Another visit with Dr. Awesomesauce has come and gone, and once again I am left to ponder the discussion and extract the pearls of wisdom from it. I do this every time I see him, because there really is a lot of substance even in the joking and teasing interspersed between the serious talk.
As I expected, I got my ass handed to me for not calling him immediately when my depression spun out of control. “You scared the hell out of me,” he said, “and if you ever do that again you’ll get a size-10 boot planted in your backside!” He was only half-kidding. I told him I’d given Will permission to call if I started sliding—or zooming—which mollified him somewhat, although he reiterated that he would be seriously pissed (and very sad) if he had to attend my funeral.
We went over my hospitalization and he was pleased with the progress I’d made in there. But he made it clear that one of the things I’d been working on still needs improvement, and that is my tendency to take on other peoples’ problems…..in no small part because it allows me to not deal with my own. I’ve done it all my life, and it’s hard to remember “not my circus, not my monkeys” when I’m in the thick of someone else’s situation.
But remember it I must, for I have plenty of my own business to take care of. Something drove me crazy enough to want to commit suicide; it was all the crap I’d allowed to build up over time until it nearly crushed me. I’ve allowed myself to get sucked into the vortex of others’ drama over and over, trying to fix their problems and feeling guilty because I couldn’t; in the meantime, my personal stressors were mounting and I wasn’t paying attention to them. The combination of these was what led to the collapse of all my defenses and landed me in the hospital.
So I’m having to draw boundaries, which is NOT easy for me. I can love people and listen to them when they’re going through things, but this is one of those times when being an empath does not serve me well and I must resist the urge to ignore my own needs in order to try to meet theirs. If I’ve got a handle on what’s going on in my life I can be a little more helpful, but I still need to maintain my boundaries. Or, as Dr. A so delicately put it: “don’t smell the shit in someone else’s yard when you’re up to your neck in your own pile”.
Not my circus, not my monkeys. He liked that expression and we had a good chuckle about it. Then he grinned and said, “You’re laughing—that’s a VERY good sound.” It was nice to know that he had missed my laughter, like Will had. Our last several visits have been sober and serious, and this one felt more like the old days when we’d spend a good part of our sessions cracking each other up (and sneaking therapy in between bursts of giggles). We talked about Australia and how stinky koala bears are and how the tame ones will hold onto you just like a baby. He showed me pictures of his recent trip to Florida and told me about the jellyfish he’d accidentally touched (“ugh, it was just like touching snot”). And I told him the story about Carl, the housefly who plagued us while I was inpatient.
It’s good to have things back on track with Dr. A, even though he stared me down till I confessed that I still have ever-so-fleeting thoughts of death (which are banished fast when they do come). Now, if I can just get my life in order again, I’ll be golden. :-)
I saw my new primary care provider yesterday. My doctor of some 20 years retired this past summer, so an appointment was set up for me with the resident whom I will call Dr. Pleasant when I was released from the hospital. I wondered why I was following up with an internist after a psych hospitalization (I see Dr. Awesomesauce on Monday), but as I’m generally a compliant patient, I decided to keep the appointment.
It turned out to be a most satisfying experience. Dr. P spent a full hour with me, going over my entire medical history—when was the last time that happened?—and he listened respectfully to what I had to say. He may be all of 30, if that, but he is very thorough and seems to know what he’s doing. He’s a lot more interested in my diabetes than my former doctor was, and of course he wants me to diet and exercise; but he’s realistic about what I can do (or will do) with all my aches and pains and isn’t going to push me too hard. As a result, I’m going to cut back on the carbs at least a little, and make a good-faith effort to take off a few pounds.
Then we got down to basics about the bipolar. I wasn’t looking forward to this part of the discussion, seeing as how I live on the thin edge of dignity and it’s always hard to talk about my psych history with medical people who don’t know me. But it became obvious within a very short time that Dr. P is completely non-judgmental about mental illness, and he thinks it’s great that I finally have a definitive diagnosis so I can work on getting better within that framework. “Sometimes it takes a hospitalization and new eyes to look at the situation,” he said. “It’s tough to be in limbo and not know for sure what you’re dealing with.”
You can say that again. All I feel, now that the question of what “flavor” of bipolar I have is settled, is relief. I’m not thrilled, to be sure, but I can live with it. Besides, I had it long before someone slapped a label on it…..I just wasn’t fully accepting because the old diagnosis was so nebulous. It gave me wiggle room to deny I had the illness at all, and for me that can be very dangerous. You can’t give me wiggle room on such a serious issue.
I did the same thing with alcohol way back in the day, before I quit drinking—I figured that if I didn’t get hammered every time I drank, I didn’t have a problem. But then it got to the point where I WAS getting hammered all the time, and when I finally sought help, the good people at Alcoholics Anonymous broke through the last of my denial. I accepted the fact that I did, indeed, have an alcohol problem, and it happened much more quickly than accepting that I had bipolar disorder. The only thing that’s kept me from destroying myself completely is that dignity thing I was talking about earlier. I don’t want to be messy. I don’t want to be thought of as a coward. I don’t want people to know how much I hate myself sometimes. And I don’t want anyone to be angry with me.
But those are thoughts for another day. Today it’s cold and dry, but the sun is shining and my daughter has invited Will and me over for a barbecue. It’s time to enjoy life a little and appreciate its gifts.
Awhile back, I wrote a post about my frustration with what I considered to be a “wastebasket” diagnosis (bipolar not otherwise specified), wishing Dr. Awesomesauce would pick a number and settle the question for good. I was in bipolar limbo; I remember the Vocational Rehab counselor who asked if I was BP 1 or 2, and trying to explain what the hell NOS meant in the larger scheme of things. He was confused, and for that matter, so was I.
But now all that’s past history because I received my definitive diagnosis in the hospital. Funny how a depressive episode and not a manic one got me “upgraded”……if you can call it that. I totally skipped BP 2 and went straight to type 1.
I have mixed feelings about this. I’ve actually long suspected I had the more severe version of the disease because some of my manic episodes have been pretty wild. No, I’ve never walked down Main Street naked, but I did cause a lot of disruption on the job at times when I was working, and there have been a couple of instances when I was so out of control that I nearly had to be hospitalized. Still, I was able to continue my dalliance with denial, almost convincing myself that my case wasn’t really all that serious. And sometimes I’ve even talked myself into believing I wasn’t bipolar at all.
That’s over with now. If nothing else, this diagnosis establishes once and for all that I really do have a major mental illness and I can’t screw around with it anymore. It’s not something I can’t live with or learn how to handle better, but I have to give it a lot more respect than I used to.
If you’re not bipolar, you may be wondering what the difference is between bipolar 1 and 2. On the surface, it’s fairly simple: it’s the degree of mania one experiences. People with bipolar 2 have hypomania rather than full-blown mania—they are often more talkative and productive than usual, they tend to increase their activity and have grandiose ideas about what they can accomplish, and they can become hypersexual, which obviously can be a strain on relationships. On the other hand, they may be more irritable and angry, which is called dysphoric hypomania, and thus quite unpleasant to be around.
People with bipolar 1, on the other hand, have “classic” manic symptoms, many of which are exaggerated versions of the behaviors seen in hypomania and can be very dangerous. We can have hypomania too, either by itself or as a prelude to mania. Most of my own manic episodes have been preceded by a hypomanic state, which is the part of the disorder so many of us yearn to hang onto. I looooves me some hypomania and wish I could live the rest of my life in that condition; unfortunately, there’s no medication or therapy that allows us to keep the hypo without either going off the deep end into depression or sailing off on a manic high.
Not that it keeps us from trying. I myself have been known to drink a half-gallon of coffee and/or manipulate my medications to keep a budding hypomania going; trouble is, I usually don’t stop there, but keep zooming—straight into the danger zone. Only the thin edge of dignity has prevented me from taking actions that would embarrass me forever or put me in danger of incarceration. Otherwise, my manic state usually results in loud arguments in front of restaurants (in the pouring rain, no less), wild shopping sprees (I spent us into bankruptcy twice!), psychosis (gotta love seeing cats running under the linen carts in the ER), even threats to kill people (thank you, Wellbutrin).
Which is why I wasn’t sure if my manic episodes rise to the level of bipolar 1, but apparently the doctor who diagnosed me saw enough in Dr. Awesomesauce’s notes to label it as such. At any rate, it’s settled now, and it will never change because this is not the kind of illness that goes back to a lower level once the patient is better.
I would be lying if I said the label doesn’t hurt a little bit. No one grows up thinking they want to be bipolar 1 (or any other kind) when they get older. But it’s also a good thing because there is no more dancing around it, and God knows I needed to accept this as a permanent part of my life. And at long last, the confusion is over.
They weren’t in any hurry for me to leave.
I’d been inpatient for five days when my doctor and the treatment team asked me when I wanted to go home. I wasn’t quite ready, but I was eager to get out before the weekend. I wanted my husband, my pets, my freedom. And I really, really wanted my own bed because the one I was sleeping on jerked knots in my back.
So we settled on Friday, even though the team suggested that if I felt even a little freaked-out about going home, I was welcome to stay longer. What a contrast to regular hospitals, where they boot you out the door before you’re fully awake after a day surgery. But I was determined, because I felt safe and I didn’t want to become so comfortable in there that I wouldn’t be able to manage on the outside.
I continued to take advantage of groups and individual therapy, except the art classes because I’m about as far from artistic as one can get. I did join the drumming group though, and I played blackjack with some of the other patients on my last night in the facility. What fun that was—all of us were in there because we were or had been suicidal, and here we were laughing and having a good time. What a difference a week can make!
Then Friday dawned, and I performed a quick mental inventory to assess whether I was truly ready to go home. Yes, I was. The experience of being in the psych unit had been a good one, but I needed to resume my normal life, as stressful as it was. So when Dr. W met with Will and me, he agreed that I’d improved enough to leave. Then it was off to the nurses’ station to gather my belongings and get my discharge medications…..and then finally through those locked doors to the outside, where an impossibly blue sky and brilliant fall trees awaited me.
I never knew that fresh air could feel—or smell—so good. I marveled at the grass, which had never seemed so green, and the bright orange pumpkins that remained in front of a few houses. As we drove home I had to fight off the urge to stick my head out of the car window and take in the commingled aromas of burning wood and newly-fallen leaves. Everything was so beautiful that it nearly took my breath away. Who knew that a week in a mental hospital could make one appreciate life so much?
But I knew that week had made a real difference in mine. For one thing, I was alive, and I might not have been had I not checked myself in when I did. For another, I’d gotten over my fear of the place, and if/when something like this happens again, I’ll be less reluctant to go. And I’d learned that being around other mentally ill people had its benefits too—there was no judgment, because we were all going through a bad patch and we could relate to each other’s suffering. No one else can do that, no matter how much they love us or how hard they try to understand.
Thus endeth my story about my first (and hopefully only) hospitalization. Thanks for following along on my journey. :-)
Here’s another big thing that happened during my hospital stay.
I had a wonderful case manager named Ted (name changed to protect his privacy) who visited me, sometimes more than once a day, to talk and do a little therapy. Like most people with a psychiatric history I deal with a lot of guilt and shame, especially when it comes to the fact that I have one. As I told Ted, I can’t help it. It’s the way I was raised. I would never in a million years judge anyone else with a mental illness, but with myself I’m as tough as nails. I have no right to be sick. I have no right to seek help when I need it. And I certainly have no right to let my condition affect others.
So when he mentioned writing a letter of forgiveness to myself, I automatically demurred, citing my upbringing as the reason for hanging onto the guilt and shame even though the people who perpetrated it are long dead. But then I thought about it: what might happen if I did forgive myself? Would the world come to an end? Or might I be able to move forward in my life and leave all that behind?
Alone in my room that night, I began to scribble notes for my letter. At first it felt false and unnatural, but as I warmed to my subject, the words flowed more smoothly and the thoughts behind them came more rapidly. Here’s what I wrote:
It’s been a long time coming, but I need to write this letter so I can finally let go of the self-flagellation and self-hatred I’ve hung onto all these years. This will be a hard habit to break. Fear and loathing are all I’ve known since I was very small. But break it I must if I am ever to become a whole person.
I forgive myself for having a mental illness that I never asked for, didn’t want, and can’t get rid of. It’s nobody’s fault…..not even my own.
I forgive myself for my behaviors during mood episodes. I am not always in control and that frightens me as much, if not more than it frightens others. But I am doing my best to minimize the disruption to our lives by taking my meds and getting enough sleep and seeing my doctor regularly.
I forgive myself for being an inadequate mother. The children have already done so, and so far not one of them has seen the need to sit on a psychiatrist’s couch in an effort to get me out of their systems. I did do some things right.
I forgive myself for not being the woman I think my husband deserves. Not once in all our married life has he ever said I lacked anything as a wife—I put that judgment on myself.
I forgive myself for scaring the hell out of my loved ones from time to time. Will looks worn out and I know part of that is due to worrying about me, but he says there’s nothing to forgive and I’ve got to let it go.
I forgive myself for being afraid to NEED. It’s OK to call my doctor when I’m feeling fragile instead of waiting until I’m desperate. It’s OK to ask for support during difficult times. So many people have offered to help, and it’s OK to let them do it. Really.
I forgive myself for losing jobs, being irresponsible with money, and generally causing problems. It’s done and I can’t undo it. All I can do is keep trying to make it better.
And perhaps the most important of all:
I forgive myself for not being all things to all people, and even for disappointing them every now and again. I’m only human and I can’t meet everyone’s expectations all the time. It’s time to let go of being a “people-pleaser” and avoid getting sucked into their dramas. And it’s time to regard myself at least as well as I do others—to draw boundaries and have them respected.
Now, I can’t guarantee that I won’t still be hard on myself sometimes—over half a century of self-criticism doesn’t go away overnight—but I have this letter as a reference point. It’s all good. :-)
It was on my second night in the unit that shit got real.
I had never fallen this far down the rabbit-hole before, and if I hadn’t been where I was, I probably wouldn’t be here to tell the story. That was when I hit rock-bottom and realized that no matter what I might want to believe, this was some really serious stuff I was dealing with and it wasn’t ever going to go away.
You see, I was surfing the Internet on the Kindle Fire they kept at the nurses’ station for the patients to use (with a ten-minute time limit), when I decided to see what was in my chart on the patient portal. I was curious to see what was being said about me. What I didn’t expect to see was a new diagnosis, and for a minute my blood ran cold. Bipolar 1!?? I couldn’t possibly be THAT crazy, could I? It wasn’t that I hadn’t suspected it or that Dr. Awesomesauce hadn’t talked about it, because I’ve had some pretty gnarly manic episodes and it only takes one to be diagnosed with BP 1. But seeing it in black and white like that made me realize that I really was sick, I wasn’t making it up, and it wasn’t just “all in my head” (although it is in the technical sense).
I skulked off to my room before my ten minutes were up, where I proceeded to bawl until I thought I was going to throw up. I did it quietly so the nurses who popped in every 15 minutes wouldn’t think I’d totally lost it and ship me off to the unit where the really sick people were, but it took me about half an hour to get it out of my system. It wasn’t just the diagnosis itself; it was missing my husband and pets, wanting to be home and yet being grateful that I wasn’t, and wondering if life would ever get better.
But as the days passed, it did get better, and before I knew it, my sense of humor returned and I found myself laughing and joking with my fellow patients. I was getting intensive therapy and meeting daily with my treatment team, but there was a great deal of healing in the bantering and the trading of one-liners. There was a single housefly who had made its home with us, and it buzzed us all the time, creating consternation and generally irritating the hell out of us. Someone named it Carl, and we began to share our theories about how he’d gotten through three doors. One girl drew a picture of Carl, to which I added a poem, and we gave it to our therapy leader who was in on the joke.
I know…..only in a psych unit could a fly be the source of amusement.
Patients came and went. One night a fellow came in who I will call Manic Man; he was in a mixed episode, which meant he was suicidal and had enough energy to attempt it. He dominated therapy groups; he paced endlessly and tapped his pen against the table until the rest of us wanted to scream; and worse, he never shut up. Yap, yap, yap. And then it hit me: this was exactly the way I behave when manic. And I understood for the first time why Dr. A works so hard to prevent it, and why my family gets pissy about it. It might be fun for me, but for them it’s annoying!
Finally the day came when my attending psychiatrist, Dr. W, asked me when I thought I’d be ready to go home. They were in no hurry to kick me out—in fact, I got the feeling they’d have preferred that I stay a little longer—but by Wednesday I felt so much better that I wanted out before the weekend. We agreed that Friday would be my release date…..but first, I had some work to do. And that was where the forgiveness letter came in.
To be continued…..