ball, saying the grownup equivalent of “Nobody loves me” because the whirlwind in my abdomen felt that way. I still functioned at work, because I have a solid sense of duty that keeps me from calling off.

I just figured out on Saturday what happened, and by Sunday I got the prescription refilled. I am recovering.

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It sobers me that one half of a teaspoon of chemicals daily keeps me from non-functionality, or at least less functionality. I admit the meds are miraculous, even with their side effects, which include benign tremor, dehydration, and maybe a bit of incoordination¹. These meds keep me from despondency, from helplessness, from inertia, from self-flagellation, from a variety of self-deprecating and ultimately self-destructing exercises in my life. On the flip side, they also keep me from frightening elation, a feeling of invincibility, magical thinking², and a touch of grandiosity.

I function well because of chemicals. Not even perfect chemicals — none of these efficiently target the difficulties in the brain, but work together to keep something (usually excitatory actions of the brain) from happening and make other things (retention of neurotransmitters and inhibitory processes) more likely to happen. My brain chemicals are tripping my body to be hyper, to be miserable, to be depressed, to be despondent when there are no stimuli backing up the feelings. The medicine keeps that from happening.

Very few people tell me to “go natural” and quit treating my bipolar. I think it’s because bipolar scares them and they don’t want to see me without my meds. I suspect they think I will become psychotic if I go off the meds. Probably not. But I appreciate their faith in my meds.

Again, it’s sobering that I function because of medications. but I’d rather function than not.

It’s hard to tell which is my natural incoordination and which is the medication, to be truthful.
Magical thinking is believing in irrational connections between A and B, where A is “step on the cracks” and B is “break your mother’s back.” I contrast this to most practitioners of magic, who believe that stepping on the cracks may affect your relationship with your mother but not break her back, and besides that, they don’t do actions with evil undertones.

How to Talk About Not Being Okay

How do we talk about not being okay?

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Being vulnerable is that scary, that human. It’s scary to risk rejection because we have been a sloppy mess in front of someone. It’s scary for society to witness the breakdown.

The alternative, however, is that we stuff our feelings until we explode. Or we manipulate others so we don’t have to feel. Or we try to control everything until we cannot function anymore. None of these are good ways to deal with feeling like a mess, but ironically, those methods can seem more functional in the short run. They give an illusion of power — power over oneself, power over other people, power over situations.

I have very raw moments in my life. Although it’s kept well under control, I have a mental disorder. I have breakthrough times in February and October. During those times, I have sleep disturbances that keep me exhausted, severe anxiety, and a general feeling of being overwhelmed. I have to talk about it because it’s an overwhelming bad feeling and, at the time I have it, I feel like it’s always been there and will always be.

I’ve come up with some rules for myself on how to talk about not being okay:

Choose wisely who you will talk to and how much to disclose.
- Mere acquaintances might rate an “I’m under the weather right now.”
- Coworkers might rate very simple situational statements, like “My father died.”
- Good friends, if they can handle things, might rate a description of what’s going on with some frankness, like “I have seasonal affective disorder right now and I’m doing pretty poorly.” This list is to protect you from the people who might reject you or the message.
- The best thing, though, is to approach people who are supportive toward you.
Don’t use your friends as therapists.
- Don’t rehearse negative scenarios on them and expect them to argue endlessly against you.
- Also, don’t unleash your worst behavior on them. Treat them like friends and honor their feelings.
Apologize if you have behaved badly, just as you would when you’re not overwhelmed.
Do not expect your friends to keep dangerous secrets, like suicidal or homicidal ideations, for you.

If you are dealing with depression, anxiety, bipolar, schizophrenia, or other mental health issues, your best support system is not a substitute for therapy, whether that be psychotropic prescriptions, talk therapy, cognitive-behavioral therapy, or others. Reach out to your health care providers or get yourself some providers on your side.

I hope this has been helpful. I feel like I’ve clarified some things for me, and I hope that I’ve helped others think about this, because all of us have heavy times.

The Dreary Months

We’re officially past Christmas and New Year’s, and I’m officially done with the first draft of my next October release, and the skies are relentlessly gray. For someone with bipolar (II) disorder who uses the holiday season to hide from the darkening days, I am officially in the dreary months, or those months where I’m at risk for depression.

I’m tired all the time right now, and I’m weepy. I feel bogged down by a pretty normal workload. The answer to the question “What am I looking forward to?” is “A nap”, but there seems to be no time for that. I might nap on Wednesday. I have meetings all afternoon this week. On Friday I have an appointment in large letters: “NATHAN”. I do not remember who Nathan is or why I’m meeting with him. Since it’s in all caps, it must be important.

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What I need to do is get some strategies in place to help boost my mood:

A sun lamp. I don’t know if these really work, but they give me a sense of control
Naps when I can, even if this means while sitting under the sun lamp drinking coffee.
Things to celebrate. (I need help making this list)
Cat therapy
Possibly a phone call to the doctor

More coffee and booze are not on this list, as these will make my mood worse.

I’ll keep you posted.

Being bipolar means saying “Well, I got through that” a lot. An awful lot.

Remember that I am relatively stable right now and have been for a few years. No giddy, voluble mania; no draining depression. I almost wonder sometimes if I never really had bipolar at all, I’ve been comfortable for so long. Life gives us an amnesia when it comes to strong emotions; otherwise no woman would have a second child. So I know that my bipolar isn’t a figment of my imagination, even if I forget how traumatic it’s been.

My bipolar sits below the surface, waiting for its chance. It likes to boil up when I haven’t had enough sleep; I guard against that with a regular sleep schedule and supplemental medication for bad nights. It bursts out of quiescence when I face a lot of stress, and it roars into my life during crisis. Not always; that’s the tricky part. It’s not even predictable in crisis.

So I find myself saying “Well, I got through that” a lot lately. As in, “Well, I got through my dad’s death” and “Well, I got through all that grading” and “Well, I got through finals week” and even “Well, I got through carrying that heavy Nespresso machine down a flight of stairs without dying”. I feel relief that I haven’t gone on a three-day rant or begun tripping over my words in racing thoughts.

Sometimes I’m so relieved I feel like crying, and then I worry that a depression threatens to emerge. I shrug and promise myself that I will get on top of any threatening moods. I know the drill: Get enough sleep, talk to my psychiatrist, journal. Well, I got through that rocky patch.

Dear Universe, Please Deliver One Muse.

A message to the universe

Sometimes I write because I see it as a method of getting an idea out there into the universe, as if the universe will supply me with something I need to deal with it creatively. Part of my belief system holds that, if one listens closely enough, the answers or comfort or solution is out there. I like whoever’s providing the aid to know what I’m asking. It comes from Quakerism and it also comes from the Christian belief of praying for what you need. I don’t know if I believe in what would be called “intercessory prayer” in some circles wholeheartedly, because my spirituality has become a muddle from the time a psychiatrist diagnosed me as bipolar. But I put words out into the universe occasionally, with some witnesses to hear. That’s you.

My life with the muse

Right now, I struggle with creativity. The spark is gone. I am writing without that burning desire to see what comes up next in my work. Everything I write feels pedestrian. I lay my problem on the muse I have had throughout my career. Muses exist to give motivation. For example, my writing life goes like this:

Inspiration>Obsession>Writing

I assume the muse enters at the inspiration part of the equation. I used to get inspiration from my dreams. My dreams haven’t come from a muse lately. They’ve come from the Karen of my subconscious. In my dreams, I forget little things like showing up for class (I’m the professor) and wearing clothing. I’m doing everything wrong, and I am about to be discovered as a fraud. My bad dreams don’t even have the courtesy of being a dystopic plot line, preferring instead pedestrian impostor syndrome.

As muses are notorious for whipping up their subjects into a creative fury, I lay the problems of my obsession stage on the muse I’ve had as well. The obsession is the need to get into the story to interrogate the dream. I want not just to know the story but to be in it. To be it. It’s an exhilarating feeling, like flight. The obsession part is alright, unless it’s not. I know writers go a little crazy when they write, but my obsessions come with hypomania. I get into mood swings that swing between elation and Subconscious Karen, telling me I’m out of control, as if she fears I will skip class and run around naked. (Thank God I have done neither.) So I don’t get wild, but I fear giving creativity any quarter will cause the calamity I dream of.

Go away, muse

So I fired my muse. Those obsession parts were too wild, and I feared sliding down a slippery slope to a bacchanalia in the middle of the University Ballroom and all those other explosions Subconscious Karen feared. I never have experienced the wild elation since I fired my muse. I miss it sometimes, but it’s nice not having Subconscious Karen around all the time (she’s only around sometimes now, usually when I’m under a lot of stress).

Now I wonder if I can hire a new muse. I don’t want an erratic, frenetic, startling muse anymore. But I want a muse to inspire me without the feeling that I’m about to choose to swing naked on that chandelier. There has to be a middle between swinging on a chandelier and Subconscious Karen.

It’s not about a muse, is it?

Writing this article has been alchemy. I discovered, in writing this, that it was about writing with bipolar disorder. Although I am convinced that I am not less creative with the bipolar meds, I don’t know how to grasp my creativity as readily as I would like to. In a hypomanic state, ideas jump at me and I grab onto them and run. I feel touched by the muse and my self-doubts melt. I feel gifted, and this makes writing easy. Subconscious Karen keeps me from veering off the deep end but makes my life uncomfortable and my mood swings worse. I have given up those things which encourage artificial highs (irregular sleep, extended stress, obsessive crushes) and thus have robbed myself of the muse.

My thought going out into the universe: Help me live with Subconscious Karen in a way that doesn’t rob me of joy. Help me find inspiration without obsession, intensity without disruption, creativity without condemnation.

Ever Vigilant

I’m irritable. I have a crush on someone again^*. It’s a change in season. An ordinary person would think nothing of this, but I have bipolar disorder (bipolar 2), and this makes me worry. Am I becoming manic (hypomanic)? Do I need to check in with my pdoc? (Actually, checking in with my pdoc would be a good idea, as our last appointment got canceled.)

I’m probably overreacting; I often do. It’s easy to overreact when one has bipolar disorder, because the mood swings wreak havoc on one’s life. Even hypomania puts strains on relationships and budgets, and the full-fledged depression can make wanting to live difficult.

The states of bipolar mania/depression are hard to explain. It’s hard to explain that my judgment is great unless I’m in one of my extremes, and then I need a trusted voice to walk me through things. Even then, my judgment is not impaired but influenced by intense moods. I do not act on my moods as much as I suffer frustration.

As I wrote this, I got a call in to my pdoc and made an appointment, which will be in two weeks. If I’m still feeling like this then, I’ll bring it up to him.

^*I know I’m married; I still get crushes. I have a crush on Jason Momoa; nothing’s going to happen there either.

Memories of the Dark Times

I haven’t written in almost a month. It’s been a rough month, a month of remembering, a month of irrational fear. It’s the ten-year anniversary of being diagnosed as bipolar. The tenth anniversary of being hospitalized. The tenth anniversary of not believing in myself.

It’s a harsh thing realizing that one’s invincibility is simply a state of hypomania. That one’s optimism is a mood swing. (Admittedly, it’s good to know that one’s suicidality is just a depression, but it’s hard to remember the lows when one is on a high like I was ten years ago).

Ten years later, I’m pretty stable, except for some depression in late winter and some giddiness early Spring. And superstitious worry that I will become unstable again every year at this time.

It’s a new normal for me, especially when writing, because I don’t feel overwhelmed by emotions when I write anymore. I wonder if my writing’s as flat as I feel compared to my amped-up days.

I am plagued with second-guessing my writing. I have strayed away from it. If you feel like sending good wishes, vibes, etc., please do!

A Little Discovery

An insight

I had two good things happen to me yesterday, neither of which had to do with writing. One was an invitation to a focus group that resulted from a leadership class I took nine years ago, and one was a request to do moulage for the city of Albany, MO’s high school docudrama (think staged car wreck with all the resultant carnage). Both requests made me feel wanted and worthwhile, and I marveled at how much better I felt at the meeting I ran for the Human Services committee for my department at school.

Being in demand vs being lauded

All this time, I thought that what I wanted was recognition, what I called “cookies” in my mind. But I realize I feel ambivalent about cookies, because they too often result from the rewarder’s motives rather than intrinsic work. I received a National Merit Scholarship Award from AT&T in 1981, and I realized quickly the banquet was more about AT&T than about my award. Several more situations like that make me feel ambivalent about cookies.

Being in demand, however, says “We called you because you’re the local expert.” (Or perhaps the cheapest, but I know my reputation for doing moulage). I enjoy sharing my expertise and getting praise for it. I enjoy showing my talent off.

It feels especially good that I get this attention when I’m worried about mood swings coming up on the 10th anniversary of my hospitalization. It reminds me that there’s more to me than the depression.

It feels fantastic.

Anniversary of the Worst Time of my Life

Ten years ago this season

I read a Facebook Time Hop today in which, ten years ago, I wrote about the last Family and Consumer Sciences banquet at Northwest Missouri State University. It was the last banquet because my department got axed that spring for reasons that never quite made sense. Our enrollment was healthy; what was not healthy was the scorn society heaped on our existence. For we were the very unsexy formerly known as home economics. That, I think, was enough to cause our demise.

It’s also ten years since the most horrible semester I’ve had here at Northwest, because as my department’s demise brought a very clear fear of being left in the unemployment line, I also had my definitely hypomanic moment. I was hardly sleeping, putting large amounts of work into a project that wasn’t supported by the leader. My gradebook was a mess. I was going fishing at 2 in the morning by myself. I was angry — at the university, at my coworkers, at Richard. This led to a Bipolar II diagnosis and a few days in inpatient care to level out my meds. My semester ended early, but I had become passive, inert from a medication that didn’t work for me, and which incapacitated me all summer before my new psychiatrist and I realized that the tiniest dose made me into a zombie. My husband and I bought a house somewhere between the end of the semester and the internships I would not be allowed to supervise; I was one thing we moved into the house.

I’m superstitious

I have been pretty stable with the meds for the past ten years, if “stable” means having periods of moderate depression (but no suicidality) or months of hopeless crushes (but no stupid midnight dates with catfish — real catfish — at Mozingo Lake). Sometimes I feel like a nut, sometimes I don’t, but I’m pretty stable. The gradebook is always neat in case I become unstable again.

But I’m superstitious. I have been stable for ten years, but this year’s an Anniversary. When I see the light through the curtains, I worry about my job falling apart. I smell Spring and remember growling at Richard until he let me go fishing before the sun came up. Beauty is suspect, because the greens of mania scintillate with colors brighter than life.

It’s been 10 years, and I still feel like that Spring long ago broke me. Who I am now seems diminished, and my writing was a way to transcend the mousy older woman I’d become. It hasn’t worked.

It seems like I’d have gotten used to the “New Normal” by now, but having spent 48 years in at least cyclothymic and bipolar 2 state, those highs and lows were my personality. Now I need to find the personality that remains when the highs and lows are taken away.

Busy/Not Busy

New responsibilities at work

I’ve been moving into a period of more responsibilities at work, probably because I’m seeming more stable lately. I don’t mind, but I have to make sure I don’t a) procrastinate; b) overwork myself.

Balance

Work is a balancing game for me because of my bipolar disorder and because of my writing. I have office work to do today. And a meeting with a therapist. And part of my outline for It Takes Two to Kringle. Luckily I’m working at home today and I can get the work stuff done before I do personal stuff in the late afternoon.

The work unnerves me when I look at it all in one piece. Which, I guess, is a good reason not to look at it all at once.

Time for rest

I have to work on this one. I get plenty of sleep (this is necessary with bipolar) but I don’t always feel rested. I think a lot of this is psychological — when I’m faced with a pile of work, I fret about whether I’ll get it done, and that makes me tired.

I need to work on resting my mind, which comes from things like meditation, time management that includes free time, and sleep without dwelling on things. Empty mind, in other words.

Time to quit writing and do something

Yeah.