Daily Archives: January 26, 2016

Somewhere…

If “The Martian” is a clear illustration of what my illness feels like, then this song is a pure vocalization of what it feels like to be totally well and at peace! Somewhere over the rainbow, absolutely my preferred place of residence :-)


SOMEWHERE

Budding Tree Haiku

DSC_0003

Winter will you pass

And let Spring renew my will

As new growth begins

 

Fifty three days more

Is the official measure

I can’t wait that long

 


Filed under: Bipolar, Haiku fuckin rocks, Psychology Shmyshmology Tagged: Bipolar, Hope, Mental Illness, Psychology, Reader, Spring Haiku

Peer-to-Peer First Impressions

Last May, at Sadie’s suggestion, I signed up for the local NAMI Walks.  Then I signed up to receive their e-mail newsletter, in which I learned about a Christmas dinner they were having at a local restaurant.  NAMI in my area only holds programs for family members, not for the mental illness sufferers themselves, so […]

‘I don’t know what to say.’

Yes, I know I should cycle more. Yes, I know I should prioritise it. I think about it, I talk about it, and, of course, I write about it. I don’t know what to say. Last week I rode 25 miles in the countryside – the first time I had done that since, well, forever. How do I explain why it has been so long? How do I make sure I get out (much) more often? How do I ensure that I actually do what I know to be so good for me?

I don’t know what to say.

And this all sounds so familiar. I know what’s good for me, I know what works, I have the means (in my case a bicycle, and time). And yet. There is always something else. Things I enjoy, things I want to do.

I don’t know what to say.

Last time, I wrote about how the suicidal mind is one that does not see alternatives – the most dangerous word is ‘only.’ I ended by asking you to have a conversation with someone you are concerned about. In doing so I inadvertently did what so often happens when we are concerned about someone’s well being, suicidal or otherwise – I shut down the conversation and sent you away. I described what we see, what we feel about someone we are concerned about. There was even that picture of the inside of a neglected fridge to make you flinch and look away.

‘I don’t know what to say.’ I hear it often, from friends, family, colleagues and employers. How do I broach the topic? Much of the advice and guidance these days is centred around normal, low – key things, treat the person just like you would anyone. Put on the kettle. Suggest an activity to do together.

‘Be there’ for the person. What does that mean, exactly? Be available 24/7, on call, ready to drop everything at a moment’s notice? Move in together, maybe? What niggles me about that phrase is its vagueness. It fails to answer the question: what do I do exactly?

So, that is why it is important to have the right vocabulary. I don’t mean a technical lexicon, it’s more about the proper use of punctuation. Eh? Asking questions. I can feel jaws clench and eyes dart about among some of you as you read that.

There are so many times and places, so many personal and professional relationships. How can anything I suggest here be relevant in so many different contexts? I’ll leave that to you to decide. I trust you, so trust yourself.

Trust the person you want to talk to. Trust them to make this all easier than you think. You are feeling apprehensive about all this? So are they. You are worried that you’ll say The Wrong Thing. Tell them how you feel about the situation – what has made you feel so concerned. That is never, ever The Wrong Thing.

What do I say after that? This is the hard part: say nothing. You didn’t know what to say, earlier, right? This is the point – right after the conversation has begun – when the best, most effective thing to  do is to remain quiet. Put your ears and your eyes to work. They are both more patient and kinder than almost anything that that coarse, pink muscle behind your teeth has to offer.

It’s hard, isn’t it, to say nothing. But that is going to be the best conversation you can have. You have said how you feel. You have signalled the fact that you have noticed (whatever it is you have noticed) and that those feelings have not silenced your concern.

In this quietness, this hesitancy, or the rush of words that have been leaning heavily on the door whose knob you have just turned, know this: there is nothing you need to understand right now. No specifics need take hold, no plans …. and most of all, no advice. There may be a clamouring tide of voices choking in your throat that you want to share. Remember this: if you are listening to their wise, clever words, you aren’t listening to him. Of course we feel the impulse to solve  this thing.

The best you can do, the thing that works, is to focus your attention again and again and again (because it will fade into the clamour I just described) on the one you are with. Why so? Like this you establish trust. You are here for the long haul (and it is mostly long.)

If she is in crisis, other things apply. It’s to  be practical, specific and not flinch (not outwardly, at least, there’ll be time for that later.) If you are concerned that they may try to hurt themselves – ask. If they trust you with their suicidal feelings ask them the following: ‘do you have a plan?’ Just that. Often we are full of suicidal thoughts – as I have said it speaks of the narrowing of options. The feeling, the thought, persistent and ever – present thought, that there is no other way. If the answer to the question about a specific plan is ‘yes’ then it is time to act. This is where the professionals come on the scene. Crisis management means – where possible, and with her consent – contacting people who she says need to know. They could be people who can offer practical support. Like driving, or accompanying, your friend to the nearest Accident and Emergency Department (that’s what we call them in the U.K.) Just like fractures and burns there will be specialist mental health staff there who can make a thorough assessment and provide support. In some cases this will mean immediate admission, in some cases visit from a community – based professional at home.

Either way, you will have said The Right Thing.

Disputation

I remember times when the inner disputation

Was quite fierce (to pursue the game, or sign

A full stop to pain.) The call was mine –

Or so it seemed. Each voice a singular temptation:

 

The beguiling cries of longed for rest,

The easeful quiet, the total peace

– what a boon! finally to cease

The struggle; to know that nothingness is best.

 

But then, from the barely bubbling sieve

Of my active self, a tired but urgent call

To return to habit and duty; reluctantly to fall

Again into pain and heartache – and so to live,

 

Oh soul! Thou then stood on an isthmus break

And heard, in separate ears, Aegean and Ionian wave.

What sea? To drown, or combers once again to brave?

The vital choice was mine alone to make.

Edwin S. Shneidman (1918 – 2009)


Panel Calls for Depression Screenings During and After Pregnancy

Dyane at http://www.proudlybipolar.wordpress.com/ this is for you! A major positive development, don’t you think?!

http://www.nytimes.com/2016/01/27/health/post-partum-depression-test-epds-screening-guidelines.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=0

Women should be screened for depression during pregnancy and after giving birth, an influential government-appointed health panel said Tuesday, the first time it has recommended screening for maternal mental illness.

The recommendation, expected to galvanize many more health providers to provide screening, comes in the wake of new evidence that maternal mental illness is more common than previously thought; that many cases of what has been called postpartum depression actually start during pregnancy; and that left untreated, these mood disorders can be detrimental to the well-being of children.

It also follows growing efforts by states, medical organizations and health advocates to help women experiencing these symptoms — an estimated one in seven postpartum mothers, some experts say.

“There’s better evidence for identifying and treating women with depression” during and after pregnancy, said Dr. Michael Pignone, a professor of medicine at the University of North Carolina at Chapel Hill and an author of the recommendation, which was issued by the United States Preventive Services Task Force. As a result, he said, “We specifically called out the need for screening during this period.”

The recommendation was part of updated depression-screening guidelinesissued by the panel, an independent group of experts appointed by the Department of Health and Human Services. In 2009, the group said adults should be screened if clinicians have the staff to provide support and treatment; the new guidelines recommend adult screening even without such staff members, saying mental health support is now more widely available. The 2009 guidelines did not mention depression during or after pregnancy.

“It’s very significant that the task force is now putting forth a recommendation that’s specific to pregnant and postpartum women,” said Katy Kozhimannil, an associate professor of public health at the University of Minnesota. “Policy makers will pay attention to it. Increased screening and detection of depression is an enormous public health need.”

The panel gave its recommendation, which was published in the journal JAMA, a “B” rating, which means depression screening must be covered under the Affordable Care Act.

For years, obstetricians and other health care providers who saw women during and after pregnancy often felt ill equipped or reluctant to ask about problems like depression, anxiety and obsessive-compulsive disorder.

“Ob-gyns thought that if they identify something and don’t have resources to support it, it puts them at significant legal risk,” said Dr. Samantha Meltzer-Brody, the director of the perinatal psychiatry program at the University of North Carolina at Chapel Hill. “Pediatricians have the added caveat that the mom isn’t really their patient — the child is.”

And, she said, many women are reluctant to share symptoms with doctors on their own. If a mother is “feeling so anxious you’re going to come out of your skin or feeling that you’re going to harm your baby, you may think: ‘Oh my God, I’m having these crazy feelings and nobody’s talking about it. I must be a terrible mother.’”

No one screened Melissa Mead, 30, of The Dalles, Ore., during or after her first pregnancy, five years ago. Shortly after her son Brady’s birth, “I experienced postpartum depression, anxiety and O.C.D.,” she said, and “I didn’t know what it was.”

Ms. Mead cried constantly, barely slept, rarely left home and was “scared to death that my baby was going to suffocate,” she said. At her job as an optician, she said that people asked, “‘Isn’t everything so wonderful?’ and I was like ‘I kind of feel like dying on the inside,’ and you don’t want to say that because you’re afraid what people will think of you.”

After a year, she saw a psychiatrist for talk therapy. When her second son, Emmett, was born, and she had more symptoms, including fearing that she would stab herself with a kitchen knife, Ms. Mead tried several medications until one worked. She now volunteers for Postpartum Support International.

The panel’s recommendations do not specify which clinicians should screen or how often, and Dr. Pignone said that “anyone who has a caring relationship with the patient” should “sit down and say, ‘How do we want to do this in our practice?’” For screening methods, the group said that theEdinburgh Postnatal Depression Scale, a 10-question survey, was effective.

The panel said evidence showed that cognitive behavioral therapy was helpful to mothers. It said that the use of some antidepressants during pregnancy could cause “potential serious fetal harms,” but that “the likelihood of these serious harms is low.”

Dr. Pignone also emphasized that “untreated depression has a lot of adverse consequences itself.”

Among them, experts say, are that pregnant women with depression often take poorer care of their prenatal health. And maternal mental illness can affect children, leading to behavioral problems, emotional instability and difficulty in school.

Besides citing evidence that screening accompanied by even minimal counseling helped women with depression, the panel found that screening caused no harm.

“A decade ago there was more concern that screening pregnant and postpartum women for mental health would do more harm than good,” said Wendy N. Davis, the executive director of Postpartum Support International. “Medical providers would say to me, ‘If I screen and she screens positively for depression and anxiety, I’m afraid that it will just make her feel more scared, or there’s more stigma to that label.’”

But, she said, “screening tools actually can give a language for both the providers and the patients to feel comfortable talking about it and prevent the stigma.”

The panel recommended that clinicians have the ability to diagnose and treat women, or to refer them elsewhere.

That is crucial, said Dr. Lee S. Cohen, the director of the Center for Women’s Mental Health at Massachusetts General Hospital. “I applaud identifying women who are ill,” he said. But “will she be appropriately referred, will she get treated whether it’s medication or therapy, and over time does she actually ever get well?”

The only state that requires screening, New Jersey, has had mixed results because too few treatment options have been available. While pediatricians and obstetricians were trained to screen, they were not compensated for screening, a study by Dr. Kozhimannil found.

A dozen other states, including New York, now have laws encouraging screening, education and treatment. And Bill de Blasio, New York City’s mayor, recently announced a goal of universal screening of pregnant and postpartum women, saying it “should be a part of routine care.”

Routine screening could have benefited Jenna Zalk Berendzen, 40, of Cedar Falls, Iowa, even though during her first pregnancy, five years ago, she was studying to be a nurse practitioner and had medical knowledge. She also had a family history of postpartum depression, but had assumed “it’s not going to happen to me,” she said.

A week after delivering a son, Maxwell, depression “hit me very, very severely,” she said. She felt suicidal, and at one point, while her husband and baby were sleeping, “I had in front of me 15 bottles of different kinds of meds,” she said. “I would open the bottles up and I would close them, open them and close them. I didn’t want to die, I just thought, ‘It’s never going to get better.’”

Ms. Zalk Berendzen ultimately found effective treatment, and has since weaned herself to a low dose of medication. She had no symptoms with the 2014 birth of another son, Samuel. She now works in gynecology at UnityPoint Health in Waterloo, Iowa, where, she said, “Within the last year, we’ve started to recognize we need to be screening every woman.”


Freezing Cold

cold

If you’re one of those poor people affected by the recent snowstorm, you have my sympathies. Nope, this post isn’t about the temperature, it’s about having a cold.

You’re probably wondering how I can create a blog post out of having a cold and you’re right…it’s difficult. But I will plunge in.

I caught a cold from my daughter who teaches first grade. It’s not the worst cold I’ve ever had, but it’s annoying. I’m three days in and I feel miserable.

It’s not really that I mind being sick, it’s that I feel worthless and guilty. I am down on the couch because I am achy and too tired to get up.

I think all of this goes back to the bipolar. I spent so much time on the couch and lately I have been getting out and being productive. So, today, even though I had plans I have to stay home. The good news is…my plans today did not include any other people so I am not letting anyone down.

I feel a little stupid. I am writing a blog for all of you nice readers and I am writing a book. I can do both of those today when I am “down”. So that is not worthless. But still I have the guilt thing going. Guilt is a big problem for me. Anyone else?

Let’s switch over to quilting. I have a quilt top almost done. It just needs the borders. For a new quilter, I am pretty darned pleased with it. It’s the first one I have done on my own. Once I get the borders on, I will send it off to Missouri to be quilted on the big machine they use. They put the batting and the back and the binding on. You can’t beat it.  I found another quilt on YouTube called the “double slice” quilt. That’s my next quilting project and I ordered the fabric for it.

My husband sort of made a mistake and got me in a bit of a jam. He totally meant well though. He bought a gift certificate at a quilting store for Christmas. But it wasn’t MY quilting store, it was just one I had stopped in to check out. So I had to spend the certificate. I decided to take a class there to make a baby rag quilt. Anyway, now I am in a bit of a panic. I don’t know any of the people there. My hands shake terribly and it’s embarrassing. I don’t have total confidence on knowing how to work my sewing machine in front of “strangers”. I’m flustered. I may just not go and waste the $19. But then I feel guilty again. Sigh.

Did I tell you guys my husband and I signed up to be on the missions committee at our church? We are assigned to work at a day activity center for homeless vets and seniors. This sounds right up my alley. We mainly see what their needs are, make a plea at church for item donations, and then haul it down there. We also can work down there all we like. I think this will be good to get me out of my own head and quit feeling sorry for myself.

I have a friend, Abby, who does self-harm. One of my goals this year is to get together with her in person and do something like coffee or a sandwich. I’d like to see her get out of the house. Another thing I thought of was her coming to my house to crochet while I sew. She is so home bound and I hope to make an inroad or two there. I know you can’t force people to do things, but you can gently encourage, right?

Another goal I have in the next few weeks is to call a few relatives of my husbands’ and arrange to meet with them socially. I don’t mind doing this…they’re pretty nice. We have some other relatives I just skip. Irritating people.

On to my weight issue. I have had a few days of eating everything in sight. One thing I learned during this time was that I craved bread, crackers, and cereal. This gave me some more awareness. Anyway, I have settled down and am back on my food plan. I hope to lose a couple of pounds still this month and then lose six in February. If I eat when I am supposed to I am not hungry. But if I skip a meal, watch out!

I’m still REALLY dealing with driving and riding anxiety. My husband and two of his friends (that I like) are going to a rock show in a city about 2 hours away. The plan is for me to look at rocks Friday afternoon, check into the hotel, do a little shopping and then eat (food on my plan, of course). Then Saturday I will hang out at the spa at the hotel. Sunday I will go with them for a little more rock show looking. This all sounds great except riding in the car to and from the other city. I am somewhat terrified.

I think the driving thing started when I was so sick I was unable to drive. My husband drove me everywhere which was the normal thing to do. I was drugged up to the gills and would have been pretty dangerous on the road. Then I got better (after quite a while) and it was still just easier to have him drive. Then I increased my meds and watch out.

I don’t mind the driving fear so much as I can always get rides. But the RIDING fear is terrible. It’s starting to limit my life. My husband is sensitive to it and drives slowly somewhat, but other people drive crazy fast and scare the s*** out of me. I still will drive around my “area” and can get to things fairly close by. So i haven’t totally stopped driving. But it is all a pain.

Thank you for reading this. It makes me feel less guilty about “wasting” a day.

hugs,

lily

 

 

When All Else Fails, Help Someone Else

Well I am off to Fort Collins, Colorado to help my technology-challenged Aunt look into other phone options.  She “may” finally be ready to graduate from her flip phone to a smartphone, we’re not sure.  She is very hip, but still in her 70’s, and very intimidated by all this new-fangled shit like iPhones and Internet and she sure as fuck wants nothing to do with Facebook!  Nevertheless, she needs someone to hold her hand when she goes to the Verizon store and if there’s one thing my disability has afforded me, it’s the time to be of service to my family members and their various needs.  I am going to stay grateful, try not to panic, and go one day at a time.  Just as I remind myself when I’m working out and waiting for that thirty-three minutes to pass, Be In The Moment.

And in other news, THE BRONCOS WON AGAINST THE PATRIOTS!!!  It’s the little things, people, the little things that renew my will to LIVE!  LIIIIIVVVVVEEEEE another day.  The Denver Broncos are going to the SuperBowl!!!  Now I have renewed my faith in Jeebus Krikey and I pray that they don’t get their asses handed to them by the Carolina Kittycats.  SO EXCITING!!  Off I go to walk through another day . . . I hope yours is splendid <3


Filed under: Bipolar, Psychology Shmyshmology Tagged: Bipolar, Go Broncos, Hope, Humor, Mental Illness, Psychology, Reader

Sticking With the Devil I Know

A few months ago, when I had a Med Change (Sort Of), I confessed to having a crush on Brent.  I still do, and when I was last in inpatient after being unable to assert myself with him, I met a psychiatrist who seemed really helpful (and said Brent is “Not What You Need“).  I […]

suicide

bleached noise

I have controversial views about suicide. I make no apologies for that. Our views of suicide are as culturally determined as food taboos and table manners. Socialization has failed in my case, and not just on this issue.

I believe there is such a thing as a good suicide. Leaving survivors’ feelings aside for a moment, if a person has lived long enough to have accomplished something, is mature enough to know that she may very well feel different at a later time, but still wants to end her long-term suffering from a mental illness by giving her life back, I cannot fault her for that. I do not think it’s weak or shameful. I think it’s entirely understandable.

I have always assumed I would die by my own hand. After a couple failed attempts and hospitalizations in adolescence, I have managed to make it to adulthood, self medicating along…

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The Functionality Flip

Following Sunday night’s meltdown into the abyss…I took all my anxiety and hatred and became a cleaning whirlwind yesterday. I’m not saying I dusted (geesh, this is a non fiction blog!) but wow, I got six loads of laundry washed, folded and put away, including bedding. My sister gave me her old vacuum last month and I finally brought it in from the car and started on the sabertooth fur cats that had been gathering on the carpets for months. I couldn’t believe the difference simple vacuuming made. My carpet is still stained and stuff but, wow. I was impressed. Guess that goes to show how long I haven’t had a working vacuum. I mean, I even used the attachments and bothered getting into crevices and along the walls.

I was possessed. I think mainly because it beat thinking of all the horrible machinations the donor may be up to. Every time my mind wandered to that, I gave myself a new task to work on. Cat boxes? Emptied, cleaned, refilled. Dishes? Done. I brought a different lamp into the living room (where I stayed the entire day rather than hiding in the bedroom crypt.) Oh, I finally took the Christmas tree down, ha. Or I put it in a trash bag and shoved it in the spare room anyway. It’s down at least. I swapped out my bug damaged six year old microwave for the “new” one dad got at auction and I left sitting on the couch for oh…four months. (Yes, I suck.)

I remember thinking, if only I could be that functional everyday. The mundanes think it’s a matter of simply wanting it and it happens. It really doesn’t work that way. The uber functional mind set, especially in the midst of depression and anxiety, is a fly by night operation. It hits, it leaves, and you may not see it again for months.

Of course, it wouldn’t be my life if some wrenches weren’t thrown in the works. While vacuuming I overloaded the outlet and crashed half the place’s power. I got most of it reset but now I have no power in my bedroom or living room which means…Fuck, I’m gonna have to ask the landlord to get an electrician here, who will no doubt say it’d be cheaper and safer to just move and have this place demolished.

Then true to form…I broke the vacuum. Well, not broke, but it shut off and wouldn’t come back on. I was starting to freak out, so I pushed it aside. Then realized if I didn’t try to fix it I was right back to square one so I got out my screwdriver, plopped on the floor and proceeded to remove the bottom. Now for normal brains it’s just four screws and putting the belt on the roller properly. For MY brain it was panic city as I tend to forget what goes where. My short term memory is fucked. But once I removed the roller and cut through all the cat hair and tree tinsel wrapped around it..Bam. I fixed it, yay me.

I felt good to have accomplished so much. Especially that vile word housekeeping, ewwwww.

Today…I don’t know if it’s the gloom or knowing R wants me to pop in and look at his cousin’s laptop but I am not feeling functional at all. In fact, I want to go back to sleep. I haven’t even taken my meds yet. I also need to call the dr’s office and explain, you won’t find my lithium level test because um, I can’t afford the gas to drive all the way out there and have it done…This thing where the school won’t let my kid ride the bus is bankrupting me, it’s like seventy bucks a month gas just for her transportation which means we don’t get anywhere else….Not even for me to get my lithium level checked cos that’s gas I have to keep in the car to transport her so she isn’t called truant.

Frick fuckity frick fuck fuck.

On a happier note, I watched episode one of The X-Files reboot and it is AWESOME.  And hitting pretty close to the truth these days.

Sorry I yapped so much about the housework thing. I know it’s what everyone else does every day, BFD, blah blah. It was a huge accomplishment for me, even as I look at what still needs to be done to make the place “clean–ish” and want to return to fort blankie.

I told R last night I am worried sick that the donor is going to try to get joint custody to get out of paying the twenty percent support on Spook. I am not off the wall here. Why would someone say they needed to consult an attorney on a matter of child support unless they’re looking to work their way out of it? I just have a bad feeling, no matter how much everyone reassures me.

I guess I am gonna play the “will I puke today” lottery and take my lithium. Joy. I think I forgot my dose last night…

Damn it, this is where I get all fucked up. Give me pills I can just take as one handful once a day, ffs. My brain is too scrambled to remember two pills here, two there, another two here, take three of these at 4 p.m….If I were competent enough to do numbers I’d still be working, damn it.

Stupid fucking bipolar. I felt like a normal human yesterday and today I am a discombobulated basketcase.

Fuck you with a thousand barbwire dildos, bipolar. Just…fuck you.