Last time I wrote about missing the signs of improving bipolar disorder but today’s question is, if your bipolar is improving, how do you know what you’re doing right that’s driving that improvement? In my case, the answer to that question was easy – it was a bipolar medication change. But things are not always so simple.
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It’s easy to tell when your bipolar is getting worse. At least, it sure the heck is for me. I spend my nights crying and trying desperately not to kill myself. It’s a notable thing that you really wouldn’t miss.
But how do you know if your bipolar is improving? Is it actually possible that you might miss the signs of your bipolar getting better?
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I was having breakfast with a friend of mine the other day and the topic of her suicide attempt came up. She attempted suicide years ago at a very low point in her bipolar disorder. And what she said was, she found herself very upset about it presently, even though it was years ago. She said she never dealt with her suicide attempt and now that was hurting her.
I understand. I think many of us don’t deal with the realities of a suicide attempt. I think many of us what to put our suicide attempts behind us so badly, that we just push them away without ever considering how deeply something like that scars us.
For my own part, I know what I’ve done with my suicide attempt. I’ve rationalized it. I’ve intellectualized my suicide attempt as “passive” and “not a real attempt” (since my chances of truly dying were low) and this has allowed me to, well, pretty much ignore it. But will that technique come to haunt me one day?
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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.
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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.
I don’t. I’m depressed. I’m anhedonic. I’m apathetic. I don’t have fun. I just don’t.
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.
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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.
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Last week I wrote about my urge to self-harm. I talked about how after many years, I still have the urge to self-harm but that I don’t actually follow-through and do it.
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.
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(Yes, this gets a trigger warning.)
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.
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.
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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.
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