Friday, December 15, 2017

Proceed with Caution

I’ve written on it before, hypomania. But I can’t ever seem to nail it down. It’s just so different each time. What I’m realizing now though, is that, as written in a study on Interpersonal Social Rhythm Therapy (IPSRT) and bipolar II, bipolar is as much a disorder of energy as it is a disorder of moods. Granted, I could be noticing an increase in energy because I just finished off three antibiotics. Perhaps. But I doubt it.

This week, I have gone on three bike rides and walked the dog three times a day, with at least one walk lasting over an hour, sometimes two. I have . . . ENERGY!! It’s fabulous. I hadn’t ridden in months. The dog is getting her exercise. I’m socializing. I’m reading. I can focus.

None of these are bad things. None of these are dangerous or reckless. They’re antennas-up signs, though. At times like this I ask myself, am I sleeping? Yes. Phew. One danger averted. Am I being loose with my money? Nope. Two dangers averted. Am I agitated? Nah. Three dangers averted. So far, this is a safe energy.

My therapist said the hope is, someday, that’s what this will be for me: “oh, I have more energy, how nice,” or “oh, bummer, less energy,” instead of it being an anxiety inducing phenomenon. The hope is someday more energy doesn’t mean a full blown episode is pending, but rather, it means I clean the house or do something productive.


For now, though, I’ll be cautious. More energy? Nice, yes, but, proceed with caution.

Saturday, November 4, 2017

A Note to Myself

Between July 2016 and June 2017 I was hospitalized four times. We’ve been over this. The anxiety was crushing, the depression debilitating, and the agitation dangerous. Two of the hospitalizations failed to thoroughly treat the symptoms, so I returned shortly after discharge. In retrospect, I can see warning signs that built over time and contributed to the necessity of the hospitalizations.
Before the first stay, I was clearly hypomanic and agitated. I took on too many projects and failed to recognize my hypomania for what it was: I thought it was anxiety. My second stay and first stay were only separated by ten days. But there had been too many med changes to keep track of in that first hospitalization, so when I began to crash and the agitation returned with vengeance, we had no idea what was working and what wasn't working.
I stayed remarkably healthy for the eight months following my second stay. I had one mild hypomanic episode and some mild depression that was curtailed by a medication increase. But then school ended. And I began to work four days a week, closing once or twice. Educational tidbit: social rhythms are incredibly important for those with bipolar. That means shift work is not ideal. That means Annie feeling more energetic April 2017 and having more time on her hands and taking on closing shifts is asking for trouble, because that means getting off work at 11pm or 12am one to two nights a week. And then the energy leaves and the agitation remains and the soul sucking depression takes over. And then what? What could I have done to stop it? Nothing. It moved so quickly. There wasn’t time to call the psychiatrist and for the psychiatrist to send in new prescriptions and the pharmacy to fill them and me to take them and changes to be effected.
And similarly, after my third hospitalization, I was only out two days before the depression came back strong enough to steal my words. I sat mute in therapy and in the psychiatrist’s office. Maybe if I had the words, I would have said, “help.” And maybe we could’ve made some changes to reverse the depression, but I couldn’t speak. And before I knew it I was back in the hospital.

So what have we learned? Honor your social rhythms (don’t close at work). Watch out for energy: don’t feed it; try to ride it out with grace and gratitude. Beware of the agitated depression. Speak. Or write. Well, try to, anyway.

Friday, October 27, 2017

More from Anxiety

            Anxiety speaks. Quietly. Loudly. Quickly. It says, “ you will get sick again.” It says, “December will be dangerous, but April will be near if not fatal.” And there’s nothing you can do about it. Yet it insists that I worry. Because perhaps if I am prepared—if I worry enough—I won’t be hit as hard when the mood changes. Maybe, if I’m on the outlook—if I’m paranoid—I’ll note the subtle changes and seek help early enough to stay out of the hospital.
            And then anxiety laughs. You can’t be prepared. “It’ll come faster than the speed of light and cut you down,” it says. When depression comes you loose control—you know that. Your “supranormal” lifestyle becomes depression led and directed. All you know is sleep and solitude and suicidality.

            “It’s bound to happen,” says anxiety. Bipolar ebbs and flows and turns your world upside down; it isn’t cured. “It’s coming,” anxiety says, “just wait.”

Thursday, October 26, 2017

Bipolar's (and Anxiety's) Response to My Request

I wrote my bipolar a letter. I begged it to let me be. It seems to be listening. It’s been four months since the last hospitalization. It feels longer. It’s been three months since drug-induced hypomania. It’s only been two months without cutting. It feels much, much longer. And I am thankful.
            But I am also fearful. So long as I’m busy, I’m safer. And, as shown in a research article I recently read, I am also safer if I live a “supranormal” life: go to bed at the same time every night, wake up at the same time every morning, keep a routine schedule of work and play and healthy interpersonal relationships. I know this. But I can’t do it.
            Life is unpredictable. Well. Rather, even when life is predictable, big changes and all, my biological reaction to each change is a crap shoot. I can know a change is coming, but I can’t know if a depressive episode will come crawling out of, say, school ending.

            I have plans. I hope to start practicum next fall. I’m en route to being eligible for it. But there is a sneaking suspicion that I will be blind-sided by an episode the moment I get too comfortable and hope a little too fervently.

Saturday, September 2, 2017

A Letter to my own Disease

Dear Bipolar II,

STOP. Enough. I’m exhausted. Let me get on with life.

In the last fourteen months, I’ve spent too many days, weeks, months depressed beyond recognition. I’ve spent weeks hypomanic, dangerously hypomanic. There have been weeks where I was more drug than person. Days where I cut violently: with X-Acto razors, with shaving razors, with broken plastic.  There have been too many sleepless or sleep deprived nights. I’ve taken too many medications. I’ve hurt myself and others. I’ve caused worry. I’ve wasted money.

And I’ve changed. You took a not-quite-innocent but not yet victim to severe, reckless, relentless self-damage of various types young woman and hurt her, badly. As my therapist would say, it’s not a tragedy; it’s a bummer. And it is a bummer. I’ve changed because of you.

Please. Enough. Leave me alone. Let me live. Let me breathe. Let me be without paralyzing fear of your coming, the behavior’s you’ll encourage, the damage you’ll do, the mess you’ll leave.

Please. I beg you. Go.

And don’t return.

Sunday, August 20, 2017

Not a "Cheery Disposition"

Is it just me, or are some of us just blessed with unexhausted-looking-faces? Un-anything-looking-faces? What was God thinking? Is it a product of the fall? Really! Humor me. I usually appear pretty alert. This is unfortunate. Pity me . . . boohoo. This means, when I’m too exhausted to be the preppy, “bubbly introvert” of a barista I’m supposed to be, all the customers and my coworkers see is a bitter barista’s—excuse my language—bitch-face.
A coworker today bemoaned how exhausted she was and then asked if she look it. “Well, no, I mean, you look a little out of it, but not a train wreck. You don’t look how you’re describing the way you feel.” I wanted to ask her the same question of myself.
I’m EXHAUSTED. But I knew the answer. I simply have a complexion that hides a multitude of sins. Occasionally people will notice that I’m depressed as fuck or exhausted or strung out on meds, but not usually. But take my word for it. I’m EXHAUSTED. I’m foggy. I’m confused. I’m slow. I’m blurred out on Abilify and Lithium, and a few others at inconsequential doses. Nothing wakes me up. Even the sting of getting a tattoo wasn’t enough to jolt me out of my viscous state.
I have worked up until the day before being admitted for hospitalization. Smiling. Pouring hearts on cappuccinos and wannabe rosettas on lattes. Ringing up orders with spring and positivity and patience. And I skip my merry way off to the hospital less than twenty-four hours later. I am a fantastic liar. But completely by accident. My demeanor on auto-pilot is somewhere between seriousness and welcoming while at work. But it is never one to elicit concern. I smile, I laugh, I joke with the customers. At home I remain neutral. At school, serious. With friends, I mirror them.

It is so confusing. I don’t want to be a puppet or a liar or a fake. But, depressed or exhausted or anxious as I may be, it is not appropriate to show up to work and not try to pretend to care for the customers. And what makes them feel cared for? Prompt service, excellent product, a smile.

Saturday, August 12, 2017

5/31/17 DEPRESSION INDEX


“Someday,” says the living part of me, “someday, I want to write a book.” The living part of me is very small right now. Nearly invisible. It’s battering around in my chest, banging fists, stomping feet, screaming for mercy. Yet it’s muted. I can only feel living-Annie. Her words are slammed into the ground by the gravity of depression. She’s hurting. That much I can tell. Every time she thinks about that theoretical book or the someday being a therapist, the pain increases. I can’t tell if she thrashes in hopes to free herself from the pain or to end the pain by bringing an end to herself. Lately I’ve favored the latter interpretation. Reality? Who knows. I don’t believe she can ever be free from the pain She must learn to coexist. She must learn to occupy space with the fire. But how? At this stage I feel I am more pain than life.