Category Archives: Health

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.

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.

Eighty Days In

My longest stay occurred from early March to late May. I was mostly confident I could discharge since I was going to a friends’ house to stay and daily spend some hours at home for a couple weeks.

2016-01-18 21.08.16I was overwhelmed with my first time back at home, even with friends there. And then again today when there alone. It’s filthy, with even just one cat living there alone. I guess she really does need staff to look after her. I called a cleaning service but they are booked out till the following week, which is probably the case for most places. So, I’m looking for teens who need spending money. ­čÖé I can’t do this alone. I’ve got to keep asking for help. I spent 80 days institutionalized. Living on the outside takes some time.

Some details about my time inside. My doctor increased my mood stabilizer and lowered my anti-depressant. That led to a depression that led to a suicide attempt. So we spent 6-8 weeks coming back up from depression. Then we tried a different mood stabilizer cocktail. That didn’t seem to help. Then we added an additional anti-depressant to help the one I was already on. That would take 4-6 weeks to kick in, and we figured I’d be out before it kicked in but ECT would speed up the process. So I tried one ECT again and called it quits. It’s just not for me. Never got results from it anyway. And as it turned out, I was in the hospital the 4-6 weeks needed for the second anti-depressant. Meanwhile I’m taking heavy duty prns to handle anxiety and agitation. Finally got a day of stabilization without having to take haldol or thorazine on a huge increase of mood stabilizer. I got sent home with haldol and accompanying drugs just in case.

Whirlwind, right?

All the while I’m in daily group therapy with a very good therapist. And we uncovered the shame and anger and embarrassment of being in the hospital again, of having and living with bipolar and having to ask for help. Lots to talk with my regular therapist about.

For about 9 weeks I felt like this:

Death is not. It is nothing

I am not. I am nothing.

I don’t want to die. I want to die.

Make it end. Make the thoughts of hurting myself end.

Make the emotional pain end – anger sadness.

I am less than human because of them – thoughts, feelings.

I am pain, a hemorrhage of negativity.

No one understands unless they know this darkness.

Black hole, sucked into nothingness from images of gruesome death.

 

Am I romanticizing it, or speaking truthfully from a hurting being?

I am not thinking of others.

Their pan will be deep and unending.

I will not be in pain anymore.

Whose pain is worse?

Do I deserve to be less human because others will have pain?

 

Mostly Stable

balance┬á ┬á ┬á ┬áIt’s been well over two months since hospitalization, but I had such a difficult time around Christmas that I feel like stability started with the first of the year. I feel mostly stable – mood pretty solid and thoughts of suicide everyday (my baseline) with varying intensity. I’ve had a cold which kept me down a few weeks, still recovering from that. At its height I had fewer suicidal thoughts, which my doctor expected. “Your brain isn’t thinking well and shuts down.” Hallelujah for sick brain! Got a few days off from thinking I need to die.

I haven’t been volunteering (or exercising – sick), so my schedule revolves around television and being social. I’m starting to get an itch again to volunteer – the first I’ve felt in several months. I want it to be in mental health though, which has been my dream for a few years. Sharing my story or teaching a class. Office work. I have to be out of the hospital for at least 6 months for one main place that is the obvious place to volunteer as a speaker. I’ve found a few places in the local area worth a phone call. Maybe there is something I haven’t thought of in the depths of google.

Day 3 – DIY Residential Program

Well, I’ve made it to the third day of my strict schedule of workbooks, expressive therapies, meals, gym time and free time. I’ve had a FaceTime meet up with one of my supportive friends, dinner with another, and now lunch with another today. I’m still feeling pinched for time and tired a lot. I think I would feel that at an official residential program, because it takes a few days to acclimate. And that’s what I’m doing in the DIY program. Still acclimating to the schedule. The highly detailed google schedule is a life saver. I just have to look there to see what I’m doing, for how long, and with whom. And I’m logging whether I’ve done it so my supportive network can keep an eye on me. And they are! Thank you!

I’m noticing that I wish there were staff to process stuff with. I miss that daily check-in and extra work with a therapist to work on issues as they come up. I’m journaling, but mostly as notes for what I’m learning and not thoughts on what I’m learning. I do miss the staff portion of a residential program.

The topics I’ve studied so far have been self-worth (from a Cognitive Behavior Therapy workbook on Self-Esteem that I had from my therapist to review), and Thought Delusion (from an Acceptance and Commitment Therapy book, The Happiness Trap, which is the therapy I’m focusing on). The self-worth brought up tons of stuff, naturally, since I feel worthless much of the time which leads to feeling like throwing it all up in the air and exiting stage left.

However, the ACT topic of Thought Defusion, which I know and practice not as much as I should, reminded me that just exchanging negative thoughts with positive ones doesn’t work. And don’t we all know that. Better – stop being fused to them and believing them and following their commands. Instead, notice them as part of the thoughts that the brain churns out regularly and move forward with your life anyway. You can’t stop the thoughts from coming, but you CAN let them be and move on. And when you find yourself believing them, you can defuse from them with various techniques like saying to yourself, “I notice that I’m having the thought that…” or singing the thought to Happy Birthday or Jingle Bells, or saying them in a funny voice or thanking the mind nicely for offering its opinion. It takes the power away from the thoughts. You can use these with images and emotions too.

I had the opportunity to use Thought Delusion a lot yesterday as the old story of letting go of life via suicide reared its ugly head. I was defusing like mad. Eventually the emotion waned, as they do, and the thoughts were left with little power. But the anxiety and desire were hard to get through. You don’t use the skill to get rid of the thoughts, feelings or images, but to move past them by just noticing them and doing something else.

Here’s to the next topic!

Passed the Month Mark

Ijournalt’s been a month since leaving La Paloma Treatment Center, and I’m still doing well. I haven’t written much because – happy to say – there has been little to process in this little journal of mine.

  • I had a couple of weeks of high energy while resetting routines and finding more volunteer locations.
  • I had a week of low energy as reality sank in and I got tax news.
  • I made a trip downtown to see a friend I hadn’t seen in 20 years.
  • I started to write my book Suddenly Bipolar in earnest, based on these blog posts for the last 4 years.
  • I had a week down low – depressed though NOT suicidal – and then back to balanced.

This month has been so different from what my last few years have been like! No need for the hospital to keep me safe. In fact, so few thoughts of suicide that I could very easily remind myself of my commitment “Not an option. Never gonna happen.” I’m surprised at how easy this month has been to monitor and live with my mental health.

And at the same time, each day has been difficult, for instance, re-establishing routines such as exercise and not being able to do as much as I used to (still dealing with the knee injury from La Paloma). Getting up at 6am is harder at home than it was at La Paloma, and I’m still looking for ways to keep from falling asleep on the couch for a few minutes every morning. I’m afraid I’m going to miss an exercise class or an appointment from dozing off.

When reality set in and when the depression from the equinox kicked in, I found all the volunteering I set up to be difficult, hard to bear and not fun. Compare that to today, feeling much better after the equinox and the depression lifting, and enjoying volunteering.

So, the month hasn’t been perfect. Whose life is? But I managed it, reached out to accept help when needed, and made it through. I’m confident I can handle the next month. One day at a time, of course.

 

If you see your way clear to help me pay for the miraculous experience I had at La Paloma, check out my my “Saved My Life” Go Fund Me page at www.gofund.me/nlckak

Residential Treatment Transformations

Much of my suffering has been assuaged by my time in residential treatment. The first step was taking suicide off the table as an action I would take. First, I could only do that on a trial basis, to see what that would feel like. After a day, I felt so much freer and open that I decided to make the decision permanent. No more struggling over whether I would do it or not. No more torture when the suicidal visions show up, as I’m sure they will from time to time (as they did while I was there, at various frequencies). They are just a feature of the illness.

gut instinctThis was not an easy decision, and I needed the whole month to let the choice sink in deeply from my head, through my heart, and into my gut. I still waffled with the decision to the end and even a little bit now that I’m home. But I remind myself of my mantra that recalls the feelings of openness and freedom that I experienced: Not an Option. Never Gonna Happen.

The second step I was able to take while in treatment had to do with the intense grief, pain, and haunting I have felt with churchy things and worship and religion in general. I discovered there was so very much overlap between that grief and the grief I feel for my marriage since separating 17 months ago. I had quite a while when churchy things didn’t bother me, but it had started up again several months ago.

As it turned out, both griefs circled around being in The Caretaker role, one I learned from childhood and identified closely with being a woman. Also, just as important, both griefs mourned the hypomania and mania that characterized most of my young adult life before we found bipolar after the brain crash of 2010. My professional life and personal life only knew that mood state as normal, and I again had associated it with who I am at a deepest level, including that of being a woman.

One of the things I was able to do was to say about churchy things that I will use comparable skills again, in some form, probably in ways I can’t imagine, and therefore churchy things don’t have to be a trigger for grief and pain and haunting anymore. I can attend church for the community and service that I’m looking for and talk about it with authority and without deep sadness (other than the deep sadness for all the churches who just don’t “get it”).

The insight about The Caregiver and the hypomania also calmed the grief about my marriage. The grief is more about me and less about him. And then when I think of him, it doesn’t have to hurt or be a trigger. It’s just a thought followed by a feeling, for myself.

So, mostly, I learned to manage my thoughts better in ways that specifically dealt with my anxiety and depression and grief and suicidal visions. I think it was the time with my individual therapist rather than the intense groups that helped the most. I think the intense groups helped my decisions to settle into my being instead of being superficial changes. I already have a pantheon of the coping skills they taught – skills which I haven’t had to use all the time anymore.

The true test will be as time goes on and these things cycle around. Will my convictions stay solid? Will I still be working on myself and letting the grief go? I certainly hope so, especially considering how much I will be paying for the opportunity to come to these conclusions.