Feeling Guilty, Feeling Inadequate

My elderly Mom (a Senior) has recently been in the hospital for several days. She has had a close friend/comrade staying with her during the night in the ER and then each night she was in a hospital room.

If this were to happen again and this comrade were not available, I would have a hard time sleeping in the ER and sleeping in the chair by the bedside once my Mom moved into a room.

For my own health, I need to be in bed by 10:00pm and up around 9:00/10:00am. If my Mom were to be readmitted to the hospital, I would need to put my own health first which means taking meds at regular hours and getting a very full night’s sleep.

I feel guilty and inadequate about not being able to care for her as I would prefer. But like the saying goes on the airplane safety drill, put your oxygen on yourself first and then others.

I know the right thing is to accept what I can do for my Mom and maintain my health. It is just that my wishes are that I could be with her round-the-clock if needed.

Sleep: When is too much of a good thing or not?

When I was in the early stages of bipolar disorder, a gap of 2 nights sleep was a trigger that I might need to be hospitalized for bipolar disorder or go to my sister’s house for in-home care.

Some 25 years later, I find that sleep is also an indicator of how I am doing with the bipolar. If I have interrupted sleep or sleep less than 7 to 8 hours, the next day is a struggle and a warning sign for the next few days to come that things are fragile.

In semi-retirement and as an empty nester, I allow myself more sleep than I normally would. I go to bed around 9:30 or 10:00pm and wake up between 8:00 and 10:00am the next day after several interruptions in the night. I know some people might see this as a sign of depression. I actually don’t. I have come to rely on the good nights sleep with clozapine since 2008. And this sleep generally helps keep me feeling relaxed and less anxious through the day. It is not a cure-all for anxiety, but being well-rested does mean I am less likely to expect the worst in whatever situations cross my path that following day.

I am not tied to the schedule of ten to twelve hours per say. I do get up and go to early doctor’s appointments and the like. I just like being completely exhausted of the need to sleep. If I can put it that way.

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.