A Cautionary Tale

Whether you've been diagnosed with bipolar disorder, thyroid cancer, or have never had a funky day in your life, this kind of thing can happen and does, all the time.  Without advance directives you may be at the mercy of the ER and hospital, should a serious emergency arise, and you have no one present who will speak up for you to say, "She's bipolar.  Here is a list of the medications she's on.  Here is her psychiatrist's name, here is her primary care physician's name and number.  She has a DNR"  Everyone of us should carry a card that says at least this much about us.  Because if you have family that feels shame or denial about your mental illness or any illness and those people can speak for you in a situation where you can't speak for yourself, their shame and denial can kill you.

I know a man who has been overseeing his elderly sister's bipolar disorder.  Due to his diligence to get her the best possible psychiatric care, she was on the medication necessary to control her bipolar psychosis and other bipolar symptoms.  Anyone on her cocktail of drugs might seem a bit slow on the uptake, a bit casual about disorder and mess.  To a religious and disapproving sister who didn't believe her sister was psychotic, only uncooperative and lazy her sisters psychosis would seem like another kind of illness altogether.  The brother was out of town when the bipolar sister had a crisis in the presence of her disapproving sister.  Psychosis was misdiagnosed at the ER and her medications were not administered making her psychosis worse.  She was admitted to the hospital, but not the psych ward.  She was six weeks in the hospital developing strange symptom after strange symptom that eventually developed into pneumonia and then something that made them think she needed her gall bladder removed, or some other surgical procedure, and then an infection and then, death.

The man was notified of his sister's hospitalization, probably by the sister who did not believe in bipolar disorder.  Because of HIPPA laws and the strange politics of family dynamics he was not given authority to intervene in any decisions about her care.  He watched helplessly as his psychotic bipolar sister died inch by inch. 

Her funeral came a couple of days after the funeral of Wayne, his friend, the pianist who died in a car crash after the Salt Lake Jazz Festival.  I can't begin to imagine his grief.  But I can imagine my own death in circumstances where I have a stroke or accident that lands me in the hospital with no family at all,  and my friends are unaware that I'm in need of their help.  I'm a solitary woman who seldom leaves home.  But when I do, anything could happen.  Life's messy like that.

When I finish this I will type up a list of my medical conditions, all medications I take on a daily basis, the names and numbers of all my doctors, the name and number of the friend to call in case of an emergency.  I will keep copies on me at all times, just in case.  I don't fear death, but I do fear mistreatment in a hospital if they do not know my history of bipolar disorder.  I also fear mistreatment in a hospital if they do know I'm bipolar.  Medical professionals are not immune from mistreating the mentally ill.  I know.  It happened to me in a much less serious circumstance when I was in the hospital with diverticulitis.  There are people who have no compassion for the mentally ill in every ER in the country. I know,  I had a roommate who worked in an ER and for most ER staff, someone who is crazy and needs emergency medical attention is seen as much less deserving of sympathy than almost anyone else.  We are just a pain in the ass.

Shopping's a Symptom?

Show me a woman with a real serious shopping compulsion and I'll show you a bipolar woman.  If that woman's mother found her life's greatest pleasure shopping, I'll show you the closest genetic link, though there will be many in the lineage of that family. It's probably the most under-diagnosed of the mental illnesses and yet it seems everyone's bipolar these days. It's one of the few genetic illnesses with two genetic markers, which means that if there is one bipolar person in your family, there will be many more, diagnosed or not. 

Compulsion (mania and psychosis) and the complete absence of compulsion (depression) are the two poles of bipolar disorder.  With compulsion comes boundless energy.  The joy of having both energy and the purpose of compulsion feels great and no one in a slightly manic swing will want to come back to earth.  The compulsion to shop takes me when I'm transitioning into hypo-mania.  That's when I have boundless energy and feel a strong sense of well being and optimism.  "Money's like a river; it has to flow.  Spend it and more will come."  It's the "zen like" place where I have absolute faith that it will all work out and I need those Gucci high heeled boots. It would be great if I used that energy to clean my closet and scrub all the floors since I don't have enough money to quite pay all my medical bills.  The impulse to shop, especially shopping without a list (for things I don't really need) should be a signal for me to check in with my therapist and see if I need an appointment with my shrink for a med check. Problem is, it feels so good.  Hypo-mania is like the very best drug.  This is how life is supposed to feel.  I feel charming, but I'm probably a little too intense, a bit too loud for most people.  It might be that's when I start thinking that my sex drive isn't dead after all.  Another red flag for those with bipolar disorder is an intense and perhaps inappropriate sexual appetite that might lead to disastrous sexual encounters.  Yes, encounters with an S. Yes, without protection. Yes, with much younger men. Yes, possibly married younger men. Yes, maybe married to your sister.

A lack of impulse control and a high tolerance for chaotic disorder is a another symptom of someone in the hypo-manic phase of the illness.  All these things might seem to you like personality. And yes, there might be a narrow line between being a charming, flirtatious, fast-talking smarty-pants, but then if you have no boundaries at all, and you feel compelled to fuck your sister's husband, you are probably at risk of driving the bullet-train that is your "personality" off the cliff.  We can be incredible drama queens.  We can be very destructive and self-destructive.  But then our lives have probably been quite trying, not to mention embarrassing for our families.  As children (if female) we are the ones who get bullied and abused.  We may be the family's scapegoat.  We might be the child who is sexually abused.  And as we grow into our teens we will likely become the ones who cut ourselves so we can feel something, so numbed by stress and psychic pain are we.  That's not to say that every child who is bullied at school and abused at home is going to be bipolar.  But a high percentage of female bipolar adults had that kind of childhood. We are the vulnerable ones, no matter how brash we may seem.

So what does this have to do with you?  Bipolar disorder is under-diagnosed, and if diagnosed, often kept secret.  And in the early stages of depression you do feel sick.  Depression may begin with a strange fatigue, a headache that won't go away, a low grade fever that lasts for weeks.  You ache all over.  These symptoms have sent me to the doctor many times, and each time tests have been run and one of the things they check is my thyroid.  Before any doctor diagnoses depression other things have to be ruled out.  And in the testing phase, they may find a thing or two.  I once had a one-time sugar spill in a urine sample.  This was so perplexing to my doctor that she had a complete endocrine work up done.  I was desperately hoping that it would be an endocrine problem, anything but another depression.  But there is nothing wrong with my endocrine system.  I do have heart problems, but they have never been mistaken for bipolar symptoms.  Depression is serious.  It can't be dismissed as just laziness.  If you're the only one in your family who's ever been seriously depressed, it might be that other members of your family tend to be a bit on the manic side.  If mania is the predominant side of bipolar disorder for those in your gene pool, chances are those folks will never be diagnosed.  Because who ever thought dynamism was a bad thing? Those who mostly swing towards mania are energetic, fun in a breathless sort of way, and productive powerhouses.  They are often greatly admired.  And they can be mean, so woe to the depressive bipolar child who lives in a family of manics, for there will be no sympathy there.  We just seem terribly lazy to the rest of our lunatic relatives.

Bipolar disorder can be managed quite well with the right drugs.  But finding the right drug might take a bit of trial and error.  And once the right drug is found compliance is often a problem.  Few bipolar drugs are weight-neutral.  I carry forty pounds of drug weight.  Zoloft makes me lose weight, but I tend to get a bit manic on it.  Wellbutrin can help you quit smoking but made me psychotic.  Most bipolar drugs keep me from dreaming, and for me, dreaming is one of life's little miracles.  So I'm willing to trade being thin for being able to time-travel in my sleep.  For most women the weight gain may make compliance problematic.  For men, just admitting that they have a problem that needs medication is astonishing in itself.  Men experience bipolar disorder differently than women.  Or at least they shop for different things like cars and boats and tools and such.  Men may be violent when manic. The high of a manic stage can manifest as aggression for both men and women, but men express their aggression more often with fists, and most bipolar men think having an insatiable sex drive is the ideal anyway so what's the problem there?  Inappropriate sex?  Are you kidding?

I've been in a lot of group therapy for bipolar disorder and I have never seen a man in any of those groups. And it's not because they were women-only groups.  Men don't seek treatment unless repeated incarcerations find them negotiating further jail time for therapy and enforced drug treatment.  A lot of men would rather do jail time than admit they have a mental illness and have to take drugs that take the thrill of risky compulsions out of their lives.  Because the compulsion for risky sexual behavior is a lot more fun than feeling just normal.

We still live in a time of shame when it comes to mental illness.  Many of us just self-medicate to try to feel normal.  We smoke cigarettes (which are a mild antidepressant) and drink too much.  We smoke pot and drink too much.  We do meth so we can have the energy that depression takes away, and drink too much.  We will try damn near anything to feel "normal," except take an antidepressant or anti-psychotic that will stigmatize us as crazy and make us gain weight.  But remember, along with a high degree of creativity we also have the highest rate of suicide for any illness.  It is our leading cause of death before the age of fifty.  After that we're the real experts on the illness.

Coping

Ms M has decided to keep Roscoe at her mother's house.  I feel as if we're all being punished for being happy.  She said he needs to get used to being alone.  Why now?  He'll have plenty of time to get used to being alone when they move. 

In the years Ms M and Roscoe lived with me I was a generous supportive friend.  I've always cared for Roscoe when she worked.  I encouraged her to go back to school.  I helped her in every way I could.  Taking care of Roscoe was part of my helping her.  Now it feels as if she's punishing me for my generosity.  I wonder how Roscoe feels?

I'm coping.  Marly and Cyrus are coping.  I talked to my therapist, Fred, on Friday.  He's kind enough to do a mini-session on the phone as an assessment.  Do I need to see Dr Isabella or not?  Do I need a change of anti-depressant or not?  "Or not" is the conclusion we both came to as I talked to him.  I have a bad day or two and think I'm coming undone.  Bipolar disorder can get tricky when you're transitioning.  The way down and the way up are dangerous times.  It's then when you have the energy to do real damage or chose the final solution.  I'm not worried about that for myself.  I know that if I stay on top of this illness I can keep myself fairly stable.  It's when I ignore changes that I get into trouble.  It doesn't take much to knock me off this narrow balance beam.  So I'm vigilant and I don't put off checking in with Fred.

Saturday morning I woke up and decided to cut my hair.  Change can be good.  Change is inevitable.  Embrace change!  I didn't hesitate.  I got my coffee, had a smoke, and hacked off my hair.  I went from chin length bob to short short in less than a half an hour.  I'm good.  I can cut the back of my hair using only touch to feel the length and thickness of it.  I think of the first big haircut change as a rough draft.  But when writing poetry and cutting my hair, the rough draft is often what works.  I'm happy with the result.  I almost have a Rachel Maddow cut.  And the few people who've seen it have been complimentary.

Now I have to take Marly for a walk so she'll stop waiting for Roscoe.

The Incredible Shrinking Woman

I'm fading into the background of my own life.  I'm hardly even here anymore.  Nothing works to distract me from the bleak realities of my everyday existence or the disgust I feel for my bad attitude.  There are no humans in my photos.  That's a result of my having alienated everyone.  There's no one left to offend.  I have driven them all away.  I make no effort anymore.  And aside from the things I've blogged about there are a couple of new things that are now just having an impact on my state of mind.  Yes, circumstances can tip the scales toward a bipolar event.

A couple of weeks ago I found out that my internist is going to work for the V.A.  I think it's admirable that she's willing to work with Vets, but she has been a very good medical professional for me.  She knows me very well.  She was the gate keeper, the nerve center, the one person who could tell me to call my shrink when I got too gloomy.  She didn't nag me.  She didn't judge me.  She seemed to genuinely like me.  I don't get that much.  I know I'm not that easy to get, to like, to care about.  I'm sometimes very prickly, impatient, irritable.  Now I have to start with someone new, who hasn't read my fucking chart, who has no idea who I am or how I think, or what matters to me.  She even shared my political passions.  I've been sitting on this catastrophe as if it hasn't really happened or won't matter all that much, but today as I was filling my pill minder I saw that I was running out of Warfarin.  I called in my refill but the pharmacy will need to contact my doctor to get more refills.  And that's when it hit me.  I've lost someone else who really matters in my life.  Now I have to negotiate everything anew.  Now I have to prove to someone else that my bipolar diagnosis isn't the totality of who I am.  My bipolar disorder is a challenge but it doesn't explain everything.  It's not the only reason I'm a difficult woman.

Last night Ms M came home from Michigan to pick up Roscoe.  Last night Ms M told me she's taking Roscoe with her to Savannah when she moves in July.  Months ago she asked me if I'd keep him when she moved.  I said yes.  At that point I began to think of him as my responsibily.  He's a wonderful dog who has spent almost all of his life here.  This has been home.  This place, these people, these dogs are his familairs.  I was losing Ms M.  But I was happy for her, proud of her.  I was doing her a favor and doing her dog a favor.  Now I'm losing them both.  If you've looked at my photos much you know that Roscoe is the most photographed presence in my pictures.  Roscoe is a big part of my life.  Roscoe has special needs.  He's a dog who hates to be alone.  Now I have to start learning to live without him.  My life is shrinking at an alarming rate.

Am I sick or Is It Bipolar Disorder?

I don't feel well.  There are many reasons I might not feel well right now but I can't rule out the possibility that this might be the beginning of depression.

I don't want to do anything.  It might be the unseasonably cold temperatures and the fact that I awoke yesterday to a snow storm.  Or it might be the beginning of depression.  I can't quite wake up.  Things that usually please me, like visitors, make me feel vaguely annoyed.  I'm not exactly annoyed at the people visiting me, but at my own lack of enthusiasm.  I can fake it for awhile, long enough to make it through a visit.  I don't lack interest.  But when the visitor leaves, I'm relieved to be alone again.  Today, though it's cool now, it's supposed to be 71 degrees.  Perfect weather for working outside.  Perfect weather for taking a walk.  But I want to pull the shades and sleep.  I can't quite wake up.  The dogs enthusiasm for their morning routine makes me irritable.  I can fake my way through the morning.  I know what the dogs expect of me.  But I just wanted to sleep another hour or ten, so when I get out of bed, I'm very very tired.  And there is no good reason for this fatigue.

Usually when I wake up one of the first things I do is look in on twitter.  I have no interest in twitter today.  I feel a little bit sick.  This used to confuse me because feeling sick can be cured, but a depression can last for years and there seems to be no reason for it.  I'm a reasonable person, so a bad mood or a need for a nap I can deal with.  But the black cloud of depression can't be dealt with in quite such a rational way as tackling a real illness or just a bad mood.  If I were vomiting or had a fever, I could overlook this lethargy and know why my body didn't want to do anything but lie in bed.

I have congratulated myself for this long period of stability.  It's been years since I had a real serious bipolar event.  I take my medications and check my emotional temperature every day.  If I'm really off, like very angry or very irritible, I realize that I might not really be all that angry or irritible, it might just be a bipolar event.  I can't take my feelings at face value.  My feelings could be quite reasonable given my circumstances.  But if they seem overblown to other people given the provication, I have to consider the possiblity that it might just be bipolar disorder and not my friend's incredible insensitivity.  Fact is, not one of my friends is all that insensitive.  Nick just called to see if I wanted to go to a movie.  And I worry that my lack of enthusiasm for much of anything might seem like I just don't want to do anything with him.  Truth is, he's the only person I'd go out with.  But for now, I'm going nowhere.

Twitter and My Bipolar Disorder

I woke up this morning feeling like the air was the weight and density of molasses.  I felt like depression had claimed me and as I sat on the toilet I thought the next thing I should do is call my therapist and ask for an antidepressant change.  But first I got coffee, slammed back a hand full of pills, and then the tall boy's girlfriend came out to visit the dogs.  She's very sweet and smart.  I love the energy these young people have.  She's working on a studying film making at the U. (I was a film student there a year or two after the program began).  They're having another dinner party this weekend.  I heartily approve.  When she left the phone rang.  It was my friend Esther.  Talking with her cheered me up even though we both just complained about one thing and another.  She's far more cheerful and optimistic than I, but she'd had a pipe burst in her bathroom and needed a plumber, quick.  I have a handyman who can do it all and I gave her his number.

I checked the weather forecast and realized I'd need to mow the lawn, and soon.  Snow is forecast for this weekend in the foothills and higher.  It won't stick, but still, it's almost summer.  But when I stopped to check my email and look in on twitter I realized today is Friday.  Fridays are celebrated on twitter with the hashtag #FF or #ff which means Follow Friday or FollowFriday.  I had a bunch of follow Friday messages.  I know it sounds very silly, but it's a way of letting your favorites know you appreciate them.  So there are people who think of me as a favorite. People say good night to each other on twitter.  People listen in and then let you know they wish you well, or hope things get better soon.  People encourage one another and flirt with one another and tease each other, even as we tweet our reaction to politics and disasters.  Even as we pass on breaking news stories.  I've heard more news reported first there, often hours before I hear it on MSNBC or NPR.  It's always exciting and interesting on twitter.  I follow some very intelligent, funny and passionate people on twitter. They inform and entertain me. Life is sometimes more real on twitter than it is in the meatworld.  I love the written word.  Twitter is all about concise use of language. Twitter is pithy at it's best.  Roger Ebert is really great on twitter.  Can you feel how visceral my reaction to a dose of twitter is? Speak the written word. Forget rules. Write like you talk.  I'm off and running.

So I'm no longer mired in the molasses like atmosphere of depression.  In fact I may be rapid-cycling a bit.  A transitional position on the bipolar roller coaster of tripping from pole to pole.  It's hard to be around someone who is rapid-cycling because they will be motor-mouthed and oblivious of the needs of others.  But on twitter I can have conversations with ten or twenty people about many different topics.  It's a fast fast world on twitter. Perfect for the woman rapidly swinging from pole to pole of her bipolar disorder.  "Disorder" is such a great word for it.  When one is "rapid-cycling" there is very little order and what order there is can be smashed in a second by the next mood swing.

When I went outside to mow the lawn the lawnmower gas cap was missing.  The tank was empty too.  This made me angry at myself, since I was the last person, the only person to use the lawnmower,  After I filled the gas tank I went in the house and bitched about the missing gas cap on twitter.  When I came in after mowing the lawn there was a message to me with a warning from a tweeter about getting a replacement for the missing gas cap, with a command to do it soon. I'd used tinfoil to fashion a temporary cap.  There's a risk of flash fire when you're mowing sans gas cap.  Good thing I'd finished.  And I won't use it again until I get a replacement.  Thanks, friends from twitter.  You changed my attitude and helped me keep from sinking into the quicksand of depression.  Or maybe my drugs are working better than I thought.  Maybe both. 

I seem alright tonight. But who knows about tomorrow.  I could wake up unable to pull myself out of the quicksand, unable to tell the difference between being tired and being depressed, because depression often begins like any other illness.  It aches all over, it hurts to move, light is too bright, the dark might be the only comfort.  It might be impossible to speak without slurring words.  It might last an hour or a year.

It's an intricate dance we bipolar people perform with all the passion we can muster.  Please understand, those of you who are not afflicted with this monster of an illness, but live with someone who is, that, in as much as everything is in one's head, this too could be said to be "all in my head."  Ok, I'll give you that.  It's all in my head.  But no one can simply snap out of an illness.  Only the illness can snap you out of it, and the illness can turn you into a tireless, cheerful, organizing wizard or it can turn you into a hot tempered shouting, sobbing mess so fast there seems to be no precipitating event.  Would anyone choose to feel this way if they could choose the way they felt?  Certainly not, especially if one lives in a disapproving and shaming family.  It's painful to know that those you love find you embarrassing or think you're lazy and self indulgent.

There are times when this illness is wonderful.  It bestows a certain access to a world of creativity that I never want to be cured of.  Sometimes, in a blissful moment, I think I would choose to be this way, but then I live alone. I can do what I please on my schedule.  I think for me it is easier.  There is no one shaming me for my mental illness.  There is no one calling me lazy, moody, too loud, acting crazy.  There is no one yelling at me to "SNAP OUT OF IT!"

Stress, Anxiety, and Bipolar Disorder

I'm tired, so tired, and have been for days.  I haven't been able to just sink into this fatigue, since there are still things to do that are time related. I've been working on deadlines for weeks.  I've been spending money I don't have, trying to get things done that will at least allow me to have an income so I can start paying off the things I couldn't pay for once my bank account was emptied but the work not finished.

I always worked on deadlines (modeling and acting) and I always spent more than I earned (compulsive shopping is a symptom of bipolar disorder).  This creates a lot of stress even without the horrifying thrill of knowing that your house might fall down around your feet. I have termites.  And it's been the rainiest spring I remember.  This is a dry climate, and so termites are not that common.  But this year it might as well be the Pacific Northwest and termites are drawn to wet wood.  So I'm exhausted and worried.  That's not a good combo for anyone with bipolar disorder.

Those of us with bipolar disorder spend most of our lives coping with the stress our disorder creates.  For people with families, bipolar disorder effects everyone.  In my case, it has effected a man or two or three.  I can only imagine how difficult it would be to know that my personal chaos was driving my children crazy.  And then there is the genetic factor.  I didn't reproduce because I'd been raised in an abusive family and wanted to stop the cycle of abuse.  But in the bipolar family, if one person is bipolar, there will be others.  Bipolar disorder is one of the few genetic illnesses that has not just one genetic marker, but two.  This is a double whammy.  There is no escaping the fact that if you have children, you will be passing this illness on to the next generation and the next and on into infinity.

I take my bipolar medications religiously.  Even when I was on bipolar drugs that made me fat and lazy, I took them as if my life depended on it.  And in truth my life does depend on it.  I have had bad psychiatric care and good psychiatric care, but no matter the quality of care, I've taken the drugs they prescribed for me.  Suicide attempts and hospitalizations for psychosis will scare the bejeezus out of almost anyone.  Years of sleeping as if you were under the spell of an evil witch will make you hate your wasted life.  Depression kills.  There is no way around that.  And after awhile, it is only on the way down or on the way up that you know you have a window of opportunity and the energy and the knowledge to plan and carry out another suicide attempt. Suicide is our leading cause of death.  I know this, and so I take my medications.

I carry thirty to forty pounds of drug weight.  But I'd rather be fat than dead.  I'd rather be fat than in a sleep coma.  I rather be fat than bankrupted by a shopping compulsion.  And even with those extra thirty or forty pounds I'm normal weight for my height and age.  It's just that as a former model I was always very slender.  I am genetically predisposed to be thin.  So "fat" to me is not "fat" to most.

Today I'm taking a day off.  I'm going to stay in my little house and putter around.  I'll do a load of laundry and make my place a little cleaner.  I'm going to let the boys do their thing without any help or input from me.  I'm going to ignore the phone.  I'm going to nap when I feel like it.  I'm going to rest my weary body and mind.

In Memory of Suzanne Horn, Liquid Illusion

Suzanne was a blogger who wrote lovely poetry and was a photographer with an incredible eye.  She was beautiful.  She had children.  She was bipolar, and like so many of us, had a hard time dealing with Christmas.  She killed herself Christmas Eve last year.  It was about this time last year I found out about Suzanne's death, so it's now I think about her, like a lovely melody I can't quite name, or a line of poetry I can't quite place.  I will always think of her during the holidays, and like many of you, I'll always wonder if there was something I could have said or done that could have kept her with us.

Riding the Bipolar Roller Coaster part II

It's been a long time, in bipolar terms, since I experienced a real depressive episode. But I remember all too well that depression sometimes presents as organic illness. I start to feel sick. Feeling sick is not my normal state. This feeling sick sends me to my internist. And in the early phase I might have some mild and transient bug that can either be treated or waited out. But I don't bounce back. Feeling ill lingers. Not sick enough to simply stay in bed, but not well enough to want to do much of anything. It's a headache that's hard to get rid of, or a bowel disturbance, or low grade fever, or a slow, creeping stupidity that scares me more than anything. It's the transitions from one pole to the other that are the most dangerous. It's when we, the bipolar, realize depression is bearing down on us and we still have the energy to do something about it, that we know we can't stand it again. That's when we think about suicide. If I were suicidal, I would not be talking about it, so relax. I'm not suicidal at the moment. But I have been there many times. It's why I don't fear death by cancer or heart disease or a fatal car accident.

In Salt Lake, under the umbrella of Medicare, we have Valley Mental Health. And within Valley Mental Health is a group called The Master's Program. You have to be bipolar and over fifty to qualify. I think calling a program for the old bipolar patients "The Masters Program" is both funny and apt. If you've lived past fifty and you are bipolar, you're damn special. You have survived a very difficult life. And I'm always amazed how many of us there are. We are often treated for substance abuse(self medicating) which might result in a bit of trouble with the law, especially for men. Men are more likely to be incarcerated than women, since men are more likely to be violent against others, whereas women are more likely to be self destructive.

We can be extremely charming, and we can be horrid. I would not choose a bipolar friend to hang around with. In my opinion many of us are more trouble than we're worth. In transition we can be seething with barely suppressed rage. In a manic phase we can seem as if we're taking large doses of amphetamines--motor-mouthed and loud. I sure wouldn't choose to spend my time with anyone like me. But for the person experiencing a bit of mania it's damn fun. We all live for the hypomanic phase of the illness. But, like the way down, the way up is also dangerous.

I have over the course of my life dealing with this monster illness found that not that many of the drugs to control my illness are tolerable to me. They all have some side effects, most commonly weight gain, which makes it hard for a lot of women to stay with on them. And some side effects are worse than others. One drug gives you tremors and one drug makes you fat, one drug makes you stupid and one drug steals your dreams. Go ask Alice. I'm guessing she was bipolar.

There are bipolar drugs I am frankly afraid of. I know that if the constellation of side effects is both weight gain and an inability to create I will not take the drug. I can tollerate the weight gain but not the inability to write. And like all medications not all people react the same way to the same drug. The drugs I hate the most are those used to treat mania. In the first place mania is fun and you have enough energy to clean your house, do the laundry, carry on loud long conversations while you bake a cake and paint the ceiling red. Most of the really hard outdoor work done on this piece of property, was done by me working round the clock making stone pathways and patios in the middle of the night with outside lights on.

The dangers of mania are an expansiveness that makes casual sex easy and fun, it makes shopping sprees with a new credit card seem like the best of ideas. It makes an already mercurial personality, capable of inflicting whiplash injury to loved ones with the harsh word and the hot temper more intensely painful to those close to you. Tears flow easily. You feel everything more intensely, like you were on a great high. But the drugs to bring you back to earth are harsh. The are deadening. I've had a major psychosis which is the real danger of uncontrolled mania. It takes at least a two week hospitalization in a psych ward to get that under control. And the drugs to stop the hallucinations left me feeling lobotomized. I remembered nothing much, not even my way home. I lost my way within a few blocks of my house. And I had tremors that were so bad I had trouble drinking coffee. To my friends, my affect was pretty flat. But I've lived to tell you about the dangers of the journey.

If you have one family member with bipolar disorder, chances are there have been many others in your genetic pool. I was doubly cursed in that both my mother and father were bipolar. This is an illness with two genetic markers, not the usual one. So it's a mighty potent gene.

My father was diagnosed with schizophrenia in the late 1940s. I'm told by my psychiatrist that most bipolar patients were diagnosed schizophrenic in those days. He was hospitalized twice that I know of. I knew him as a rage-aholic. He was mean and abusive to me and my mother. Maggy, my mother, was the more manic type of bipolar personality. She always saw my depression and tendency to isolate as being lazy and too sensitive. She would never admit that there was anything wrong with her. She was critical and disapproving of almost everyone else but especially me. She was known to her siblings as the mean one in her family, bordering on sadistic. She was the classic narcissist. She was perfect and everybody else was fucked. Life in my home was hell for me. And I was given the advise by three separate therapists to vanish and never contact her again, to move and leave no forwarding address. But she was my first unrequited love. I never was good enough for her but I kept trying like a woman in an abusive marriage.

But My Mental Health is Great!

I had a mental health summit today on very short notice. When I get bad news and or the days are growing shorter, I call my therapist to schedule a check up , much like I take my car in for winterizing and a safety inspection. If you're bipolar and you don't have regular check ups you're crazy.

While I'm waiting for test results on medical stuff it seemed quite possible that I might get depressed and as winter comes on not be able to pull out of it. I didn't expect that my call Monday would be returned this fast and time made to see me. Usually you need to make your appointment with the psychiatrist a couple of months in advance. Not this time. She skipped lunch to meet with me. And I'm feeling pretty good that both my mental health experts think I'm peachy in the mental health department. I've been doing the happy dance. Don't worry, it's just the happy dance not the manic dance.

I Woke Up This Morning...

Well, waking up at all could be considered a good start. I let the dogs out and went to the bathroom to pee. As I sat down I felt my legs disconect (in my brain) from my hips. I swear it felt neurological. My legs were useless, like long dangling flipper things, completely useless. When I got over the shock and after I finished peeing, I had to use my arms to get my feet under me. Then I had to use my arms to work my way hand over hand from piece of furniture to piece of furniture to get back to bed. Fuck! Dead legs are a real drag. And I mean that literally.

I was concerned, but it was too early to do anything about it, like call my doctor's office. So I grabbed my sleep mask and tried to still the screaming going on in my mind, and eventually went back to sleep for a second or two. Usually the dogs leave me alone until I open the door and let them back in, but not this morning. Roscoe the big yellow lab positioned himself under the window closest to my bed, and Marley positioned herself under the kitchen window . Roscoe whined like a baby and Marley barked nonstop. I gave up after half an hour of trying to ignore them and found that my legs were working again. Whew! I was so scared for a second I had goosebumps.

There were a lot of things going through my mind during the hour or so I lay there with my eyes closed, blacked-out by my sleep mask. I have a friend with MS, so MS was on my mind. I also considered that it was just a reaction to stress, just a momentary blip on the radar screen of my addled mind. I checked gingerly to see if my legs would propel me to the door to let the dogs in. They did. So now I will need to call my doctor's office and check out this new symptom that is the collection of symptoms that could just be a transient hysterical paralysis, or some other non-serious momentary psychosomatic bit of flotsam from the weird constellation of my many little health issues.

My Daily Twitterscope

Others may be quite certain that you are lost in space today -- and they might be right. But it's probably more correct to say that you are detoured, for you really do know where you are and where you are going. You're not, however, aware of how you're going to get there. Don't pay too much heed of anyone who judges you too harshly now. Let your wounds heal on their own schedule. You'll still have time to reach your destination. Get your complete Cosmic Profile

I'm fairly sure there are those who KNOW that I am lost in space everyday, but compared to many of my "sane" friends I am incredibly grounded. Yes, it's probably true that dingbats attract dingbats, but I swear I know some of the nuttiest people who are thought to be completely normal, whereas I am known, especially by myself, to be nuts. I do avoid relationships with other mental patients. I have enough problems with my sane friends. But at least one of my sane friends (Z) has eight, yes, that's 8 friends who are bipolar. That qualifies her for the loony bin to my way of thinking. I have met a couple of her other bipolar friends, and I wouldn't let them in my house if they knocked on my door and asked for a drink of water. Heartless? Maybe. But what is it that would make a fragile woman surround herself with so many people who obviously need help? Yes, some of us can be quite charming for minutes on end, but her other bipolar friends, with the exception of me, are non-compliant bipolar patients who refuse to take their meds and who engage in shrink-shopping--looking for a therapist who will give them a kinder, gentler diagnosis.

My Therapist, Fred

Fred returned my call yesterday evening just as President Obama was starting his press conference. As you might have guessed, when the phone rang, I checked caller ID and seeing that it was an "unknown caller," I picked up and hung up since it was the hour of day most nuisance calls are made--telemarketers, insurance companies trying to tell me I MUST have insurance coverage to get the most out of my medicare coverage (lying, opportunistic bastards). I wonder why they think calling while most people are sitting down to dinner is a smart idea? If I'm not watching something that's really important to me, I like to tell them what asswipes I think they are. I try to keep them on the phone as long as possible while I tell them the truth about their smarmy business. But last night I was watching the President, so I just hit on and then off so it was obvious that I was not just ignoring the call but actually hanging up. The phone rang again almost instantly, so I thought I was going to have to yell at someone.

Turns out it was Fred calling from The Masters Program where discretion is important, so no caller ID. Since this was a call I really needed to take, I cranked down the volume on the TV and Fred and I talked about my appointment with my internist yesterday. In my conversation with her while she was checking my clotting factor, I told her I'd figured out that what had begun as a mild upper respiratory infection has turned into a mild case of mood disorder heading toward depression. We talked about the specific drugs I'm on for bipolar disorder and she suggested that rather than switch to another antidepressant I might just need an increase in the dosage of my major antidepressant. I like this idea, since the antidepressant I'm on (Doxepin Hydrochloride) doesn't usually interfere with my sleep cycle and allows me to dream. It does add weight. So far it's put 30 pounds on my normally slender frame. If I were still modeling this would be a deal breaker, but now I don't really give a shit about an extra thirty pounds. What I do care about is this volatility, this whipping around of my moods, this creeping downturn into cottony dumbness and drifting off to sleep in the middle of the afternoon. A half hour nap in the mid afternoon would be terrific, but once asleep, I can't wake up. And whether or not I take that three hour "nap," I'm waking up at 4:30 in the morning with a killer headache. For a woman who was never a morning person, this is way out of character for me. I hate being wide awake when it's still dark outside. I hate Morning Joe. I was raised by a person who thought early morning was the best time of the day, and anyone who disagreed with her was an idiot. I guess we already know I'm an idiot. But the dark before dawn is highly overrated in my opinion.

Anyway, I have an appointment next Wednesday early afternoon. Fred is a civilized man. He may have some serious image problems (that I could fix if he'd only listen to me) but even though he looks stupid, he's smart. He used to be my Group leader. I was skeptical at first, because how could anyone with a combover and scraggly shoulder length dingy gray hair, wearing a really ugly Hawaiian shirt, black polyester pants, a belt with a big round buckle (almost covered by a pot belly) and cowboy boots be smart? If this sounds familiar to anyone reading it you know this thread in my relationships with men marks me as shallow in the extreme. Come to think of it, every man I've loved and left got a makeover.

Riding the Bipolar Roller Coaster

It's been a long time, in bipolar terms, since I experienced a real depressive episode. But I remember, now that I've been going through it again, that depression sometimes presents as organic illness. I start to feel sick. Feeling sick is not my normal state. This feeling sick sends me to my internist. And in the early phase I might have some mild and transient illness that can either be treated or waited out. But I don't bounce back. Feeling ill lingers. Not sick enough to simply stay in bed, but not well enough to want to do much of anything. It's a headache that's hard to get rid of, or a bowel disturbance, or low grade fever, or a slow, creeping stupidity that scares me more than anything. It's the transitions from one pole to the other that are the most dangerous. It's when we, the bipolar, realize depression is bearing down on us and we still have the energy to do something about it, that we know we can't stand it again. That's when we think about suicide. If I were suicidal, I would not be talking about it, so relax. I'm not suicidal. But I have been there, more than once. It's why I don't fear death by cancer or heart disease or a fatal car accident.

In Salt Lake, under the umbrella of medicare, we have Valley Mental Health. And within Valley Mental Health is a group called The Master's Program. You have to be bipolar and over fifty to qualify. I think calling a program for the old bipolar patients The Masters Program is both funny and apt. If you've lived past fifty and you are bipolar, you're damn special. You have survived a very difficult life. And I'm always amazed how many of us there are. We are often treated for substance abuse(self medicating) which might result in a bit of trouble with the law, especially for men. Men are more likely to be incarcerated than women, since men are more likely to be violent against others, where as women are more likely to be self destructive.

We can be extremely charming, and we can be horrid. I would not choose a bipolar friend to hang around with. In my opinion many of us are more trouble than we're worth. And in transition we can be seething with barely suppressed rage. In a manic phase we can seem as if we're taking large doses of amphetamines--motor mouthed and loud. I sure wouldn't chose to spend my time with anyone like me. But for the person experiencing a bit of mania it's damn fun. We all live for the hypomanic phase of the illness. But, like the way down, the way up is also dangerous.

All this to say, I called The Masters Program today, got through the gate keepers to the psychiatrist's nurse. She said she would get back to me tomorrow when she'd had a chance to talk to Dr. Issabela, whose booked two months out. So I was instructed to call Fred, my therapist, set up an appointment on a day Dr. Issabela will be in the office. She will look in on me between appointments, consult with Fred and between them they will decide if I go off Doxepin Hydrochloride and back on Zoloft. I have over the course of my life dealing with this monster illness found that not that many of the drugs to control my illness are tolerable to me. They all have some side effects. And some are worse than others. This drug gives you tremors and this drug makes you fat, this drug makes you stupid and this drug steals your dreams. Go ask Alice. I'm guessing she was bipolar.

Creeping Depression

Well, this morning I put in a call to my shrink for an appointment. So I wait for a call-back to set up a time. I seem to be slipping into a depression like a warm bath on a cold day. Yes, sometimes sleepiness feels good, especially if you have nothing pressing to do. Taking care of Cyrus is one job I don't neglect, but Cyrus, if he had a shrink, would probably be categorized as a depressed dog. And why not? Cyrus spent his first 9 years in a "shelter" mostly kenneled with a dog run. This would account for his inclination to always pee in one place and poop in one place not far from where he pees. I have never seen this behavior in another dog, so I'm speculating the kennel and dog run were his world. According to what Cyrus' Vet and I can tell from his behavior (completely content to doze beside my bed most of the day) he is happy here. But if this is happy, sad must have been terrible. He is now living on borrowed time, as am I. We seem to be two peas in a pod.

I plan to let myself do what I'm inclined to do--nap. A nap for the depressed could be round the clock sleep, waking only to go to the bathroom. I've had my usual two big mugs of coffee and milk. It has not made the slightest difference in my inclination to go back to sleep. And yard work is out of the question for me today. I just don't care that I have plenty to do. It's plenty to do that will either get done this year or will wait till next year.

When I met Ricardo I wanted to have a birthday party to introduce him to friends. But since Ms M has no interest in getting to know him, other than money, I have nothing to offer him. He doesn't seem to be terribly motivated by money. He seems far more interested in getting to know Ms M. I think it would be hard to find a better man, but romance is a mysterious emotion. You either feel it or you don't.

Now I have no interest in a birthday party. I've decided to pass. I've also decided to go back to bed. I have no appetite. That's nice. No appetite means no effort to come up with something tasty. I ate a banana. I will not starve. I'll take some vitamins and call it good.

And I won't be doing much visiting blogs today, since I hear the sirens call of sleep.

Crazy Talk

I've mentioned in the past that I'm bipolar. I'd have to research my own blog to find out what I've said, but I want to talk a bit about the symptoms, the treatment, and family. I use the term family loosely because who ever you love is your family as far as I'm concerned. And family is where I want to start.

Bipolar disorder is very hard for a family member who is not bipolar to deal with. Sometimes it's awfully hard to know what is personality and what is disorder and what's PMS. "Normal" is a hard psychological trait to measure. Too normal and we're dull as dust. But crazy has a big fat book with symptoms and graphs, and the weight of both law and medicine to measure how just how crazy is too crazy to function in the "normal" world. I'm so crazy I'm disabled. Legally disabled.

But you say, "You seem able to write every day. How can you do that if your disabled?" And I say, I always wrote. I just didn't have a blog. Sometimes I couldn't read the scribble that was my writing, but even bat-shit crazy I wrote, documenting every little thing, taking notes as if life were a class and there would be a test. I also read like it was a full time job and I was getting paid by the page. Both those occupations allowed me to be alone a lot. And the thing about being alone is the relief of not having to pay attention to someone else and their needs.

Another symptom is "inappropriate" sexual behavior. I think the word "inappropriate" means with someone too young, or too old, or just met. It also applies to what some call "sex addiction."

We tend to self-medicate. For most that means alcohol (legal and easy to get) for others it might be pot or heroine or meth. For others it means, a plethora of other drugs, but the one drug most Shrinks don't blink at is cigarettes. Nicotine is a good antidepressant and plays well with other bipolar drugs. I found it interesting that in the Bin, we were all sent out into the open air to puff away on our cigarettes. Mormons with bipolar disorder in the Bin with us were given nicotine gum.

The one symptom of my illness that isn't fairly well managed with two drugs twice a day, is my intense need to isolate. It is also what makes it possible to write and read to the exclusion of all else. I also engage in obsessive news watching, and then there is need for food cooking and cleaning up after cooking and foraging for food and feeding Cyrus. But, whereas most of you work full time, raise children, have a social life, keep your pets alive, and your spouse or lover happy enough to stay, I do none of those things. I make no room for anyone else. I keep all but one or two friends at arms length. I might be good for a visit from a close friend for an hour or two, but that's my limit. I can attend to the needs of another only that long. This makes me a big selfish asshole. But did you ever think it might be for your own safety? Maybe I'm doing you a big fat favor.

If my bipolar disorder where not well managed I would be signing up for every credit card company dumb enough to send me the invite. Then I'd go shopping. Compulsive shopping is a huge symptom. I was once a woman who really loved to shop, a woman who bought what she didn't need or even want, just because it was a great buy or on a whim I thought I loved it. All these shopping sprees create another problem that is common to those with bipolar disorder. DEBT. And in the end, in a bad economy, crushing debt leads to bankruptcy. This is not to say that all these things aren't done by perfectly normal healthy people, but add another symptom or two and Bingo! You might have a family member who is bipolar, and if you have one family member with bipolar disorder there are probably more. Moody? Life of the party one minute and sobbing the next? It could be PMS, or the boss, or the guy who dumped you, or it could be bipolar disorder. A child who everyone says is too sensitive? That was me. Too tired to get out of bed and feeling like you've been lobotomized? Could be a hangover or the flue unless it lasts for weeks or months or years. Occasionally having fits of rage? Dramatic and angry, exciting and too happy, too exciting? Finding life too hard to live? Well, welcome to my world. Do I enjoy this? Not that part. I do enjoy the fire in brain that keeps my fingers dancing on the keyboard. I do enjoy the complete and utter focus of the mind's creation. There is magic in the creative act no matter what the medium. But is it art? Who the hell knows? Probably not. It might just be a necessity. But the medical journals are full of histories and great stories of very famous creative types who were/are bipolar. We tend to be very creative people. We also tend to be very difficult. And finally we tend to commit suicide.

The really bad news for us and our families is that this disorder is incurable and genetic. It runs in families. Often undiagnosed or misdiagnosed. Most genetic diseases have one DNA marker. Bipolar disorder has two. It gets worse with age. And though there are some very good drugs, there comes a point when the good old drug no longer works and you have to experiment with something new. It's hit or miss. And all the drugs have side effects. I'm currently on a drug that adds 20 to 40 pounds of drug weight. If I were to switch to Zoloft I'd lose some of the drug weight. But then I wouldn't be able to dream. The weight gain of so many of the bipolar drugs keeps a lot of women from compliance with taking their medicine. There are also problems with lowered sex drive (I say good riddance) but for many people this is a serious problem. And a big (pardon the pun) reason for men to be noncompliant with taking their medicine.

I think we're a pain in the ass to live with. I do not chose other people with bipolar disorder to hang out with. We're either too much fun or a real drag. Sobbing for no reason or hysterical laughter. Always out of sync. Would you chose to hang out with someone like that? I once asked Tom why he hung in there for so long. He said it was an interesting challenge. He could have just said he loved me.

Am I crazy? Have I Ever Denied It?

I'm bipolar. Have I said that before? I think so. Probably a bit too often, actually. This is the danger time of year for me to have bipolar episodes. And forcing myself to interact out in the public in a time when I'm already pissed off that the day is gone in so few hours is almost more than I can bear. The actual onset of winter depresses me, and all I really want to do is lie in bed, but stuff needs doing. Not cookie making--I like cookie making. But in this particular point in the season, I grow melancholy. And in the transition from feeling fine to melancholy is a minefield of emotion like sparks and loud noises and lots of other irritable people, forced by the season to spend money they don't have. Property Taxes are due. Thanksgiving is almost here. Then Xmas. Sorry. That's how I feel about the holidays.


I forced myself today to maintain an inner calm and to be as kind to my fellow prisoners as possible. I went out of my way to help an old women (even older than I) find Rebocks at the department store that's going out of business. Then I helped her find someone to ring them up for her. The young woman who rung them up for her was sporting a spectacular display of ink on her neck. I complimented her on the beauty of this body art. And she told me her family owns a tattoo parlor in New Jersey. She proudly told me that she too was a tatoo artist, and showed me the canvas of her arm. A line of impatient shoe buyers formed behind us, so I thanked her and moved on. But I'd have loved to hear her story.

Off to the bra department relatively cheerful. That didn't last long. The cheerful part. Oh I remained kind to my fellow prisoners, but I hate the bra shopping experience and am always shocked by the cost.

Then up to bed linens and another pleasant interaction with a women looking for a particular sized and colored top sheet. Easily accomplished, I found what I wanted and went to the check out desk.

On the way out the door, an alarm goes off and a loud voice comes on the speakers telling me to go to the nearest check stand. It took me forever to find someone to tell me what needed clearing so I could leave this part of the prison that is the entire outside world to me. Life is hell. I don't know how you do it. You have nothing but my respect and admiration.

Then it was off to Big Lots! You can imagine how that went. At this point I was not the only cranky shopper. Lets have a round of scowls now. I did not find what I was looking for, but managed to spend near $100 anyway. Now this is a really bad sign. Spending money you don't have on shopping sprees is one in the constellation of symptoms that makes up the disorder called bipolar. Shopping with abandon is a symptom I can't afford. It's often the thing that brings a person with bipolar disorder to financial ruin and causes great stress and strain on families.

The last straw was the grocery store. Yes, I have what I need to bake cookies, and will do so with love in my heart, but I'll spend the rest of tonight recovering from the tantrums that went off all over the store. Not me, oh no I kept my cool, but children of all ages were having fits and their parents were having meltdowns and it was a bad time all round until I got the check stand. And I was able to do one last good deed for the day. I let the alcoholic lady with the cart full of Junior Mints go before me. She said, "Are you sure?" And I nearly got a contact hangover. But I smiled sweetly, I swear, and said, "It's okay, I'm not in a hurry."

And since I got home a couple of hours ago I've had three visitors. So I haven't had my news fix or my cup of tea. I haven't even unpacked my shopping bags. So for now, the doors locked, I'm not answering the phone and I'm resting.