Back At It

It’s been a long time since I’ve written anything, it started off as “writer’s block” and then I just kind of forgot about it. I’d like to start writing again though, to share my more recent struggles with ADHD and Bipolar and maybe help someone along the way.

Earlier this year I had a lot of trouble with anxiety and periods of emotional distress (basically just out of proportion reactions that had me sending intense emails to my therapist when something happened that stressed me out and made me anxious) but with a few medication and lifestyle adjustments we have been able to dull these down quite a bit. For the anxiety, my psychiatrist increased the dose of one of my antidepressants and had me go off caffeine (luckily for me I don’t get caffeine withdrawal) and since then I have been doing very well. I also received some “words of wisdom” from my therapist. Every time I was anxious about something she would ask me what was the worst thing that could happen and then get me to give her possible solutions if that did happen. After doing this for a few months she made me realise that no matter what happens, it’s not the end of the world and I will find a way to figure it all out and that has calmed me down quite a bit. I’m fairly chill and at ease nowadays, which is a very weird feeling for me. Reducing my anxiety has also helped a lot with the emotional distress because I don’t freak out about things anymore, but my therapist helped me as well. Initially she just had me try to distract myself when I was upset so that I could get through those periods relatively unscathed but then one day when I went to see her, we talked about my most recent distress period and she said what if you just didn’t freak out? What if you accepted that you were anxious or upset about something and then just let it go, moved on? And somehow that worked. The next time I was getting panicky I just let it go and all was good. Strange that that’s all it took but hey I’m not complaining.

On another note, my presentation skills have definitely improved. I used to get really nervous and I would be shaking while I was giving my talk but that barely happens now. I recently gave a talk and didn’t shake at all! I don’t know if the reduction in my anxiety helped with that or if it’s just that the more you give talks the more comfortable you are but I feel like it was a combination of both.

So overall, I’m doing pretty well these days, at least on the bipolar side of things. I still struggle a lot with the ADHD symptoms. The main problems are that I have a lot of trouble getting motivated to do work and that my brain goes dead around 3 pm. Now, I do tend to go in to work earlier than most people but I still wish I could work longer without my energy being drained or my brain shutting off. I guess that that’s my next goal for therapy. And maybe I would benefit from some more medication adjustments. I guess we’ll see. I’ll let you know how it goes.  

Break Out 'The Routine'

       One of the things they are very adamant about when you have bipolar or ADHD is that you stick to a routine. You’re supposed to wake up at the same time, eat at the same time, take your meds at the same time, exercise at the same time, and go to sleep at the same time every single day. Unfortunately, I don’t do routine, and my work isn’t routine either and I’m assuming this adds to the sleep trouble I already experience and likely also affects my moods. The reason I’m bringing this up now is that I arrived at the field station a little over a week ago and had to deal with a 3 hour time change and a whole new, incredibly sporadic schedule. For the first week I was happy, energetic, and didn’t sleep very much (hypomania at its finest) which would have been great if I had had work to do but work-wise the first week was pretty slow. Unfortunately a few days ago I experienced the not-so-unfamiliar crash into depression (although somewhat milder than I used to experience). I’ve been oversleeping, I’m always tired, and I’m completely apathetic about everything, I just can’t get myself to care (which is not ideal when you only have a few weeks to get experiments done). On top of that, I feel like a failure because I can’t motivate myself and I’m worrying about what other people think when I stay in bed for 12 hours. 

       One of the worst things about it is that the depression phase always lasts so much longer than the hypomanic phase so my times of not being able to get motivated are not completely balanced out by my times of extreme productivity. One of the other worst things is that I have had zero success in finding a way to overcome my lack of motivation. I can’t seem to overcome the extreme desire to ignore the alarm and fall back asleep for another few hours, or to just lie on the couch and watch TV. This is also the one area where my therapist has been very little help. She refuses to suggest ways that I could get myself motivated, she just sits there and waits for me to come up with something on my own but I never can so we end up just sitting there in silence for a while. I get that your therapist wants to teach you to become self-sufficient when it comes to solving these sorts of problems but there has to be a point where they can give you a hand. I’ve been struggling with these periods of depression where I can’t get myself motivated for a long time and clearly the things I try aren’t working so I could really use some help. Anyway, getting back to the disruption of my not-so-routine routine, being at the field station has definitely affected my mood but this happens at home as well, probably because I’ve never fully followed a routine. I abhor the idea of a 9 to 5 workday and I enjoy being able to get work done on my own terms but I may have to give this whole routine thing a try when I get home. I just hope I can find the motivation to stick with it.

One Year Anniversary

       It’s been about a year since I was diagnosed with and began treatment for bipolar disorder. It’s been a long, gruelling journey and I still have a long way to go, but I think I’m impressed with the progress I have made and I’m glad to be done with the process of medication adjustments. I still have my moments but for the most part I no longer spend days in bed because I’m too depressed to do anything, I don’t go into hypomanic episodes where I lose all impulse control and end up drinking excessively, the fits of rage and intense mood swings have disappeared, and I’m gaining more confidence because I now have some control over my life. Most of this is due to the cocktail of drugs I take every day but I also owe a lot to my therapist, she’s helped me take some of the blame off of myself and changed my way of thinking about things (at least to some extent). I hate that it took so long for them to figure out what was wrong with me because I spent years hurting people and making them think that I’m unstable and just not a very good person. I’ve definitely dug a pretty big hole for myself but hopefully I’m on my way to getting myself out of it.

       I’ve also learned a lot about my learning disabilities in the past year and this has helped to explain many of my perceived “inadequacies.” I now know that my difficulty with doing things the way others can is not my fault and has nothing to do with my intelligence or capabilities and I also know that ADHD is a lot more than just the inability to pay attention. Unfortunately, I’m still expected to fit into the little box of expectations which occasionally makes me appear incompetent. I can’t make everyone understand what exactly my disabilities entail and I’m always going to have to do things that don’t come as easy to me so I’ll have to work harder than most other people. I don’t mind the hard work but it would be nice to have things catered to my abilities on occasion. I have to give a talk next week which is a little scary because I know I have difficulty understanding what people are asking me sometimes, my working memory is less than ideal, and it can take a while for my brain to actually process the question (meaning that I’ll know the answer about 30 mins or so after the question has been asked). This can all lead to an incredibly embarrassing moment, hopefully I’ll get out of it with my dignity still intact. 

       What do I still have to overcome? I think the biggest things are the inability to get myself motivated and my inherent need to procrastinate. Motivation and procrastination are a big problem with ADDers and I am no exception. I often dub myself the world’s greatest procrastinator and I’m sure people who know me can vouch for that. In general, I work better under pressure so if there is no impending deadline it’s hard to get myself motivated to do something. One of the strategies is to set your own deadlines but I find it hard to stick to that if there’s no one else depending on me, so that’s something I still need to work on. In terms of just motivation, ADDers tend to get bored with things pretty quickly (hence our consistent lack of follow through) so I lose my motivation for working on a project a lot sooner than I would like. I’ve tried a couple of things to improve on these problems but again, I lack the follow through so about a week after implementing my new strategy I’m right back to where I started. At least I’m trying though and hopefully one of these days I’ll find a strategy that works.  

My Brain Needs Glasses

     Back when I first started seeing my new therapist, one of the main things she was trying to do was to get me to believe that it was okay to have bipolar and ADHD, that it didn’t mean I was defective. One of the things she said was that my brain just needed glasses (and then she told me about a book with that title which I haven’t read). She said that you wouldn’t call someone who needed glasses defective so I shouldn’t call myself defective. I never really got the relation though. Then the other day something struck me about how my brain worked not on the ADHD drugs, but on the bipolar drugs.

     I’ve been studying for my exam and I noticed that everything seemed so much simpler and made so much more sense now. These are things that I have learned numerous times before but had always just memorised the facts, I could never fully comprehend it. I realised that since I started the bipolar meds, everything seems to get through a lot easier. I’ve mentioned before that it’s like watching fifty different TV channels at once, now imagine trying to learn or comprehend something with that much going on, it’s next to impossible. This is where the whole my brain needs glasses thing comes in. For almost ten years now, my brain has been fuzzy, just like how the world is blurry when you need glasses.  But once I started the new meds, the “haze” disappeared and now I’m finally able to think clearly, my brain got glasses. Studying is so much easier than it was during my undergrad because there’s no longer anything clouding my ability to learn, I finally understand everything I’ve been taught in the past four years. Now I realise that me suddenly understanding everything could be because I’m older but for one thing, I doubt that my IQ has increased all that much in the past couple years and for another thing, it’s hard to believe that my mind clearing up after I started the bipolar meds is just a coincidence. 

     It’s unfortunate that it took so long for me to get some clarity; I kind of missed out on ten years of my life. Sometimes my therapist asks me about how I felt during high school or my undergrad and I can’t answer her. She says that she’s older than me and if she can remember high school then I definitely should be able to, but I can’t. The past ten years are just a hazy blur that I wasn’t really there for, not mentally at least, what’s it called? Non compos mentis? That terminology may be a little extreme but I think you get my point. All in all, I’m not defective (although I still think that my brain is at least defective), not because I have bipolar or ADHD and not because I wear glasses.              

Stress

     The other day I mentioned that I’ve been having a bit of a rough time lately, and I couldn’t really put my finger on why (except that we’re still working out my drug regimen). And then last night something happened that had me a little stressed out and panicked and I became hypomanic (which was followed by a short but intense bout of depression). Now, I normally lack any ounce of self-awareness. Doctors and therapists ask me questions about myself or about the effects of increasing the dose of one of my medications and I honestly have no idea what the answers are. I’m sure it’s very frustrating for them because it’s not like anybody else can answer those questions for me but most of the time, I know nothing about myself. So imagine my surprise when I was able to make the connection between me being under stress and the occurrence of hypomanic episodes. This makes perfect sense though, and if I was self-aware I would have realised this a long time ago, because stress is on the list of things to avoid if you have bipolar disorder. Unfortunately, I’m a grad student and stress is part of the job description. Not to mention I am currently studying for an exam that I really need to pass, so a little extra stress is inevitable. But how do you study when your mind is going at a million miles an hour and you couldn’t sit still to save your life? And then when the depression hits and you can barely get out of bed, how do you study then? What about on exam day, how do you get through it if the stress induces a hypomanic episode and you can’t get your thoughts straight? The answer: I have no idea.

     I’m sure there are a number of therapeutic techniques that allow you to cope with stress and prevent it from triggering a hypomanic episode, or to lessen the severity of an episode once it hits, but I haven’t been dealing with this disorder long enough to have mastered any of them. I’m still working on recognising when an episode is starting so that I can ignore my brain and keep myself from doing something stupid and irresponsible. And since there’s only a month until my exam, I don’t really have a surplus of time in which to work on any coping strategies. Hopefully my therapist will have a quick fix, or the new psychiatrist can adjust my meds to make me a bit more stable, otherwise I’m seriously out of luck. Then again, I was pretty much out of luck when I developed the disorder so this really isn’t anything new, just another wonderful hoop to jump through.        

The Ups and Downs of Bipolar

     So I’ve been having a pretty crappy bipolar week this week. It started last Friday, I felt really good about the fact that I was no longer hiding my disabilities and that people were interested in what I had to say and by that night it had escalated into the beginnings of a hypomanic episode. I guess I should explain what hypomania is; in short it's mania without the hallucinations and delusions (which is characteristic of Bipolar Type I, hypomania is characteristic of Type II). When you’re experiencing a hypomanic episode, you are excited and almost euphoric, you have intense amounts of energy, it’s “go go go” all the time and at superhuman speeds. You talk fast, you multitask like it’s nobody’s business, you sleep less, and sometimes you have an incredibly short fuse and will lash out at anyone around you without warning. Now, on one hand, you’re experiencing a true “high” and feel pretty awesome for most of the episode and you can be extremely productive (provided you can control the restlessness). On the other hand, you have no impulse control whatsoever and also, the higher you fly, the farther you fall. Once the hypomania ends, you are left exhausted and depressed. 

               

     When my episode started Friday night, I felt awesome! Actually, I felt awesome for the entire weekend and my mood kept improving every minute. By Monday night I was talking (to myself) at a hundred miles a minute, blasting music, pacing/dancing around my apartment, and just having the time of my life. And then all of a sudden I was calm. My euphoria had subsided and I was on my down. At first I just got super tired and ended up passing out a lot earlier than usual. Now, normally the depression sets in right away and when I woke up Tuesday morning I wasn’t expecting to be able to get out of bed but to my surprise I didn’t feel all that bad. I wasn’t happy but I wasn’t depressed either and judging by the degree of hypomania I had reached, the depression should have been pretty severe, but it didn’t come. I had a relatively normal day that day and yesterday started out pretty normal too, until I got home that night. Apparently the depressive episode had just decided to hold off for a bit, to make me feel secure and then when I least expected it rip the rug right out from under me. I had felt fine all day, we went out for a celebratory dinner and I was in a perfectly good mood when I got home. I got into bed and put on an episode of Bones and then it hit, the intense depression that allows follows a hypomanic episode. For no reason I was crying hysterically and I couldn’t stop. I was (silently) screaming because my mind was going at a million miles an hour and I had no control over the thoughts that were racing through. Good thoughts, bad thoughts, neutral thoughts, you name it. It was all rushing through my head at once, like trying to watch fifty different TV channels. I eventually ended up crying myself to sleep and then spent all morning in bed. I had to go to school for a bit this afternoon and I’m glad that I actually got myself up and left the house because it brought my mood way up. That’s not always the case though. A lot of times I can’t get out of bed for two or three days, and even if I do manage to get out of the house for a bit, I just end up going straight back to bed when I get home. Hopefully this is a sign that my condition is improving but I’m not holding my breath. There is nothing predictable about bipolar disorder, regardless of how well your treatment regimen is working and mine clearly isn’t figured out yet.

     I’m seeing a second psychiatrist in a couple of weeks, maybe she’ll be able to make some changes and get me back to my life.       

Stigma

     What’s the first thing that comes to mind when you hear the words “mentally ill”?  Most likely it’s people who wander the streets, clearly experiencing a break from reality, or who’s illness is so severe that they require institutionalisation, or even an incredibly dangerous criminal. The media has done a pretty good job of stereotyping psychiatric disorders. Let’s face it, the mentally ill people we see in movies go way beyond the average definition of crazy, every serial killer portrayed either has bipolar disorder or schizophrenia. And while in some cases these portrayals are accurate, there are many high-functioning mentally ill people out there, I myself am living proof (and my therapist assures me that I am not like the people wandering the streets). But even more importantly, the majority of these people don’t pose a danger to anyone (except maybe themselves). Lately mental health associations have been campaigning in an effort to make the public more aware of the realities of mental illness and to eliminate these stereotypes (something that is long overdue). Nonetheless, when I found out I had bipolar disorder I couldn’t help but worry about what people would think about me when they found out. Would they think I was crazy? Would they think that I wasn’t capable of the same things everyone else is? Would they think I should be locked up in a padded room? Ok, maybe this is a little extreme, but you get my point. Not everyone is going to think that there is nothing wrong with being mentally ill.

     Luckily for me, I’ve yet to encounter someone who has had an outwardly negative reaction to discovering that I have bipolar disorder, but I’m sure this won’t always be the case. Then again, everyone doesn’t need to know about it. Once my medications are stabilised and my condition is under control, there will be no need to tell anyone in order to explain my manic or depressive behaviours. The only problem is that recovery can take years. You get put on this drug and that, trying out higher and higher doses of each one, you have to deal with a myriad of side effects and spend countless hours in therapy. Unfortunately, I lack any ounce of patience. I like results. I like things to be done ASAP, not to be dragged on for months.  This poses a huge challenge for me in therapy because it doesn’t take days or weeks for this type of thing, it takes months or years and this frustrates me to no end. I like my therapist---okay I’m going to go off on a tangent here for a second:

It turns out that therapy doesn’t have to involve lying on a couch while someone writes down everything you say. I know eh? Who knew? Well ok, I was aware that most people don't have you lay down on a couch but until about eight months ago, therapy (and doctor visits) for me did involve someone writing down every word that came out of my mouth. Now I understand that taking notes is generally a good thing because it allows your therapist to remember what you talked about in your previous sessions but seriously, how is having someone write down your every word comforting? Your therapist’s office is supposed to be a safe place where you can talk openly but having someone transcribing my thoughts and feelings just makes me feel incredibly self-conscience and does not make me want to talk. Enter my new therapist. The first time I went to see her I was incredibly confused. She wasn’t holding a clipboard, she didn’t show any sign of wanting to write down what I said, she was just going to sit there and talk to me, have a (relatively) normal conversation with me and not make me feel like a mental case for having to go see her. Since then, she has become the only person in the mental health profession that I have ever trusted or been willing to talk to and a big part of it is that she doesn’t shove the different approaches down my throat like it’s a one-size-fits-all thing. If I think the exercises she gives me are stupid, I can tell her straight up and then we're done with it. Plus, like I said last time, she lets me email her between visits because it’s easier for me to talk to her that way. Anyway, she’s kind of awesome (hopefully she never reads this or I’ll never hear the end of it), and if you don’t like your therapist this much then get a new one, otherwise you’ll get nowhere, trust me. 

     Alright, where was I? Oh yeah, I like my therapist and I don’t mind going to see her, but it’s such a slow process. There’s nothing I can do about it though, I’m just going to have to deal. I have now completely segued and am not sure how to bring this back around to the point of this post but basically, the media makes life seriously difficult for people like me.  Hopefully this will change but in the meantime I’d like to get stabilised so that telling people is no longer a necessity.

Three posts in as many days, can you tell that I’m trying to avoid studying?

The Ugly

     I can’t even begin to count the number of times I’ve managed to talk myself into a panic attack (thank you Lorazepam) because of worries stemming from my pre-diagnosis days or from recent episodes (medication can only do so much). Before I get into that though, this is probably a good time to describe myself before I was diagnosed and prescribed the proper medications. From what I hear, I was horrible to deal with and a force to be reckoned with. I mean, sometimes I had “normal” periods and wasn’t a burden to anyone but I think the manic and depressive episodes significantly outweighed these periods. I was never fully aware of what I was doing (and am still not) during the manic periods but I have a vague idea plus what I’ve been told from others that should allow me to piece together my psychotic era. I realise that generally you start with The Good, and then move onto The Bad, and finally The Ugly. However, in my case, the story is just ugly.  Since I’ve been diagnosed there has been some good and hopefully this will continue so I can write about it down the line but for now, it’s just ugly.

     First, there’s the inexplicable rage, irritabiliy and constant mood swings. I don’t even want to think about how many times I’ve gone off on someone I care about for no apparent reason. From what I remember, I wasn’t provoked, there was nothing that could justify the onset of that amount of anger in such a short period of time. And I’m not talking about getting mad and telling someone off. I’m talking about full on rage: screaming, yelling, punching inanimate objects, etc. I left the people I care about feeling utterly terrified of me, of what I might do (although I never physically hurt anyone besides myself). [If they ever read this, once again, I am tremendously sorry. I know an apology isn’t enough and may mean nothing to some of you, but I will probably spend the rest of my life fretting and feeling guilty about what you had to go through with me.] If anything good can be said for these fits of rage, it would be that they occurred sporadically (ie. I wasn’t turning into The Hulk on a daily or weekly basis). The irritability and mood swings, on the other hand, were anything but sporadic. I was snarky and got annoyed with everyone regularly and could go from happy to sad to angry in 1.2 seconds. I didn’t want to be around anyone and some people had learned to recognise these periods and avoided me at all costs. Clearly, I was a delight!  

     Next, we have the debilitating depression and sometimes aggressive depression (part of which is the fits of rage I just mentioned) making me even more delightful to be around. I had no energy, no motivation, and most days I could barely get myself out of bed. I didn’t want to spend time with anyone, I didn’t want to talk to anyone, I just wanted to lay in bed and be sad. I had lost all hope and nothing seemed to matter anymore: school didn’t matter, family didn’t matter, friends didn’t matter. I felt so alone, no one could understand what I was feeling, and so I started pushing everyone I cared about away. I had chronic insomnia and would spend all night crying until I, unfortunately, turned to cutting. My brain forgot everything and focused solely on the pain, allowing the mental anguish I had been experiencing to dissipate at least for a little while. I finally felt some relief but was using the worst method possible to get it. After about a year of this, the aggressive depression set in.  When I say aggressive depression, I’m referring to the mixed state in bipolar disorder where you are technically having a depressive episode but at the same time are experiencing certain symptoms of mania. During these periods, I would be depressed to the point that I couldn’t get out of bed and wanted to die because I felt worthless and insignificant. Then the manic symptoms would set in, relentlessly urging me to act on the negative thoughts. [It could also go the other way where the drunken mania would become accompanied by depressive thoughts]. I was losing control. My mind was constantly racing. I became beyond desperate. I was screaming for help from people who couldn’t help me and ruining my relationships with these people in the process (what ADHD and BPD do best).  

[This blog post by another person with BPD pretty much sums it up: http://natashatracy.com/bipolar-disorder/attempt-suicide-not-die/].

     This last bit brings me to the point of this post which is the reason I cause myself to have panic attacks. I am now relatively aware of what people probably think about me after witnessing any of these episodes and unfortunately I can never take it back. I have created a reputation of being psychotic and unstable and there may not be much I can do to change this, especially since these episodes will still happen from time to time regardless of how strictly I stick to my treatment regimen. I’ve taken to spending most of my time home alone so that when the episodes strike there is no one there to witness them, but occassionally a bit of bad luck brings them on in public. I constantly worry that my future isn’t looking to bright and that I’ll never be stable enough to get where I want to be. All of this causes me to panic on a regular basis. If only the onset of a new year actually did wipe the slate clean and eliminate your past. I’ll soon be seeing yet another psychiatrist but hopefully she can help to make my life a bit more stable. I guess only time will tell.  

Bittersweet

     Attention-deficit disorder. Bipolar disorder. Auditory processing disorder. And no one figured out I had any of them until my early twenties. Years of doctors, therapists, wrong diagnoses and ineffective medications until I (and the people around me) had had enough and suggested that there was something else seriously wrong with me. Within days of starting the new medications, I was a new person. A one hundred percent turnaround. I was happier, more social, and (relatively) stable. No more psychotic, out-of-control episodes induced by my bipolar brain. No more depressive episodes so severe that I would spend days just trying to get myself out of bed. I mean, I still have to fight with both of these disorders on a daily basis. Medication isn’t the be-all and end-all (I still experience episodes of depression and drunken mania, albeit less frequently) but it has made a significant difference in my life. The rest will be subjected to years of psychotherapy. I guess it’s a good thing I like my new therapist, eh? Third times a charm.  

     Some people may think that finally getting a proper diagnosis and treatment plan would be incredibly enlightening and may even provide a great sense of relief, and in some ways (or for some people), that’s true. For me though, it’s extremely bittersweet. Yes, I now know I’m not crazy or just an outright horrible person. I know that there’s still hope for me and that I will no longer be unpredictable and harrowing to the people I care about. Unfortunately, I am also more aware of what these same people have had to deal with during my “episodes” for all these years. [I hope they know how sorry I am and how guilty I feel about the way I’ve treated them, regardless of whether I could control it.] In addition, I get to spend the rest of my life taking a cocktail of drugs and fighting off these exhausting conditions because, like I said, medication doesn’t fix everything. Every day I have to fight to get motivated and stop procrastinating, to fend off the mood swings and sudden, inexplicable rage, to overcome the cognitive impairments associated with my learning disability, the list goes on and on.  And more than anything, I have to fight to prove myself, to show that I can be dependable and that I can accomplish just as much as everyone else. This is especially true since there remains a lingering stigma associated with being mentally ill (and I proved myself to be very unstable prior to my bipolar diagnosis).

     Now, getting back to the point of this blurb, I had been diagnosed with ADHD a few years before the bipolar diagnosis came to light but no one had ever really explained to me what exactly ADHD was or all of the symptoms associated with it. Last week, however, I brought up a couple concerns about bipolar disorder to my psychiatrist and he told me that those particular symptoms were most likely due to the ADHD. He then recommended a book for me to read, “Driven to Distraction.”  Before I read this book, all I had ever known (or assumed) about ADHD was that it caused restlessness, an inability to concentrate or focus, and hyperactivity in some people. After reading this book, I had a list of twenty some-odd symptoms that could be explained by ADHD alone. It was like the authors had written the book about my life. It was a freakishly accurate description of me. I also found out that many of the symptoms that had led me to believe I had bipolar disorder could also be explained by ADHD, which is probably why these disorders are often comorbid. Unfortunately, as eye-opening and self-revealing as this book was for me, it also provided a detailed description of how I have treated the people I care about and how they must have been feeling all these years. And once again, I am left feeling horrible and guilt-ridden. 

So, like I said, this diagnosis, this whole process, is extremely bittersweet.