Silver Linings Playbook

Why is it that you always have to see a movie more than once to catch its more subtle nuances and flesh out the characters?

I loved Silver Linings Playbook the first time I saw it. There were a few cringe-worthy scenes in which the bipolar lead would go off on a loud, profane, and often tangential rant, during which my husband glanced at me with a half-smile as if to say “See what I get to live with?” And I LOVED the scene in which Pat and Tiffany got to chatting about the different meds they’d taken in the past: I’ve had similarly animated discussions with my son’s mother-in-law (also BP) over the baked beans at family dinners while everyone sat back and watched us, like cats at a tennis match.

This time, however, I viewed the film with a more critical view of the relationship between Pat and his family, all of whom are rather rough around the edges, but Dad is by far the most challenging. In fact, he has many of the same issues as his son, but cannot seem to understand for the life of him where Pat’s coming from. Well, I don’t know about Pat, but I’d have issues with a family member who craps all over me and then gets offended when I complain about the stench.

In fact, I’m dealing with such an individual as we speak. Tonight, I found out that my closest relative, who’s headed for assisted living (courtesy of a fall and subsequent hip fracture), has her late husband’s snub-nosed .38 revolver hidden somewhere in her room at our house. She’s never even taken it out of its holster; its only value to her is that it DID belong to him, and thus holds some sentimental value.

Only one problem: assisted living facilities don’t allow firearms on the premises; she really has no other option than to give it up. None of her kids wants it, and they all live too far away to come and get it even if they did.

Now, I’ve wanted a gun since I took police firearms training awhile back—I once had a concealed-carry permit and was a pretty decent shot—but never got around to buying one. Not that I’d have gotten all butt-hurt if my relative had preferred to sell it, but it seemed to me that a good solution would be for me to keep the weapon. However, when I said as much, she declared loudly that she’d throw it in the river before she’d let me have it.

The reason? She didn’t like the fact that I wanted it… she hinted dramatically at her suspicion that if I were to go “mental” again, I might use the gun on myself.

I should mention that this relative is one of the only three people who know I briefly considered suicide a couple of years ago…..and now she was using this knowledge against me to announce in front of God, her roommate, and anyone who happened to be walking by that she thinks I can’t be trusted with a firearm. It’s apparently never occurred to her that there are enough pills in my medicine cabinet to kill me five times over, or that I would never in a million years leave a bloody mess for someone else to clean up. All that matters to her is some long-ago speculation about what it might be like if I weren’t here.

And as the story of Pat Solitano shows, it’s hard to focus on the silver linings in your future when your family insists on dragging you back to your past.

Driving While Bipolar

I got pulled over awhile back for driving under the influence of Zyprexa.

Actually, what the Oregon State Trooper noticed was my huge gaping yawn and erratic weaving within my own lane as I was passing him on the freeway about half a mile from where I worked. I was still yawning uncontrollably, with both hands on the steering wheel in plain view as I’d been taught many moons ago by my brother-in-law (himself a veteran of countless traffic stops), when the officer came up to my car window and asked for the usual documents.

“Get enough sleep last night, Ma’am?” was the initial query as he looked over the information, then peered into my eyes over his sunglasses. “You look pretty tired this morning. Did you know you were having trouble staying in your lane?”

I didn’t—at least, not until that moment—but then it occurred to me that I had absolutely no recall of the drive, and I lived 25 miles away from the job. “I guess I am a bit tired,” I conceded, then promptly stumbled into an episode of verbal incontinence that could have gotten me arrested. “I’m taking this new medication, and it makes me a little drowsy in the early mornings.”

The trooper was instantly interested. “What medication, Ma’am?” he wanted to know. I could’ve bitten my tongue off at that moment, because not only had I essentially just admitted to DUI, but now I had to explain what I was taking, and even worse, why I was taking it.

With all of the intelligence and grace of the college graduate that I am, I replied “Umm…’s well, um, Zyprexa.”

He was diplomatic, but firm in his pursuit of the truth. “And what kind of medication is that?”

“It’s something to calm me down a little,” I answered, realizing in the same moment how this second blunder must have sounded to the officer, but I was still reluctant to tell him that it was an antipsychotic. “It’s not a narcotic, though. Look, here’s the medicine.” Luckily I was carrying it with me for PRN (as-needed) use, so after fussing in my purse for a moment I produced the little green bottle and held it up for inspection. I was hoping he’d see that there was no red “C” for “controlled substance” on it and let me go without further ado.

“And you’re taking this because……..?” he persisted.

My humiliation was almost complete, and I blushed to my hairline. “It’s for my bipolar disorder.”

The expression on the trooper’s face changed the instant my confession was out. “I’m sorry,” was the surprising response. “My wife’s sister has that. Brutal disease—she had to stop working because of it. Wouldn’t wish it on anybody.” Then he handed me back my license and registration and continued, “You know it’s a crime to drive under the influence of ANY intoxicant—even prescribed meds. Right?”

My mouth went dry instantly and I could barely croak out the words “Yes, sir.” But instead of ordering me out of the car and reaching for the cuffs, he leaned in closer toward my window and said, “Look, Ma’am, since you’re close to your work I’m going to let you go, but only THIS time. I don’t want to see you on this freeway again when you’re too sleepy to drive safely. Good luck and have a nice day.”

To say that this was better than a Christmas gift would be an understatement. Not only had I barely escaped an embarrassing and potentially damaging criminal charge, but by the grace of God I hadn’t injured or killed anyone……including myself. So whenever I talk to people about bipolar medications, I often throw in this little story as a public-service announcement that even non-narcotic drugs can make us unsafe behind the wheel.

Bottom line: NEVER operate a motor vehicle until/unless you know how a medication affects you. (That includes dosage increases; something that was OK at 20 mg may knock you on your keister at 40 mg.) Thank you for not driving while bipolar, and like my friend the trooper said….have a nice day!

Normal? What Is This “Normal” You Speak Of?

Actually, it looks an awful lot like…… At least for the time being.

It seems a bit odd to be discussing bipolar disorder when I’ve never felt less bipolar in my life. But I think I love this newfound serenity even more than I do my hypomanias. This is what it must be like to live without a mental illness. I’m not bouncing off the walls, I’m not sweating bullets, I’m not itching to claw anyone’s eyeballs out, and I’m not the least bit depressed.

I’m feeling—dare I say it?—downright normal.

It’s not that I don’t have a lot of stress in my life. I have a close relative whose health has been in free-fall for over a year, and then wound up in a nursing home after breaking her hip in a catastrophic fall. Suddenly, I’m thrust back into a caregiving role without the title (OR the pay), and while I don’t mind helping her face the transition from independence to assisted living, I am greatly disappointed in this relative due to her mean-spirited and incessant sniping, almost all of which is directed at me.

I understand that she’s upset and angry. I understand that she’s scared of leaving her comfort zone and going to live in a place where they’re going to insist that she get out of that damn bed of hers and take a shower once in a while. But it’s not my fault that she chose to overdo it on the narcotics—AGAIN—lost her balance, and fell….or that she’s no longer safe to manage her life alone, at home or anywhere else. I wasn’t the one who did it, and I don’t have to own it. What a concept!

And I’m handling it. It pisses me off, but I’m dealing with it competently and with a degree of equanimity that I wouldn’t have thought possible even a few weeks ago. At long last, my meds are working in perfect harmony and all’s right with the world, even though what’s going on in MY world really sucks right now.

It doesn’t hurt that the weather has been bright, warm, and sunny for the past week; that’s when I’m at my best no matter what the surrounding circumstances may be. But there’s a maturity in the way I see this situation that wasn’t there before, and I’m almost afraid to trust it for I know how my illness works, and I’m already waiting for the proverbial other shoe to drop. In fact, it’s such a foreign concept that I can’t help thinking that it’s all a dream, and that I’ll wake up in the morning in my default mode….which is to say, a bipolar hot mess.

But for today—and maybe even tomorrow—I’ll take pride in knowing that I’m taking care of business like a real, live normal person. And for now, that is enough.

Strange Brew

Looking down at my handful of sanity tonight, I am once again amazed by the different colors and shapes of the various medications in my palm, and I wonder at the technology and the brilliant minds that brought them into existence.

Here is a dark blue capsule; it’s the antipsychotic, which for some reason costs less for 40 mg caps than it did for the 20 mg. About $50 less, which is a significant savings. I don’t think I’ll ever figure out what pharmacies are thinking when they set drug prices…..all I know is I appreciate spending less money and getting more bang for my 100+ bucks.

Here, too, are the two giant fish oil capsules which help keep my blood fats within acceptable levels; they’re a clear amber and really quite pretty, if a bit hard to swallow. The major side effect is the seal burp—a nasty phenomenon that accompanies the ingestion of said fish oil, which is rather unpleasant and causes my cats to circle around me and sniff my breath for half the night.

The round yellow pill is Klonopin, which I take only on the nights when I want to sleep and not be anxious the next day. Then come the five little white ones; the diamond-shaped one is metformin, which is the only thing I take for diabetes. There are also round ones of varying sizes; the largest and second-largest are blood-pressure meds, and then come the 1 1/2 tablets of my mood stabilizer and a 3 mg melatonin to seal the deal on sleep.

My daytime regimen is much simpler: another dose of mood stabilizer, a Vitamin D gelcap (is there anyone who lives in the Pacific Northwest who’s NOT Vit. D deficient??), still another blood-pressure pill, and the oval, salmon-colored antidepressant. Make that one-half tab: I’m on a sub-therapeutic dose because my p-doc (psychiatrist) won’t let me increase it. Unfortunately, a therapeutic dose tends to throw me right into mania and he knows it, so I’m forced to cut these itty-bitty pills into two pieces.

I cursed him for almost a year over this. Every Sunday when I filled my med minder, I’d have to haul out the pill-splitter and try to get this slick, odd-shaped, elusive little sucker to fit into the mechanism. Every week, I’d chase them round and round the bathroom, split ’em into thirds instead of halves, crush a couple inadvertently, and swear horribly when I did it because he kept me on a VERY short leash with those; and if I tried to refill even a day too soon, I couldn’t get them until I was completely out.

And then, about a month ago, I accidentally discovered that they split beautifully when you hold them between your thumbs and index fingers and merely snap them in half. Who knew??

Stuff about Nothing

OK, so I talk a lot about bipolar disorder and what it’s like to live with it, but I don’t ALWAYS talk about bipolar. Sometimes I will hold forth on politics or religion (you know, the topics our parents taught us never to discuss in public), and other times I just yammer about anything that comes to mind. Today, I’ll tell you a little about who I am.

As mentioned elsewhere on this blog, I’m a registered nurse who’s been more or less happily married for almost 33 years. My husband should be high on the candidate list for sainthood after putting up with me for so long, although he does have his own less adorable moments (like when he buys yet another model airplane when there are 75 others downstairs in the man-cave). We have 4 beautiful grown children; we also had a daughter who died shortly after birth, which was easily the worst time of our lives. To say the least.

Three of these beautiful children have produced a total of six even more beautiful grandchildren, with one more on the way this October. My ‘baby’, the 22-year-old, is gay, and while I’m pretty much your average conservative Catholic girl, to see this young man and his partner together is one of the joys of my life and I will defy ANYONE to claim I should be ashamed of him.

When I’m not working—like now—I enjoy blogging (surprise, surprise), gardening, writing articles for the world’s largest online nursing community, NFL football (my team is the perennial also-ran Chargers from San Diego), church activities, and good times with my hubby and our ever-growing family. Life is never better than on a summer’s day with the grandsons playing on our big front lawn, the barbecue grill cooking up a delicious meal, the sounds of birds in the tall pines, and a glass of iced sweet tea in my hand.

Still, if I didn’t have this weird, warped sense of humor that enables me to laugh uproariously at almost anything, I’d never have made it through life. While I don’t find physical comedy particularly enjoyable (think the Three Stooges and most Jim Carrey movies), I delight in life and break up at some of the damnedest things…….like body noises. I’m the eternal 10-year-old; though I love sophisticated humor, there’s nothing funnier than a perfectly timed butt-trumpet during a sober moment or the middle of a tense movie scene.

So, that’s a bit about me. How about you?

How I Got Here

You know, no child wakes up in the morning thinking, “Gee, I wanna be a psych patient when I grow up.” For one thing, they don’t understand it, no should they be expected to; mental illness is hard enough to explain to adults (especially those who don’t have it). For another, kids with issues don’t usually know that ‘normal’ kids interpret the world differently, and wouldn’t believe you even if you told them so. All they know is that somehow, in some way, they’re always wrong.

That’s how it was for me, anyway. It didn’t help that I was the daughter of hypercritical, social-climbing parents who never admitted to having skeletons in the family closet. To hear them tell it, we didn’t have mental illness in the family. We didn’t have alcohol or drug problems. We were too good to possess such low-class character flaws……even though both sides of the family were loaded with alcoholics and depressives, and I’d bet the house payment that my mother was every bit as bipolar as I am.

That attitude was a good portion of the reason why I was never diagnosed until late in middle age. Even though my folks are long dead, it’s hard to overcome thirty years of conditioning and another couple decades of trying to undo the damage it did. Looking back now, I know I’ve had this illness for most, if not all of my life; the signs were all there even as far back as kindergarten. I was the kid who was always about 15 degrees off ‘cool’, the grade-schooler who was picked last for the softball team and perpetually stuck in the outfield.

I was the 13-year-old who fell into a months-long depression after my grandmother died and was put on about a half-dozen different meds in the search for what ailed me. I was the high-schooler who dreamed of escaping my so-called life full of dateless Friday nights, and making my parents sorry for treating me like crap by dying in some dramatic fashion.

I was also the young wife and mom who would’ve committed suicide the night after my second child was born and then died, if only I’d been able to pry open the seventh-floor window in my hospital room. And, I was the adult who drank like a fish and still have no recall of entire six-month periods of my life, courtesy of what I now know to have been mania and alcoholic blackouts.

But since we supposedly didn’t have these problems in our family, they went mostly unnoticed—and untreated—until the defining mixed-manic episode in the winter of 2011-12 that led to my first visit to a psychiatrist. I’d secretly suspected bipolar disorder was at the root of my issues for years after taking a couple of online quizzes that pointed strongly in that direction, but when I waltzed into my new doctor’s office with this announcement, he asked, “What in the world makes you think you’re bipolar?”

It wasn’t to be the last time he would challenge my thought processes…..not by a long shot. Although he wound up agreeing with me about the initial diagnosis, we’re still wrangling about the type of bipolar I have, and just about the time I think it’s time for him to pin it down once and for all, the damn thing does its chameleon act and changes again. My provisional diagnosis was Bipolar Disorder Not Otherwise Specified, which in essence is a wastebasket diagnosis that means “It looks like bipolar, smells like bipolar, and walks like bipolar…..we just don’t know which flavor.”

Then he reluctantly changed it to a squishy Bipolar II because I had a couple of hypomanias which may or may not have crossed into manic territory; he just couldn’t put a finger on the way my illness was acting. Now that I’ve had a full-on mixed manic/depressive episode, however, he can’t rule out a determination of Bipolar I, even though I’ve never had frank psychosis (except, of course, for the hot mess I found myself in during my brief time on Wellbutrin).

I don’t know how I feel about this. While there’s absolutely NO reason to get hung up on a number, it bothers me that after 15 months and several near-disastrous mood swings, I still don’t have a definitive diagnosis….other than the fact that I’m bipolar as hell. Meh.

The “C” Word

No, no, no, not THAT “C”-word……I meant The “C” Word. As in “crazy”.

I can’t speak for all bipolar people, of course, but I’d have to guess that most don’t particularly like having that term applied to them. It sounds so “One Flew Over the Cuckoo’s Nest”-ish. Who wants to be associated with images of straitjackets and padded rooms?

Part of my personal issue with the “C” word is the fact that it’s slung about so carelessly. There is actually a bedroom-furniture store in my area of the country that calls itself “Mattress Mania” where, according to the commercials, their customers “save like CRAZY!!” I’d like to think that the suits who run the company came up with this out of ignorance, but there are times I feel like writing to them and asking them if they ever once considered how it might come across to people who suffer from real, live mania (and don’t want to be called crazy).

So…..are bipolars crazy?

Natasha Tracy, a bipolar blogger of considerable repute, says she is. She wears her BP colors proudly, even defiantly, and has no problem calling things as she sees them. I want to be her when I grow up. But somehow I doubt I’d ever be comfortable with using “crazy” to describe what I go through with this illness. Sometimes I’m out of control, strung out, not in my right mind, even desperately ill…..but I am not, nor have I ever been crazy. Capisce?

Fortunately, I don’t face this situation often….for one thing, I’m able to maintain at least SOME dignity even during a mood episode, and have thus far managed to refrain from swinging from the chandelier or mooning some poor schmuck driving down the interstate. (Well, except for this one time when I was with some friends and we were all pretty wasted……)

In fact, the only time I’ve been called crazy was a few months ago, back when I was still employed, and my assistant and I were taking a break and talking about some unusually heavy stuff. She was aware of my ‘nonconformity’ and tried very hard to understand, even when I was off my rocker and behaving erratically, and when she used the “C” word, it was in the context of trying to explain my own illness to me: “But it’s not your fault that you’re crazy, it’s the bad genes you got and the brain chemistry that’s out of whack.”

It was on the tip of my tongue to use a few of my choicest adult words in response; luckily, I was pretty stable at that time and I was able to swallow them, realizing in that same instant that her intentions were wholly benign—she had no IDEA of how much I dislike that word. That’s one of the aspects of stability that I really love and wish I could experience all the time….the nanosecond or two between an act or a statement I consider insulting and the knee-jerk reaction, which has enabled me to save several relationships since I’ve been medicated.

So my sweet little helper went on her way, believing she’d offered something of value to the dialogue and never knowing that for an instant, I’d wanted to belt her over the head with a copy of the DSM-IV.

Now THAT would’ve been crazy!

My Meds, My Self

And now, a few words about the wide, wild world of bipolar medications.

Now, I am in awe of the few BPers I know who manage their illness with nothing more than a healthy lifestyle. Yes, they still have their ups and downs, and some I quietly suspect would do better if they’d take at least a mood stabilizer. But after 15 months of tweaking, adjusting, discontinuing, adding, and otherwise messing with some very powerful drugs, I often wish I had the grit (to say nothing of the self-discipline) to take bipolar in my own hands and tell it, once and for all, to go to hell.

Alas, my version of the disorder is serious enough that it requires multiple medications to wrestle it under some sort of control. Four, to be exact, unless you count the over-the-counter melatonin tablets my psychiatrist recommended to help me sleep better. I’ve got ’em all—a mood stabilizer, an antidepressant, an anxiolytic, and even an antipsychotic, which is really only to prevent mania, and the dose gets increased when I have a breakthrough episode.

Not that I’ve ever been psychotic. Well…OK, I have been. Once. But only when Wellbutrin (a different kind of antidepressant) made me bat-shit crazy a couple of years ago and I threatened to kill a co-worker’s abusive boyfriend…among other illegal and despicable acts. That damned drug is the ONLY reason the term psychosis is noted on the same page as my name and date of birth, and it looks terrible there. And that pisses me off.

Fortunately, my current regimen seems to be working well. It took me a long time to accept that I have to take pills—several of them—just to be normal. In the beginning I really resented this and fought it tooth and nails. But then, I’m still having trouble accepting the fact that I am, and will always be “mentally ill”, though there are nice periods of stability in between episodes when I’m not sick at all. It’s a great feeling to not be actively battling the disorder…..Big Ugly, as I call it, and I have simply called a truce.

And it’s times like this that I find myself absurdly grateful for the handful of sanity I gulp down every morning and night. I’m grateful for the scientists who invented them, the wise physician who prescribes them for me, and the fact that they pretty much keep me from hunting for the snub-nosed .38 I asked my husband to hide from me during my last bout with suicidal ideation.

I’ll talk more about my love/hate relationship with bipolar medications some other time, but right now, it’s time for my ‘nightcap’ of Lamictal, Geodon, and Klonopin. Sweet dreams!

For Rent: Used Nurse. Dirt Cheap!

I’d better explain that. I am not, of course, a ‘lady of the night’ who dresses up in a nurse costume and gives bed baths to her, um, patients for money. What I AM is a newly unemployed, 50-something nurse who’s showing her age, and as such, does not suffer fools gladly. Although I was fired, essentially, for working while bipolar, it became evident that I had to go when I stopped co-signing peoples’ bullshit.

As a nurse in 21st-century America, I’m more like a glorified food server than a skilled technician. Nurses in almost every healthcare setting are expected to fluff pillows, bend straws, suck up to administration, doctors, patients and their families, and even use scripted messages when addressing their “customers”: “Is there anything else I can do for you right now? I have the time.” Oh, sure, by all means let me fetch that warm blanket for you while ignoring your roommate who’s turning blue…..

It’s even worse in management. At least when you’re a wage slave, you get to clock out, go home, and let somebody else deal with the irate family member who’s making completely ridiculous demands on behalf of his relative. As a salaried executive type, you not only have to listen to the jerk, but you must bend over and take whatever he dishes out, fix whatever led him to complain, and then apologize profusely so that maybe—just maybe—it will raise your Press-Ganey (customer satisfaction survey) scores. Or failing that, you might be able to convince him not to file a lawsuit against the facility for not giving his 300-lb. diabetic grandmother a piece of cake.

Yes, it’s that bad. And I’ve got to admit that after several years of dealing with this sort of thing every day, I finally marched in to my boss’s office and refused to handle any more of it. By that time I was literally on the verge of a nervous breakdown (which I proceeded to have a couple of weeks later) and no longer cared what he or anyone else said: I was done catering to idiots. He was more than welcome to continue doing so himself; I, on the other hand, was over it. In fact, I’d already decided that the next 70-year-old “child” who got in my face about Mamma’s laundry getting mixed up would be informed that she a) had obviously mistaken me for someone who gave a shit, and b) might want to take that up with the poor woman who was actually in charge of that department.

But it wasn’t until the nervous breakdown happened that someone decided that I was no longer fit to work in the capacity to which I was accustomed. I could’ve understood it if I’d been fired when I declared my freedom from petty crap and verbal abuse, but having panic attacks and going out on medical leave? Really??

So here I am, healed up and ready to go back to being a worker bee…..but nobody’s hiring. And at my age, my prospects aren’t exactly dynamite (even if my temper is). Now what do you suppose a used nurse with a bad back and a sketchy work history is to do?

You know what, I should become a waitress! I’ve been slinging hash and kissing ass for years……and I never even got any tips for it. Where’s the closest Denny’s?

I Hate Being Bipolar. It’s AWESOME!

If ever a bumper sticker needed a beverage alert, it was this one. I saw it a few months ago on the back of an old Honda that was held together with prayer and duct tape—kind of like my life—and promptly spewed Diet Coke all over my dashboard.

Then I went home and told this story to my family, only to have them stare at me like I was wearing red ribbons in my hair. I keep forgetting that people who are not cursed/blessed with a serious mental illness can’t quite wrap their intact little minds around the humor inherent in carrying around a big, bad ol’ DSM diagnosis like bipolar disorder. They don’t get the jokes. You know, like Foghorn Leghorn saying, “Boy, I say Boy, you’re exceeding the limits of my medication!”

Then again, those of you who are too young to catch the reference to a 1960s-era cartoon chicken might not get that one either. ‘S okay…..sometimes, you just have to get to know me to understand my peculiar brand of warped. The fact that I’m a registered nurse of some years’ vintage also has done things to my sense of humor that would make a sailor blush. Poop stories? Nurses know ’em all: we’ve seen it, smelled it, cleaned it…..and they’re made fresh daily. Ba-da-boom!

All kidding aside, being a health professional who just happens to have a nasty case of manic depression really sucks sometimes. Well, it sucks more often than that, but I digress. It’s a difficult thing to hide when you’re working side-by-side with other nurses, doctors, patients, and the assorted characters who populate healthcare facilities. These people usually know each other’s business only slightly better than they do their own, so when you experience a bout of mania or depression, everyone in the building knows about it almost before you do.

I’m a rather unusual case, seeing as how I wasn’t even diagnosed until the age of 53. Now I look back and can see that I’ve had bipolar for most, if not all of my life; it explains the melancholy of my childhood, the tempestuousness of my 20s and 30s, the crazy things I did (like throwing a change of clothes and a pack of cigarettes in the bed of a co-worker’s truck and driving down to Ensenada, Mexico on a Friday night). But like too many people with the disorder, I thought I was merely defective and didn’t deserve any better, and I was also terrified of mental illness. My parents used to talk about people who were “loco en la cabeza” (IOW: nuts) in hushed tones, and of course there weren’t any crazy people in OUR family……no, we just had parents who drank like fish, and aunts, grandmothers, and sisters who had quiet nervous breakdowns behind closed doors.

So I got to be the ‘special’ one. I don’t get what my mother called “the vapors” or pass out drunk in the parlor; I have a MENTAL ILLNESS. And sometimes the label seems to weigh more heavily than any patient I’ve ever lifted.