I had a run-in with my therapist yesterday

I had a run-in with my therapist yesterday. I was talking about having a lot on my plate with a daughter going off to college soon, a Mom needing cataract surgery and me not knowing for a week or so about a brain tumor and whether that required follow-up with the neurologist. Thankfully it does not.

Where my therapist and I disagreed was whether I had a lot on my plate. It is true my daughter is a stellar student and good athlete. So she is likely to get into some if not several colleges of her choice. But, that does not mean my feelings on her behalf don’t include anxiety. I was diagnosed with bipolar while in college — so that makes me worry about her.

My therapist also reminded me that my sister is the point person for my Mom’s cataract surgery and there is very little for me to do there. From my point of view it is difficult to have my Mom age, it is difficult in having to set limits on how much I can help with her care because of the bipolar (like driving across town at 5:00/5:30am under heavy sedation with meds). It is also stressful for me to see my Mom as she insists until recently on driving herself and I don’t feel that is safe.

The MRI for a brain tumor was stressful because I did not know if I would need brain surgery – literally.

My admiration for my therapist is at a low point. Rather than acknowledging all these stressors, she basically said I did not have a lot on my plate and I should be doing better. She texted me that she thought I had enormous difficulty managing my own life and to stop trying to manage other people instead of managing my own struggles.

This is the first time in 13 plus years where my therapist in my view made the wrong call. If I were in a wheel chair, the doctors would not necessarily believe I should walk again but that I should be making the most of my life albeit in a wheelchair. For the first time in 13 years, I feel my therapist just “doesn’t get it.” I feel she doesn’t get it that anxiety can be really rough even if it looks like things on the outside are pretty much handled. The anxiety doesn’t necessarily go away when life’s challenges are getting managed one way or another.

Has anyone had this kind of fall-out with their therapist or their doctor? Any ideas on how best to move forward?

Back in 2004/2005 I was diagnosed with a brain tumor

During a routine MRI after my daughter was born, a frontal meningioma was found – that is a small tumor in the brain sac likely benign. I was told at the time not to worry about it. In 2013, I asked the doctor specifically if follow-up was needed. He said no unless there were new symptoms. For about the last two years, I have been experiencing additional anxiety and short-term memory loss. I am unsure whether these are signs of the bipolar condition progressing with age or are symptoms of the meningioma pressing on the frontal lobe.

Friday, I had an MRI of the brain and should know the results next week. There is a part of me that is hoping it is pressure on the frontal lobe so that once removed my anxiety and memory loss should be better. It is craziness to think that way, but there you have it.

Anxiety is a bully

I have been journaling since March 2021 about strides I am making in practicing yoga or walking on a regular basis. A week or two ago, I decided to include journaling about my anxiety in the same log. Once I started writing about my anxiety, it was as if I could not stop.

I called my anxiety a bully in that it instills pain wherever it goes. I called my anxiety cancerous in that the anxiety causes good health to go bad. I wrote and wrote and wrote about anxiety not being a friend but being a bully and how there was no room in my home for a bully. I do not allow bullying to occur in the neighborhood or at school, so why would I accept bullying at home?

I know I don’t always have control over my emotions and that is why I have a diagnosis of bipolar, but it is soooo helpful to be able to call out anxiety as a bully and think of it as something that is pervading my home rather than a feature of the bipolar I just have to accept. It is true I cannot control the anxiety when it occurs, I can only control how I respond to it when it does occur. But calling it a bully somehow helps me to think of the anxiety as “other than” and not me. I am not my anxiety. I am not my diagnosis. I am not my bipolar. My anxiety exists as a bully as part of my illness. I can call it out for what it is and I can tell it off and I can tell it it is not welcome in my person, in my home, or in my relationships with family and friends.

Does anybody else have coping mechanisms for anxiety that seem to help by differentiating the anxiety from the person experiencing it? Is it helpful to you too to think of anxiety as a bully to be kept at bay?

In a few months’ time

Come the end of December, I will be writing a series of blogs about my time in the workplace and the various responses I have gotten over the years either when I have exposed my bipolar diagnosis or it has been exposed through circumstance. I believe you may find that not too many workplaces are supportive of a mental health diagnosis. I have struggled over the years as to whether to reveal this “secret.” I hope these several blogs will give the younger folks following this thread some indication of the pitfalls of allowing your behavioral health diagnosis to be open or not in the workplace. My sentiments still remain mixed as to whether disclosure is a good thing or not.

I have just discovered

I have just discovered that my blood pressure goes through the roof when I drink caffeine. For 17 years I have limited my coffee intake largely to the morning to wake up from sleepy-time meds. Sometimes I have had an occasional afternoon coffee. But my blood pressure has been giving me problems so I have been taking my levels at home several times a day.

What I am finding is that my blood pressure spikes in the morning after my daily caffeine ritual. I have cut my caffeine in half over the years making coffee with half caf and half decaf. But to be honest it sort of defies the purpose when I have four cups of this mixture a day anyway.

I have posted a message on the patient portal at my primary care physician’s office asking whether I need to curtail caffeine. I am almost sure her answer will be to cut out caffeine completely. I can do this, but it will be a huuuuge adjustment. I use the caffeine each morning to kickstart myself after a long medication induced sleep on clozapine/clauzerile.

I am not looking forward to this change in habits/behavior. But perhaps it will help with the bipolar highs and lows as well.

Anybody else have caffeine challenges? Anybody else asked to go off coffee to help with health conditions? If so, do you have any secrets for how you accomplished it?

Does anyone besides me have symptom exaggeration on vacation?

Vacation is supposed to be the time to relax and rejuvenate and get ready for what comes next. For me though, vacation can be a time of challenge.

Often during vacation we are with 3 to 4 generations of family under one roof. While there is generally no direct mal-behavior toward me from family, I can get overwhelmed with this many people sleeping and eating and playing under one roof. I am often unable to keep my same routine or best perhaps I can modify it – I am definitely a creature of habit.

During this summer’s vacation with 4 generations of family I had a bit of a meltdown. I was being extra-sensitive to the comments of my seventeen-year-old daughter when I should have known better. My Mom chatted with me about it for a while. My sister chatted with me about it for a while. My sister even let me know that when her boys were 17, she went through her husband to communicate to them. She could not get answers to direct questions or to requested behavior change. That made me feel better that my daughter’s shortness of temper with me was more a product of her age rather than that I am not measuring up due to the bipolar.

All in all we had very nice vacation times this summer with my husband’s family in June and with my family in July. I am working on letting teen-age behavior just roll off my back. Of note is that now we are back home, my daughter’s behavior is nicer and more respectful than any time since the beginning of the pandemic. I think we all forget how the pandemic has made us live on top of each other and each other’s emotions while in quarantine.

Anybody else have a vacation hiccup this summer to share? Anyone have a vacation where you might have experienced an unexpected meltdown? Were you able to work through the bulk of the meltdown by talking to others and getting more perspective? Is there anything you could name to prevent a similar hiccup in the future?

Are we having fun yet?

I have spent a good bit more than half of my life dealing with a bipolar disorder diagnosis. Thanks to modern science I have been on a drug called clozapine since 2008 which treats treatment-resistant bipolar illness. Since taking the medicine I have been hospitalization free for almost 13 years.

While that is an accomplishment for me, I would like to raise a subject that often alludes me – having fun. It feels like most of my energy is wrapped up in getting things done, handling things in my life and my family’s life and staying symptom-free or almost.

What is completely missing from my life however is the element of having fun. What is fun anyway? Is it laughing aloud with family or friends? Is it listening to music I knew before I was diagnosed at age 22 that feels like letting go? Is it cooking a meal with my daughter — not so much full of laughs but full of good times?

In general, I feel like my illness has made me a doer. As long as I am doing this or that and fulfilling obligations of wife and mother and daughter I give myself a grade of doing OK. But still, it feels like something is missing – that illusive idea of having fun.

Does anybody have a bucket list for laughter that they’d like to share? I will be working on a new list soon – a list that includes things that don’t just need to get done but also includes whether or not I am enjoying myself. I know it’s hard to fathom having fun when you are depressed or even when you are manic since that’s not the fun I am talking about. I am talking about fun that is centered in a centered self.

Does anybody want to help get the having fun list together? I think we all could benefit from reading it and/or trying to help create it?

My Sojourn through Bipolar Illness – Imprinting (reposted and a continuation from prior post)

What I took away from this first break experience during my Senior winter at Ivy College is that being mentally ill meant I was first a criminal and second a person. I know that first responders were doing their jobs to watch out for the safety of all those who were boarding the plane and/or in the airport. But that experience told me: “You are a criminal. You were trying to bomb the plane. You are guilty of anything and everything until proven innocent. You need to be handcuffed. You do not have the right to have fears much less to express them. You do not have the right to have perceptions that are not 100 percent clear. You are a danger to others around you and you need to be locked up.”

My first episode imprinted me for the rest of my life. For years, I would try to escape the label of criminal that had been imposed on me by circumstance and happenstance. But try as I might, I still felt like I was a criminal every time I had a subsequent break-through episode no matter how big or how small.

In hindsight, things could have unfolded quite differently. I could have reported to the school clinic that I was having anxiety about traveling to Chicago and had been having some trouble sleeping. I could have gone into the clinic for a routine evaluation and perhaps been put on lithium or some other drug for bipolar. But sadly, that is not the way my first episode and subsequent diagnosis of bipolar went. I remember to this day looking at those pictures on the wall in the police station and thinking they must be looking for me as “most wanted.” Being mentally ill simply meant I was a criminal.

I will talk later on about stigma and first responders — including the importance of training first responders how to recognize the signs if a person is a danger to him or herself or whether the person is also a danger to those around him or her. But that discussion about stigma and first responder training is for another day.

My Sojourn through Bipolar Illness – Family Then and Now (part one)

That I have felt loved by my family of origin as well as my family by marriage including my in-laws who put up with a lot of crazy behavior from me in the postpartum period has made a huge difference in my ability to move forward in my prognosis.  Although it felt at times I was going it alone, in reality I have had and continue to have huge support from my family – as much as they were capable of providing given knowledge of the illness at the time.

Throughout my twenties and thirties, I seemed to pivot back and forth between the two models of successful marriages that I knew.  At times I would fall for a guy who had no delight in earthly things (more like my Dad).  At other times I would fall for a guy who was very established in his career and financially secure (more like my stepfather).  This back and forth continued through the time that I met my first fiancé and ended when I met my current husband.  My husband James was a perfect blend for the most part of the values of my Dad’s remarriage and the values of my Mom’s remarriage.

When I met James, he was very informed for a lay person about bipolar illness.  He was successful in his own recovery from addiction and had heard many stories of bipolar illness in that context before hearing mine.  Most of my prior boy friends had little if any experience with bipolar illness.  In addition to his familiarity with my illness struggles, another aspect of our relationship was that we tended to fight well.  Regardless of the topic, our fights were usually brief and seldom fell into the same old rut that marriage disagreements often follow.  We continue to fight well today although we do have our marriage ruts to get through.  The third aspect of our relationship which seems to help a great deal is that we share a faith journey.  This faith journey has shifted in the past year due to a situation at our church which caused a massive leadership change. James and I still stay vested in helping to develop a faith journey for our daughter even though we as a family are not in a church right now.

James’ and my shared goal right now is for me to be volunteering or working a stable but not particularly demanding job preferably part-time.  We are in agreement about what this goal is and what the desired future looks like. We continue to fight about money from time to time but in general our goals are on the same page. 

My Sojourn through Bipolar Illness – Development of High Anxiety

In the years after I was first diagnosed with bipolar illness, I would have a break and go into the hospital about every six months.  Eventually with the right meds I got to the place where I would have mini-breaks every six months and stay with my sister Jane and her family rather than go into the hospital.  This was during the days of Mellaril, Ativan and Haldol.  I would leave my apartment and take the subway to my sister Jane’s house about 25 minutes away.  Oftentimes this ride was a huge challenge.  I would arrive at Jane’s house with an overnight bag and some meds and put my belongings in the basement where there was a guest room.  I would spend between three and seven nights at Jane’s house where she would help me with administering meds.  In those early days, the anxiety associated with waiting for the meds to kick-in was excruciating.  I often requested to hold Jane’s hand as we lay in the bed until the medication had had time to sink in and sedate me. 

At that time, the meds for bipolar illness were not very advanced.  Meds seemed at that time to treat the symptoms of the illness rather than seeking to manage the illness before the break-through of mini or grand episodes.  I am forever grateful to my sister for allowing me several years of staying with her and her family every six months or so and managing though those mini-episodes. When I was at her house and under the care of Mellaril, Ativan and Haldol, it would take about an hour for the impact of the meds to sink in.  During that hour of sheer hell I would sit and smoke cigarettes nonstop waiting for the meds to kick in.

Since those early days of a mini break every six months, I have been prone to high anxiety which is often at times consuming and sits sometimes in the background, as a nagging reminder that I continue to struggle with my moods every day.   Managing the anxiety associated with bipolar illness has developed into my greatest challenge besides the reversal of stigma.  Perhaps pairing the management of this anxiety with a willingness to explore potential abuse as a child will make an impact on this generalized anxiety – hopefully reducing it substantially. 

I also have more recently added an additional medication Trileptal to help with the anxiety and this appears to be making a difference for me.

As an aside based on commonplace discussions, I have been told that family intervention for people with behavioral health diagnoses is much more common in Europe than in the US.  Just like our propensity in the US is to care for the elderly in homes for the elderly, we tend in the US to care for people with psychiatric disorders in a hospital setting.  Personally, I feel that the more care that can be provided in the context of the family and the family home the better.

Once again, my illness has developed in phases.  Early in my diagnosis were “grand episodes” including hospitalizations.  These ”grand episodes” gradually gave way to more “mini episodes” managed in the home with a few exceptions. In my postpartum period, I was back to having “grand episodes” and being in the hospital again for those first three to four years. 

As I became more comfortable with managing my illness and being a Mom, I went back not to having “mini episodes” but to having a general level of anxiety to manage at all times.  Goals but not necessarily accomplishments include daily meditation, daily exercise goals including walking and yoga and a daily commitment toward transparency in my faith and my diagnosis.