Tag Archives: doctor

My Internalized Stigma

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I am fully committed to my recovery. I can and do live a full life. I am very grateful to have a good job helping other mental health peers find their own paths to recovery.

This morning, I faced the fact that I still carry internalized stigma against mental illness.

I have been experiencing intense but unfocused anxiety for about 3 days. I left work early Tuesday. Yesterday, I went in and started work, but I left after an hour. This morning, I went in, sat at my desk, and immediately sent two emails requesting sick leave. I need to take care of my mental health.

Yet I felt guilty requesting time to take care of my mental health. I felt guilty for having debilitating anxiety.

I feel nothing when I need to take time off for a cold or worse, but this morning, I felt guilty. Something inside me said I need to be tougher. That’s bullshit.

From now on, I will not say I need to take care of my mental health. I will only say that I need to take care of my health. My mental health is just as vital to care for as my physical health. In my situation, it might even be more important.

I have taken an important step toward regaining good health. I have called my psychologist and asked for an extra appointment, and he is checking to see when he can work me in. He told me he will find the time. Therapy is an important tool I use to maintain my recovery. Getting this appointment is a signal to myself that I will do whatever is necessary to care for my health.

I am worth it.

I will continue to tell the voice that says I should be tough and not take leave to care for my health that it is wrong on every level. I am valuable. I am worth having good health.

One Nice Thing

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My friend suffering from major depression contacted me after a long quiet spell. Actually, I initiated the communication reaching out to him. We’ve been sending text messages for a number of days now. He doesn’t seem to have the energy to speak on the phone.

I’ve known him for about six or seven years now. I’ve talked to him in times of deep crisis and in happy ones, too. When my internship begins, I am going to strongly urge him to join in the WRAP classes.

A Wellness Recovery Action Plan as taught by certified facilitators has the capacity to alter lives. It changed mine. I cannot stress enough my personal transformation. I walked into the job training a frightened individual who believed he was defined by his illness. I leaped through a stage or two of recovery the first week. My eyes opened. I shed my negative self-talk miraculously.

Recovery works. It really works.

My friend can’t see that as yet, and I do not push. I offer understanding. I have been in the dark pit of despair and made it out with the help of a cadre of supporters. I had family, friends, case workers, a therapist, a psychiatrist, and a psychiatric prescribing nurse practitioner all working to find what would work for me. I believe it allowed me to reach a place of acceptance, opening me to the possibilities of recovery.

My mantra encourages those suffering depression to do just one nice thing for themselves each day. Just one. A simple one.

Many years ago when I was at my lowest, my one nice thing was brushing my teeth. I was incapable of more. Gradually, I was able to exert a bit more energy and add activities to my list each day, but I began slowly.

It’s important for people with mental illness to practice loving acts of self-care. We, who often feel the opposite, are worthy. I am worth it.

The Good News

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Followers of this blog will know that I have spent some time in mourning recently for a former lover who took his own life. I can report that I’m well on the way to healing. The initial shock was tremendous, but as with all things, time heals. There will be a memorial gathering for him in a week, and I will attend. I doubt I’ll share anything, but I will be there supporting my other friends.

On the job front, I can happily and loudly report that I passed my written and oral exams, and I am now a Certified Peer Specialist Intern in mental health. I can also shout out that I will start my internship at a local mental health clinic in early June.

I am going to a family reunion at the end of May, and I’m taking the opportunity by stretching my stay to have a nice long visit with my parents and family. When I get back from that trip, I’ll walk straight into my internship.

Things are really moving along quickly.

Things are not moving quickly in my romantic life. My beau lives two hours away, and I haven’t seen him since January. I was traveling too much for job training, and his job schedule keeps him very busy. We’ve spoken on the phone a number of times, and we’re still interested in each other. However, being apart does not make this easy. There’s no cuddling, and that makes me sad. At the same time, it makes for wonderful dreams of reuniting.

Through the statistics of this blog, I can view how people find me. One of the highest ranking terms is bipolar dating. To those searching for love and acceptance as a person with bipolar disorder or with a person who has it, I can safely assure you that it is possible to find a partner.

There is no magic pill to swallow that will make your perfect match appear, but then that’s true for everyone and not simply those with mental illness. While having a disability can add a layer of difficulty to the mixture, it’s not necessarily the defining factor. No person is solely defined by any one particular point, and we with mental illness are not either.

I truly believe in the tried and true formula of finding a mate the old-fashioned way. There are people in clubs who have similar interests and are also looking for companionship. Volunteering is a great way to meet others. The secret – and it’s no secret – is finding a way to get outside one’s head and open up to the possibilities  that abound all around us.

Opening up is easier said than done for some of us. I had my own long, dark period. It lasted for years, and every aspect of life was a chore or nearly impossible. I have been in that deep despair when simple acts of self-care like brushing my teeth were close to impossible. I clawed my way out with the help of loving caregivers, medication, and therapy. I did not do it alone.

All the time, I wondered where the right man for me was. It’s just a thought, but now I believe my focus should have been on being the right man for someone else.

When I take the focus off me, I win.

It is paradoxical, but it starts with loving me and spreading that. I give love more freely when I love me. I give more of me when I take care of my simple daily needs.

I no longer believe in countering negative self-talk with positive affirmations that I find unconvincing. I have no evidence from my past that looking at my reflection in the mirror and reciting clichés ever made me feel better. What worked? A lot of time and effort put into finding the right combination of medicine, meditation, exercise, and therapy from many loving caregivers.

This thought that I start from a place where I love me first is new. I was taught long ago that I had to ignore my inner voice and my feelings and only concentrate on the needs of others. I have no evidence that action ever helped me.

Today, I have abundant evidence that loving me allows me to then reach out and give. I struggled with guilt and shame for decades. Today, I live openly and honestly.

Today, I live in truth.

I Braved the Movie Theater

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I have written in this blog about not being able to watch television for unknown reasons. It makes my brain twitch uncomfortably. I have avoided movies for the same reason. My brain throws a switch that makes my skull itchy inside. (You can find the blog entries by typing “I can’t watch TV” in the little search window on the right.) The crowds in movie theaters are also a deterrent.

I have seen three movies in the last month. It’s been amazing. I had to practice some deep breathing at points during each one, but I made it through. Last night was the most difficult. I saw Silver Linings Playbook, a movie about a bipolar man and his budding relationship with a troubled woman.

The movie begins with words on the screen announcing the upcoming scene as taking place in a psychiatric hospital. I tensed instantly. A group therapy circle unfolded on the screen with someone speaking gibberish about his hair. Another patient sat in his chair but had physical tics. The lead actor was composed but spouting loudly about finding good things in bad circumstances.

The movie twists and turns through the life of the lead actor. He moves back to his parents’ house, and immediately begins to obsess about his estranged wife. He meets an interesting, troubled woman, and they begin seeing each other. Their relationship revolves around his learning to dance. There are scenes finding the man up all night pouring through books only to toss them through a closed window into the street. He wakes his parents at odd hours to rant about wild things. He jogs a lot. The pair spark off each other, though their relationship remains platonic since the man insists he’s still married.

Some points of the movie were particularly wrenching for me to watch. When the lead actor maniacally reads, I was reminded of myself engrossed in books all day long. A crowd encircles the man at one point, and I found my heart pounding in real fear. I have been in the middle of crowded department stores and had to leave to breathe. He went on a painful, angry hunt for his wedding video, and I understood the drive, the single-minded mania. I have been in the situation where I had to accomplish a minor task at all costs and was thwarted.

There was quite a bit of violence in the movie. I’m very lucky that I’m not given to violent outbursts. I withdraw inwardly and use a great deal of negative self-talk.

The movie talked a lot about medication, and the lead character refused to take any. Some of his more egregious explosions prompted him to take medication, but the subject was treated poorly. Regular readers here know I am a strong advocate for taking medication to treat bipolar illness. I only speak for myself, but there’s no amount of prayer or meditation, no distance of running or walking, nor any length of talk-therapy or doctor visits that can control the hallucinations, the rapid thinking, or the burning brain. I need medicine. It’s plain and simple.

The movie ended happily. The boy got the girl. There was no hint of disability. All was right with the world, and I call, “Bullshit.” I’ve been manic about love in the past. If a relationship would fix me, I would be on every dating site around. People can’t fix me. If a relationship could fix the lead character in the movie, then why couldn’t his loving parents help?

Bipolar illness is tricky. I appreciate this cinematic portrayal. I intend to get the book and see if it may be different. I wish my happy ending would be so simple. I’d pay $10 for that.

I Suffer from Bipolar Disorder Type 1

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This is what the Mayo Clinic has to say about bipolar 1:

Bipolar 1 disorder. Mood swings with bipolar 1 cause significant difficulty in your job, school or relationships. Manic episodes can be severe and dangerous.

On their website, the Mayo Clinic lists the following symptoms for a manic phase of bipolar disorder:

  • Euphoria
  • Inflated self-esteem
  • Poor judgment
  • Rapid speech
  • Racing thoughts
  • Aggressive behavior
  • Agitation or irritation
  • Increased physical activity
  • Risky behavior
  • Spending sprees or unwise financial choices
  • Increased drive to perform or achieve goals
  • Increased sex drive
  • Decreased need for sleep
  • Easily distracted
  • Careless or dangerous use of drugs or alcohol
  • Frequent absences from work or school
  • Delusions or a break from reality (psychosis)
  • Poor performance at work or school

For depressive episodes, they list the following:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Low appetite or increased appetite
  • Fatigue
  • Loss of interest in activities once considered enjoyable
  • Problems concentrating
  • Irritability
  • Chronic pain without a known cause
  • Frequent absences from work or school
  • Poor performance at work or school

Another sign of the disorder is

  • Psychosis. Severe episodes of either mania or depression may result in psychosis, a detachment from reality. Symptoms of psychosis may include false but strongly held beliefs (delusions) and hearing or seeing things that aren’t there (hallucinations).

I have all these symptoms at one time or another. Thankfully, they don’t come all at once, but they do come. My doctors tell me at times I am psychotic. In other words, I have a break with reality.

In other places on this blog, I have gone into great detail about my personal struggle with this disease. Please, explore and read. The disease is real and devastating. I live on disability payments from the government. The process to receive that distinction is long and arduous often requiring two or three attempts. I won on the first try. Even the government noted the severity of my case.

This blog is my safe place. I will not defend myself here. All comments in which my status or my experience are belittled will continue to be deleted. If you think mental illness is not real, go somewhere else. Leave this blog.

This blog is also meant to be a resource of others with mental illness. I want them to know they are not alone. Others experience the horrors of delusions. I once thought I could cure AIDS with eight apples and a plastic water bottle. I only had to breathe on the apples and write magic words on the bottle, and a person with terminal AIDS would be cured. It took six months of concerted effort to convince myself that delusion was false.

I have hallucinations. I hear voices that are not there, telling me secrets or just speaking gibberish. I have seen people who were not present.

The euphoria of mania is luscious. I am invincible at those times. I have a cracked tooth from trying to walk through a wall; another delusion.

The rapid speech baffles those around me.

The racing thoughts are scary. My mind careens out of control and often the only thought I can cling to is death.

My risky behavior has put me in places where I could lose my physical health, my freedom, and my home.

The depression is akin to being a the bottom of a black pit so deep that not even a pinprick of light shines through. I have sat on the side of the tub with a utility knife ready to commit suicide and was saved only by the chance ringing of the phone. I have been hospitalized twice for suicide attempts.

I have experienced everything in the list for depression.

It is demeaning that I am having to defend myself on this blog. Walk in my shoes. Spend a minute inside my head. If you can stand the horror, then I will count myself less a person.

I feel alone.

My Bipolar and My Alcoholism

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I have bipolar disorder with psychotic tendencies, and I also happen to be an alcoholic with twelve years of recovery. Which came first, the disease or the drinking? I’ll never know. I certainly started drinking many years before my diagnosis, and the doctors all say that I probably started drinking as a way of medicating the growing disease. The alternative flits around in the back of my mind: my drinking caused my disease. Perhaps that’s just another of my many forms of self-loathing showing itself.

I drank for many reasons, but one in particular can’t be ignored. Drinking numbed me. For short periods, it blocked from my mind the hatred I had for my homosexuality, the guilt I felt for my sham of a marriage, the shame I harbored for my shell of a life, the anger that seethed within me for my weaknesses, etc. After many years of recovery, I can say that I choose to believe the doctors. I drank also for the comfort it gave me in dealing with the mental illness that lay just below the surface of my mind. It smoothed the highs and the lows into a seamless, numb existence.

It didn’t work, however. I crashed as all of us do. The alcohol stopped working, and then the mental illness had nowhere to hide. I had a psychotic break that led to my diagnosis. I found help for my alcoholism in the rooms of A.A., and I found help for my mental illness through family, doctors, nurses, caseworkers, therapists, and friends. The treatments for both conditions have been quite different. On the one hand, A.A. provided me with the twelve steps that I had to rigorously apply to myself to learn to live daily without drinking. On the other hand, my bipolar disorder has been treated largely with medication.

There are similarities in the treatments. That’s in the way I have to take responsibility for my own actions and well-being. I am responsible for working the steps of A.A. to remain sober. I have to be honest with myself, my sponsor, and other members of the program in much the same way I have to be honest with my doctor, my caseworker, and my therapist. Both recoveries have a spiritual element for me personally. I meditate. I sit quietly for periods and let myself just breathe. I expect nothing from these sessions other than an awareness of where I am and what I’m trying to accomplish.

My bipolar disorder and my alcoholism are intertwined. I don’t understand it, nor do I worry about it. For today, I’m simply relieved that both are being treated.

Trusting Caregivers

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I’m lucky to have people in my life who care about me. Some are friends, and some are professionals. I have not always been the best friend I could have been. It’s strange, but I’m almost more trusting of the professional caregivers in my life than the others. Do I give more weight to the fact that the professionals have credentials? I’m not sure of the answer to that.

When I was first diagnosed bipolar ten years ago, I was in a terrible state. I had an awful time of it for quite a few months, and I had one caseworker for that initial period who was a godsend. He helped me get the necessary paperwork filled out for medical help where I live. He listened to my concerns and fears and reassured me. He helped me obtain food assistance and other charities. He got me plugged into the system, and he got me help that I needed to live.

My current caseworker is also a hard worker who listens when I need to talk. He helps me keep my priorities straight about some of the mundane things in my life. He helps me order my life in such a way that I know what to take care of when. I listen to him. He looks out for me.

I know for sure that I treat my psychiatric prescribing nurse with respect, because she has a great deal of knowledge about the medicine that keeps me stable. I can’t imagine where I’d be without medication. I don’t take a lot of different things. I have in the past had to take many kinds of pills, but it’s narrowed down to four at present. The nurse is my doorkeeper to what is working and what’s not. I report to her what’s going on with me, and she evaluates it according to the criteria that she’s devoted long hours to studying.

I can’t talk about caregivers without talking about my therapist. I’ve been her patient since 1997. She’s guided me through coming to terms with my alcoholism, my homosexuality, and my mental illness. She’s helped me see my issues by allowing me the time to develop the ideas on my own. Over the years, she’s seen me laugh and cry, get angry and be calm, and a myriad other emotions. She’s been a rock when I’ve been desperately depressed. She’s been a help when I’ve been over the top with mania. She’s a close ally in all ways.

I have a few friends who know everything about me and stay close. Those friends I hold dear to my heart. Some are close at hand, and some are far away. I try to keep in touch with all of them as best I can. It’s more difficult to say how friends have affected me and my mental illness. They have often simply been present when I’ve needed an ear to hear whatever it is I have to say. Most importantly, the close ones give me nonjudgmental love. It’s like breathing. They are that important.

Great News

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No, I’m not cured of bipolar disorder. That’s not the great news. I’m happy to report that I got my annual HIV test results today, and I remain negative. That’s no small accomplishment for a gay man. You never know when something might have gone wrong. I am grateful that my higher power continues to grace me with such good health. I’m very lucky.

I know many who aren’t lucky. I have a very dear friend who needs a hip replacement due to arthritic deterioration, and I have another very, very close friend with breast cancer that spread from his breast to his spine and has now metastasized in his brain. The former friend is only 46, and the latter is only 66. One is battling a debilitating disease, and the other death.

While I was visiting with my doctor today, he paid me an unexpected compliment. He said, “You’re honest, and that’s very rare for me to see.” He described how most of the time he has to deal with murky disclosures or outright lies, and he’s constantly having to read between the lines of what his patients are saying. With me, he said he feels relaxed. He doesn’t have to second guess what I’m saying.

Being honest did not come naturally to me. I’ve been in therapy for 24 years, and I’ve worked the 12 steps of A.A. on a daily basis for 11 years, 11 months, and 4 days as of today. I would say that it’s a combination of those two things that has taught me honesty.

I hold nothing back from my doctor. When I went in to request the HIV test, I was honest with my worries. I hold nothing back from my psychiatric prescribing nurse either, nor the psychiatrist before her. They can only deal with the information that I give them, and if I lie, then I’m only hurting myself. I don’t lie to my therapist, caseworker, or my A.A. sponsor. Even in depression, I stay honest and report my suicidal thoughts.

Perhaps that’s the most important time for me to be honest, during depression. That is the time when I am least equipped to deal with my own issues, and I need the professionals in my life to guide me. I talk to so many people suffering from depression or bipolar disorder who innately distrust their physicians. I’m glad I have doctors and professionals that I feel are looking out for my best interests.

Don’t get me wrong. I’m not a pushover. I have declined changes in the doses of my medications in the past when I felt it was wrong. I have pushed to get other medications when I thought it was needed. Sometimes I’m right, and sometimes I’m not.

The important point is that I have built up a rapport based on honest interaction with my healthcare providers, and we complement each other.

Today, I’m breathing sweet air. I’m eating good food. I have a roof over my head, and so much more. All of that is great news.

Just “ugh”

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Mania. It’s a strange mixture of feelings of invincibility and depression. It’s euphoria mixed with self-loathinig for me. I woke up in the middle of the night again tonight. It’s a desperate desire to be normal added to a feeling that I never will be, which triggers self-hatred.

I was depressed. Desperately depressed, so the doctor reluctantly put me on a low dose of an antidepressant not wanting to trigger a manic episode. After 2 months, I can see he was right. I can’t go back to that blackness, but I’m on the edge of dangerous behavior. No, I’m not on the edge; I’m living dangerously.

I’m also having these unreasonable urges to go out and spend and spend and spend money which I do not have. I know that’s part of the disease, but where does this crap come from? Jeez!

I’m calling the doctor first thing in the morning, and I’m going to ask to go off the antidepressants or change them. I’m going to be open and honest as I have been in the past. I’m going to calmly advocate for myself as I have done in the past.

Sigh.

A damn shame

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My psychiatrist is moving. He’s actually being transferred from one public clinic to another one in a town two hours away. I’ve been seeing this doctor for three and a half years. He knows me inside and out. I’ve built a solid relationship with him.

Now, I’m going to have to start all over again. His replacement is a nurse practitioner. That’s not the problem. The difficulty lies in dealing with somebody new. I’m going to have to build a new relationship, and that takes time and effort.

I’ve been feeling like quitting lately. Not life. Everything else. I want to cut myself off from all the hurt the world throws about. I have been seriously thinking of quitting the few clubs I belong to. I want to lie down and sleep. Just sleep.

Simultaneously, I’ve been putting out personal ads asking for men interested in long-term relationships. I’m tired of hurting, and instead, I want touch. I want intimacy, yet I desire isolation.

I am conflicted.

This too shall pass.