If physical illness was treated like mental illness

The hamster wheel of bipolar depression

My pdoc said to me at our last appointment, "Bipolar depression is a lot more severe than unipolar." On the one hand, that's validating. On the other, it's depressing. Sometimes I look at folks who have depression and are still having relationships, working, having lives, and I feel so inadequate. Especially after a weekend like the one I just had.

I wrote a few days ago that I had gotten out of the house -- and showered -- three days in a row! And I had all these weekend plans, and was going to go to synagogue, Disney World, and the moon, and write a novel in two days...well, that didn't happen.

I decided that I would take Friday off. I hung out all day, basically doing the things I usually do, which is not much. Saturday dawned and I woke up late. 9 am. Not off to a good start, since I had planned to go to synagogue. Oh, well. It rained in the afternoon, as it does around here. I found myself hoping that it would continue raining, so I'd have an excuse not to go to the outdoor Woodstock event with the Meetup group (I had also invited some other friends, but I hadn't heard from them, so I figured that they had made other plans). By the time that I needed to leave, it really wasn't raining. But it was in my head. So I slouched on the sofa and watched TV instead. Sunday, I got up at 11, and the day was more of the same. Monday...I forgot it was even Monday.

I don't know if I need to take a day off for every day I get out into the world, or what. I don't know if I can get my sleep back on track, or how long it will take. I get so tired sometimes, even when I have enough sleep.

It's so very frustrating.

I did manage to leave the house today, and take another shower first (yay!). Went to Wendy's, then got groceries.

I don't really have a plan for tomorrow. Maybe I need to think one up.

The cat thinks I exist to pet him. I don't think that can be my raison d'etre, but at least I'm making one little furry person happy.

Tired but less fragile

So I went to the minyan yesterday and it was very nice. Got a massive hug from the synagogue president. I'm a big believer in the healing power of hugs, and his hug was worth about four normal hugs. There was lunch after the service, and although I was feeling kind of tired, the president encouraged me to stay, saying, "It's about COMMUNITY." He turned out to be right. I connected a little, and also I felt better after eating something.

After the meal, someone led a discussion on the meaning of some of the prayers we say during services. Well, that was the intended topic, at least. These discussions typically get pretty free-wheeling, and loud, and argumentative. All in a loving way. It's a Jewish thing.

I got groceries, went home and started noodling around on the computer, as you do. Suddenly, I get a text from my therapist, "Hey, I just wanted to know if you were coming today?" I had completely lost track of time and forgotten my appointment! So I rushed down there, and we had a pretty abbreviated session, but at least I showed up. We looked at my goals, and added a few more. It's not like a to-do list, but maybe it should be. Because there were other things I needed to get done, like sending birthday cards to some people, getting my hair cut, etc. Maybe I can bring this up next session. Which I hope will be next week. It depends on whether my sleep schedule stays consistent. I've slept nights for five days in a row. Still getting up and sitting outside for my 30 minutes of light.

I got a call back from an old friend who I'd left a message for a few days ago. We ended up talking for two hours. It's been thirty years. We have a lot of catching up to do.

So yesterday was a pretty good day for getting out of bed and out of my head.

I kind of had to drag myself up this morning. My alarm plays the Beatles' "I Saw Her Standing There," which starts with John counting, "One, two, three, FOUR!" It's not my favorite Beatles song, but the FOUR always wakes me up.

So I'm taking it easy today. Omigosh, I took showers three days in a row this week! I deserve an award! I think I'll go make one in Word and give it to myself! The Awake and Clean Award goes to me! I'd like to thank all the little people who made this possible.

Feeling fragile

NOTE: Robin William's suicide has been all over the news and social media. Sometimes this kind of extensive coverage can lead to more suicides. There is help. If you or someone you love is feeling suicidal, please call the suicide hotline: US 800-273-8255. UK 08547 90 90 90.

Now back to my irregularly scheduled post:

I tend to hide from the world a lot. This isn't entirely intentional. My weird sleep patterns prevent me from making plans because I have trouble showing up. Depression doesn't help much either. It's hard to get going and get out of the house.

Lately a lot of my human interaction has taken place over the internet. Mainly on Facebook. And a lot of it is just me "liking" stuff, reposting other stuff -- and just stuff.

My sleep is turning towards normal again and I'm perking up -- possibly due to adding Adderall to my medication cocktail -- and I felt moved to try and make some social plans.  So I called the synagogue that I had been avoiding attending for the last year to make a reservation for an event they were hosting. The woman that I talked to was filling in for the secretary, but she took my information and everything seemed fine.

The reason I had been avoiding attending the synagogue is that, during the summer of last year, I made the mistake of thinking I was fine and overcommitted myself. This happens a lot when I'm in that other fun part of being bipolar: hypomania. I've never done anything extremely manic, I just feel really good and believe that everything is going to be great and, well, make promises my brain can't keep. I offered to fill a position on the board, started doing work, and then got depressed again and dropped out of sight. I finally touched base with the president a few months after, and explained about my depression, and he said it's good to hear from you, we'd welcome you back. Ok. And then I didn't go back because I was still feeling embarrassed about letting people down, and afraid of what they'd think of me. I'd barely connected there, and then I disappeared.

The secretary called me back today. She was all, where have you been and why do you want to come back now and very annoyed at me. Proving that my fears were justified. So I hung up and cried. Then I e-mailed the president and asked him whether or not I was still welcome there. He gave me his cell number, and when we finally connected, he went through the same rigamarole that the secretary had gone through. So I ended up in tears again. I said that I felt like he was angry at me, and he said, no, it's just that he speaks his mind. 

He finally said that this was a big event with an enormous amount of people attending, and suggested that maybe it might be better for me to think about coming to a minyan* on Thursday. I agreed that it was a good idea. And he said that if I come I will see how much people miss me and appreciate having me there. 

So that is my plan. Also to renew my membership. I hope people appreciate me being there. 

In the meantime, I am also trying to make plans with some friends who live near me, but not near enough that it's easy to get together. I think that's also coming together.

I've made a few other social plans, too. Hopefully will be able to follow through. I don't like living in isolation. It just sometimes feels safer that way. It feels safer having a monitor screen between me and the people I interact with. Hello, you. But when I do get out, I generally enjoy myself. I need alone time, but I don't need to be isolated all the time.

*A minyan is the ten Jews that it takes to be able to say certain public prayers and to read from the Torah. So it's kind of shorthand to call a weekday prayer service a minyan.

Juggling patients' rights and caregivers' limitations

Last month, San Francisco approved a law that requires mentally ill people who refuse help to be "given" (read forced into) outpatient treatment. There are, of course limitations to this. But it is an interesting step in taking away the rights of individuals. On the one hand, a family at their wit's end trying to help a family member who is ill and refuses treatment, or is homeless because s/he refuses treatment, now has further recourse than before. In most states, a person can be compelled to be hospitalized for a minimum of three days if they appear to be a threat to themselves or others. This law takes things a little further.

On the other hand, it's can be seen as another way to depersonalize and take away the rights of those who are mentally ill.

Does it erode an individual's rights? Or are we talking about people who aren't well enough to know how to take care of themselves? Outpatient treatment isn't as bad as compulsory hospitalization. Hospitalization can be an additional stressor to a person who is already at the end of their rope. Sometimes, you are required to sit and wait indefinitely in claustrophobic ER rooms for a doctor to come admit you. Sometimes, you are taken in shackles by policemen who really don't understand what they are dealing with (although more and more police forces are getting training in working with mentally ill people in crisis). Your belongings are searched, and anything that might be used to harm you or others is taken away. All this and more can happen, even if you are there voluntarily.

Outpatient treatment is a little gentler. This could be daily or periodically. It would probably involve supervised medication (they watch you swallow, and they keep your pills for you). It might involve therapy, and consultations with family members,

To me, the one 100% positive outcome of this law is the requirement that "Voluntary treatment with the same level of outpatient services must be offered throughout the process and also made available to those who do not qualify for Laura's Law." People on psychiatric medication often have fragile lives. They lose jobs, supports, housing. They lose insurance, and have to jump through hoops to get help paying for medication that in some cases is obscenely expensive (For example, the average price of a 30-day supply of 5 mg tablets of Abilify is about $850 without insurance coverage). Most of these medications only work if you take them consistently over a period of time. So if this law provides help for the people who ask for it, I say amen.

LA Times: S.F. approves Laura's Law to ensure mentally ill receive treatment
SFGate article: Laura's Law passes easily in S.F. supervisor's vote

MOS

I haven't written in a while, mainly because I have MOS syndrome: More of the Same. My sleep keeps getting kicked around the clock, I keep having to cancel appointments, I have no social life to speak of (unless Facebook counts). Do I need a med adjustment? Do I need a kick in the ass? I don't know.

So I haven't wanted to come here and write the same old boring crap. Then today, I remembered that writing this bs sometimes helped me to come to grips with things, so I thought I'd give it a shot.

Beats playing Facebook games all day.

I'm stuck in a hole where taking a shower or cutting my toenails is a big accomplishment. On that scale, yesterday was a Good Day, because I did both of those things. I also did a little laundry and unloaded the dishwasher. Go, me.

One thing I am currently managing to do right is to change my eating habits. I don't understand how I drifted so far into junk food land. I used to love fruit, and ate vegetables every day. That's not to say that I didn't eat junk food, but I also ate healthy food as well. Lately, I've been eating less and less of the produce aisle and more of the candy and chips aisle. My sister and I joke about getting the four major food groups: candy, cookies, chips and soda. I buy lettuce, but it usually rots in the fridge. I told my sister recently that I should just bring it home from the store and toss it right into the trash.

But slowly I am starting to actually eat that lettuce. Also vegetables and fruit. Trying to get more fiber. When I crave junk food, I try to eat something healthy first, see if it does the trick.

So far, it doesn't. I can't fool my taste buds. But at least I've eaten something healthy before I eat the M&Ms.

Also, you can take my diet Coke when you pry it from my cold, dead fingers.