I took care of a very, very old problem last week.  One that I had been avoiding for about 15 years.  I finally went to a psychiatrist after spending what must have been nearly two months trying to keep a lid on rising, chronic anxiety and agitation that I am fully convinced is related to having quit smoking (nicotine is a seriously deviant neurochemical).  Really, it’s been years that I’ve kept a lid on those things, but this time they were lasting longer than they had before and I was starting to frighten myself a bit, so I went to get some help.

I had avoided doing so for so long for a lot of reasons.  I had a fear and distrust of the psychiatric community in general after spending the first seventeen years of my life watching my mother go in and out of hospitals and take virtually every type of medication available, to no avail.  That probably wasn’t psychiatry’s fault, it was probably Mom’s.  Drugs don’t make psychiatric disorders disappear, they just make them easier to manage and if someone wants to be truly better, they still have to do a lot of personal work.  Personal work that Mom was never willing to do.  She was just too selfish, or too deep in her own denial, or something.

I also had a fear of the medication dance that so many who suffer from psychiatric disorders seem to have to do, as well as the myriad side effects that those medications often saddle their takers with.  Weight gain is often a primary side effect of many psychiatric drugs for some reason, and as someone who has always struggled with their weight, I was reluctant to even entertain taking something that would make me even heavier potentially.  Also, for many years I feared the sexual side effects that often come with psychiatric medications, but over the years, my illness itself along with leftover trauma from childhood sexual abuse has conspired to essentially make me mostly dead from the waist down anyway, so I didn’t really have anything to lose in that department.

Perhaps most importantly, I had to get over my own pride and individuality.  Everyone tells themselves they want to be different from their parents.  It’s how progress is made over the generations.  In a healthy family, people are different in action but not in fundamentals, because they had loving families that bonded together.  Unhealthy families don’t bond like that because there’s nothing desirable to mimic.  Over the years, in my efforts to be different from people who were unhealthy, I set myself up for a game of denial when it came to my own mental health.  Sure, there are some aspects of it that are the result of the environment that I grew up in and can be corrected with therapy.  The rest, though, that’s all genetics.  I can escape that no more than I can escape my family’s cardiovascular health history.

Hopefully it’s easy to see how something no less medical in nature than, say, diabetes can easily become horribly stigmatized if you’ve made a lifelong effort not to be that way.  I told myself that it was something I could deal with on my own.  That combined with my distrust of Western medicine in general led to fifteen years of essentially self-treatment using herbs, meditation, yoga, exercise, and karate.  Which actually are fairly effective, but they require hypermanagement of one’s lifestyle that is nearly untenable in modern society if you’re doing anything more than going to school or holding down a stress-free job (is there any such thing?).

Fortunately, I was going to school for a while, and when I wasn’t, I didn’t have to work, so it was easy for me to live a life that avoided triggering unpleasant episodes or allowed me to hermit when they did.  Then I had a baby and whatever control I had over my life disappeared.  I hadn’t realized how carefully managed my life was until my daughter was born and I could no longer do things the way I had been.  I quickly slipped into a deep postpartum depression, one that was practically prepared for me by a nearly 48-hour labor and delivery that ended in a C-section and failed anesthesia.

About a year and a half after Zoe was born, I had a serious mental crash when we had too many stressors all at once in the form of unrelated medical issues and a car wreck that very easily could have killed both my husband as well as Zoe.  At that point I was put on Zoloft, Buspar, and Ambien.  I was in a depressed state so it was assumed antidepressants would help me.  They didn’t and I wound up on two more drugs, Seroquel and Valium, to try and address untreated symptoms.  I did that for about a year and a half and then stopped.  I’m glad I have pictures of that period of time or else I wouldn’t really remember it.

Finally, I stopped breastfeeding Zoe when she was about 3 and miraculously my mental health as well as my metabolism improved greatly.  I felt better and started losing that baby weight, finally!  I hear that breastfeeding is supposed to make mothers feel happy and help them lose weight, but in retrospect, for my own health, I should have stopped nursing Zoe when she was no more than a year old.  It obviously did bad things for my neurochemistry, for whatever reason.

So did bad life stressors.  That year I let my brother and his wife stay here while they had their baby and found a place to live.  I’ll spare you the gory details, but it turned out very badly.  What was supposed to be three months turned into eight.  It was miserably hot that summer, everyone was out of work, and there were four adults and two children living in a house of less than a thousand square feet.  In a strange quirk of fate, my brother and his family moved out and my husband got a job all within five days of each other.  Suddenly, for the first time since my daughter had been born, it was just the two of us.  My husband had worked from home for her entire life to date, and now he had to take a job out of the house.  Not long after everyone left the house, I had myself a little breakdown.

I tried to get help, but by then the health insurance industry had made it nearly impossible to get treated for anything mental unless you were actively suicidal, and then they would only pay for whatever the bare minimum was to get you back at home.  So unless I wanted to kill myself, my insurance wouldn’t cover a psychiatrist or even a GP visit if it was mentally related.  It was going to be cheaper to make the four hour drive to Mexico and buy drugs there than it was going to be to actually get the help that I needed.  I decided it was easier to just hunker down and wait until the mental storm had passed.  It was a crime that I had to do that.  I and my entire family suffered needlessly because of it.

It was then that I decided that I was probably bipolar and not just depressive.  I had checked out some books from the library about women, anger, mental illness, and other topics, including a couple of books by Kay Redfield Jamison, author of An Unquiet Mind.  She’s a psychologist and she details her own experiences with bipolar illness.  Her descriptions of her own mental states resonated strongly with me.  Still, I was too traumatized by trying to get help and by the possibility of it taking a long time to figure out what was wrong and how to treat it, so I continued to just wait.

I got better, that time anyway, and tried to manage my moods as best as I could.  Yoga helped in that regard immensely, and yoga will remain a part of what I do to make myself feel better, even if I do require medication for the rest of my life.  Karate also helped a great deal.  It requires a focus that is soothing, calming, and quieting to my mind.  I tried meditation, but I found it to be even more agitating than just my normal mindset.  I would figure out why later.

Last year I had to go mucking with my hormones, and I immediately began to feel worse than I had in several years.  I had always had trouble with bad PMS, and it was returning, despite my doctor’s insistence that the pills I was on were essentially identical to what I had been doing.  A couple of months after that, I quit smoking, which meant that I could try other kinds of pills (birth control pills are dangerous for smokers over thirty-five) to try and alleviate the PMS and other symptoms I was experiencing.

That was three weeks ago.  Over the next two weeks, while I felt better in some ways, I felt much, much worse in others.  I hadn’t felt this unstable since I found myself with an empty house save for a 3-year-old a few years before.  A week and a half ago, I tried to get a doctor’s appointment because I was feeling dangerously agitated, but the office I had gotten my new pills from wouldn’t let me speak to the doctor: they just made an appointment for the following Monday, four days later.  O_o  I was too agitated to sit in an ER: that would have made me worse.  So I called upon the people who never fail to come to my aid: my friends.  They brought me what I needed to get through the weekend, which included a summer camp fair for work which I doubt I could have tolerated, given the size and noise level of the room I was in.

I avoided as much stimulus as possible over the weekend, and stopped taking the offending pills.  On Monday, after taking my aging cat to the vet, I went back to the doctor and began a day that involved a lot of kleenex, two doctor’s offices, and at least four different healthcare workers of varying flavors.  Not to mention a busted car fender due to an elderly neighbor who shouldn’t be driving anymore.  I will spare you the day’s details, but suffice it to say that the fine people at Austin’s emergency psychiatric office must have agreed that I needed assistance because I made it through all of their hurdles in less than four hours.  In case you didn’t know, that’s nearly unheard of.

To make an already long story a little shorter, I have been indeed diagnosed as bipolar, type I.  The nice Indian doctor prescribed me some lithium to stabilize my moods and some trazodone so I can sleep.  He told me to read up about bipolar disorder, which I didn’t really have to after so long of trying to convince myself I didn’t have it.

“I’m not listening, I’m not listening!” – Gollum, The Two Towers

Near as I can tell, I’m one of those unlucky people who gets to enjoy mixed episodes: up and down at the same time.  It’s about as crazy as it sounds and feels worse.  I also suspect I’m a rapid cycler, or even ultra-rapid: more than one cycle a year, perhaps more than one in a day.  I try to avoid contact with humans on those days.  Not much has really changed.  I just have names and labels for what’s wrong sometimes, and I don’t have to beat myself up over feeling or behaving a certain way.  I can just identify it, remedy it, and move on, or stay in my room if that’s necessary.  I’m sure I have more than a few friends whom upon hearing my diagnosis have gone, “Aaahh, so that’s what’s wrong with her sometimes.”

It does mean that I now have the label of “chronic illness”.  I must take my medication: there is no alternative, just as a diabetic has to take their insulin or they can die.  Diabetes is actually my favorite non-mental chronic illness to compare to, because diabetics can exhibit some seriously aberrant and even violent behavior if their insulin and blood sugar levels get too wonky.  No one thinks diabetics are “crazy”: they just have to maintain their blood sugar properly.  I feel the same way about most mental illness that can be treated with medication.  Mother Nature forgot to wire our brains quite right so humankind has to fill in.  The only thing to be ashamed about is when I fail to do what I need to do to stay healthy, which is a lot.

It is now super-important for me to keep regular, healthy routines.  Now is the time that I should make a super effort to get that meditation practice going, especially now that I’m taking something that will shut off the hamsterwheel in my head that has always made meditation so frustrating for me.  Everyone gets the hamsterwheel when they meditate, but mine never, ever goes away.  Consequently, I just don’t meditate, or I haven’t been anyway.  Now it will be easier and that will help more than anything else in alleviating what is still an ongoing anxiety and inability to truly relax.  It’s getting better, I can tell, even after only a week on a relatively low dose of lithium.  I hope it continues to improve, because I would give anything to just be able to sit and relax and not feel like I have to get up and do something.  Yay, mania.  *sigh*  I also have to make sure I eat and not let my blood sugar get too low, which will also disaffect my mood.  Same with sleep.  Everything has to be kept in equilibrium, an ironic task for someone medically diagnosed as being out of equilibrium.

I’m trying to take an attitude of permissiveness rather than dictatorship.  After all, I’ve essentially been given permission to do as much yoga, karate, and meditation and communing with nature as I can possibly get.  Doctor’s orders!  😀  This is also a huge red flag for me to really work on incorporating Buddhism into as much of my life as possible.  Only a whole lot of acceptance, love, compassion, understanding, and metta is going to get me through the rest of my life.  I do admit, and had to admit to the doctors, that while I am not actively suicidal, I am sometimes filled with the sense that I shouldn’t be here, that I’m a mistake, that I shouldn’t have been born, and I don’t know if that’s the result of my disease or the result of the terrible environment that I had to grow up in.  Whatever the case, I’m going to have to make friends with those thoughts and figure out how to banish them, or make them ineffective, because they get worse the older I get.  Seems like a lot of love is the way to go on that one, and the only place I feel that love from is my family, and my friends, and the Buddha.

I was so grateful for my friends and family the day I was at the doctor all day.  Thanks to modern technology, I had my Android phone with me so I was able to stay in touch via Facebook and Twitter and email all day long, which was incredibly helpful to me.  All day long, I had little messages of love and support from everyone and it meant so much to me.  I have something that my mother never had, which is unconditional acceptance and support from a fairly large circle of friends and a husband who really loves and cares about me.  I would be just as lost and crazy as she was without these people in my life.  That’s far more powerful than any bottle of medication.

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