What do Fall and December Holidays look like this year?

From where I sit, it is looking like Fall / Thanksgiving and December / Christmas Holidays will be experienced at home without visiting out-of-state family. It is a two-day drive to get to see the in-laws. There is staying in a hotel on the road and then exposure to everyone in our extended family. I just can’t see that happening with covid-19 lurking about.

What are other people planning for fall and winter breaks?

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

After the postpartum period began to become more under control, my relationship with my own mother blossomed.  She was able to step in and care for my daughter when I was overwhelmed by postpartum depression.  In addition to her developing as a grandmother to my child, I felt that she over the years began to learn to let go of feeling responsible for my illness or for controlling my illness and was more able to be just “a support.”  She became someone to talk with about feelings and issues when needed.  At other times she was a person to bring the family together in a weekly meal at her house.

I attribute NAMI (the National Alliance on Mental Illness) to a lot of my mother’s development and understanding of behavioral health issues.  NAMI programs helped her just to be there for me as a Mom and a friend.  NAMI taught my mother I believe the importance of just being there – not necessarily doing anything but just “being there.” Granted there were times in the past that I felt that she wanted to be intimately involved in my care and in my therapy in a way that I did not want.  When she gave up this control and decided to focus on being a support, our relationship blossomed as did the growing relationship between her and my daughter. 

Over the sixteen years of my daughter’s life, my mother has become a great presence in our family interactions.  We get together most times weekly or more than weekly for a meal or a soccer game or both. Today in covid-19 times that has migrated to a daily phone call and some outside social time with masks and social distancing. 

My relationship with my husband James has also matured as my health has progressed.  We continue to have our favorite arguments, but in general we are on the same page of putting our daughter first including school time, school work, hobbies like Cross Country, Track and Chorus and her spiritual development.

My husband has continued to be one of my most staunch supporters but not in a way that is easily described.  More than giving me a safe harbor in which to rest my myriad of thoughts and perceptions, he has challenged me to find my rock bottom and work my way out of it.   He is no way gets involved in my illness but rather gently or sometimes not so gently reminds me that my illness is mine to deal with.   This expectation that I will deal with my illness is both verbal and non-verbal.  In addition to working though my illness, my husband has largely been accepting of the fact that a high paying job is likely not going to be something that I can stick with and maintain.   It is with his support that I have been writing this text off and on for the last several years.

In addition to my Mom and my husband in recent years and my sister in years’ past, my in-laws have been extremely supportive of me and my efforts toward financial security.  From the beginning of my relationship with my husband, they have provided fiscal support that has allowed me to work from home on a variety of health and health measurement concepts. Through this work, I have traveled for presentations in Zurich, Switzerland as well as in Brighton, England.  Work also has been presented at CJR School of Public Health.  Without the fiscal support of my in-laws, none of this work would have been possible.  

My family support over the years has grown in parallel to the understanding of the illness among the public and among medical providers.  My family always has provided me support over the years even through some of the most heart-wrenching episodes of my life including fits of blaming them for my troubles. 

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 – Family Then (part one)

There had been no prior established case of bipolar illness in my family before 1985 when I was diagnosed.  There was an isolated incident of an uncle who wanted to drop out of college and sail a boat around the world, though this incident was not widely discussed then or now.  The uncle with the sailing fantasy never was treated for a mental illness though he continued and continues to be highly religious in his outlook and in his behaviors. 

So, like for many families, this incident of bipolar illness was unprecedented at that time in February of 1985.  Upon return from Ivy College my parents placed me in a local psychiatric hospital.  Within a number of weeks from the episode on the runway of the airport near Ivy College, I was diagnosed with bipolar illness.  This was about in July 1985.  The relay of the diagnosis was less than spectacular.  I was in session with the psychiatrist whose name for the sake of this text is Dr. Hamilton.  At the end of the session Dr. Hamilton informed me that I was bipolar and left little to no time in the session to talk about what that meant or how it impacted me and my family. 

As with any developmental story after being diagnosed, I had issues with my parents that would consume a portion of my therapy early on in the years following college.  A lot of this therapy focused on the death of my older brother John who was an infant when he died of spinal meningitis.  He would have been 2 years older than me.  Through extended therapy in the early years, I pieced together memories that would allow me to see that much of my parents’ separation and divorce could be seen in the light of John’s early and tragic death.  Few parents I learned survive in marriage the deaths of their children.  And so it was with my parents.  Once I understood more about John’s death and its impact on my parents I could begin to process my place in the family as “the replacement child” or not. This seemed to be a place in which my parents diverged.

My childhood appears to have been largely uneventful with the exception of this divorce, which included happy re-marriages for both parents.  But as we have seen time and time again, that may not be the case.  On the one hand, I later began to believe that these two second marriages provided me the opportunity to have two examples of working parents but with two very different sets of role models.  My Dad and stepmother lived a very quiet life with few outside stimuli. My Dad was a minister yet he preferred to be working in the garden on his rose bushes rather than leading a congregation.  This was probably due to the stress of stigma that at the time accompanied the divorce of a member “of the cloth.”  My Mom and step-dad were both very involved career people and active in the church where our family attended.  They married when I was 15.  We had the typical turmoils of a mixed family particularly since there were four teens in the combined family.  The remarriage was more difficult for my stepbrother and stepsister.  Just months before they had been with their mother who was blind from diabetes as she was killed in a car collision.  In hindsight, my parents agreed that this might have been handled differently. 

What I am mostly trying to express about family is that my childhood originally seems to have relatively very little trauma or negligence or abuse.  I was raised by caring parents whose marriage did not work out for reasons beyond my control and theirs.  I continued to claim responsibility for that divorce well into my twenties as most adult children of divorce do.  But overall, it appears at first blush that I had very little trauma compared to others with a similar diagnosis.  Oftentimes, I tell myself I did not have a particularly difficult upbringing.

However, with the benefit and hindsight of a few more years of emotional work and discovery, I am coming to terms with the fact that I likely sustained substantial abuse at about the age of six.  This abuse was likely at the hand of a neighbor.  Regarding this potential abuse, I have deep pockets of black-out symptoms.   I also recall certain images (not exactly memories) of sexual assault but they are very unclear and very murky. Abuse at the age of six remains relatively unexplored territory at this time and will continue to be a focus of work with my therapist going further. 

(To be continued.)

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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.

My Sojourn through Bipolar Illness – Rock Bottom

That said, it is not unusual for medications to become ineffective or non-therapeutic after a certain point in time.  It is also true that as a patient I have had to participate in the “laboratory rat syndrome” and try different medications by trial and error and see what works and what doesn’t.  This ‘laboratory rat syndrome” is described later in the text. 

But what is most important to convey about this time period in my life is that I made a conscious decision to be transparent to my health team including my doctor, my therapist and my family. 

It was at this time that I hit rock bottom.  As they say in many recovery programs, you don’t really ever reach sobriety or true healing until after you hit rock bottom.  This period of three to four years after my daughter’s birth is my rock bottom.  I tried several doctors.  I tried several therapists.  I tried several new types of meds.  But none of these worked. At the root of what was going on in hindsight is that I was not being honest or truthful to myself and my support team.  I would schedule doctors’ visits every three to four months as compared to once a month so as to “prove” to myself I was healthy and not in need of help.  There were times when I felt the drugs weren’t working and I stopped taking them. 

This period of sheer and utter chaos in my life finally came to a close when I decided to put my health first.  After the lengthy hospital stay, I stopped working altogether and began weekly sessions with my new therapist and monthly sessions with my new doctor.  I communicated openly to my husband James, my mother and sister Jane about my health and how I was doing.  I became transparent in my place of worship and informed my clergy of my condition.  Basically, I decided at this critical juncture in my life that I was not going to lie to myself or to any other person close to me about how I feel.  Further, I determined that I am not going to hide my condition from myself or from my support team. 

Slowly and very very slowly, after this lengthy hospitalization and move to Clozaril or Clozapine, I began to gain more stability.  This I believe is equally due to the meds, my work with my doctor, my work with my therapist and my dedication to illness transparency in my place of worship and in my family and extended family.  I do not believe the end of the rock bottom period would have occurred without any one of these four developments: meds, doctor, therapist and transparency. 

Further, the end of the rock bottom period did not occur suddenly.  There was no silver bullet toward health.  But rather, this time of reparation was marked by gradual developments in learning to express my fears for safety, learning to address these thoughts of safety before they developed into full-blown paranoia, learning how to be a mother to my child which was preceded by my developing ability to be a parent to myself.  This journey was to take not just weeks or months but years of work. 

Initially, my therapist and I met weekly to work through issues of abandonment and replacement child concerns.  But what was a complete turnaround for me was when I began to talk openly to my therapist about how I perceive the world. It was at this time that I started talking more openly about how I am drawn toward coincidences, patterns and pattern-recognition.  We talked about my fears for safety for my family, my nation and my world.   These fears continued to haunt me throughout the process of climbing out of the hole at rock bottom, but somehow just knowing that another person understood what it meant to see the world in terms of patterns was a huge relief and an even more huge release.

For the first time in my life (literally) there was a person who understood my train of thought.  I no longer felt that my thought processes were singular and inexplicable and inaccessible.  By somehow working with my therapist and my doctor on the intricacies of how my mind worked and how my feelings had been somewhat left behind in the process, the fear that had consumed me for the first three to four years of my daughter’s life was released.  Not cured however but released.

By talking about the patterns that I saw, I no longer felt isolated in my existence.   Without the isolation, the fears of safety seemed to become more and more manageable.  In those years that followed rock bottom, my therapist and I were working on releasing the fear that had been mounting for me as a person not just from the point of birth of my daughter but from a point all the way back to college days at Ivy College where I first discovered my chemical imbalance.  We talked a lot about Professor Flannigan but mostly we talked about how I was intellectually a star student but not so much in touch with my emotions.  Someone more centered in his or her emotions would have been able to tell Professor Flannigan to “go to hell.”  From here, we spent several years looking at my propensity to approach life from my head rather than from my heart.      

In addition to this work with my therapist, I developed a huge amount of trust and respect for my doctor.  We talked about the fact that for the four years’ preceding my work with him, I had not found any sort of solace in my meds.  This doctor seemed to understand that prescribing me an anti-depressant as doctors had been doing since my postpartum period was a huge problem and something to avoid.  This doctor realized that anti-depressants that had been prescribed had been catapulting me into mania off and on for four years prior. 

Perhaps in writing this book or blog, I am encountering a new aspect of the rock bottom experience.  Perhaps the chapter of my life that includes potential abuse as a six-year-old is now sitting on the desk awaiting work.  Working through these details surely will help enable my security and my feelings of security and well-being both for myself but also for my daughter and for my family in general.