Category Archives: Coping Skills

Texas Healing potential

Well, it has been way too long, dear reader, since I have checked in. A week after finishing the outpatient program, I flew from Chicago to Dallas to spend a couple months with my family. The purpose is establishing healthy routines I’ve fallen out of. The very routines that could anchor me and my moods in an environment that will help stabilize the swings. Plus I’ll be in a supportive, social environment to help make the process a success.

That stabilization is the theory anyway. ­čśÇ My therapists and psychiatrists are on board. And so I’m giving this a try. 

We are focusing on getting up and going to bed at the same time (something I’m already ok at), showering regularly (which I’m not good at), eating regular meals with more healthy snacks. I’m also focusing on regular exercise by walking after breakfast and water jogging three times a week, with some treadmill thrown in. I’m going to church on Sundays, an important part of my spiritual practices.

I also brought all my art supplies and books and paper, and there are puzzles here, to do some art therapy and some mental exercising. It’s been two weeks and I’ve already finished my first 500-piece puzzle ever!.

Sadly, with all we are doing, I’m still heading into a depressive episode now and I’ve been feeling alone, fearful and suicidal (with plans) too. I can’t win. And I’ve gained weight even with all the focus on losing weight. Gah! Not helping.

I talk to my therapist once a week. Today we talked about my resistance to defusing from my thoughts (ACT skill), and how I can use my support system better, when I’m out of my home and close to them. 

I just don’t want to feel alone and fearful anymore. Here or at home. 

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Stabilizing

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I am doing an all-morning outpatient program Monday through Friday. Group therapy, ┬áskills, expressive therapy – all working to put me back together again. Following the program, I’ll be going to Texas for a couple months to be with family for reestablishing healthy ADLs (Activities of Daily Living – hygiene, cooking, exercise, cleaning, etc.) that I can then use and not neglect when I return to my little apartment. One of my friends will board my cat for me while I’m gone – very generous!

An important revelation occurred to me in the last couple days. I’ve felt shame, ashamed of myself, since I was a very young child. Guilt is something you feel when you make a mistake. You can make restitution, ask for forgiveness, and change. Shame says “I am a mistake,” leaving very little room for fixing anything. I think this shame I’ve felt for so long may be fueling my suicidal ideation. If I’m not worth anything, then might as well take me out. It’s a wonder I only came across suicidal ideation after the fall of a high mania when I landed in the hospital with suicidal depression. The visions of me killing myself have plagued me since – almost 7 years now. And yes, I still feel shame. Not sure that will ever go away.

Down the Same Road Again

Here I am again. Anxious and suicidal. I have been feeling this way for several days now. Twice now I’ve stayed overnight at a friend’s house because I didn’t feel safe alone. I’m scared I’ll end up in the hospital, but at least I feel safe there. There are no temptations to end it all.

I think this was brought on by a med change. I’m so frustrated by that because my doctor and I made them, and made them slowly so that I wouldn’t have that hangover feeling until mid-afternoon when I finally had energy to start the day. I often fall asleep in the morning a couple hours after I get up too. I hate feeling like a slug.

I think lowering one drug in particular brought on increased depression and anxiety, as well as increased suicidal thoughts with plans (which I always have, even when I’m not actively thinking about suicide, I have the thoughts WITH plans).

That drug has been increased for several days now, but I’m still feeling horrible. Anxiety is cycling with suicidal plans. Impulsivity is growing. I don’t have the means to carry out my primary plan at home so most of the time I feel “safe” – I’m less likely to┬ádo anything. Doesn’t mean the thoughts aren’t there or the plans or the impulsivity. Sadly, my main plan is one I can carry out at my friend’s house where I stay when I feel unsafe. I’m not alone until after I fall asleep, I sleep pretty hard and I wake up groggily when people come downstairs. So I’m mostly safe.

I’m so tired of the lost time I get in the hospital all these days and weeks I’ve spent in my 30+ times. I grieve for the time even though there is nothing else I can do to stay alive. I grieve for the burden I become on friends to take care of my cat or bring me clothes. I’m ashamed of my self for not trusting myself to keep myself safe or using skills strongly enough. I’m very hard on myself. I feel a hospitalization coming. I’ve been on the increased medication for several days now and I’m still just as bad. I don’t know if I can wait a full week to give it a shot, or for another week after that when we increase the first medication, which is likely.

I don’t know what to do. I feel horrible.

Spring Dating

I’ve been doing a fair amount of dating the last couple months. Most breakups were weird, whether it was I who did the breaking up or he. I feel like a teenager or college student with some of the drama or figuring out what to do. I’ve been doing online dating which makes the intensity of relationships hard to figure out. ┬áDo I stop talking to others once I’ve hit it off with someone when we meet in person? That’s my M.O. I only want to date one person at a time so I tell others I’m interested in online that a casual relationship has turned more serious and I don’t want to lead them on. A response that makes it weird when it hasn’t worked out and I go back to getting to know people, and I want to restart relationships. Normal guys understand. Drama-laden guys freak out. The whole dating thing has so much drama. Sigh. But I’m glad that I feel stable enough to offer myself in relationships.

I’m dating someone now that probably has some more staying power than others. We are really compatible, like each other and taking the relationship slowly. An interesting bipolar moment… I usually wait a few dates before explaining that my brain disorder is bipolar disorder and how it affects me. With this man, I needed to tell him on the first date (!!) since he had been married to someone who was bipolar and didn’t take her meds. I wanted to be clear that I’m a good patient, take my meds, have a good support system. Turns out it wasn’t a big deal for him, no matter how nervous I was about putting it out in the open so early. I’m stable right now, which is easier to deal with I’m sure. It’s the summer manias and fall depressions that we’ll have to deal with together. I hope I weather them ok – for my sake more than for his. But it would be good to see how he responds if I do get unstable or hospitalized. Important to know for longevity of the relationship. I need someone who can be caring and supportive and not freak out, withdraw or get really anxious. We’ll see!

Mood and Life Choices Intersecting

asMid January through early February I spent in the hospital. Yes. Again. My psychiatrist was adamant we need to find another way than bouncing in and out of the hospital. I agree! The changes we agreed upon were staying with friends if I didn’t feel safe. That would allow me to ride the wave of emotions longer without using the hospital before I need it. And it would provide a chance for me to trust myself to keep myself safe. These things seem basic and “Why didn’t you try them before?” We have, but not with the same rigorous energy to keep me out of the hospital. The bouncing this time was ridiculous.

In other news, I’m still in physical therapy after shoulder surgery in early December. It still hurts, and the exercises seem to make it hurt even more. This pain has kept me from getting back into the pool for water aerobics. I’m too concerned about damaging the progress we’ve made. I could go to the gym and focus on the lower body. I’d be moving and re-establishing the habit of going to the gym. The water aerobics classes that are best for me are in the evening. But going to the gym in the afternoon and evening uses up any available energy. I’m a better morning exerciser.

A real factor in the exercise department is that I’m depressed and low energy from the depression. Any extra energy anywhere is like pulling teeth. So even though there is concern about hurting my shoulder in the pool exercises, the going-to-the-gym option seems less of an option because I am depressed. I already feel bad about myself. Now I can have guilt for not exercising added to that. Another real factor is that my drugs keep me hungover for most of the day too. And yet another┬áreal factor is that I made the decision I’d rather be healthy than skinny. That doesn’t help motivation to get back to the gym. I do still want to work out, but I’m less concerned with weight loss. Might be a mistake, but my mood affects the decisions too. I’m still trying to manage the mood. How am I supposed to manage pain and weight loss too, when my energy is zapped and I feel horrible about myself anyway?

One foot in front of the other in a boring life right now.

Trying to Travel

For people with bipolar disorder especially, travel can be very destabilizing. Time changes, schedule and routine changes, new activities and people – all work to change one’s life enough that a mood change might commence. 

I’m visiting my family several states away, but in the same time zone. I haven’t seen them in over five years. We are celebrating Thanksgiving together since we haven’t done that in 25 years. The visit sounds great, right? My schedules and routines and stamina are different. Being with family is being around some kind of strangers since I hardly ever see them. We have different views on politics and religion so we don’t talk about them – my idea. We’ve done some kind of activity every day. So I’ve needed to have stamina for all the driving (they live in the boonies) and the activity itself. 

I discharged from the hospital the Saturday before I traveled on Tuesday. My mood really was stable. Starting yesterday I’m feeling a dip in mood toward depression with suicidal thoughts and plans. I would say I’ve been managing anxiety well – one day, one hour at a time. But anxiety, I think, is triggering this potential mood change, as often happens for me. Some environmental factor triggers anxiety which leads to suicidal thoughts, and I feel depressed that I’m feeling suicidal. 

My therapist thinks I get suicidal when I don’t feel perfect, my too high expectations aren’t met. Maybe in this case, I wanted to feel relaxed around my family. And when that didn’t happen – which should have been obvious from the beginning – I become anxious, then suicidal, then depressed. 

And that’s where I am now. I can probably make it til I get back home. I just don’t want to spiral as I do into needing the safety of a hospital. 

What Stable Might Look Like

I’ve been out of the hospital for a month now. That is a milestone for this past year. Last time I was out for a significant period of time was last spring and summer for 6 months. I wasn’t happy, but I was out of the hospital. Not suicidal at all.

It was a mostly good time. I was doing important volunteer work, but it wasn’t feeding me. What was missing was something that seemed meaningful to me and used my skills that I still had from being a pastor. I wanted to speak and teach, two of my greatest strengths and what I imagined I would do in the future. Instead I was volunteering where I was mostly alone.

This time around I am putting together a presentation that I will share with churches. “Hear the story of the Rev. Deborah xxxx and her life with mental illness and how congregations can be involved in mental illness help in and outside their doors.” I’m offering it for free – there is no barrier for small churches with little or no budgets for adult education. I think this will help with reducing my own stigma about myself, as well as stigma in society. Congregations can be powerful actions for change. I can start somewhere.

I feel like I’m doing meaningful work and using the skills I love the best. I hope this keeps me out of the hospital for a very long time.