Taking Bipolar to Work

agony

I become aware of a familiar hollowness in my chest, like something has been removed and I don’t know what it is. I feel shaky. I suggest to the participants in the 2-day workshop I am co-training that we take a break, even though it is not time for one. I go outside and begin pacing. I go up and down the sidewalk, turning around in the driveway of the building where the training is being held. I go back down the sidewalk and return to the driveway, pacing in an arc pattern. I do not feel right. I do not know yet what is going on, but it’s obvious that something is wrong. My co-trainer notices and I say I’m not feeling well. She suggests I go home, that we’re halfway through the second day and she can finish it from here. I apologize and thank her, go back inside to get my things, and get in my car and drive off. I cannot sit still in my seat; I feel an overwhelming urge to continue pacing. I feel like sobbing as I’m driving so I keep gasping, trying to stave off the deluge that I know is coming. I should probably pull over but I just want to get home, feeling guilty that I have left my colleague and that, for the first time at this job, I have “allowed” my disorder to affect my work. After what feels like an eternity I pull in my driveway, run into the house, and sob as I pace rapidly around the dining room table, unable to stop myself. I now realize that I am in the middle of a mixed episode of bipolar, and the relentless churning pain in my head makes me want to die.

*

Any employer, co-worker, or client can Google my name and it won’t take them long to discover that I have bipolar. Online, I don’t hide it. In my writing, I try to bring about more awareness of what it means to have bipolar and how it affects people individually. I try to fight the stigma. But the unfortunate truth is that how I present myself online and in my personal life is very different from how I present myself in my professional life. And it’s hard for me to reconcile that.

If I didn’t have bipolar, I wouldn’t have to worry about my colleagues or clients questioning my ability to do my job (read here for details about what I do as a behavior consultant). And despite the fact that on rare occasions it has affected me on the job, I believe that my bipolar enables me to identify with my clients and understand that part of why they feel the way they do and how it affects their behavior. This enhances my ability to provide better ideas for how to support them.

I am one of the lucky ones. In addition to some lifestyle modifications (mostly dietary), I only have to take one medication and it does its job well. I rarely experience debilitating episodes (although I would within a few days of stopping my meds). So why don’t I talk about my diagnosis in my place of employment? Why the “don’t ask/don’t tell” stance?

I don’t really have an answer that makes sense, even to myself. Maybe it’s the fear of seeming incompetent. Or being stereotyped by whatever that person’s exposure has been to bipolar, and having to prove that I’m not like that. But I hope at some point I’ll be brave enough to risk being labeled with the stereotype, to start the process of ending the stigma by starting the conversation about it.

*

Maybe my co-trainer had gone online at some point and knew that I had bipolar. I don’t know. Maybe she could just tell that something was wrong, regardless of the cause, and I needed to leave. Since that episode happened, I’ve often wondered (with dread) what I would have done if I had been training the workshop by myself (which is usually the case). I berate myself about it. But emergencies happen. Would I have felt ashamed if, in the middle of the class, I suddenly began to experience severe abdominal pains and could not continue teaching that day? I would have felt bad about needing to stop, but not ashamed. A sudden bipolar episode warrants the same viewpoint. It’s not shameful. It’s not a character flaw. It’s a health issue just like any other requiring medical attention. That afternoon I called my doctor, who prescribed an emergency medication, and I was back to work the next day. Life goes on, and hopefully we are the wiser for it. All of us.

[Image credit: PsychGuides.com]

The Middle Ground of Middle Age

Age-Quotes-17

It was my birthday. After class, I changed my clothes and drove to the large chain drugstore where I worked. I went to the back area where the employee lockers were and stowed my purse and jacket and walked back to the time clock to clock in. In the hallway I was greeted by my boss, a middle-aged woman with short curly brown hair and oval glasses, dressed in the same gray smock uniform as me. She stood there, her shoulders hunched as always, and stated, “It’s your birthday! How old are you?” Twenty-two, I said. “Aw, you’re still a baby!” I felt deflated. Every day after that I wondered how old you have to be to garner some respect. I’m still wondering.

*

All my life I’ve never minded getting older. In fact, at certain points in time I actually looked forward to it, and not just when waiting to be able to drive a car or buy a bottle of wine. After 21, what age is there to look forward to? At age 25 you can rent a car (which, being a traveler, was important to me). And at some unspecified advanced age you “get” to retire (of course in recent years I became painfully aware that this does not happen automatically).

There was that saying – “Don’t trust anyone over 30” – coined by activist Jack Weinberg in 1964. Someone posed that “over the hill” referred to age 40. When I was 5 my grandmother was 58 – and I thought she was really old. Now we hear “50 is the new 30!” and such. I think we Gen-Xers are staring into the face of middle age and wondering what the hell happened. Some of us in our 40s are starting our second of the two careers we’re predicted to have in our lives. We need glasses. We get hot flashes. We have to be careful of our backs.

I’ve never been bothered by birthdays, but in turning 45 this month, I realize that in the last couple of years my body is not what it used to be. And that bothers me. Not the numbers of the years, but how they make me feel physically. I could “grow old gracefully.” I could “not go gentle into that good night.” But what I want to do, what might take me a while to figure out how to do, is to find the middle ground. To be devil-may-care but graceful, too. To embrace but not resign. To finally garner some respect, and to live life in such a way that I can.

*

It’s my birthday. I have a busy day at work and then go cook dinner for my 21-year-old autistic son, who lives in a supported living apartment. I have dinner with him every Wednesday. The only years he has ever observed my birthday were when someone else facilitated it. But tonight when I arrive, he opens the door and wishes me a Happy Birthday. Then in his deep monotone voice he says, “I got a surprise for after dinner.” He opens up his freezer and shows me a half gallon of ice cream. It’s Tillamook, an Oregon coast brand from a town famous for its creamery. And the flavor Nigel chose was Birthday Cake. Ignoring the lump in my throat, I thank him and tell him how thoughtful it is of him. A part of me wonders if someone reminded him, but if so, no matter. He went to the grocery store, he bought the special ice cream with his own money, and the fact that he did it is better than any birthday gift I could ever hope for.

[Image credit: Relatably.com]

The Writing on the Web

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An electrical cord has somehow twisted around his neck. He lies on his back, his arms pinned behind him underneath his convulsing body. His head is smashed at a right angle against the wall and there is so much froth in his throat he is choking on it. This is how I find my son.

*

A quick online search yields a list of over 20 anticonvulsant/antiepileptic drugs on the market, and the long-term use of many of them can compromise the health of the liver. Take into account that some people need to take more than one of them (either because one seizure med is not enough or because they have both epilepsy and bipolar, and one anticonvulsant is not enough to keep mania in check), and it’s definitely cause for concern.

My son Nigel fits into the latter category. Some people with bipolar find that an anticonvulsant works to stabilize them, and others don’t. He needs an anticonvulsant to treat his epilepsy and lithium to control his mania. Both are hard on the liver, and not a day goes by that I don’t hope for another option, something that manages his disorders without compromising his physical health.

I have been considering the use of Charlotte’s Web for treatment of his seizures (for those unfamiliar, Charlotte’s Web is a high cannabidiol (CBD), low tetrahydrocannabinol (THC) Cannabis extract. It does not induce the high of recreational marijuana strains that are high In THC). In the past week I have talked with the parents of two different clients of mine about the success they’ve seen with their adult children taking this medication. There are many other parents who’ve experienced remarkable results with their children who have epilepsy. However, even with plenty of success stories, a position statement by the American Epilepsy Society maintains:

“The recent anecdotal reports of positive effects of the marijuana derivative cannabidiol for some individuals with treatment-resistant epilepsy give reason for hope. However, we must remember that these are only anecdotal reports, and robust scientific evidence for the use of marijuana is lacking… at present, the epilepsy community does not know if marijuana is a safe and effective treatment, nor do they know the long-term effects that marijuana will have on learning, memory and behavior, especially in infants and young children.”

The italics in that quote are my own; I find it ironic that AES would say this. Long-term seizure activity already negatively affects cognitive function, including learning, memory, and behavior, hence the urgency to prevent seizures from happening. And if pharmaceuticals aren’t effective, resulting in more seizures, wouldn’t we want to do something different? Yes, it’s true we don’t know the long-term effects of Charlotte’s Web. But when weighing the consequences of using an undeniably effective non-pharmaceutical treatment that we don’t know the long-term effects of versus the consequences of continued seizure activity – which we do know the long-term effects of – I’ll take the former.

*

I don’t know how long this massive grand mal seizure had lasted. And I don’t want to think about what would have been the outcome if he hadn’t been at my house when it happened, or if at that moment I hadn’t gone upstairs to ask him something. He was unconscious and choking on his own bodily fluids. He would have died. He hadn’t had a seizure in over three years and I assumed that he would continue to be seizure-free. But the fact is that the effectiveness of a medication can diminish over time. And Nigel is living proof of that. Living.

Answering “So What Do You Do?”

cocktail party2

She tells me that her 11-year-old son, who is on the autism spectrum, hits her and laughs. When he watches a DVD he will put his Mario Brothers backpack next to him on the couch and talk to the backpack. He carries it around and hugs it. He dumps all the shampoo down the drain. She tells me that he holds knives to his throat and threatens to kill himself.

*

As a Behavior Consultant I go into people’s homes and talk with them about some of the most difficult aspects of their lives. I am part confidant, part counselor, part troubleshooter, part scapegoat. I work with families, foster providers, and agencies. I create and implement behavior supports for people with developmental disabilities, ranging in age from 3 to 62. I use visual supports to provide structure and consistency for those who have great difficulty functioning without it, often resulting in challenging behavior to try to meet their needs, especially if they are not able to communicate through speech.

Here’s a sample of what was on my calendar this past month:

  • Write a Functional Assessment for a nonverbal 5-year-old whose grandmother is his primary caregiver
  • Via a sign language interpreter, teach sex education to a 23-year-old deaf woman who has Fetal Alcohol Spectrum Disorder
  • Drive an hour and a half to a different county to work with a 4-year-old girl with Down Syndrome who hits her head on the floor
  • Create social stories and checklists for two different teenagers and three preteens, all having significant challenges with emotional self-regulation
  • Develop strategies of positive reinforcement for a ten-year-old boy with FASD who exhibits physical and verbal aggression, property destruction, and other difficult behaviors
  • Teach a 2-day workshop on positive behavior supports and protective physical intervention
  • Attend a 3-day conference on dual diagnosis – people who have both a developmental disorder and a mental disorder, like my son (who has both autism and bipolar)

It is equally an honor and a challenge. [Troubleshooter.] But sometimes it’s a huge challenge. Some people expect me to have a magic wand. I make a suggestion and they try it once or for a week and get frustrated when it “doesn’t work.” [Scapegoat.] Others want to spend the entire hour talking about personal things that have nothing to do with their child. [Confidant.]  Some people cry when they’re describing what they go through and how isolated they feel, and that’s when I look in their eyes and tell them I’ve been there. [Counselor.]

I didn’t set out to work in this field, in this position. I didn’t want to be this when I grew up. But at different points in my life I wanted to write, I wanted to teach, and I wanted to be a counselor. And because my 21-year-old son has multiple disorders, and because I wanted to support other parents so things could be easier for them than they were for me, after years of writing and volunteering and connecting, this position was offered to me. I am now all those things I wanted to be when I grew up. And I have a really cool response to that cocktail party question.

*

She speaks Spanish, and we communicate through an interpreter. I tell her I understand, that my son went through a period of time when he would bang his head on the floor and wanted to “rip the autism out” of his head. That I found him one night threatening to hang himself. I ask if she would like my son to come and talk to her son, tell him that he felt the same way but came to terms with it, with being different. She says Yes, tears forming in her eyes. I explain to her that her son views Mario as his friend; my son felt that way about Winnie the Pooh. A squeeze bottle with water and a little dish soap inside solved the shampoo problem. If only they were all that easy.

What Becomes of Six and a Half Pounds

N 2121 years ago I held this guy in my arms for the first time and was paralyzed by the thought of how much my life would change, having no idea that it would change even more than I had thought it could. This guy, who was 6 ½ pounds, would set my life on an uncharted course and lead me to a place completely different from where I thought I would go, from where I had planned to go. (Where was that? Oh, yeah. An editing job in New York.) My career evolved into something I would have never considered, and I couldn’t feel more fulfilled.

Today marks 21 years of this guy leaving his mark on the world, on me, on our family. 21 years of trying to figure him out, wondering what would happen next, what I needed to do. 21 years of keeping up with him – and trying to keep my sanity. 21 years of wanting to “give him back to the circus” (as my grandmother would say). And 21 years of loving him.

Last year he turned 20 (I know that probably didn’t need to be pointed out, but stay with me), and the whole two-decade milestone was cool, but something’s different about 21. For many parents of kids with special needs, it’s when their kids no longer attend a public school transition program. (Nigel refused to attend high school longer than his peers, but when you’re voted by your senior class as Most Likely to Survive a Zombie Apocalypse, high school’s not really on your radar.) Anyway (thanks for staying with me), turning 21 is not always about drinking (because when you have autism, epilepsy, and bipolar – and take meds to treat them – any amount of drinking is ill-advised, with emphasis on ill).

But turning 21 is about adulthood. For the last five years I’ve written on my websites about Nigel’s “transition to adulthood.” And – my God – we’re here. This is what adulthood looks like for my son. Yes, he will continue to grow and evolve as everyone, regardless of abilities or disorders, does. But for right now, I look at this young man who has come into his own, I look at the hurdles he has faced, the mountains, and what he still contends with every day to navigate this world, and I marvel at him. I marvel at his tenacity, evident in infancy, his adventurous spirit, his creativity, his insightful musings and comments, his wit (have you read the Nigelisms?), and his steadfastness as he envisions his dream of having a career in filmmaking.

Twenty-one. I went out to dinner at Red Lobster with my dad and my grandma. I moved to a different state (for the third time). I changed my college major (also, I believe, for the third time). That was 21 for me. For Nigel: dinner at a gourmet burger joint with his family. Later in the year, maybe getting his GED. Maybe working at Home Depot and starting to save for film school. Adulthood on his own terms. Making his way in a world from which he constantly needed relief, but in which he always desperately wanted to be.

Happy 21st Birthday, Nigel. It’s all you.

A Suicide of One’s Own

There are different ways to say it:

Took his own life.
Self-inflicted death.
Died at her own hands.
Offed himself.
Committed suicide.
Killed herself.

Multiple ways to wonder the same thing: Why?

*

Though her body of written work is extensive and laudable, Virginia Woolf is best known for her extended essay “A Room of One’s Own” and her self-described “mental disease” – what is now termed bipolar disorder – which led to drowning herself. Statistics say as many as 15% of people with bipolar disorder will commit suicide, half will attempt to, and nearly 80% will contemplate doing so (Everydayhealth.com).

Recently a good friend of the family became one of the 15% (perhaps that is yet another way to say it). He had three prior attempts that we know of. He had severe bipolar. And he had no success with medication.

There are those who would say it should “come as no surprise, considering his history” – as if grief were unwarranted for those who wanted to die. There are those who would say he “gave up on life” – as if the physical pain caused by malfunctioning neurotransmitters in his head had not played a significant role.

And then there is this:

Why.

We may never really know what goes through one’s mind, what demons lurk there, what insufferable agony. There could be many reasons. But does knowing the reason make up in any way for our loss? Our grief? Is it because we want testimony that, no, there was nothing we could have done? Or do we want to berate ourselves till our own dying day that we should have done something? That berating ourselves absolves us of the fact that we didn’t?

But it’s human nature to wonder why – probably because we want to understand. We want to make sense of the seemingly senseless. Most of all we want closure, and to many people knowing why seems to be one way to get it. Why isn’t it enough that a person was in pain? There must be more to it, some think, more reason to have done something so horrible, so irrevocable, so final. So selfish, some think. They don’t ask why; they only judge.

Whether we seek closure or make judgments, we somehow must come to terms with the untimely death that is suicide. We can grieve, we can postulate; we can put someone on a pedestal or we can condemn them. We may try to understand. And sometimes we must accept that trying may be the only thing we’re able to do.

[Image: The Suicide by Édouard Manet]

Transition Check-In: The Three

It hit me today that I have reached the point where I don’t always know where Nigel is – and I’m okay with that. He is in a supported living program. He’s not in college or driving. But he turns 21 in two months, and he is a walking, talking special needs success story.

~

It was fourteen months ago, with no small amount of trepidation on my part and his, that Nigel was given the key to his own apartment. In his words, he has “learned a lot” since then and wisely remarks that he is still learning. He is semi-independent, receiving daily support from Living Opportunities, a local organization that provides support for adults with developmental disabilities. They check in to make sure he is taking his meds, take him grocery shopping, help with doing laundry, keep track of medical appointments and provide transportation to them, among other things. I pay his bills out of his Social Security income and obtain and fill out all paperwork associated with his various benefits. I probably do a lot more I’m not even thinking of at the present moment.

It should be noted that no success of his came via luck. It involved tenacity, determination, and years of all kinds of therapy for a five-year-old who, when asked by a doctor, could not say his own name. Whose severe sensory issues precluded going to the grocery store and any other public place because this was a time when no one thought to suggest wearing noise-cancelling headphones. Instead, he shrieked and bolted. The list of his challenges, past and present, is long.

But now the guy safely rides his bike everywhere, up to twenty miles away and back. He handles its maintenance himself. He pushed his bike with its bike trailer attached all the way up a 3600-foot mountain because he was training to climb a 9500-foot one. (And with the accompaniment of my amazing, wildland firefighter sister, he succeeded.)

He takes good care of his cat. He likes to vacuum (read here why this is huge). He refers to his autism as his “difference,” and he has begun to ask me for dating advice and ways to meet “young ladies” who would understand and accept him.

Most importantly, he comes and goes as he pleases. Yes, you read that correctly. He comes and goes as he pleases, and I feel okay about that. I’m no longer frantic at the thought of him out alone in the community. Yes, sometimes I worry – he is vulnerable socially (being taken advantage of) and physically (bike riding in a city – or on a mountain). But from his own apartment he comes and goes as he pleases and I’m not wringing my hands all day long.

I don’t know which is more significant.

~

He calls them “The Three” – his wallet, keys, and phone. He got tired of hearing me list all three items individually, having to say Yes, yes, yes to each separate inquiry, and he came up with a collective term. So now when I pick him up to come and spend the night at the house or to leave for some other activity, as we head for the door I ask, “Do you have The Three?” And he says Yes, only once, and then we go about the rest of our day, truly blessed, well aware of what The Three symbolize for both of us.

The Unwelcome Presence of Epilepsy

I started to hear a repetitive banging noise coming from the living room, and I yelled out, “Stop the banging!” When it did not stop, I marched out to the living room. “I said to stop the banging! What are you doing?!” I yelled again, looking at Nigel, whose body was half-off the couch with his legs stuck under the heavy coffee table, banging it. I thought perhaps he was acting out a scene from the movie or laughing in an exaggerated way, but that was before I saw his face. I pulled back the blanket that had been covering him, and then all at once it hit me. The violent convulsing, the profuse frothing at the mouth, the eyes rolling back in his head: He was having a seizure.

~

My mind likes to torture me by replaying the events of Nigel’s first seizure five years ago. The above quote comes from the post I had written about it, and I still remember everything about that night. Mostly I remember the terror.

His subsequent seizures were the same. Always the violent convulsing, the eyes rolling back, the frothing at the mouth, the rigid limbs. Often the unmistakable thud of a body hitting the floor. I still hear it. Every time I hear a thud, even when Nigel is not in the house, I freeze, my heart races, and my PTSD kicks in. The force of his seizures is still with me, probably always will be.

The first medication we tried for him was not very effective. He continued to have seizures on a regular basis, like clockwork. Finally I convinced his aging doctor to try a different anticonvulsant, and we got it right just the second time out. It worked. I still lived in fear of the seizures, but they appeared to be controlled, and I felt so fortunate.

Last summer marked two whole years that Nigel, to the best of our knowledge, had not had a seizure. His neurologist ordered a 24-hour ambulatory EEG to see what the seizure activity in his brain now looked like. If it had decreased, we could begin the slow process of reducing the daily medication that, although a blessing, compromises his liver.

Nigel was excited about the prospect of eventually not having to take pills every day, of people not having to remind him. And he is also concerned about liver damage since his grandfather died of liver cancer. We were optimistic about the EEG.

But the results indicated that the amount of seizure activity had not decreased. At all. In his frontal lobe he still experiences the frequent, random spiking that, according to his doctor, could cause him to have a seizure at any time. We were disappointed that the medication could not be reduced, but immensely grateful that it was doing its job, and doing it well.

~

This month marks three years that Nigel has been seizure-free. Three years! We are so blessed that not only do we live during a time in history in which we are able, in many cases, to control seizures through medication, but also because we found one that works for Nigel. I quickly remind myself of that whenever I lament that the epilepsy is still with us, still maintaining its unwelcome presence in his frontal lobe, continuing to compromise his executive function ability and his cognitive processing. It may always be this way. But at least we have the upper hand.

[image credit: Science Life]

The Journey: My Parenting Milestones

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I looked up “top parenting milestones” online, since with Aidan’s high school graduation this month I’ve made it to what I consider one of the biggest, and the first three pages of the search engine lists milestones for new parents. Baby milestones, like first time sitting up or cutting a tooth, most of which are now in the backs of our minds for those of us with teens and young adults. The only baby milestones that stand out for me are when they started walking and talking. And when you have kids with special needs, those milestones and others may be delayed – or they might not happen at all.

~

Both of my boys were walking a month before their first birthdays. The talking milestone took a lot longer to achieve and involved some intensive therapy, but it happened. So did toilet training (although also delayed). I would have celebrated the day the word playdate was retired, if I’d ever had to use it. Alas, many of our milestones were different. I have a friend who threw a huge party when her 10-year-old son was finally toilet trained (and I know others who aren’t and may never be). I celebrated Nigel’s first unprompted thank you – which occurred at age 15. So, things like that.

I think, special needs or not, we all have our own parenting milestones that we celebrate. What’s a big deal for me might not be for someone else, and vice versa. Here are mine (those I have reached, in addition to those mentioned above), in order of importance (not chronological):

• Moving into a supported living apartment (way sooner than I thought would be possible! Yes!!)
• Getting haircuts and going into a restaurant or grocery store without a sensory meltdown that involved shrieking, bolting, or writhing on the ground (it took a very, very long time, and I still don’t take it for granted)
• Learning to read and write (one guy had a hard time with reading, the other with writing)
• Graduating from high school (almost didn’t make it)
• Flying on a plane alone (wow!)
• Learning to make their own simple breakfast so I could sleep in on weekends (thank God)
• First time home alone (without setting things on fire – yeah, that happened)
• Taking their own showers (I think all three of us were excited about this)
• Learning to ride a bike (one guy took a lot longer)
• Going to prom (well, one did)
• Me noticing their leg hair growing in (yeah, I’m a mom of boys)
• When they started shaving (one even cuts his own hair now!)
• No longer having to bake/bring treats for class parties or facilitate the signing and addressing of Valentine cards (so glad that was only elementary school)

~

There will be more down the road, more things to marvel at and celebrate. For now, having both the boys out of high school is huge to me. It hasn’t hit me yet that, as a long-term single parent, I’ve actually made it. Who am I now? Where do I go from here? For the past 21 years my identity has been Mom. Of course, I always will be Mom, and that is a gift I treasure. But what can I now focus on that I couldn’t for the past 21 years? I’m not the person I was; I don’t even remember that young woman. It’s like going to your hometown decades later and not recognizing it. You know you’re in the right place, but everything’s different. My young adult sense of self cannot – and probably should not! – be reclaimed. So, I have the opportunity to reinvent many aspects of myself, and I’m excited about that, but also comtemplative. It’s a welcome change, but it feels odd, and somehow sudden, like being in a monsoon for hours and then all at once it’s over. I’ve still got the new graduate at home for a few more months, but life with him is different now, and although positive, it will take some getting used to. I’m happy though. I’ve waited a long time for this, and I’m finally here. Bring on the empty nest!

[Image credit: Therapies for Kids]

The Health of Our Heads

In retrospect, I can recognize the signs. It starts with agitation. I mismatch and contradict what people say. My filters are gone and I sometimes say insensitive things, things I wouldn’t normally say or would have said more diplomatically. I don’t sleep well that night. And the next day – well, the next day is unbearable.

*

For most people, Mental Health Awareness Month means educating ourselves about mental health and acknowledging its importance. It means that for me as well. I’ve always been intrigued by various mental disorders and learning about them and how they affect people and their families. But over the last two years since the commemorative month was designated, the awareness part of it means something much more personal, much closer to home. May is Mental Health Awareness Month. For me, it’s every month.

My typical bipolar episode is one that most people don’t really know about: the mixed state. It’s when you experience both mania and depression at the same time. There aren’t that many references to it, and when I find one, it’s very short, almost dismissive. And that’s dangerous because of the 10-15% of people with bipolar who commit suicide do it while in a mixed state – you’re depressed but you have the energy of mania to do something about it. One minute you hear raging and wailing in your head, and the next minute you can’t stop crying. You don’t rest. You don’t lie down waiting for it to pass because you can’t. You pace, you walk in circles around the kitchen table, you feel like throwing your head into the wall, and sometimes you do. You’ll do anything to stop the relentless churning. It’s like having an egg beater in your head. And usually the only thing that stops it is the right medication.

Often when people feel better after taking their medication, though, they think they don’t need it anymore and stop taking it. And they immediately go into an episode. I knew that I wouldn’t stop taking my medication because I felt better, and so I developed this false sense of security that if I just took it every day, I would never experience another episode.

But if I don’t manage my stress, I can easily have what is termed a breakthrough episode. It will seemingly come from out of nowhere because I wasn’t paying attention to my triggers, and I wasn’t aware of the signs I exhibit when I’m beginning to go into an episode, the signs I mentioned at the beginning of this post. Over time and vigilant self-awareness, I have come to recognize the signs much earlier and can take some backup medication that my doctor has prescribed for these situations. It usually does the job, and I am back at my baseline within 2-3 days, very grateful that I didn’t advance into a full-blown episode, which sometimes feels like a glimpse of hell.

There are worse disorders than bipolar, worse diagnoses and outcomes. This is not a poor-me post; it’s an attempt to increase knowledge during Mental Health Awareness Month. We are not just in treatment centers and residential facilities. We are among you every day, working, paying bills, taking our kids to scout meetings, grocery shopping, lobbying for our children who have developmental disabilities, trying to function even when our neurotransmitters misfire, hoping like hell that when they do, we’ll gain the upper hand.

[image credit: Gifts for Awareness]