Today my anxiety really flared up. I suddenly found I had less time to get to a bus that took me to a train that took me to another bus that took me to a hotel. And if I missed that last bus in the chain, there wasn’t another for five hours. And I still had to pack and get dressed and eat cake and just, in general, get ready.
And this freaked me out – or, put another way, this created some instantaneous, nasty stress and anxiety. My mother tried to help with the anxiety. It didn’t work.
You know what I hate? I hate the concept of “having fun.” I hate the pressure to “have fun.” I hate the notion that so much of what we do is to “have fun.” Now, don’t get me wrong, I don’t begrudge others their fun. They should have as much of it as they like. But for me, trying to have fun is just a big chore (or a big lie).
So I’m here, in Parma, Italy and I’m supposed to be chill-axing and “having fun.” Italy is a fun place, after all. All you need to do is stumble from gelato stand to pizza bar to have a good time.
But here’s the thing: I don’t have fun.
It’s not that I don’t want it, or that I wouldn’t have it if I could, it’s just that I can’t.
In my life depression is the worst thing in the world. Depression takes away everything from me. It tends to destroy love, life, work, everything.
And while this is due to the symptoms of depression like, “depressed mood,” it’s also due to something not mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM, the manual that defines mental illnesses) – apathy. Apathy basically means that you don’t care about anything. And when you do a “care-ectcomy” on a life, it makes it seem not worth living at all.
And one commenter left a comment to the effect of,
. . . surely if you loved and accepted yourself, you wouldn’t want to self-harm.
Yeah, that’s bullshit.
Or, more politely, that’s a myth. Just because I have the desire to self-harm doesn’t mean I don’t like, love or accept myself.
(Yes, this gets a trigger warning.)
My History with Self-Harm
I used to self-harm, sometimes known as self-injury, self-mutilation or nonsuicidal self-injury. It started when I was 13. I remember the first time. I remember thinking that the point on a compass (used for geometry glass) was very, very sharp. And then I remember thinking what a bad daughter I was. And then I remember using the very sharp compass point over and over on my flesh until I had dug a line extending about two inches on my ankle. After that, it happened again and again. I remember thinking I deserved it. And when I got older, it became more apparent that I was using that behavior as a way of dealing with pain that I couldn’t control. At 13, I didn’t get this, but at 17, I did. At 17, I was aware of the acute, painful, depressed (although I didn’t know it was depression), suicidal feelings I was having but I had no way of dealing with them so out would come the Exacto knife (I had graduated to actual blades when I was quite young). But things got better when I graduated from high school and got away from my very sick family. Over time, I stopped self-harming without really trying. I knew I didn’t want to do it so eliminating the behavior was simple once the pain lessened.
The Pain of Depression Returned, and So Did the Self-Harm
Unfortunately, the pain came back a couple of years later. When I was 19 or so, the depression really hit, like being bludgeoned with a 2×4 with nails hammered into the end of it. The pain, in all its infinite darkness, had returned. And so did the self-harming behaviors. Self-harm was being driven by the pain.
Don’t Believe Everything You Think
Recently, a commenter was here and she was frustrated because her doctor told her to separate herself from her bipolar thoughts. And the commenter remarked,
How am I supposed to separate myself from my thoughts? I AM MY THOUGHTS. Everything I do, everything I say, everything I am, started with a thought.
This is true and it isn’t. I understand this commenter’s frustration and I understand how illogical it seems to suggest that you can separate yourself from your thoughts. After all, don’t you have to think about the separation? And how does that work, exactly?
What this commenter’s doctor failed to mention is probably the most confusing part of any mental illness. The mentally ill thoughts come from the brain while the ability to separate from those bipolar thoughts come from your mind. And you brain and your mind are not the same thing.
For weeks people have been asking me my opinion of ABC’s new show Black Box. According to Wikipedia, about 6.9 million people watched Black Box’s series opener and it seems like about half of them have contacted me about it.
People are wondering about this show because Black Box’s lead, Catherine Black, (played by Kelly Reilly) is a neuroscientist who has bipolar disorder. In fact, the first episode of Black Box details the Black’s descent (ascent?) into mania after she stops taking her medication (which includes lithium, an anticonvulsant, and an antipsychotic).
In short, I think Black Box tries for accuracy and they hit it here and there but, as with all television shows, it’s dramatized and so bipolar disorder isn’t terribly accurately, or fairly, portrayed.
Earlier I wrote about the realities involved in bipolar relapse and now I want to address the question as to how to plan for a future when relapse of bipolar disorder tends to hang over your head.
I understand this question and this uncertainty. It’s very hard to live with a disease like bipolar that you know can bite you any day, any time and often without any provocation. And it can be very hard to see yourself as a serious professional, with a 24/7 career, when you know that relapse is almost a certainty, at some point.
It’s trite to say that, “no one knows what the future holds for any of us.” It’s true, but it’s hardly helpful, and it’s unfair to compare the uncertainty that the average person faces (ie, I might be hit by a bus tomorrow) to the uncertainty that a person with bipolar faces when, in his case, bipolar relapse is very likely.
So how does one plan, or even make big life decisions, when bipolar relapse means an uncertain future?
Recently, I was asked about planning for the future with bipolar disorder considering the threat of immanent relapse. This individual was in the last year of medical school and wanted to know how to plan the rest of his life, knowing that, at any moment, he might have a bipolar relapse. He was on meds, and they kept him functional, most of the time, but the bipolar medication didn’t prevent two major relapses in the past.
So the questions in this scenario are: How likely is a bipolar relapse? How can I avoid a bipolar relapse? How can I plan a life with such uncertainty?
Some people with bipolar disorder are lucky in that when they get treatment, they find something that works for them within some reasonable period of time (and this might be in a year or two, maybe not altogether reasonable, but on the whole, good). However, not all people sick with bipolar are so lucky. Some people with acute bipolar symptoms don’t find anything that works for them for prolonged periods of time. In fact, for many people sick with bipolar, it seems like they will never find any treatment that will work.
So if you’re in this latter group (and I am) what keeps you going? If you still suffer from acute bipolar symptoms and the treatment isn’t working, how do you keep trying to get better, day after day?
My bipolar brain and mind are interesting places to live. Pleasurable, no, but interesting, yes. At the beginning of the day my mind seems to start out like a blank chalkboard and then my bipolar brain screams at it as soon as I wake. And little by little the chalkboard fills up. Each scream takes up a line. Until eventually there is no room for working thought or working memory or anything all and all I can hear is my brain screaming, “I can’t do this.” It’s a feeling of stress and anxiety and it’s inescapable.
I’m not sure why my brain chooses to yell this particular phrase at me, but I can tell you, it’s impossible to focus through all the yelling.