Taking Care of a Senior when You Have a Mental Health Diagnosis

My Mom has been in the hospital for the last five days. She has a good friend who has done the heavy lifting of staying overnight with her in the ER and in her room once assigned. She is home now.

I have been going to the hospital several hours a day with my husband to visit her. Anywhere from 4 to 7 hours or more. I have been able to sleep at home and largely keep my health maintenance routine in tact.

I am wondering how those with a mental health diagnosis manage when their elderly mother or father is ill. It would have been extremely difficult for me to spend the night in the hospital one night much less five. I am very grateful to my Mom’s friend that he stepped up to be her care provider at this juncture.

Does anybody else have stories of having to manage through your own illness while taking care of someone else like an aging parent or a sibling?

My First Job out of Graduate School – Compartmentalization

My first job out of graduate school was as a Business Analyst in the IT department of a local engineering and environmental management firm. This position built upon my role in information management at the state cultural organization where I worked before graduate school. Shortly after joining this firm as a Business Analyst I was promoted to a financial application services manager position and worked in that capacity for a couple of years. The position used and developed project management skills but was more process oriented than project outcome focused.

During this time I completely compartmentalized my bipolar illness. I went to Psyche appointments on my lunch hour. I went for lab work on Saturdays. Basically, I provided no insight to my employer or my boss that I was managing bipolar symptoms.

Ironically, this seemed to work well for my career. I was managing four programmer analysts and helping to manage and develop software systems. It seemed to help that I was managing a team who had more technical know-how than myself. So, I was just facilitating progress; I was not driving progress. It also really helped that my boss trusted me implicitly to manage the software program assigned to me and was always available if I had an issue that needed to be escalated to her level or above. It meant a lot to me and to my ability to function that this escalation window was always accessible to me.

Within a relatively short period of time, I went from being at a reasonable paygrade to being at a somewhat high paygrade for the time. There was definitely stress on the job but what seemed to make a big difference was that the team of four programmer analysts were first in line when there was a triage situation. This occurred a lot since the application we were using was still in a beta test mode for all intents and purposes. But when there was an emergency as there was about once a month or so, my programmer analyst team was first in line to answer the “distress page.” (This was still the time of pagers and not smart phones.) My role was more to manage the process when there was a software outage rather than come up with the solution myself. I depended on the programmer analysts for that.

So my problem with having reduced sleep at night was not really a problem in this job due to the pager protocol and my team being first in line rather than me being first in line when there was an outage or some other problem with the software. This idea of missing a night’s sleep to nurse the computer system back to health did not really start until I began work a few years later as a project manager for a large telecommunications agency.

Looking back on it now, I did not necessarily have less stress at this financial software job, it was just that I did not have stress that was a trigger for the bipolar symptoms – mainly lack of sleep for one or more nights. In addition, it meant a lot that I functioned more as a process manager than a formal project or program manager. It was my job to ensure problems were resolved but not directly to resolve them. As a certified project manager some years later, the job was to solve the problem directly with the team. This may seem like there is not much difference between these two scenarios, but the bottom line is that it is different to be responsible for process rather than outcomes. In the financial services job, I was focused on process. Later in more formal project management jobs I was focused on outcomes or results. Also, again, it really helped me to perform in this job knowing that there was a clear escalation process when issues arose that I was not qualified to address.

In terms of mental health stigma at this job, there was really no disclosure of my bipolar illness so there was no “real stigma” to address unless of course you count the fact that I felt compelled not to share my diagnosis with anyone at work. I had circumnavigated the stigma situation, but this was only for a few years of my career. I often wonder if compartmentalizing my illness during this job should have served as an example to me in later project management jobs. I believe I continued to try in later years in project management positions to continue with the compartmentalization, but as the stress of the work positions grew so did my inability to control my bipolar symptoms on the job and off. The increase in stress of the job was coupled by the fact that the stress I was now experiencing was directly triggering my bipolar symptoms – largely the sleep deficit trigger. The compartmentalization was something like having a pressure cooker going all the time. The pressure was there even if I was not acknowledging it. At some point in each project management job I took, the top was bound to blow off.

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.

What does behavioral health mean, anyway?

My last blog post referenced those with mental illness and addiction issues under the same umbrella of “behavioral health.” A fellow blogger had the insight to question use of the term “behavioral health” which is used widely in the US but perhaps not elsewhere. She is at: https://mentalhealthathome.org.

The challenge for me is finding a term that includes mental illness and addiction in the same breath. At first glance “behavioral health” does that – include mental health and addiction diagnoses. But as my fellow blogger and friend pointed out “behavioral health” is a weird way of describing mental illness and addiction. The use of the term “behavioral health” seems to imply that all that us mental illness or substance abuse sufferers need to do is change our behavior and all will be well.

Further, the term “behavioral health” does not include the more common understanding that both mental illness and addiction are associated with or caused by a chemical imbalance in the brain. The chemical imbalance is clearly an illness.

While there is room for behavioral change in any illness diagnosis including cancer and heart disease, the idea that a diagnosis can be reversed through behavioral change is missing the point. If I have heart disease, I can change my diet and exercise regime. If I have cancer, I can also adopt a healthier diet and exercise. However, my diagnosis of heart disease or cancer is not defined by my behavior. It is defined by the diagnosis and prognosis of the illness itself. If you are dying of heart disease or cancer, no one says “change your behavior and all will be well.”

So why should we term mental illness and addiction as “behavioral” issues? The key to understanding mental illness and addiction is in understanding there is a chemical malfunction in the brain. Sure, you can mitigate this some with behavioral changes, but that does not mean that mental illness and addiction are explained best by our behaviors or changes to our behaviors.

What are your thoughts on using the term “behavioral health?” Is there another term you choose to use to describe mental illness and addiction?

*****

If you had a wish list for your mental health, what would it look like?

Here goes nothing….

I wish for psyche meds to be 100% therapeutic 100% of the time.
I wish for no side effects to meds like drowsiness or weight gain or Type II Diabetes.
I wish to recover all those times when I was emotionally inaccessible to those closest to me due to my bipolar illness condition – this is mostly having to do with family and definitely has to do with my daughter.
I wish for my bipolar condition not to be genetically an issue for my daughter.
I wish to undo any harm / make amends for any harm I have brought to people because of or during my bipolar condition.
I wish for the stigma associated with mental illness and addiction in society to magically disappear.
I wish for the United States to have a healthcare plan that covers everybody at a reasonable cost including pre-existing conditions and including mental health and addiction benefits.
I wish for the covid-19 virus to become a thing of the past as quickly as possible since it has so many emotional components that impact my mental health and the mental health of others.
I wish for a covid-19 vaccine in the next 4 to 6 weeks or better yet now.
I wish for a support team for anyone experiencing any sort of mental health or addiction diagnosis / symptoms and that that support team is always there for you.
I wish for everyone with mental illness or addiction issues to never feel alone or never feel separate from the rest of the world.
I wish the world to embrace and include all people no matter what their diagnosis, skin color, religion, etc.
I wish I could return to the weight I was when I married or close to it…..

What would your wish list look like?

My Sojourn through Bipolar Illness – Becoming a Mom

Becoming a Mom has been the greatest gift God has ever given to me.

I got married at 38, got pregnant at 39 and had my child at 40. I often talk and think about how as a person with a behavioral health diagnosis I have done everything “late.” I have to talk with myself about how life events like graduating from Ivy College or graduating from Business School or obtaining my professional project management certification may have occurred on God’s timeline rather than on my own.

Perhaps I am not late in achieving these life events any more than I am early in my perceptions or thoughts about time and matter and anti-matter. Perhaps all of these thoughts and events and timelines are under control with the ultimate project manager – God himself.

Still, I have a hard-time accepting that these successes are on God’s timeline rather than my own. I want to be able to say “I’m normal” and therefore “my successes have occurred in the way I have prepared for, planned and executed.” In reality these successes are contingent upon allowing myself some “grace” and the opportunity to pursue my accomplishments in an elongated timeframe. There are many goals that I have currently that I continue to pursue – the message to myself along these pursuits is that God is in control of these developments, even though I would prefer to be in control myself. I would prefer to be in control just as that ten-year-old child within does so as perhaps despite myself to take full blame when things don’t go according to plan. If my child within is six and/or if God is in control, I am no longer in control of the outcomes of my life. If I give my life over truly to God, then every outcome including the potential for child abuse at age six is part of his plan for me and I need not accept any particular outcome as “my doing” or “my fault.” Perhaps my role in God’s eyes is to tell my story of abuse so that others will not have to endure such happenings or at a minimum can feel some solidarity surrounding those events.

So it was with having my daughter — the biggest accomplishment of my life. For years, I heard that Lithium was contra-positive toward being pregnant and carrying a child. For years in my twenties and my thirties, I asked to change my meds so that I might be ready once I got married to carry a child. When I met my husband, we talked at length about the fact that bipolar illness has a huge genetic component and that there would be some risk of passing the illness along to my child. I considered this strongly and even looked into the idea of surrogate eggs and surrogate Moms. In addition, there was a study occurring at a local university hospital which posited that risks to the fetus for heart impacts associated with lithium use by the mom were grossly overstated. My husband was not keen on the surrogate or adoption alternatives, so about 7 months after we were married, we started to try through traditional methods to get pregnant. I was 39 at the time. I believe that prior to this time, I may not have been ready to be a Mom, at the same time I do not really advise people to wait too long to have kids. My husband and I were very blessed to become pregnant within two months of trying. For most people at the age of 39 in vitro and other pregnancy/fertilization tactics would have been needed.

Even amidst the throes of postpartum depression and related problems, having my daughter in my life and experiencing her as part of my family with my husband continues to be the greatest blessing in my life. Even now in the midst of the teen years and our occasional head-butting, my daughter continues without a doubt to be the love of my life tying with my husband.

My Sojourn through Bipolar Illness – Fear of Flying

Note – several names and places have been changed throughout this text in order to keep my story somewhat private. Thanks for understanding that need. I hope you will tell me what most interests you from my story so I can focus on that moving forward.

Although I had had no prior fear of flying, my first episode of bipolar illness was in a tiny airport near my Ivy League college (hereafter known as Ivy College). While I was waiting for the plane to get ready to taxi off the runway and take me to my first interview for a job after college in advertising, I was consumed by runaway thoughts. My thoughts were anywhere but on my interview for an Account Executive position at Chicago Avenue Advertisers. I had no specific directions for my fears but I took out some papers I was working on for my undergraduate thesis at Ivy College and was writing and writing furiously in and around the margins of the pages of the papers I previously had written. The thoughts seemed to co-mingle with the characters in the fiction as well as characters or people I knew in real life. The writing was fast and furious until I finally heard the flight that I was to take to Chicago on the puddle-jumper called.

For some reason I did not feel safe in myself enough to board the plane once the flight was called and I came to the conclusion that the plane was going to crash. I did not communicate this fear with anyone. Instead I determined that I did not want to get on a plane that was going to crash, so I got my suitcase together and asked the airplane attendant if I could check my bags on the plane but not board the plane myself. For some unknown reason, the contents of my suitcase were of paramount importance. I recall a navy suit that I had packed and feeling like that suit should reach a friend who I was going to see in Chicago. The label on the suit became extremely important at the time – it was an Evan Picone double-breasted navy wool suit. The airport personnel immediately got suspicious and asked me why I was putting my suitcase on the plan and asked me to move away from the plane with them. When I refused, the safety patrol man exerted more force and tried to get me to go with him. In my fears, I turned to run down the runway away from the scene of the fears and ran completely down the airport runway up into a stand of pines, one shoe flying off in the process and resting in the snowy runway. I recall exactly what I was wearing – a plaid pleated wool skirt in muted tones, a long sleeve silk blouse and a double breasted woolen gray or taupe sweater. I don’t recall a coat or over-coat. The safety patrolmen at the airport followed me into the woods with snow all around and made a chair with their arms for me to sit on. I was in some stage of delirium and thought they were providing me some sort of throne to safety.

Instead the next thing I knew I was being handcuffed to the backseat of a patrol car with the patrol lights flashing blue and white and was being escorted to the police station down the road. When I arrived at the police station I kept telling the police that I was a Senior and straight A student at Ivy College and they must have made some mistake. On the walls there were pictures of wanted criminals – I kept trying to figure out what the pictures meant. There were three pictures: a young woman who I thought looked like Ayn Rand, a man with a long beard who looked in my state to be like a long-haired Jesus and one other picture of a youngish man whose face I cannot recall. What I do recall is feeling like a criminal and being treated like a criminal until a kind policeman named Michael started to ask me questions. Once I started to talk with Michael I began to calm down.

After what felt like days of swirling and runaway thoughts and a myriad of questions, the police finally called my family and called the school clinic and I was escorted there. Soon after, several of my college roommates arrived to be with me while the admission process continued. After talking briefly with the clinic staff, I was transferred to the local hospital’s Psychiatric Unit.

Within the next few hours my parents arrived in town and tried to begin to make sense of what had happened. I recall my parents visiting me in the hospital mostly my Dad whose anxiety I could sense was through the roof. Within a couple of days, we made arrangements to go back home to Augusta, Georgia. I unenrolled from classes and moved back home to live with my parents for the spring and summer of 1985. No one was sure yet if this was a temporary reaction to stress as a Senior and as a Senior thesis writer or the beginning of a lifelong behavioral health diagnosis and challenge.