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Saturday, December 16, 2017

"Issues"

The following is a friend's post on facebook. Please take the time to read. It will help you understand what someone with bipolar disorder has to deal with... (The images, other than the last one of her meds, are mine to make this post easier to read)
Bipolar Disorder

Lately I've been seeing a lot of posts about mental health and the fight to erase the stigma surrounding it. Since I have first hand knowledge of mental illness, I thought that it might be a good time to share a little bit. Please know that this is not a "poor me" post, but rather trying to shed a little bit of light on what it means to have a bipolar disorder.

Let me start by saying that sharing this in a public forum is a little scary. No matter how much lip service people serve up about erasing stigma, stigma is still there and the consequences are potentially alarming. Especially when you're job hunting. When an employer has a stack of potential employees, they might not be able to see past the diagnosis.

It's pretty common knowledge that I have a bipolar disorder. I was diagnosed in my early 20's, but had already started journaling about the desire to commit suicide at age 8. Yes, you read that right. I wanted to kill myself at 8 years old. Mental illness can hit you before your first pimple or the need to wear deodorant. Mental illness can be very cruel and steal a childhood, teen years, an adult life. There have been a lot of ups and downs over the years, but I have essentially been in remission for 13 years. Yes, there have been symptom hiccups, but nothing significant. Unfortunately I am currently struggling through a full blown relapse. There were signs and symptoms over the past two years, but I mistakenly turned a blind eye to them and tried to push through it. Oops.

There are many challenges when you have a bipolar disorder. Symptoms can be a challenge. My gosh is that an understatement! The diagnosis is awful. The treatments are awful. To be blunt, bipolar disorder is hell. Imagine walking down the street, and you see a building. The building houses something called hell on earth. Most people are able to go about their business not even knowing that the building is there. People with mental illnesses know that it's there. Some peek in the windows briefly, and then are able to walk away. Being bipolar is like having your head shoved thru the window of hell. The heat of the fire singes your skin as the darkness tries to engulf you. You know what's happening and are trying to pull your head out, but hands are reaching out and grasping at your throat trying to pull you all the way in. It's a struggle that never ends. Some days you're winning the tug of war and are able to interact with things going on outside the building. Other days the darkness is winning, and your toes are desperately trying to cling to the windowsill.

So what is bipolar? Bipolar is a brain disorder that is characterized by changes in mood, energy levels, activity levels and the ability to accomplish day to day tasks. Bipolar type 1 is where there can be manic states or a psychotic break, in addition to the shifting moods. Type 2 has all of the shifting moods, but has at least one long period of depression. Type 2 have never had a true manic episode or psychotic break, but do experience a milder form called hypomania. Thankfully I am a high functioning Type 2. It's a battle, but I am able to maintain relationships, and be a contributing member of society. With treatment I can work, volunteer, and go about daily life without people knowing about it. It's also important to know that bipolar is often co-occurring with other mental disorders. Basically it's a big stir fry of other mental health disorders that can include anxiety, OCD, panic attacks, social phobias, ADHD, addiction issues, and other health problems like heart disease, thyroid issues, migraines, obesity. All of these things can lead to substance abuse, financial or legal issues, relationship problems, and poor work performance. Bipolar can truly be a devastating disorder.
Bipolar Disorder
So what happens when you have bipolar? Everyone is a little different. In a relapse I swing between deep depression and hypomania. Depression is deep sadness, emptiness, hopelessness and tears. Then there is the apathy. I love my volunteer work. It's something that I'm passionate about. My SAR gear is always in the front closet, ready for an activation. I have been dreaming about Project Lifesaver for 2 years, and the team is making it happen. My volunteer work at Victim Services brings purpose and balance to my life. I hold all of these near and dear to my heart, yet the depression and apathy are paralyzing. I shudder at the thought of leaving the house and having social interactions. Texts and emails send me into fight or flight panic. Decreased ability to focus and concentrate make ordinary tasks virtually impossible. I'm either unable to get off the couch or to restless to sit. The fatigue is inexplicable. You know what needs to be done, and yet there's no way to get it done. You know that you are letting people down, and the guilt gets worse. All you can think about is how they think that you're incapable and unreliable. The feelings of worthlessness cut to the core and your mind gets stuck in a relentless circle where you are haunted by every little thing that you've ever done wrong. The guilt can be unbearable. Trying to eat can feel impossible. Either you have no appetite, or are ravenously hungry and self medicate with carbs. Then without warning you switch into hypomania. You're mood is elevated and you're restless to do things. This is when the house gets clean, half the closet is steam pressed, Halloween displays appear in the yard, and Christmas planning starts. Then click, you can't think and it takes you 45 minutes to prepare a cake mix, and then have to clean up the eggs that were dropped on the floor. Did I mention the hopelessness?

One of the most serious symptom of bipolar is suicide. If someone takes their own life, cause of death is bipolar disorder, not suicide. It's important to recognize that suicide isn't actually about killing yourself. It's the point where the darkness has engulfed you and it won't let go. It's when you can't stop thinking about how long and hard you've been fighting against the darkness, and you just can't fight it anymore. You can't bear the pain anymore. There is nothing but unending darkness. It's not that you want to die, it's just that you can't bear living anymore and there is no way to numb the pain. You just want to let go and give in to the darkness.

One thing that I do know is how fortunate I am to already in the mental health care system and have access to medical support. After my accident two years ago, my family doctor was worried about how meds prescribed by the neurologist would affect my bipolar, and referred me to a psychiatrist. Then I spent a year on the waiting list. Yes, you read that right. A diagnosed bipolar patient with a possible prescription conflict spent one year on a waiting list. When I finally did see the doctor, he quickly saw the red flags that I'd been turning a blind eye to. Instead of just doing a quick review and sending me back to my family doctor, he scheduled me for regular check in appointments and med adjustments. This meant that I had almost immediate treatment when things got bad. It's hard to know if it's a good thing or a scary thing when your psychiatrist calls you at home to see how things are going. Is it good or bad to be assured that if I'm willing, one phone call should get me admitted to the hospital? I'm also fortunate that my wife's work benefits completely cover all of my $500/month medications. My wife also has a good job, so I don't have to worry about affording groceries or losing our home. I also have an amazing support system. My wife is supportive and patient with me, even if I have not showered for a week, forgotten to brush my hair, and my pyjamas are ready to walk themselves to the washing machine. If I need to go somewhere, there are friends that will drive me. If I need to talk, a listening ear is only a phone call away. People on my SAR team are graciously helping with my duties while I'm working towards recovery. Really, there couldn't be a safer situation to have a relapse.

Even though I am fortunate to have access to treatment, the treatment sucks. They're expensive and they suck. I thought that being on a triple cocktail was bad, but now with the relapse the meds are getting hard core. I think it's nine now, but I can't remember half the names. That doesn’t include the magnesium supplement that I need due to my meds interfering with absorption. Basically I'm a walking pharmaceutical swamp. Although I use the term "walking" loosely. Adjusting to new meds is just as bad or worse than the bipolar symptoms. It does take away the urge to kill yourself, but the side effects are debilitating. I wake up in the morning and try to assess what kind of day it will be. Will I be depressed or in hypomania? Will I be able to walk a straight line without falling? Will my eyes be able to focus enough to read? How bad will the brain fog be? How bad will the tremors be? If my hands are steady enough to prepare supper, will I remember in three steps to take the cutting board out of the bottom cabinet or will I pull a spoon out of the cutlery drawer and stand there trying to figure why I needed it? Will I vomit in my sleep. Can I digest food today? Can I drive today? If I have the trifecta of being able to walk, talk, and see... is it safe enough to attempt Costco and still get home? Is it safe to get groceries, or will I wind up dropping my splurged Starbucks grande peppermint mocha in aisle 3? Then have it take over an hour to find groceries that I need in the same store where I've shopped at for 6 years. These are the reasons that some people don't take meds. Honestly, taking my meds is the hardest part of my day. I stand staring at the mound of pills on the counter and try not to weep. It takes a full bottle of water to swallow all of the meds. This causes me to have to get up and pee in the middle of the night. It is a challenging task, as the sleeping pill and beta blockers leave me with no depth perception. As a result I have bruises all over my legs. Some of the bruises are still impressive after 6 weeks thanks to med side effects. I'm not even going to go into the damage that the medication is doing to my heart, liver, kidneys, thyroid, esophagus, and teeth. Did I mention the part where I cry?
Bipolar Disorder
We have not even gotten to the horror part yet. Does anyone remember the movie "One flew over the cuckoo's nest"? Did you know that they still administer ECT treatments? The big difference now is that you are anaesthetized before they send the electrical current through your brain, causing a seizure. Apparently it's like hitting the reset button on your brain. This is the treatment when meds aren't effective against suicidal thoughts. Unfortunately it takes away part of your memory along with the suicidal thoughts. Thankfully I'm responding to the meds, and just have to get through initial side effects. I'm assured that all will be well shortly.
Despite all of the above listed chaos, there are some positive aspects to having a bipolar disorder. With proper treatment individuals with a bipolar disorder actually have an advantage over people that don't. Individuals with bipolar can be more determined to reach their goals than individuals without the disorder. They work longer and harder, far beyond when others would give up. Heck if it weren't for that, I don't think anyone with bipolar would survive treatment very long. Bipolar also shows increased creativity, problem solving and spirituality. It personally provides me with a sense of empathy that I don't think I would have without bipolar. I know what it means to struggle with emotional issues and mental health, which in turn allows me insight and patience as to what others may be struggling with. Having a relapse provides some clarity and humility about what's important in life, and also teaches me what to let go of.

Many famous and influential people have accomplished great things even with a bipolar disorder. Carrie Fisher, Jim Carrie and Catherine Zeta-Jones have bipolar disorder. Robin Williams presumably had bipolar as well. Also on the list is Winston Churchill, Theodore Roosevelt, and Buzz Aldren. Looking at this list is a good reminder that there are good things in my future. I just need to focus on getting better, and then I can take on the world.

So the next time you come across someone with mental illness, know that there is a person under the symptoms. Don't automatically dismiss them as just being crazy. That individual may just be struggling with a relapse, but will improve with treatment. It might also be that do not have access to health care or be able to pay for prescriptions. They may not be able to hold down a job, and have no way to pay rent. Their symptoms might be so acute that they don't know how to get help, or even know that they do need help. Try not to judge them until you have walked in their shoes. Remember, an individual with bipolar is always in a fight for their life. Always.
My friend's bipolar med cocktail

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