mental illness issues
When someone breaks a leg, people “get” it. They understand it. They empathize with it. They’re compassionate about it. The same thing is true when people get cancer or undergo surgery for a heart condition or even get the flu. And yet when someone has a mental illness, people just don’t “get” it. And in spite of spending more than a decade educating about my mental illness, bipolar disorder, sometimes I feel like they never will. This tends to make people with mental illness feel alone.
In the world of chronic illness there is a concept of “caregiver fatigue.” This is where caregivers of people with chronic illness get burned out because they just spend so much time and effort caring for another person. This is a real thing and a real problem.
I would suggest there is also such as thing as “bipolar treatment fatigue.” Bipolar treatment fatigue is when a patient with bipolar disorder becomes burned out because of all the time and effort it takes to fight the bipolar disorder. I think this is a real thing and a real problem.
Recently a received a message from someone who was very distressed because her family wouldn’t accept her because of her mental illness. Her family hadn’t cut her out of their lives, necessarily, but they didn’t understand bipolar disorder and just waved her off telling her to “take her meds.” They made no effort to support her dealing with her mental illness.
And to this woman, family was everything. She didn’t think she could live without the support of her family.
And while I know that family is critically important to some people, I’m here to tell you: you can live with a mental illness, with bipolar disorder, without the support of your family.
I was having a very annoyed/angry day. This was annoying me and then that was pissing me off. And I realized this was a thread through my day and thought to myself, “Yup, I have days like that. It’s a bipolar thing.” And then I wondered, “Do normal people have days where they’re mad at everything?”
And then I realized I had no idea. I have no idea if normal people have irrationally angry days. I’ve forgotten what it is to be normal.
[And before someone has a hissy fit because I’m saying that people with bipolar disorder aren’t normal, please read the linked article.]
Last year, I wrote an article on psychomotor agitation at HealthyPlace. Psychomotor agitation (or retardation) is a symptom of bipolar (and unipolar) depression as well as hypomania/mania and very little information about it is available (in spite of the fact that it is listed in the Diagnostic and Statistical Manual of Mental Illness (DSM-5)).
Most definitions for psychomotor agitation include the words, “inner restlessness.” I don’t know about you, but “inner restlessness” reminds me of a 22-year-old who can’t find himself and so is backpacking across the country. It really doesn’t sound like a mental illness symptom – let alone like a serious one.
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?
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.
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?