Post-Mortem on Fall Hospitalizations

I’ve spent 4 of the last 6 weeks in the hospital. Makes it hard to keep up a blog! But I wrote for the Suddenly Bipolar book project while in the hospital. I also had to deal with a toxic patient. I’ve been with a lot of difficult patients. but this one was the worse. For several days my doctor and I couldn’t figure out how much of my anxiety was illness and how much was environment. I’m not entirely happy with the way the staff handled it, but the situation is water under the bridge now.

I think we have my meds stable to keep hypomania and mania under control, the mood states I’m likely to be in from now until Christmas. I had extra depression thrown in as reactions to drugs pushing my mood down too far. And suicidality resulted, which ended up in increased anxiety. And once the anxiety-suicidality link has been established, we have to focus on lowering anxiety to get rid of suicidality. The two are deeply connected. In my daily life, suicidality goes up when I get too anxious about anything. It’s hard to live with <said deadpan with as much sarcasm and snark as possible>.

Another hard thing I live with… Mood Changes. In the last 3 months, I’ve had 6 mood changes. I’ve learned how bad my moods are in the mid- to late-summer. And then had med reactions to prolong the process of getting stable into the fall. I also learned that the full moon and new moon also effect my energy. I’m more likely to be anxious or relaxed, but still have more energy at those times. So, I have issues with the moon and the position of the earth as it goes around the sun. Gre-e-e-a-a-a-t.

I guess the good news is we learned a lot about my illness. And I survived more hospitalizations. And my cats got mad at me for being gone. And my friends took care of me (and my cats!) during the whole thing.

I really hope I can have a couple months of stability before the next mood change in my usual pattern (depression sometime after Christmas). I feel like there’s a slight chance we can adjust meds in time to avoid hospitalization. But I’m so concerned about anxiety being a break-through manic symptom for me that it will be hard the whole time too.

Will this ever be easier?

Possible Beginning to My Book Suddenly Bipolar

bookDuring this 2 week hospitalization I did some writing that would make being in the hospital sound fresh instead of only based on memories. Enjoy!

 

The nurse feeds me my evening cup of “Skittles,” brightly-colored psychiatric medications, while down the hall waft sounds of a small group of patients singing Leonard Cohen’s “Hallelujah.” It will be Lights Out in 12 minutes. I will lie in my six-inch foam mattress bed with thoughts of ending myself racing through my slowly-sedating brain. The eerie light of the hallway won’t allow the darkness to envelope me in sleep. Nor will the shadows be chased away enough to feel safe.

“Deborah, I have meds for you!” It’s the next memory I have. The nurse calls cheerfully as she wheels the cart next to my bed for my morning “Skittles,” more brightly-colored psychiatric medications. Dutifully I swallow and offer a prayer to the bipolar gods that I’ll feel sane and confident this day. And discharge from the hospital may be only a day away instead of weeks. Slowly it dawns on me that my first waking thoughts were of offing myself instead of the usual joy I would feel that it is my birthday. My prayer now feels like a distant hope I’ll never realize.

That was the first night of my umpteenth or twenty-somethingth psychiatric hospitalization in the four years since I was diagnosed with Type I Bipolar Disorder, Generalized Anxiety Disorder and a bonus of Obsessive-Compulsive Disorder because my suicidal thoughts take on obsessive tendencies. And I’m Bipolar Type I because I’ve had at least one psychotic break – two that I remember from years – eons it feels – before diagnosis, but happenings just the same, perfect emblems that Bipolar has followed me my entire adult life, and not only the last four years since diagnosis.

This is the story of being Suddenly Bipolar and of the slow coming to terms with what Bipolar and Anxiety now mean for my future and how they made sense of my past.

Come with me and explore a sudden diagnosis and its slower cousin, Acceptance. Join me on a journey toward an ever-cycling life of moods, schedules, routines, and the intense beauty of a support system that held faith for me.

Set Free – Chained to Cycles

I’m so tired of being right.
It’s a full moon. No wonder I’m feeling good. I went in the hospital at the new moon.

Equinoxes and solstices affect my mood states. And so do lunar phases for energy (tho I no longer cycle as women do).
An Equinox with a new moon? I was doomed. Of course it took until the full moon to feel good enough to be released.

Hospital for Birthday – Again

Psychiatrist sending me to hospital.
It wasn’t just me thinking coping skills are not enough right now.

Birthday Ending

It’s not that I’m unsafe. It’s that I’m fearful All The Time that I’ll lose control and follow through with the horrendous things I think and feel.

I want to attempt and complete suicide. I see no hope for a better future. And I think and feel this in the midst of volunteering a considerable amount of time and energy in 4 places in 7 days. A good way to spend my birthday week, I suppose. Making the world a better place.

But I don’t see a world with me in it. At all. Any day now I’m going to die of something, perhaps by my own hand. I’ve had that feeling for years and years.

It doesn’t matter to me that we’ve figured out more about my illness in the last six months than the 3.5 yrs previous. That should give hope that we’ll find a way to live through the changes in mood and thoughts.

It doesn’t matter that I’ve lost 32 lbs. since April – surely a sign of life, right, that I’m taking care of myself? I don’t know why I’m doing it. I guess just that it’s something that has a goal, superficial as it is. Something to work toward. But it doesn’t make my life better.

Reading and taking MOOCs and playing handbells – or working when I was – are not improving things I value(d) in myself – focus, concentration, retention, energy. All that allowed me to be smart and quick on my feet. I liked that feeling and that characteristic about myself, and it’s gone. Poof! Deb is gone.

That’s what I want – Poof! blissful nothingness. The end.

*Yes, I’m with people and have others to call. I don’t want to though. I want to cave in.

Birthday Moods

For two weeks I used skill after skill to stay safe. I exhausted myself. And when I showed up as scheduled at my therapist’s office, she told me it was time. Time just for a respite at least so that I could go back to using skills. I needed a break where I knew I was safe so that I could rest.

I was inpatient for 5 days, a relatively short stay, and I’ve been out for 6. And some of these days I’m “wasting time” again using skill after skill to manage anxiety and suicidality to make it through the day. If it’s only anxiety, I have several skills in my back pocket from Acceptance and Commitment Therapy (ACT). It’s the way I live my life now and I feel so much better knowing I can handle anxiety.

Then there is the anxiety of suicidality, and I get flustered because what I am normally doing to live with anxiety suddenly takes on life and death. And I don’t feel prepared for that. And this is the space I’ve been in for the last couple days, as well as those last few days before this last hospitalization.

As I was hospitalized, I was aware that Anxiety was mixing with the change in mood from Manic to Depressed, and yes, I was Depressed by the time I got into the hospital. Not as low as I have been, but certainly in the Depressed cul-de-sac. My doctor increased my anti-depressant to deal with the depression, but hugely bumped up my mood stabilizer to avoid (hopefully) the Mania that I get at the end of September through most of October.

One of the things I did while in the hospital was to list coping skills that I use when anxious or could beef up when anxious AND going through a mood shift or changed mood. I also listed the skills that would help whether that was in or toward Mania and in or toward Depression. Good work. Up on the frig.

Except, I’m in my old stomping grounds (did you know that expression came from elephants returning to areas they have lived?). Anxiety and suicidality. Suicidality and anxiety. In a depressed state, though not terribly low. I’m stuck not knowing how to handle triggers (like being in church and on the chancel today, 4 years from my first hospitalization). And I’m stuck with coping skills that don’t seem to work when I start obsessing about suicide again. Am I just going to wear myself out using coping skills and end up back in the hospital again?

birthdayJust in time for my birthday on Wednesday. Yay.

Change in Moods

For those who follow me on Facebook or Twitter, you probably already know that I’ve been Manic for the last month. I’ve been running simple and complex decisions through friends’ minds because I didn’t trust myself not to **** up. I don’t like being Manic, partly because I haven’t been Manic in 4 years and did things I regret 4 years ago. And looking through my past I see things I did while I was Manic that were of varying levels of appropriate and good or bad things to do. My decision-making ability and energy levels go wacko when I’m Manic. I don’t like feeling so out-of-control!

Over this past weekend, suicidal thoughts increased suddenly and rapidly. And energy capacity dropped. And I was able to tell the difference between an easy decision (should I have diet coke with lunch?) from a hard decision that requires a lot more time and thought (should I foster kittens for a shelter? [Sadly, no. Not the right time or place.]).

I saw my psychiatrist today and we talked about the mood shift. I wouldn’t say I’m depressed, except that my concentration ability and motivation have tanked, suicidal thoughts are through the roof again, and my energy feels drastically lower. (All things that are characteristic of depression.) I did qualify that my energy might just be normal and I’m comparing it falsely with the unreal, increased energy of Mania.

The reality, she told me, particularly regarding the suicidal thoughts, is that I am doing absolutely everything right and need to ride the wave of my illness. It’s cyclical and there isn’t anything I can do to control the symptoms. I use my finely tuned coping skills (particularly from Acceptance and Commitment Therapy, but also Dialectical Behavior Therapy and Cognitive Behavior Therapy) regularly and often. I know when and how to use them. I know when it’s time to call people, go be around people, or get together with people. I know when to call my therapist or psychiatrist and I know when to go to the hospital. I participate regularly in group and individual therapy. There isn’t a whole lot more I can do. She reminded me that the hospital is there and entering it is not a sign of failure if I need the safety. She reminded me that I’m doing what I need to (exercise, eating and sleeping well, socializing, using my brain) and to just keep putting one foot in front of the other. She also said that I don’t tend to respond to medications to help me through the shifts, but that I wait them out and then go back to those actions listed above that make for a full life and one that is full of coping.

So, this is a mood change. Went through one in July when I suddenly went Manic. Anxiety kicked in hard and sent me to the hospital for safety until meds started bringing me back down. Now I’m cycling downward – as my tendency is for these first few weeks of September. Anxiety was high, but has gone back to normal (my normal).

body surfingI will try to use the physical sensations of body surfing that I remember from my 30 years in CA to help me ride these mood shifts. And as I keep using skills over and over and over again. I’m doing absolutely everything I can. My doctor and therapist reaffirmed that in this last week. Remember to let the wave push you but it doesn’t have to roll you.

I’ve complained on Facebook on a day when suicidal thoughts were so bad that all I was doing was using skill after skill to keep from hurting myself and to keep myself out of the hospital. On days like that (like today) it feels like a waste of time I could be doing other life-giving activities that move me toward my values (an ACT-ism that I find helpful). Body surfing feels like another pointless way to waste time that I could be doing something productive and life-giving to me, instead of using skills and surfing the mood shifts just to stay alive.

Bipolar Sucks.

In case you haven’t heard me say that in a while.