Friday, May 22, 2009

Bipolar Disorder and Social "Normalcy"

During my last hospitalization I was struck with how comfortable I felt. I was on what I would jokingly refer to as "the bipolar ward," where 90% of us seemed to be suffering from bipolar disorder. I was surrounded by people who battled some of the same things I struggled with and usually, like myself, had at least one or two co-occuring illnesses like anxiety disorders or addiction.
I got along with everyone. We talked about our similarities, our differences, the doctors we didn't care for, the ones who listened, and we witnessed the ascent or descent of one another's moods from afar. Respectfully distant, unless called upon, we saw ourselves and knew when to back away.
I could live like this, I thought, feeling slightly deranged at the prospect. Not locked up in an airless, stale hospital building, but surrounded by my "own kind." Granted, the hospital is designed to keep stress at bay, to keep the patients occupied with "activities" and engaged in meetings, but alot of it is hokey. Only the conversations with other patients kept me from coming unmoored.
Socially, this disorder can be devastating, particularly when one is vocal about suicidal ideation; it scares people away. Social malfunctions such as the withdrawal of depression, or the forced speech of mania, are off putting to those who do not understand. I have few friends and family who truly stick by me through these rough patches. They either suffer from mental illness, or just care enough to have empathy.
Sometimes I ask myself how I can be expected to function in a world that demonizes mental disease, or that just doesn't understand me. I have to hide my dirty little secret or become a pariah at worst, or at the least have every odd thing I do attributed to bipolar. I have trouble in groups and meeting new people due to my illness and the social withdrawal it has brought about. I also have trouble with social norms. I tend to violate them unconsciously.
One of the aspects of "recovery" is "psychosocial skills building." I see the relevance and necessity of this, yet at the same time I wonder if it needs to begin with the "well" among us. I would like to think that I am very accepting of all types of people who violate social norms, not rude people per se, but unconventional folks. I miss many of the people I have alienated and wonder if it was something I did, or if they just got caught up in their own personal lives. I try to soothe and quiet my paranoia and move on, but I don't want to miss out on the friends I haven't met yet. I want to get out there and show the world just how eccentric I can be.

Thursday, May 21, 2009

Bipolar Poetry

This is a poem I wrote 4 years ago, it is about my suicide attempt at 16. Don't worry, I am not suicidal right now, this is just a glimpse into the past. This is the first of my bipolar poems that I am sharing on this blog. I only have a few, but I do have poems on many more subjects...some of which I will probably share at some point.

The Procession to the Misplacement of a Mind, and Halfway Back, in Two Parts
By Christina

Walking to that long winding bridge,
Teetering over salt flat, marshy waters,
Bottle of pills grasped in fist,
One, two, how many taken now?
His slap still burns my cheek,
Ten, eleven, how many left now?
The sulfur odor washes over me
To float in the James River,
Released, I will drift like refuse,
Lungs becoming waterlogged, weighted down,
My hand has started shaking,
Harder now to open pills,
Antidepressants are supposed to heal,
Hate myself, going to kill,
Steps tripping faster toward edge,
Can not wait to fall,
Welcomed back by, water’s embrace,
Missed me from the womb,
So easy to let go,
My feet are heavy,
Hands can hardly fumble,
Twenty seven, Forty three....
Blurring vision smears sky,
View is almost gone,
Sun nearly does set,
Nothing more to watch,
Stinging slap comes back,
Where am I?
Will they come?
Stop and stare,
Incomplete overdose-done.
Whole body convulses,
Jerking head, twitching,
can no longer,
see the bridge,
losing my sight,
heavy breath,
pounding heart,
swaying drunkenly,
ground shifts,
spilling pills,
into stomach,
Sixty. “Gulp.”
Better now.
Licking lips...


Forced to the hospital doors,
It will be different here.
White walls close in.
“Were you lovers?” she asks again.
I drank the charcoal,
Rocks of tar in my belly,
I met a boy there,
who put a knife through,
his entire hand
What a scar
After striking me
the other one
played the guitar
Was it cold?
I don’t remember Newport News,
Virginia, I hate the state,
but wanted to drift,
Like Woolf in a river,
River of James,
Edge of swamp and city,
I am dry above your waters
Life claimed me that day,
But I was never the same
Ever since that time
Ever since the fall I had,
the one I took,
When I misplaced my mind.

Wednesday, May 20, 2009

Book Review on Bipolar Disorder Demystified By Lana R. Castle

I have to admit that I have a special fondness for Lana R. Castle's, Bipolar Disorder Demystified: Mastering the Tightrope of Manic Depression. It was the first book I read about bipolar disorder. This book is somewhat overlooked in the bipolar "canon," yet it contains many fundamental teachings about psychology and psychiatry.
Castle struggles with bipolar herself, and she experienced the loss of her sister to suicide. Her personal experiences add depth to her heavy consultation of many experts in the field of psychiatry. She also revisits, for the psych 101 student, some of the fields' historically well known contributors. One aspect of the book that really stands out is her open-minded approach to treatment modalities. So much bipolar literature pushes an agenda of "you must all take meds, that is the only real treatment for this disease." Despite her belief that they are, "integral to my own recovery," she doesn't write in black and white terms. She posits that "most" of us do need the meds, but without condescending to those who cope without them. She uses her own life stating, "Had I not discovered the ease with which I could lose my life, nor experienced the loss of my sister, I might have tried to make it some other way (Castle 194)."
The ease of using this book is also great for people who are unfamiliar with the topic of bipolar or mental health. There are bulleted "Caution" sections, charts, a glossary, exercises, and affirmations. Much of her advice is extremely pragmatic, from tips on "fighting fair," to a chart entitled, "potential ways to help someone in a depressive episode."
It is her lack of condescension and her warm, empathic voice that made this book so easy to read from cover to cover. Many books by experts without the disorder contain case studies, and sometimes those books are cold and clinical, creating an "us and them" mentality. There is only so much one can say about this disease, it is how it is said and the depth one goes into which help paint an ever more intricate picture of what it is like to live the bipolar life.

To buy this book online visit:

Tuesday, May 19, 2009

The Treatment Team

Another aspect of treatment for mental illnesses like bipolar disorder, is a good treatment team. In a perfect world someone with mental illness would have a supportive family and friend base, a good general practitioner, a nutritionist, a therapist, a psychiatrist, and a naturopath. All the books say so.
However, in the real world most of us cannot afford to have all of the above practitioners, we may have frightened many family members and friends away, and our insurance companies would just say "Naturopath?" laugh, and hang up on us. Finding "good" practitioners is also about as easy as finding the long lost friends who bolted when they learned your diagnosis. They changed their phone number.
I have had some really messed up experiences with practitioners: the hypnotherapist who lied to me to get me out of her office but had the nerve to hug me on my way out, the male psychiatrist who picked at his scabby face and head with his bitten-down nail nubbins, while twitching slightly and staring at my breasts, the stoned female psychiatrist who kept drifting off in mid sentence (having double dipped one too many times into the sample closet), and the psychoanalytical psychotherapist who I wasted 4 years with; he encouraged me to stay off meds and use marijuana, and ignored threats of suicide, all while encouraging me to wallow in the past, and that I was never wrong, even while manic and semi-delusional.
Yup, I've had some real gems on my team.
My current psychiatrist (or pdoc as we refer to them in cyberspace), forgot to write the prescription for the main drug we discussed yesterday. He also refused to take me off a drug that is making me physically unhealthy, encouraged me to try an over the counter weight loss supplement, told me to use my benzodiazepene for sleep (a no-no, especially for someone with addiction), and after informing me that I might need a sleep aid the rest of my life, due to side effects from the aforementioned ill-making med, told me to cut my sleeping pills in half...all while getting paid $150 for spending 15 minutes with me.
My general practitioner looks concerned and clueless and says "They sure have you on a lot of stuff." Poor guy. He also tries to give me meds and advice to counteract the devastating effects that psych meds and my mood disorder have had on my body. Most general docs do not treat a complex illness like bipolar, letting "the experts" treat it. I feel he may do better than them at this point.
My therapist is pretty great. She does Dialectical Behavior Therapy which teaches skills for emotion regulation, social skills, mindfulness, and coping mechanisms. The point of DBT is to relearn emotional intelligences which have morphed due to mood disorders or past trauma. It was created for people with borderline personality disorder, but can be useful for other psychiatric maladies as well. I can rarely afford to see her though, even though it is a $25 copay, I am spending all of my money on meds and seeing the semi-incompetent pdoc every two weeks.
In my dream world scenario I'd have a naturopath, a nutritionist, an acupuncturist, etc. If only I had the cash for a complete team of professionals to repair my head.
I do have several supportive family members, especially my indomitable husband, and a friend or so. It is hard to let myself rely on them due to massive amounts of guilt. They are few, but they have been integral to surviving my imperfect world.

Sunday, May 17, 2009

May Madness: How Many Pills From Normal?

Hopefully as the month progresses my readers will learn more about bipolar disorder and its treatment options. Although I appreciate that Mental Health Awareness month includes awareness of other mental maladies I have the most expertise on bipolar. Soon I may choose to move on to different subjects, as my interests are varied and unpredictable, much like my mood. Today's subject: "Crazy Meds" is a term I first saw at this great web site devoted to the topic: .
I have conflicting opinions on whether these meds cause more harm than good. Are they creating a world of moodless, overmedicated zombies trying to keep up the status quo, or are they saving lives (including my own). Furthermore, are they really necessary and effective for everyone with bipolar?

Two questions I have been asked as someone with bipolar: "Is there a pill for that?" and "Can't you just do some yoga?"

Good questions... The answer to the first one is an almost definite no. For most of us there is no magic pill, but "cocktails" of four all the way to--I don't know that there's a limit to how many pills they will prescribe. I am 5 pills or so from normal, and several of those pills are to counteract the side effects of others, which include, early waking insomnia, weight gain, and oddly, depression. Each pill has a veritable encyclopedia of side effects, some of which can be dangerous or deadly.
Being on no meds and trying yoga and positive thinking has its own drawbacks. If one's mood in unstable, beginning positive work on one's body or mind can be severely hindered. Suicidal ideation may creep up, or hypomania or mania can rear their ugly heads. Mania and its slightly less severe sibling, hypomania, can lead to anxiety, anger, irritability, elation, hypersexuality, and a level of hyperactivity that can burn a person's mind and body into ash. Bank accounts can be emptied, credit maxed out, relationships ruined, and lives endangered. At worst suicide or psychosis can occur. The crash from mania can be a devastating plummet into despair and depression. I don't think yoga or positive thinking can begin from those extreme emotional states.
There are theories about an effect called "kindling" which may occur in the bipolar brain. This theory posits that when a bipolar brain experiences stress, the stress reaction continues long after the event. The brain literally smolders with past stresses. For me stress is the biggest trigger that I face, and its effects are long lasting. Medication is supposed to prevent this reaction.
The trouble with these flawed medications is that they don't work for everyone, the side effects can be terrible, the combos have not been safety tested, and the adjustment of dosages and drug types are a fine pseudo-science; some people require an almost constant tweaking of their meds to remain stable.
There is also an enormous amount of stigma attached to taking psychotropic medications. Yet who would judge a diabetic for taking their insulin?
As a person who takes these medications I can attest to the fact that I hate taking them. I'd like to believe if I stopped them I could deal with my haywire emotions or the burning fires in my brain. Maybe one day I will be able to deal without them. For now though, I am scared of the mercurial nature of my brain, the way the neaurotransmitters dopamine and serotonin teeter totter back and forth, in a sickening motion beyond my control. The illness is real, the treatment imperfect, and the question of the lesser of two evils is right there: staring back at me in the mirror every day.

Saturday, May 16, 2009

Diagnosis and Identity in Bipolar Disorder

Continuing with the theme of Mental Health Awareness Month, today I am going to analyze the connection between diagnosis and identity in bipolar. Mental illnesses such as bipolar disorder are often seen by a percentage of the "normal" public as weakness or a personality malfunction. This misconception is passed onto the ill population, resulting in guilt, denial, and identity confusion.
When is the last time you heard someone say "I am cancer," "I am diabetes," or "I am lupus?"
Only with mental illnesses, which are so linked to emotion regulation, behavior, and "normal" functioning, do people identify so strongly with their illness. I am depressed, I am schizophrenic, I am bipolar. A physical illness is generally seen as not being one's fault, unless of course you are obese, or you smoke, drink, or otherwise abuse yourself, then you get blamed entirely for anything that goes wrong with your health, but that's another blog.
This disparity between the physical and the mental is a direct result of the guilt which is projected onto those of us suffering with mental illness. When one views oneself as somehow "other", somehow "abnormal," it can lead to tremendous feelings of worthlessness and guilt. Perhaps this stigma is what actually feeds the dysfunctional behavior some of us with a diagnosis of mental illness perpetuate in our lives.
Because of the stigma and the guilt for simply being diagnosed with a mental illness many of us who receive these hard to shake labels, deny that we actually have them. Granted, some people are incorrectly diagnosed, or misdiagnosed. However, in my own personal experience, I read book after book, and article upon article, saying to myself, "This is me." Yet at the same time I refused medical treatment for nearly a decade. Refusing treatment, for some people, can cause a diminished quality of life, many physical health problems, a host of social dysfunction, and at worst, parasuicide (suicide attempts) or suicide.
Why so much guilt, and why is it so easily absorbed? The brain and emotions feel like the "I" to most people, and when your own "I" is completely out of control it is perceived that you are out of control. No one can see the way the neurons are firing in your brain, or sense the imbalance of crossed wires as they watch you do or say something "bipolar." This is one of the reasons the connection between the self and the diagnosis is so complex, like a spider's indelible web.
Many of us do not know who we are anymore if we spend years denying our illness, refusing help, or hiding behind the disorder. Once I got help I thought, Who is this medicated person? This is not me. I have to take a cocktail of medication, I am a sick person. I am bipolar.
But then I realized I'm not.
I have bipolar disorder, it is a medical illness. I struggle with bipolar, and sometimes, I suffer with it. But it does not ultimately define me as a person. The brain is the largest unchartered area left to explore, and the sooner the knowledge of it expands, the sooner everyone will understand the mechanisms of bipolar and other mental health disorders. When the stigmas associated with these diseases can finally be shattered, maybe people won't identify them as what they are, or who they are, anymore. Perhaps the denial and guilt will not worsen people's symptoms, or cause years of pain which could have been eased, if only somewhat, by compassionate and informed treatment.

Friday, May 15, 2009

May Is Mental Health Awareness Month

Many people are unaware that May is National Mental Health Awareness Month. Thus this whole month is dedicated to getting the word out! It is one great step in reducing the stigma of mental illness. Suicide rates are also highest in May. This may surprise some of you who are familiar with SAD (Seasonal Affective Disorder). There are various theories about the length of the day and exposure to more light correlating with these increased rates. I have my own theories that some people either fail to recover from the winter blues, and succumb to their lengthy depression, or become manic during the spring only to crash into a dark depression by May-July (highest rates in an overall time period).
People need to be educated on these topics, not only to pull away the veil of mystery around mental illness, but so they can protect and care for their own mental health, or advocate for their mentally ill family members or friends. According to the Mental Health America website "58% of Americans reported struggling in their lives at the end of 2008," that is no small number. Struggles faced during trying times like these can lead to mental health disturbances like anxiety and depression, often in previously healthy individuals. There are more tragic murder-suicides than I've ever seen before on the news. People's stress levels have gone so high as to be pathological. We all know that stress kills. Stress hormones like cortisol put a huge strain on the immune system, and they can lead to obesity, heart disease, cancer, and depression.
There are many ways to practice self care to reduce stress and protect or improve mental health: eating right, sleeping right, meditation, exercise, relaxation techniques, talking to a friend, listening to music, journaling, being around pets and children (well, sometimes), watching funny movies, mindfulness practice (living in the moment), and practicing your faith (church, temple, mosque, grove of trees, etc.). If the problem is interfering with day to day activities psychotherapy, medication, or support groups (online or in person) may be helpful.
The above self care activities are things we "should" all be doing anyway, especially for those of us who are already struggling with mental illness. Some people report self care as being 50% of their treatment. Medications, particularly with bipolar disorder, generally only manage symptoms; they do not necessarily keep people free of all symptoms.
Look for more to come here during the month about mental health, and especially my intimate acquaintance, bipolar disorder.

To learn more about Mental Health Awareness Month, or tools for improving mental health visit:

For more information on the theories about longer days, light, and increased suicide rates worldwide visit:

Thursday, May 14, 2009

One Cliché After Another

This is my first blog, and I don't want to sound cliché, but after filling out the profile here with mundane things like "About me," I am not responsible for how bad my writing gets. This blog is going to be about my observations. Life, mental illness, Earth religions, poetry, book reviews, and rants will be found here. Am I supposed to pick one topic? Oops, I suppose I am not prepared to specialize yet. I'd prefer to approach this blog as if it were my own magazine on life.
I hope that I don't destroy my reputation in any way which will make me unemployable (insert sarcasm here). I am not ashamed to have a mental illness (bipolar disorder), nor am I ashamed to be an Earth religionist. If society wants to discriminate against me based on these facts than I will fight the stigmas associated with them by shouting it from the depths of the blogoshphere (where few may be likely to hear me). If you have hateful comments of your own, keep them to yourself. I will have no problem cyber-smacking you back. I do not discriminate based on someone's religion or other affiliations, but do not abide bigotry or stupidity either.
I have little to no experience with blogging, and no technical prowess, so please bear with me. Let me know if I violate some secret blogger's code. Etiquette is important to me. You wouldn't think so with the above disclaimer of cyber-smacking, but I edited out at least one four letter word.
I am a writer, and would love freelance opportunities. My interests are quite varied, and I am willing to research just about any topic and write about it, as readers of my blog will soon discover.