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Three Things People With Bipolar Don’t Want You to Know

June 27, 2019

Just when I thought I was in a solid remission…

Things have been rather tense in my world recently, so naturally I’m stressed out and anxious. Usually anxiety is a feature of depression for me, but I’m not depressed at all. Just…antsy. Like something’s coming down the pike that I know I’m not going to like, and there’s absolutely nothing I can do about it.

Which got me to thinking. There are some matters we bipolar folks don’t particularly like to discuss with others, and while we know it’s not good to keep the lid on so tightly, it’s instinctive. For example:

Our “recoveryis only as good as the circumstances surrounding us. As I’ve said in the past, I prefer the term ‘remission’ over ‘recovery’, but whatever word you use, the fact is none of us is immune to triggers, and they have a lot of say in whether we maintain our mental health or succumb to a mood episode. I have a HUGE insecure streak and it doesn’t take much to rattle me in certain situations, even though I know on an intellectual level that what I’m afraid of is not likely to come to pass. I also have some wariness of people and institutions that I’m supposed to trust, and when I’m anxious I tend to become somewhat paranoid about their intentions. This does not contribute to mood stability, to say the least.

Sometimes our symptoms embarrass us. Whether it’s hypersexuality, excessive flamboyance, or even stripping down to the skin and waltzing down Main Street, our behaviors can easily end in humiliation. We don’t like to talk about it because we know we are being judged harshly. “Normal” people don’t go around their workplace singing loudly and galloping up and down the halls. They don’t harangue others on a singular topic for over an hour on the bus. Nor do they spend money on stupid stuff like a neon-yellow tank top with a giant neon toucan splashed all over the front of it. (Dr. Awesomesauce never did let me live that one down. I wonder if he still thinks about it now and again.) I don’t even think “normal” people freak out at what freaks me out: the idea of being homeless. It’s by far my worst fear. I came within a whisker of it back in 2014, and it’s like I have some weird kind of PTSD from that experience. And lately, since I’ve been dealing with anxiety, that fear has come back to haunt me even though there is little reason to be afraid. It’s my default whenever I feel insecure in life, and it embarrasses the shit out of me. Besides, how the hell am I supposed to make someone else understand it when I don’t even understand it?

And, some of us run on what seems like a primitive part of our brain, and any deviation from our routine can throw off our whole day…or our whole life. I’m not totally rigid about it, but I have to have most of the little details lined up so I can do them in a predictable fashion. Like my morning regimen: I get up, clean my glasses and check Facebook for a few minutes before going to the bathroom and immediately taking my meds with a full glass of water. I use the facilities, wash my hands, brush my teeth, and last I brush my hair. I do these tasks in the same order every single day; if I try to change things up, it throws me off and I feel like I’m missing something. The rest of the day isn’t so tightly structured, although I like to surf the Net for awhile before (and after) doing the dishes and cleaning up the kitchen. I also shower some days. The rest of the day is spent however I choose, unless somebody in the household wants to go out to dinner and/or a movie or shopping. I can adjust to changing situations with some ability to roll with the punches, but that I owe to meds (and aging). Bottom line: if I don’t have to think about it too much, I can carry out my activities of daily living without getting stressed for the most part.

Trouble is, this isn’t a winning strategy for success in life, and one of the reasons I can’t hold a job (which is another thing that makes me self-conscious) is that I can’t manage competing priorities. It was what killed my nursing career. Whatever part of the brain that makes that aspect of life work is lost to me, perhaps forever. But that’s a story for another post; in the meantime, I’ll just fight the anxiety and keep on keeping on. Which is something that I AM good at.

Spoon Theory

June 16, 2019

Have you ever heard of the Spoon Theory?

It’s a metaphor for living with disabilities from chronic illness, and it makes all kinds of sense to me. I became familiar with it when I was seeing a therapist a few years ago. Say you’re given 12 spoons at the beginning of each day; they represent the difficulty of activities of daily living (ADLs) such as bathing, cooking, going to work, even getting out of bed. For example, a shower costs you two spoons. Making and eating a meal uses up three spoons. Grocery shopping and exercise are four spoons apiece…see where I’m going with this?

You also have to give up spoons when you don’t sleep well, skip meals, forget your meds, or get sick (physically OR mentally). This will put you behind for the day and you may even get shorted the next day if you borrow from tomorrow’s supply of spoons.

The thing with the spoons is, you only get a certain amount of them per day, 12 being the operative number here, and when they’re gone, they’re GONE. There is no substance left for anything else. So you have to be careful where you use your spoons (spend your energy). Like today, I got out of bed and performed my morning routine. One spoon each. Did dishes and cleaned up the kitchen, three spoons. Watched TV and surfed the Internet, two spoons. Cleaned up frequent puppy “accidents” and washed and folded two loads of laundry (which is a real chore for me thanks to my back), three spoons. Sat down to squeeze out this post as I can’t come up with anything else to write about, two spoons. See, I’m already up to 11 and the only really productive thing I did was the wash. And I’m done. I’ve had enough day today. I’ll use up my last spoon when I take my meds tonight and go to bed, and then tomorrow I’ll get another 12 to use as I see fit.

Let’s see, I’m going to church. Driving 25 miles to get there is three spoons, attending Mass and socializing afterwards is four. That leaves five for the rest of the day, and it’s only noon. Don’t forget, getting up and dressed and taking meds uses two…well, you see what I’m up against.

I did not make any of this up. The Spoon Theory was invented by a woman named Christine Miserandino at ButYouDon’ She has lupus and she came up with the idea as an explanation for her friend as to why she has to ration her energy and can only do so much in a given day. “Spoonies” don’t have to be physically incapacitated, of course; the theory works for those of us who have mental illnesses too. Sometimes it takes a great deal of vitality that we don’t have just to complete our ADLs. I’m not kidding. There are times when it feels like taking a freaking shower uses up the whole dozen spoons all by itself and I laze on the sofa for the rest of the day; other times, like today, I had enough spoons to do what I needed to do, and I’m grateful for days like this because I don’t feel like a total failure.

I’ve actually been doing pretty well spoon-wise; sometimes I even have one or two left to spare at the end of the day and I use them to get more done the next day. But I am always aware of the need to conserve my strength, not only for the things that must be done but for the things I enjoy.

Happy Anniversary, bpnurse!

June 1, 2019

I can hardly believe it: today is the 6th anniversary of the blog you have come to know as bpnurse. I started it on a dare back in 2013 when a good friend of mine told me about a blogging contest she wanted me to enter with her. I don’t remember what the prize was; the contest was simply 30 blog posts in 30 days. I signed up just hours before the deadline, and thus began an adventure that’s still creating itself even as I try to live my best life with bipolar 1 disorder.

I did manage to post the 30-in-30, and by that time I was hooked. My friend had bugged out in the first week and enjoyed a few chuckles at my expense because she knew I’d start writing and never stop. She was right. I don’t post anywhere near as much as I used to when the illness was still new to me and I was trying to navigate life with it, as well as cope with a sick husband, a bad job situation and other personal problems. It wasn’t a fun time, although when I scroll through my older posts I can see I was able to find some humor in it all. That’s always been my go-to coping skill: if I don’t laugh about it, I’ll cry, and I hate crying.

(Hold on a minute, I’ve got two fluffy Pomeranian puppies trying to get my attention by climbing up my legs and yipping. They’re so under-loved, under-fed, under-privileged…said no one ever.)

As I was saying (dogs have decided to turn their attention elsewhere and are now outside chasing their mammas around the deck), I’ve been through some dark, dark times and humor was the only thing I had left to fight them. There have also been times when nothing on earth could make it better, like when I became suicidal in the fall of 2014 and landed in a psychiatric hospital. The only reason I made it was because I went to the hospital; if I hadn’t, I would have at least attempted to take my own life. I am certain of that. Thank God it’s never happened again, not even with the loss of my husband in 2016, and with any luck it never will. But like with all things bipolar, I can’t trust that, so the best I can do is be prepared to deal with it if/when it does happen.

In the meantime, my battle with medications appears to be over, for now anyway. I’ve pretty much given up on the idea of decreasing my meds; let’s face it, the “cocktail” works and with this disease, it’s so hard to regain your footing once you step off the cliff. I do miss hypomania and the energy that comes with it, but I definitely don’t miss mania itself and I live in fear of having another ruinous episode. If I have to experience a little depression once in awhile, it’s better than going completely ape shit in front of God and everybody. Been there, done that, got the resume to prove it.

So I say Thank You to my 530 followers and everyone else who comes to this website and reads my stuff. You’ve kept me engaged, even when I thought I would never want to write again, and you’ve supported me when I’ve gone off the rails. I hope to continue bpnurse for many years to come. God bless you all!

A Day In the Life

May 25, 2019

And now, a few words about cognitive dysfunction. Or, as I call it, bipolar brain-fade.

It’s like my mind is swallowed up by the mist engulfing all my neurons and synapses. It’s there, to be sure, because I couldn’t function even as well as I do if I didn’t have SOMETHING going for me upstairs. But oh, mercy, the ridiculous things that happen every freaking day because I’m so foggy.

Here’s what happened today. I was sitting on the sofa, playing on the computer, when I noticed a foul stench emanating from the general direction of the kitchen. Knowing that one of the puppies must have taken a dump somewhere, I got up to search for it and grab a paper towel. All was well and good, even though I got distracted by the refrigerator door which was open. I shut it and resumed my appointed rounds, cleaned up the poop and disposed of it in the appropriate receptacle. No problem.

That’s when my choo-choo jumped the tracks. I remembered that I needed to write a check and went to my bedroom for a pen because there are never any pens in the living room or kitchen. They get stolen, or the dogs run off with them and chew the hell out of them before discarding them on the sofa or hiding them under the entertainment center. So I got one and went back to the living room without my checkbook, which was in my room where the pens were. I put the pen down on my computer table and again went to my room. On the way there one of the puppies decided to run in front of me, causing me to stop so suddenly that I almost slammed face-first into my door. It was then that I realized I had to pee…

By the time I’d finished that little chore, I had completely forgotten what I was supposed to do. The dishes needed to be done and the kitchen cleaned, so I loaded up the dishwasher and wiped all the counters down with disinfecting wipes. Ben and I are so anal-retentive about that (well, we are both nurses!) that he’ll come home and wipe everything down again, even when I tell him I’ve already done it. Then I swept the floors because the girl-dogs who had the babies are shedding like nobody’s business and there are tufts of hair everywhere—even in my room, where the dogs are never allowed and the door is always closed.

Notice that I’d forgotten my mission entirely . I sat down on the sofa and got all comfortable, feeling satisfied with my contribution to the cleanliness of the house, and then I spied the pen and remembered the check I still hadn’t written. Sheesh!

THAT’S what I deal with, ladies and gentlemen. It’s the price I pay to be sane (and to not be an asshole). Like I’ve said before, I’ve talked to two separate psychiatrists about this and both were absolutely certain it’s not dementia, but the combination of repeated manic episodes and especially side effects from the medications I’m on. Lamictal and the two antipsychotics are notorious for causing brain fog, and there’s just not much that can be done about it because I sure as hell can’t stop taking them.

So goes a day in the life of bpnurse. I have to laugh at this stuff, because my family gives me shit about it all the time and once in a while the teasing stings a bit. I don’t mean to be a dingbat, and it’s embarrassing sometimes because I never used to be like this. I wonder at times what people I once knew would think of me now—people I’ve worked with and taken care of. I was a good nurse. Now I just have to work on being a good person. And I can do that even with half a brain. 🙂

Med Change

May 18, 2019

…ain’t gonna happen. At least not for awhile. Just for the hell of it, I went ahead and asked Dr. Goodenough about possibly coming down or even off a couple of my medications. I’m on SO many and I don’t seem to be able to get it out of my head that I’m taking too much. I know other bipolar 1’s who get by on three or four; why can’t I?

To his credit, Dr. G had some ideas: we could try going up on the Geodon and down on the Zyprexa, or vice-versa. We could also try tapering off the Trazodone since it doesn’t seem to be doing much for me. But in the end, he said “Let’s just leave things as they are and we’ll talk about it again later.” “Later” turns out to be three months, as I don’t have to go back until August. That’s good news because it means I’m stable enough to not need close supervision, but it also means I can’t experiment until then. And August seems like a long way away.

Still, Dr. G’s lack of enthusiasm for my plans tells me it’s probably best to let sleeping dogs lie. He said the same thing I always say—“if it’s not broke, don’t fix it.” Besides, I go through this every spring, wanting to reduce my medication burden when the fact is, this “cocktail” works. I know better than to tinker with it on my own, and I won’t, especially now that it’s silly season and I’m vulnerable to fits of hypo/mania. I think Dr. G is just waiting me out, figuring I’ll give up on med changes once I get through the spring and most of the summer. And he’s probably right; I usually lose the urge to fuss with my regimen around the time the angle of the sun’s light is a little lower.

And Lord knows I don’t want to either go ape shit, or lose my happy thoughts. I know how bad it can get, both ways. The only thing that stands between me and disaster is the eight medications I take for psychiatric reasons. This combination was carefully crafted for me, and except for some mild depressive and hypomanic episodes, it’s kept me out of the hospital and out of trouble for years. I don’t spend outrageous amounts of money or overdraw my bank account; my credit card is not maxed out. I don’t become suicidal or reckless. I find it possible to treat my fellow man kindly and smile at people going in or coming out of the grocery store. I’m not paranoid or delusional, and I don’t see cats where there are none (and wouldn’t ordinarily be, like in the ER). I don’t even have as much trouble sleeping anymore. So why on earth would I want to mess with the magic formula?

I guess I really don’t, after all. Maybe it’s better this way. I’m stable, and if I could do it on fewer meds I would, but I can’t…at least not at this point. Who knows, I may feel totally differently in three months and not even want to experiment. That’s the thing with bipolar, anyway; we can’t plan that far in advance because we don’t know how we’re going to feel in three DAYS, let alone three months.

In the meantime, there are two puppies playing at my feet and wanting attention. Good-night!

No-Drama Mama

May 4, 2019

That’s me these days…nothing to complain about, nothing to get worked up about, and everything to be happy about. The weather is gorgeous and spring is in full bloom, but there is no hint of the insanity that tends to grip me at this time of the year. I’m back in the habit of going to Mass every Sunday thanks to the self-discipline of Lent. I’m not overspending, and my bank and credit card balances show it. And Lord knows how grateful I am to be rid of that horrible anxiety that came with my recent depressive episode. I haven’t even had to pop a Klonopin in weeks. Shit happens, I deal with it, and then move on to the next thing.

Not that there’s a whole lot of “next things”. Life is pretty routine these days, even boring to a point (and I’m NEVER bored). Bipolar 1 seems very, very far away and if I didn’t know better, I’d say it was over and done with. I still don’t have a lot of energy, but then I rarely do, although I’m showering regularly, doing laundry when I need to, and I clean up the kitchen almost every day. Sometimes I wonder if my vim and vigor would return if I weren’t on so much medication; in fact, I’m toying with the idea of asking Dr. Goodenough at my next visit on the 15th if we might try reducing the load a little bit. Just to increase my get-up-and-go, you know?

I can almost hear y’all yelling “Are you f*cking CRAZY??!!” Well, no, and that’s why I’m not experimenting on my own. I have no desire to upset the apple cart by messing with my meds like I did last spring. I only want to see if coming down on a couple of them might bring some of my old motivation back. I want to garden now that the weather is so great, but I lack the oomph to dig in the dirt and lug heavy water hoses around. I want to tear my room apart and clean it top to bottom and then rearrange it, but again, the energy just isn’t there. I don’t even seem to have the wherewithal to clean the freaking bathroom; God knows it needs it, and I’m the only one who’ll do it after Ben declared his independence from cleaning the one Shelley and I use. But every day when I wake up and look at the grime, I do my best Scarlett O’Hara impression and say “I’ll think about it tomorrow”.

Of course, Dr. G would probably greet me with a resounding NO if I were to propose cutting back. I got to be a No-Drama Mama by taking my meds in the exact manner in which they were prescribed, and tweaking the magic formula is fraught with danger. I know I only recently got to this point and the reason it happened is that my meds were adjusted. So it might be argued that I’m stable at this time only because of those increases, and reducing the dose could set me back. I certainly don’t need that!

Reading back over this post, I just realized that maybe getting my lead butt off the sofa isn’t worth the chaos that could result. That’s what a mental “disorder” is—chaos in the brain. I’ve had about all of that I can stand. It’s only the meds that make it better, so it might behoove me to stay the course and not risk everything going to hell in a bushel basket by tinkering with them…even with Dr. G’s knowledge and approval. Which, of course, I’m not going to get.

But that bathroom’s gotta get cleaned somehow.

The Doctor Is In

April 16, 2019

I’m on a roll. I’ve had to go to Dr. Goodenough three times in the last three months, and I’ve already got another appointment next month. I think Dr. G is managing me very conservatively and would rather be safe than sorry. I don’t think anything is afoot—I had absolutely NO hint of March Madness, and the first half of April has been quiet—but my sleep has once again gotten a little wonky and I know he worries about that.

So he wants me to take melatonin, an OTC supplement I used for awhile some years back and didn’t work for me, and of course use the amber lenses in the evenings. I’m not so good with that, they’re a pain in the ass and they don’t fit well over my glasses. But I can take a(nother) pill, so I bought a bottle and am taking it according to his instructions. The idea is to make my sleep aids more effective without increasing any of my other meds, and so far it’s working. I’m going to bed around midnight-1 AM instead of 2 or 3 in the morning, and I’m ready to get up around 9 AM rather than 11:30. (Although I love to lie in bed in the mornings and play with my phone, because nothing hurts and I’m nice and warm.)

I am SO glad to be 100% out of that depressive episode. I never realize how bad they are until they’re over. This one wasn’t terrible—at least I never had any suicidal thoughts—and I was able to function, albeit minimally. But it was a drag, and it lasted way longer than it should have. However, I’m doing better about taking showers and getting the laundry done, and I feel lighter and almost triumphant, as if I’d lost weight (I haven’t) or made it up a steep hill to check out a spectacular view. Dr. G was pleased to see my progress, and it pleased me that he was. I like to make him happy, just like I did with Dr. Awesomesauce. He’s always upbeat and smiles a lot, and he never makes me wait; in fact, at this last appointment he took me ten minutes early. I still don’t know anything about him even 2 1/2 years into our relationship, but I think it’s supposed to be this way. No transference or countertransference going on here: we are strictly professional.

One thing I wish I did know is his age. He’s clearly a good deal older than me, and I’m 60 so I worry about him retiring. He’s never said anything about it, and he is still relatively new at the mental health clinic, but you never know. I hate change. It’s going to be nightmarish when we move to Texas in a couple of years—I’ll not only have to find a new NP or physician but a new pdoc, and getting in to see one often takes months…that’s IF I can find one who takes Medicare. So many of them don’t. I have actually lost sleep over this. I want to move, don’t get me wrong, but the idea of being in medical limbo without a doctor and meds scares me.

But, that’s a story for a whole other post. For now, I’m glad to be well again and I really think I may get through this spring without a hypo/manic episode. It’s been almost six years since I had my last full-blown mania, and sometimes I wonder if I’ll ever have another. It doesn’t look that way, but you can never tell with bipolar; meds sometimes stop working and need to be increased, or even changed to something else. But this is just like staying clean and sober: you can only take life one day at a time. (Which is harder than you might think, but that’s yet another story for a different day.) I think that’s what the good doctor would say, anyway.