How I healed from a mental health crisis

A month ago I was in the middle of a fairly severe “mixed state”, which is like a panic attack with a triple shot of espresso.  I couldn’t sleep or eat, and I had a gigantic ball of dread and despair in my stomach.  Going for walks, meditating, lying quietly in my bed, calling a friend… none of these things could get rid of the freight train of anxiety crashing through my body.  Medically speaking, a “mixed state” is when a bipolar person is both depressed and hypomanic at the same time.  

My doctor treated this mixed state by putting me on an atypical antipsychotic medication.  That’s right, I’m on a medication with the word “antipsychotic” in it.  I have refused to take this type of medication for years both because I managed okay without them (until this incident) and because of the stigma I attached to this class of drugs.  

I hate to say it, but I thought this type of medication was okay for actual crazy people, but not for someone just a little bit crazy like me.  These medications are known to cause weight gain and I’m a little bit vain in this regard.  Being very sick is incredibly humbling, though, and really puts things in perspective. This episode forced me to realize that bipolar disorder is a scary illness that cannot be taken lightly.  I am now cured of my elitism, and I paid a heavy price for it.  

Three weeks after starting this new medication, I feel like a normal person.  If my brain was a grease fire, this new medication was the fire extinguisher.  Literally two days after starting this medication, my brain felt like a habitable place again.  

These days I’m grocery shopping, doing school drop-offs, cooking meals, reading bedtime stories, going for walks with friends, scheduling play dates, exercising, walking the dog, and the list goes on and on and on.  The speed of my recovery has been dramatic and has both my husband and me scratching our heads and asking, “What just happened?”.

In addition to medication, I owe my quick recovery to my strong support system.  My husband, my in-laws, my doctor, our church network and a few close friends showed up in a big way in terms of childcare, cooking, running the household, sending me encouraging messages and answering my teary phone calls.  I healed quickly because I had people around to support me and to help carry the load I couldn’t carry.  

The good thing about a crisis is that sometimes it can make certain things very, very clear.  Never before has it been so crystal clear to me that mental illnesses are medical illnesses. Never before have I been more committed to helping other people who struggle with mental illness.  Never before have I been more aware of how lucky I am to have access to quality healthcare.  Never before have I been more sure that healing is possible, even if it feels impossible in the moment.  I don’t want to return to such a dark place ever again, but I’m grateful for the light I now see on the other side.  

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It is a heavy burden to be the daughter of suicide and tragedy.

It is a heavy burden to be the daughter of tragedy and suicide.  My dad died at age 66.  Whether he technically died of suicide or uncontrolled diabetes is unknown, because his mental health rendered him unable to care for himself.  A few months before his death, he was committed to a psychiatric hospital for being suicidal (not his first commitment).  A few months after his commitment, he was dead.  He was 66 and he was extremely mentally ill, physically ill, estranged from family, financially destitute, and alone.  

My dad’s life certainly didn’t start off with tragedy.  He was born into a prominent family in Tulsa, OK, the son of the city’s first plastic surgeon and the oldest of five children.  His family goes back for generations in the midwest and included farmers and a dairy.  He went to private schools.  After college he managed the family’s real estate business, married my mom, and owned his own professional Formula One team for fun.  

Our family seemed to have the perfect upperclass, midwestern life.  We had our own tennis court, belonged to a country club, saw our large extended family often, took fancy vacations and my sister and I took ballet and piano. 

When I was about 8 (1987?) my dad took out a large loan to remodel a large shopping center in Tulsa.  Based on changes in the economy and the size of the loan, we went bankrupt and we lost everything.  I remember my mom holding garage sales to sell off all her nice things.  There was the threat of lawsuits.  My parents went (fled) to California to try to start a new life for us, while my sister and I stayed behind with my aunt and uncle for awhile.  

My dad never recovered from the loss of his business, home and reputation in Tulsa.  He bounced around from one job to the next, but was never able to stick with anything for long.  My dad was psychiatrically committed and diagnosed with Bipolar Disorder much later in life, and his actions during this time period are textbook bipolar behavior:  excessive spending, inability to hold down a job, periods of severe depression, enthusiasms for new projects that never lasted long, etc.  During this period, my mom did her best to keep a roof over our heads and food on the table.

My dad eventually went back to Oklahoma to try to find work, but ultimately my parents got divorced and my dad stayed in Oklahoma.  He got remarried to a women who did her best to keep him well and give him a fresh start in life, but then he started to experience severe medical problems. 

Like my dad, I also have bipolar disorder.  There are so many ways in which we were alike, too.  My dad loved to read books, he loved to (very badly) play the piano, loved animals, was emotionally sensitive and could connect with people in a very authentic way.  Also, he could “see” me in a way not everyone can.  He had unshakable faith in me and in my ability to conquer the word.  He told me all the time that I would be a great news anchor, but didn’t mind when I settled on trial lawyer.  One of my best memories of my dad is of us riding through the mud on four-wheelers, me on a tiny kid quad and him on an adult one.  He bought me a Red Ryder BB Gun when I was eight and we would shoot cans together.  I felt very close to him, even if he wasn’t around all the time.  The most common phrases he said to me were, “I love you, “I’m so proud of you” and “be careful!”.

Not only do I really wish I could still have my dad in my life, I live in terror of turning out like him.  My dad was alone with he died, estranged from two ex-wives, financially destitute, extremely sick mentally and physically, and having used up all the patience his siblings could provide.  He flew high and then he crashed hard.  Shortly before his death he called me and essentially asked me to save him and I said “no”.  It was the most painful thing I’ve ever done, but I knew I couldn’t save us both.  He was dead a month later.  

I recently experienced the darkest, most terrifying, most excruciatingly painful “mixed state” I’ve ever known, triggered by a period of extreme stress and probably being undermedicated.  People usually think of bipolar as consisting of only two states:  up or down.  A “mixed state” combines the energy of hypomania with the darkness and despair of depression.  

My mixed state lasted about two weeks and during this time period I couldn’t eat, I couldn’t sleep even with heavy sedatives, I felt like I was going to throw up at all times, and my skin felt like it was crawling.  Waves of panic and despair washed over me almost constantly.  I might have been having a reaction to a new medication, but medication changes are par-for-the-course in the field of psychiatry.  

Never have I felt so physically terrible based on purely psychiatric reasons.  I truly did not understand the capacity of the brain to torture its host.  During the waves of darkness, despair and fear I huddled on the floor in the fetal position.  It was hard on our whole family.   My husband did his best to both take care of kids and work, my in-laws took the kids for several days, my sweet mother-in-law let me sob in her arms, a good friend let me call and sob to her for awhile, and friends brought us food and hosted our kids for playdates.  I will always remember that feeling of walking through the neighborhood and just knowing that my brain was very, very sick.  Eventually I took myself to the hospital to make sure I wasn’t also experiencing any medical problems, since I hadn’t been able to eat or take my regular medication.  

During this dark time, my mind went to some very dark places.  I had thoughts like, “What happens if I never feel better?”, “What happens if I am a burden to my family and they eventually give up on me?”, “What happens if I still feel this way in a month?”, and “What will become of my children if I don’t get better?”  “What happens if I turn out like my dad?”  I had a front-row seat for most of my life to a situation that DEFINITELY did not get better, so telling myself “it will get better” can be hard to believe sometimes.

During the dark moments, though, I mustered every bit of my strength to keep the faith that things will get better.  I prayed a lot.  I reminded myself that the bad feelings won’t last forever, that I’m a different person than my dad and with a different life, that I have a full and vibrant support system, and that I have access to the medical resources I need.  It’s hard to be rational when you’re in pain, though.  

A mixed episode is first and foremost a medical situation, and the first line of treatment is medical.  I’m getting better because I’m now taking medication that will recalibrate my brain to its normal setting.  My mixed state was brought about by an extended period of extreme stress, so in the future I will need to be even more careful with not overdoing it.  Recovering from a mixed state takes time, but the medication allows me to get a little bit stronger every day.  Every day that I am stronger I am able to engage a little more fully in my life.  

Sometimes I wonder what it would have been like to have grown up in a family that was stable.  I don’t know what that would have been like, but I can do that for my kids.  Every time I rub my son’s back at bedtime, I rebalance the universe a little bit.  Every time I hug my kids as I drop them off at school, I’m healing the fear I felt at their age.  Doing the grocery shopping, preparing meals, comforting my children when they are scared or hurt, all of this is healing the pain I felt at their age.  By loving them, I’m healing myself.

Another way I heal my pain is by being very open about living with a serious mental illness.  This is a big reason why I attend mental health support groups.  I want to tell people, “I have also descended to hell.  I got better, and you will too.”  There have been times when I’ve needed people to say that to me.  The legacy of suicide, mental illness and tragedy is a terrible one.  I didn’t ask to live with this legacy or this disorder, but I will continue to get better and I will continue to use my healing to help heal others.  

Managing Summer with Two Kids and a Mood Disorder

Ahhh… summer.  Sunny weather, relaxed schedules, BBQs with friends…  what’s not to like?  It’s not that I don’t like summer, it’s just that summer with two kids and a mood disorder is scary.  Summer requires a much more concerted effort on my part to keep everything afloat.  Here are some things I do to lay the groundwork for a successful summer:  

I keep a routine.  Except sometimes not.     

In my opinion, summer camp is one of the best inventions of the modern world.  I always feel a little confused when the school year ends.  Wait… what?  They’re going to be home now?   Every day?   I may not go to work-work, but I still have a job.  My husband is out earning the paycheck that keeps the lights on, so I buy the groceries, fold the laundry, schedule the home repairs, drive the kids to their dental appointments, pickup the dry cleaning, walk the dog, and the list goes on and on.  Things things still need to be done during the summer, so I do them when the kids are at camp.  

This isn’t all I do while my kids are at camp, though.  I take naps, I attend my own appointments, I read, and sometimes I meet up with friends.  All of these things keep my mental health in check and make me a much happier person.  The time apart from my kids allows me to be a better mom when they are home.  

Our default setting for the summer is that the kids attend camp, but they don’t always.  If they need a day off, they stay home.  We still do lots of summer-y things, just not every single day.  The great thing about the summer is that there is no classwork to make up or risk of falling behind in class.  

I take care of my body.  

If I feel crappy physically, it’s really hard to feel good mentally.  During the summer it becomes extra important for me to eat real meals, exercise, get regular sleep, avoid sugar and alcohol and most of all, not overdo it.  I hate leaving tasks undone, saying no to invitations I want to accept and putting things on the back burner.  Having a mood disorder means that I don’t roll with the punches quite as easily, though, so I have to be extra careful not to overdo it.  This can be very frustrating but is very necessary.  

I get out of my shell.  

The most humbling part of parenthood has been the realization that I absolutely cannot do it alone.  Most parents learn this in about 14 seconds.  I really prefer to operate under the illusion that I have everything handled and am self-sufficient, but parenting blows this illusion out of the water.  Having kids forces me to be more social and lean on others more than I would otherwise.  My husband and I have an amazing little village of friends and family, and during the summer I depend on this village more than ever.  

I try remember that all things are temporary.  

Summer, like everything else in life, is temporary.  Living with bipolar disorder means that I live with the volume of life turned up a little higher.  I feel everything more intensely, both good and bad.  It can be hard to remember in the moment that feelings and circumstances change.  One of my favorite mantras is, “feelings are not facts”.  

Life with little kids is similarly intense.  Kids are like little unmedicated bipolar people.  It’s joy, it’s despair and it’s everything in between, often in the course of ten minutes.  It’s a rollercoaster ride that is messy, hilarious, heartbreaking, hard and wonderful.  My kids make me both laugh out loud and want to scream into a pillow every single day.  

The hardest and most important lesson I’m learning during summer, during parenting and during all of life is that it’s temporary.  My feelings, the seasons, my kids being kids… it’s all temporary.  This realization helps me chart a course that keeps everybody afloat but also allows us to have a little fun.  If this isn’t also a good strategy for life, then I don’t know what is. 

What I learned from reducing my medication

My family went to Costa Rica a couple months ago and I forgot to take my medication with me.  Such a rookie move!  I took my bedtime dose the night before our trip and then forgot to put the container back in my bag.  I don’t have a great packing track record:  last year we went to Whistler and I forgot pants.

As I’ve written about before, the medication I take works fairly well as a mood stabilizer, but also causes a major reduction in my blood sodium level (called hyponatremia, a.k.a. what marathon runners get if they don’t drink Gatorade).  It’s very dangerous and I’ve been hospitalized because of it.  If you want immediate admission to an ER tell them, “My sodium level is 123.”  BAM!  You’ve got a room!

In order to prevent this from happening again, I take a massive amount of sodium via salt pills to maintain a safe sodium level.  I also have to be careful not to drink too many liquids, which I find really difficult to do.  I love the coffee, the Diet Coke, the water, the wine, the protein shakes… all of it.  What- you CAN’T drink 64 ounces of fluid by 10 am?  Weirdo.

After we got back from Costa Rica, I went in for a blood test and my sodium level was in the “normal” range for the first time in years.  Yay!  This was a direct result of being off my medication for a week. I decided to lower my dose of my mood stabilizer on my own.  (Warning bells should be going off right now.)  My psychiatrist was not thrilled with this decision.  She understood my frustration with the sodium issue and the constant monitoring, but was concerned about my moods becoming less stable.

From September to November, I slowly started to feel more agitated.  I exercised a lot to burn off nervous energy.  I had trouble sleeping.  My children’s voices became louder.  The house felt messier and more crowded.  My mind started running circles around the same questions over and over again.  Basically, I felt like I used to feel in my 20s and 30s before diagnosis or treatment.

I scheduled an appointment with a fancy, famous, expensive doctor because I thought maybe he would know about a new medication with fewer side effects.  Fancy doctor was not magic.  In fact, fancy doctor was kind of a jerk and suggested I switch to an older medication that causes extreme weight gain, kidney damage and potentially uncontrolled bleeding.  He brushed aside my concerns about such major physical problems and ushered me out the door.  So much for a magic doctor with a magic cure.

I went back to my regular psychiatrist.  We agreed that my current medication is my best option and that I should go back to my regular dose.  I did and I already feel better.  I have some headaches and tiredness, but the volume in my head feels turned back down to a more manageable volume.

This whole experience taught me a couple things.  

1.  First, this experience reminded me that bipolar disorder is incredibly real.

Mental illness is very obvious in times of crisis.  Nobody doubts that the guy on the corner talking to himself has a mental illness.  When I was diagnosed, I was in a very hypomanic state and was clearly experiencing a bipolar episode.  The diagnosis could not have been clearer.

As I’ve gotten my condition under control, though, it’s become far more subtle.  This is a good thing!  The whole POINT of treatment is to achieve a more normal mood state on a regular basis.  Taking my medication, trying to eat a healthy diet, attending support groups, journaling, exercising, reducing my stress, making sleep a priority, meditating…. THEY ALL WORK.  I stop feeling really bipolar when I do all the things, because all the things work.

Reducing my medication reminded me how quickly things can go downhill, though.  Bipolar disorder is kind of like diabetes, in that it can either kill you or it can just be an annoyance, depending on how well you manage it.  Some people die, but others live productive, normal lives because they take the disorder seriously and have the resources to do so.  Both outcomes are entirely possible.  In fact, my dad actually did die from unmanaged diabetes and a lifetime of unmanaged mental illness.  So, I got that memo.  Take it seriously.

2.  This experience reminded me how lucky I am.  

I may be unlucky in having bipolar disorder, but I’m very lucky in the tools I have to deal with it.  I’m lucky to have a compassionate, knowledgeable psychiatrist who I can afford and who provides me with great care.  I’ve lucky that I have medication that works and that doesn’t poison my body, even if it is annoying to deal with.  I’m lucky that I can afford childcare, which keeps life manageable.  I’m really lucky to have a supportive, wise and loving husband.  I’m lucky to have the time to take care of myself.  I’m lucky that I’m in otherwise good physical health.  I’m lucky to have a good support system of friends and family.

3.  This experience reminded me to have compassion for myself.

In a weird way, it’s actually really comforting to be reminded of the seriousness of bipolar disorder.  It reminds me that I’m not being self-indulgent or dramatic in taking good care of myself.  Self compassion changes my self-talk.  Instead of saying, “I’m an unemployed lawyer who can’t even take care of her own kids” (what I used to say), I say, “I’ve created a wonderful life with what I’ve been given”.  Yay, therapy!

All of this leads me to want to connect with and support others who deal with mental illness.  I do this by writing this blog, attending local support groups, listening to and reading mental health content online and in books, donating to mental health causes, being an active member of the mental health community and doing what I can to help reduce stigma.

I don’t know what the future holds for me, but for now I’m okay with being a mom, taking good care of myself and doing my best to shout out into the void, “Hey!  Over here!  I deal with this too, and you are not alone.”  Mental illness is real, it is everywhere, and there is no reason for anybody to go through it by themselves.

On Taking Psychiatric Medication: It’s harder than it sounds

Back when I was a public defender, I represented people being committed for involuntary psychiatric treatment.  I used to get kind of annoyed with the bipolar people, because the story was always the same.  The person took medication, felt better, decided they no longer needed their medication, went off of it, and then when off the deep end.  I used to ask myself, “Why can’t they just stay on their medication?  HOW HARD IS IT?”

When I found myself diagnosed with Bipolar Disorder Type 2, therefore, I believed strongly in the importance of medication.  I also thought that treatment would be easy.  All I needed to do was take some pills, and I’d be totally normal, right?  Three years after diagnosis, I still believe in the benefits of medication, but my opinions are much more tempered by experience.

By the time I was diagnosed, I was pretty hypomanic.  My brain was not at all working properly and I knew it.  I began a very commonly prescribed mood stabilizer, but one which causes a potentially very dangerous rash in a small percentage of people.  Guess who got the rash?  I did.  So, I had to stop taking that medication.

A month later, my doctor prescribed a second medication.  This medication can cause a dangerous lowering of sodium levels (called hyponatremia), so I started getting blood tests to monitor my sodium level.  Eight months later, my husband and son and I went to Kauai for vacation.  The night we arrived, I felt incredibly disoriented and dizzy.  We went to the emergency room, where it was discovered that I had a sodium level of 123.  A normal level is 135-145.  Anything below 120 and I could have slipped into a coma.  So, we spent our first night of vacation in the E.R. with me getting an I/V of sodium fluid.

After the experience in Kauai, my doctor and I realized we needed to constantly monitor and manage my sodium levels.  I take EIGHT salt pills a day to replace the sodium that my medication flushes out of my system.  My husband makes fun of me because I carry around a little pill divider in my purse LIKE I’M EIGHTY.  I get a blood test every two to three weeks to make sure my blood sodium level is safe and I have to constantly monitor my fluid intake.  It turns out I’m also sort of a water addict, so I have to make sure I’m not drinking too much, because that can lower my blood sodium level.  That’s right, I have a drinking problem because I drink too much water.

So with this sodium issue, why not just take a different medication?  The problem is that every medication has side effects.  Some cause changes in metabolism, which can increase the risk of diabetes.  Some are extremely hard on the kidneys.  No medication is perfect, so I take the one with the least adverse affects.

Despite dealing with the side effects, taking medication is still worth it for me.  The medication I take really helps me.  I don’t have the dramatic swings in energy that I used to deal with on a regular basis.  I miss the productivity of being a little bit manic, but my life demands that I be stable and productive every day.  I haven’t been severely depressed since I started medication, which is pretty great.  I still have some days when I feel extremely productive, and I still have days when I just want to lie in bed and eat cookies, but my mood changes are more within the normal range.

Maybe someday I won’t need medication, but that day is not today.  Maybe I will take medication for the rest of my life.  Who knows.  Either way, I’m okay with it.  I’m committed to taking things one day at a time, in consultation with my doctor.

Because of my experience, I’ve also been dissuaded of the delusion that medication would “cure” me.  Thankfully, bipolar disorder is a very manageable illness, but it doesn’t manage itself.  Medication only does about 30% of the job.  Therapy, regular sleep, a good diet, exercise, and stress management are all things I must focus on to be healthy and stable.  I work every day to take charge of my life, rather than letting my moods take charge of me.

I really miss being a lawyer and some day I hope to work with the mentally ill population again.  In the meantime, though, my own experiences give me a lot more compassion for other people dealing with mental illness.  I occasionally help to facilitate a mental health support group, and I’m a lot more patient now when people vent about the challenges of finding the right medication or dealing with side effects.  I will never again wonder, “How hard is it?!”, because I know that it can actually be very hard.

My experiences have also motivated me to become involved in mental health advocacy.  I recently agreed to serve on the board of my local NAMI chapter, which is my first quasi-professional activity in years and which I am extremely excited about.  Access to great psychiatric care is just one of the things I’m passionate about.  I’m lucky to have access to a great doctor, and not everybody does.

We don’t choose our battles in life, but we can learn from them.  Hopefully others can learn a little bit from my experiences, too.

On God and Psychiatry

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M101 (the “Pinwheel Galaxy”), a spiral galaxy located 21 million light years away, as photographed at the Stanford Student Observatory.  
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Jupiter, as photographed at the Stanford Student Observatory.  

During my first quarter at college, I enrolled in an observational astronomy class at Stanford.  Every Thursday night, a few of us rode our bikes in the dark up to the Student Observatory, where we looked at various celestial objects through the telescope.  I remember looking at Saturn and its rings and thinking that it was one of the most beautiful things I’d ever seen.  The photos above were taken at this observatory, and while far better images exist, I love their grainy, far-away quality.  They give you the sense that you are peering into the dark, endless expanse of the universe.

The more I know about our universe, galaxy, and planet, the more I realize how our tiny brains can never comprehend the vastness of it all.  Orca whales swim in unison to create waves large enough to knock seals off floating sea ice.  Honeybees perch outside the hive and fan their wings to suck out the hot air for the good of hive.  The human eye is an intricate ecosystem working with our brains to give us the gift of vision.

I believe in something bigger than our tiny human lives on earth, something from which all goodness and creation flows.  I call this thing God.  Others can disagree about the accuracy of my conclusion, and that’s okay, because I’m at peace with my own beliefs.

I’ve experienced God in nature, but also in music, church, friendship, and in the kindness and love of others.  My first real experience with God came during a typical “altar-call” at a Christian camp during my teenage years.  While I no longer attend an “Evangelical”-style church, my experience with God was real and nobody can ever convince me otherwise.  I believe that God exists, that He hears us, that our lives have meaning, and that above all else, God is good.

After the much-anticipated birth of my first child, I became severely depressed.  For an entire year, I tried everything to make myself better.  I literally ran five miles almost every day (exercise is supposed to make you happy!), I went to church, I tried to make new mommy friends, I went back to work (twice), I quit work (twice), I journaled, I ate a healthy diet, and I did everything I could to “cure” myself.  I thought I just needed to be stronger, try harder and be more faithful.

After a year of doing everything “right”, though, I still felt full of despair.  Finally I acquiesced to trying medication.  Within a few weeks of starting medication, I felt better.  I still felt completely like myself, but it was as if somebody turned down the volume in my head.  I could cope.  I no longer felt paralyzed with terrible feelings.

Much is made of the “conflict” between faith and science.  I believe this conflict is largely overblown, much like the “working moms vs. stay-at-home moms” conflict, but there does exist real hostility towards modern psychiatry in certain faith communities.  The feeling of “you must just be doing it wrong” prevails.  I can partially understand this feeling, because the lines between faith, the soul, the body and the mind are fuzzy.  It’s easy to think that what worked for one person should work for everyone else.

And without a doubt, sometimes there is a place for spiritual discovery.  Sometimes, we need prayer.  Sometimes, we must summon the better versions of ourselves.  Sometimes though, we need medical help.

The hard part is knowing when we need God and when we need a doctor.  I’ve accepted that I need bothSpiritual struggle has a purpose, but suffering does not.  I believe in a God who wants me to be the healthiest, fullest version of myself.  I believe God has a plan for my life, and that in order to fulfill this plan I must be well.  Taking medication and working with a psychiatrist help me stay well.

The best psychiatrist in the world cannot tell me who created Saturn, why I am on this planet, or what it all means.  This is where faith comes in.  My church provides me with community, common purpose and tools for nurturing my spiritual life, all of which enhance my mental health.

The best pastor in the world though, cannot pray away a broken leg or psychosis.  This is where medicine comes in.  Things get complicated with mental illness, because mental illness takes place in our brains, but mental illness is just like other illness.  Tellingly, you don’t hear diabetics agonizing about whether taking insulin conflicts with their faith.

Accepting my mental health diagnosis, working with a psychiatrist and taking medication do not take the place of my spiritual life.  They do make me a healthier, happier, fuller version of myself, and thus closer to who God wants me to be.  This is my faith.

What it’s REALLY like to be bipolar

I love this picture because, a) it’s hilarious, and b) there’s so much truth to it.  As its name suggests, bipolar is an illness of extremes.

Thanks to an accurate diagnosis, medication, therapy and lifestyle choices, I don’t experience as many of the typical highs and lows as I used to.  However, I still get a little manic (literally!) about things sometimes.  I often have to tell myself to slow down when I start getting super into organizing the closets or some other activity.  Sometimes it will dawn on me after I’ve done 17 tasks that perhaps it’s time to stop and rest.

Because of the “bi” in “bipolar”, depression is also very much a part of living with bipolar disorder.  Bipolar Disorder Type 2 people never get fully manic (thankfully), but we do tend to spend more time on the depressive end of the spectrum.  I’ve learned that all I can really do during these episodes is to keep chugging along and avoid self sabotage.  Thankfully, it always passes.

Bipolar disorder is so much more complicated than the two extremes, though.  For me, having bipolar disorder means that I get easily overwhelmed.  The bipolar brain is a more sensitive brain and actually looks different on brain scans than normal brains.  (Footnote 1.)  Bipolar brains “light up” in ways that normal brains do not.

A bipolar brain also feels things very intensely.  When my daughter yells from the bathroom, “My pee is lellow!”, my whole body smiles.  When I snuggle my puppy, I am immersed in her soft fur and her sweet puppyness.  When I hug my husband, I smell his skin and fully feel his presence as my companion and best friend.  When my son feels full of despair after getting in trouble, I also experience his despair.  When I step outside after the rain, I inhale the fresh air and marvel at the unbearable beauty of God’s creation.  When the kids are fighting and screaming, my whole body is filed with anxiety.  Medication helps “turn down the volume”, so to speak, but it isn’t a cure. Being bipolar can be many things, and it is often overwhelming.  I take a lot of naps.

When I keep my life manageable and take care of myself, though, my moods remain fairly stable and I feel pretty good.  The minute I overschedule myself, though, it’s like somebody starts turning up the volume in my brain.  Sounds are louder, smells are stronger, and colors get brighter.   I feel like Arnold Schwarzenegger in Kindergarten Cop and want to cover my ears shouting, “SHUT UP!  SHUT UP!  SHUT UP!”  My mind hops on the hamster wheel of useless thoughts and it becomes harder to let things go.  I became more reactionary and less patient with everyone.  I lose perspective and feel anxious about everything.  In essence, I start to feel a little crazy.

There is a definite bright side to learning to live with this disorder, though.  I am very clear about my priorities.  My health always comes first (or at least it should), because without my health, I’m useless.  After that, I make time for my husband, my children, a few VERY good friends, a couple things that bring me joy (like my puppy, this blog, church, nature, etc.), all the necessary tasks of daily life, and that’s about it.  I say no and sometimes people are disappointed, but I can’t afford for the wheels to come off my mental bus.  Having bipolar disorder forces me to make intentional choices about how to spend my time and energy.

Learning to embrace my disorder, further, has been a very empowering experience.  Once I started attending a mental health support group and met other people like me, I started to realize that it’s okay to be me.  Being okay with what I am helps me be okay with what I’m not.  After all, I believe that God made me, and God doesn’t make mistakes.

——

Footnote 1:  http://www.webmd.com/bipolar-disorder/news/20041130/new-brain-scan-may-diagnose-bipolar-disorder#1

Recovery

After the shock of being diagnosed with Bipolar Disorder Type 2 and the mental gymnastics of accepting it, I actually felt overwhelmed with relief. Imagine living with symptoms that no one can see, but that you feel acutely.  You observe the behavior of others and know you are different, but you don’t know why.  You doubt yourself and the reality of your experiences and assume you must just be weak or flawed.  However, you never get any answers about why you do the things you do or feel the things you do.

Suddenly, a doctor tells you that what you have has a name.   Medical textbooks specifically describe symptoms you assumed to be unique to yourself.  You meet other people with stories eerily similar to yours and say, “Me too!”.  Best of all, there is medication to help you feel better!  There are tools and skills to help you cope with your symptoms.  This, my friend, is the world of recovery.

The past two years of my life have been all about recovery.  Recovery isn’t like surgery- you don’t go in for the procedure and come out fixed.  Recovery is a process of trial and error- an ebb and flow of good days and harder days, learning periods and coasting periods, testing out of new skills and unlearning of bad habits.  Recovery is life.

My recovery includes some very basic elements, which my therapist calls the “legs of my chair”.  If I take away one of the legs, the chair falls down.  When the legs of my chair are strong, I live a full, productive and joyful life.

One of the legs of my chair is medication.  Bipolar disorder is like a big spectrum, with suicidal depression on one end, mania on the other and lots of variations in between.  Because I have bipolar disorder Type 2 and not Type 1, I never end up in full-blown mania.  Thankfully, I’ve also never had suicidal depression.  However, my natural range of moods is too wide to be healthy or to allow full functionality.  Medication narrows my range of emotions and helps keep my moods stable.  I have good days and more difficult days, but I can usually still function during the depressive days.  When I can’t, I do my best to slog through, ask for help, and not make it worse with self sabotaging behavior like oversleeping, overeating and thinking bad things about myself.

Another pillar of my recovery is sleep.  I go to bed every single night at 10 pm and hopefully sleep until 6 am.  I rarely attend evening events, as they usually make it harder to fall asleep on time.  My sleep is sometimes interrupted by children, but I do my best to protect it.  I also lay down every single afternoon for an hour or so to rest and mentally “re-set” my day.  I make an effort to relax, to focus on my breathing and to clear my mind. I always get up better prepared to tackle the rest of the day.

In addition to sleep and medication, keeping my life manageable is by far the biggest aspect of my recovery.  This is why I don’t currently work as a lawyer.  As the primary caregiver of our children, homemaker and family logistics coordinator, I have plenty to keep me busy.  I think long and hard about taking on new responsibilities, and usually discuss them with my therapist.  I say no to a lot of invitations I would prefer to accept.  Some chores don’t get done.  Some hobbies languish.   I only make time for the things I really need or want to do and sometimes I don’t even get to those.  This is the price of wellness.

Seeing my therapist twice a month is another huge part of my recovery.  She is my sounding board, one of the people who holds me accountable, my medical expert and my recovery skills coach.  I attend a mental health support group, which has been hugely significant in helping to see my condition as separate from myself.  I journal and makes notes about my moods just about every day, which helps me stay mindful.  I go to church and make an effort to get outside, where I most strongly feel God’s presence.  I nurture the relationships that provide joy and companionship, like my relationship with my husband and a few very good friends.

Learning to control my relationship with food also helps keep my moods stable and positive.  I attend Weight Watchers every single week, which helps me stay motivated and inspired to make good food choices and to take care of my body. I try to avoid high-sugar food, which can trigger a food binge and consequently, a depressive episode.  Making good food choices and taking care of my body play as big of a role in my recovery as taking medication.  It took a long time to figure this out and I still am.

Recovery isn’t about being “cured”.  Recovery is about living the healthiest, most joyful, and most productive version of my life.  Sometimes I get frustrated at all the things I can’t do because of my condition.  However, I’ve also gained wisdom, friendships and strength through learning to deal with it.  Every day is a journey in recovery.  I am proud of how far I’ve come and am excited to see what the future holds.

Accepting a mental health diagnosis

Back in my public defender days, I worked for a time in various psychiatric units representing people being involuntarily committed for treatment.  As I listened to clients describe their delusions, I often thought, “How can you not realize that this is CRAZY?!”  The government implanted tiny listening devices in your ears to spy on you?  REALLY?!  The entire experience left me with one overriding impression: this shit was real.  Sit alone in a room with someone talking to their imaginary friend and you’ll believe in mental illness, too.

Despite the obviousness of their symptoms to everyone else, denial was common.  This is understandable.  After all, what reality do we know other than the one we experience?  How would you feel if you were Neo and Morpheus tried to tell you about The Matrix?  This is probably what it feels like to be told that your delusions aren’t real.

I quickly learned that the most common problem with bipolar disorder is NOT that there aren’t effective treatments, because there are.  The most common problem is that people refuse to believe they are bipolar and refuse treatment.  After all, why take medication if there’s nothing wrong with you?

In my opinion, bipolar disorder uniquely lends itself to denial.  Here’s the thing about bipolar disorder:  you’re normal, and then you’re not.  A bipolar person can go long stretches of time with a normal mood, and alternative explanations can always be found for the not-normal moods.  Typically, it takes six years for a person to be correctly diagnosed with bipolar disorder.  (Footnote 1.)

Despite my education and experience, I still struggled to wrap my brain around my diagnosis of Bipolar 2.  People are complicated, which makes mental illness complicated.  While it was so easy to see my clients’ mental illnesses, seeing it in myself blew my mind.  I was probably hypomanic in college, but college is a crazy time for a lot of people.  I became severely depressed after the birth of my first child, but many new moms gets depressed.  When I became very hypomanic, my basement had just flooded with sewage and I had two little kids.  Who wouldn’t be stressed out?

The line between mental illness and personality, character, choices, life events, etc. can be very fuzzy, but there is still a line. I’m a social person and I love people and parties.  This is my personality.  Sometimes hypomania can make people very social.  Hypomania isn’t a personality type, though, hypomania is a medical condition.  Can you see how it gets confusing to distinguish between the two?  It helps that I’ve met many types of people with bipolar disorder.  We are all different, but our symptoms are the same.  This helps me see my condition as a condition, not as my personality or my character.

Ultimately, acceptance is a choice and I choose to accept my diagnosis of Bipolar 2.  I go lawyer on myself about it.  I say, “Two separate psychiatrists diagnosed me with this condition.  My dad was bipolar, and there is a strong genetic component involved.  I’ve experienced both depression and hypomania, which is all that is required for a diagnosis.  The evidence that I have bipolar disorder is compelling.  Therefore, I choose to accept this diagnosis.”  Once a lawyer, always a lawyer.

While acceptance is very humbling and forces a re-orienting of one’s reality, it’s also very liberating.  Finally, I don’t feel alone in trying to untangle the knots in my brain.  Finally, I have a name for why I always felt so different.  Finally, I am getting the proper treatment.  Finally, I am taking proper care of myself.  As a result, I feel so much better now!   I’m more at peace and content than I’ve been in years.

I didn’t choose to have bipolar disorder, but I do choose to accept the diagnosis, and doing so is turning out to be one of the most empowering, enlightening experiences of my life.  There’s something very liberating about facing your worst possible fear and living through it.  We don’t choose our struggles, but we do choose how to respond, and who knows-  you may even come out stronger on the other side.

Footnote 1.  https://psychcentral.com/news/2016/07/26/nearly-6-year-delay-found-between-onset-diagnosis-of-bipolar-disorder/107687.html

Diagnosis

In December of 2014, I sat in my psychiatrist’s office as she asked me questions like, “Does it feel like your thoughts are racing?”, “Do you have a hard time focusing?” and “Are you sleeping?”   Were my thoughts racing?  OF COURSE THEY WERE!  Doesn’t everybody’s?  Did I have a hard time focusing on one task at a time?  Obviously!  I am a very busy person!  Was I sleeping?  I slept until 4 am every day, when I spontaneously woke up and starting thinking about my to-do list.  In addition, my senses were heightened.  Colors were brighter, sounds were louder and smells were stronger.  It felt like my brain was on fire.

My doctor’s next words were, “This concerns me.  I think we might be dealing with bipolar disorder”.  I burst into tears.  (Side note:  It’s never good news when your psychiatrist says, “This concerns me.”)  She clarified that she thought I had Bipolar Disorder Type Two, a diagnosis later confirmed by my current psychiatrist.    Bipolar Disorder Two is characterized by periods of depressed mood alternating with periods of hypomania (less than full mania), often with long periods of normal mood in between.  (Footnote 1.)

I’ve always experienced periods of intense productivity and energy, when I feel connected to the universe, can work tirelessly, am excited about life and feel full of hope, creativity and plans for the future.  I’ve also experienced periods of real depression, instability and extreme agitation.

My life story was unusual, though, so it seemed natural that my moods would be extreme.  I was born into an established, upper middle class family in Tulsa, Oklahoma.  We enjoyed a beautiful home, a country club membership, nice cars, trips to Vail and the Bahamas and an extended network of family all within a few miles.  We were happy.  Through bad luck, a downturn in the economy, and most likely an undiagnosed mood disorder on my dad’s part, though, my dad lost his business and we lost everything.  When I was eight, we sold our possessions and moved to California with nothing: no money, no family and no connections.

The next several years were a struggle and weren’t happy ones for my family.  My mom kept a roof over our heads with her teaching job, and my sister and I worked hard to get scholarships to college.  I loved school and was highly motivated to succeed.  Some caring adults took my under their wing, and I got lucky.  I got into Stanford and received enough financial aid to attend.

As a result of these circumstances, I viewed my life in terms of survival.  I was born into wealth, a large extended family, and a happy life.  Then we lost everything and it all fell apart.  My family fell apart.  Through hard work and determination, though, I had fought my way back to the top.  My life had been bipolar.  Who wouldn’t have had some extreme moods in these circumstances?  I had fucking made it.    

By the time I sat in my psychiatrist’s office at age 35, though, I suspected that I was different, and not just in terms of life circumstances.  My life was very stable by that point, but my moods were not.  I was happily married, we were financially stable, I had great family and friends, and my life was generally pretty great.  Despite this stability of circumstances, though, I still had “on” days and “off” days.  During the “on” days I could care for my kids, eat healthy food, exercise, do errands, engage with others socially, get all sorts of things done, and felt excited about life.  On the “off” days, though, I felt no joy about anything and just wanted to sleep.  I wasn’t able to care for my kids without hiring help, and this caused me endless shame.  I couldn’t reconcile my “on” self with my “off” self.  How was it that I had run a fucking marathon, but couldn’t function?

It was obvious to my psychiatrist on that fateful day in 2014 that I was in the middle of a full-blown hypomanic episode, triggered by being on an antidepressant.  This is a very common fact pattern:  person with latent bipolar disorder gets depressed, seeks help, is incorrectly diagnosed with simple depression, is put on an antidepressant, gets hypomanic (or manic) as a result of the antidepressant, and is correctly diagnosed with bipolar disorder.  (Footnote 2.)

I knew my brain felt out of control, and started to wrap my mind around the idea that it had a label.  For the first time, I considered the possibility that my extreme moods weren’t normal.  My doctor immediately started weaning me off the antidepressant, and started the process of putting me on the correct medication.  Recovery began and it was official.  I was bipolar.

Footnote 1.  www.webmd.com/bipolar-disorder/guide/bipolar-2-disorder#1

Footnote 2.  www.psychiatrictimes.com/bipolar-disorder/switching-mood-depression-mania-antidepressants