Category Archives: Coping Skills

No ECT!!!

I showed up for my scheduled ECT this morning. And in the pre-screen I talked about how well I’m doing, back to baseline on everything. Somehow the conversation twisted and the PA asked if I even wanted a treatment today. Um, NO!

I waited an agonizing 5+ minutes while she talked with the treating psychiatrist. They agreed I was doing well enough not to have a treatment! I’m to call in a week for a phone screen to see if I’m still doing well or if I need a treatment. If I’m doing fine, they will discharge me and I can get the port out of my chest (used to access a vein easily since IV’s are hard to get on me).

Hooray! I celebrated my unexpected free day and good prognosis with a ginormous mocha from the coffee shop in the hospital lobby.

I also saw my regular psychiatrist today to ask about the fine tremors I have developed in my hands. But, I got to gloat about how well I was feeling. And I was shocked to be doing so well that he wanted to see me next In Three Months(!).

Even as I’m feeling well, and stable, and Good, I’m worried about the bottom falling out and plunging into suicidal depression for the millionth time. My doctor encouraged me not to worry about what might happen, and even to make a video or add to my mirror post-its that Yes, I was doing well. Something to help remember if (when?) things get bad, that I had been healthy and it would happen again.

Why do I expect suicidal depression to come again? Just because it has been a companion I could count on? And I got as good as one could get at dealing with it healthily?

How about I have no freaking clue how to be in a good space? I’m worried that the increased energy I feel is mania, and that the only way I have to express how good I’m feeling is to talk too much or to spend money. Both of those are things I do when I’m manic, yet I’m not manic.

I just don’t know how to be healthy! What are behaviors You have when You are healthy?

See! You Have a Purpose

So I was talking to my therapist, as one does, and we were exploring what to do with the ever-present suicidal thoughts. He had tried getting me to welcome them as just part of the landscape of my mind, something I’m pretty good at doing already. Most of the time I Accept that they are there, and recognize that they are just thoughts. At various and sundry times, intent to follow through on the thoughts accompanies the thoughts, adding fear and a third dimension to what had just been landscape. Then suicidal suggestions become action instigators, and I worry, fret, ruminate and finally find someone to talk to about the thoughts until they become landscape once again.

Even as mere landscape, suicidal thoughts are not at all pleasant. Just live-through-able. I don’t want them. Now, at least. Sometimes I want them and I want to act on them. But 97% of the time, I want them gone.

So I accept their presence, in good ACT fashion (Acceptance and Commitment Therapy). The next step, says Wise Therapist, is teaching them some boundaries. In a kind but firm way, order them away. As a small child I was often sent to my room to play, when the parents needed a break. So too, I must send the suicidal thoughts to their room when I need a break. Give myself some breathing room.

Now, we uncovered today that the undercurrent of the suicidal thoughts is the thought that I don’t have a purpose or goals. I have that thought a lot on its own, and it shows up again, subtly, with the suicidal thoughts. I hadn’t noticed it there before! I think if I send the thoughts to their room, then I need other thoughts to think about: my purpose in life and small and large goals. But I don’t have those, I protest!

And I change the subject, to my brother’s very recent colon cancer diagnosis and upcoming surgery (read more here: http://gofundme.com/markfightscoloncancer). Wise Therapist puts together that the same week I struggle with my Christmas Delusion and then persistent and pervasive suicidal thoughts, I manage not to go to pieces over my brother’s diagnosis and am the only family member to keep it together.

See! You do have a purpose! exclaims Wise Therapist. You didn’t set yourself and emotional needs aside, nor did the family situation exacerbate your symptoms so that you freaked out.

I think being steady through a volatile time for my family was the purpose he was getting at. I’m not sure I agree, but it did seem I was holding it together for people. I still don’t have goals or a larger purpose – in my mind – save for doing something interesting every day and surviving, or persisting as my bumper sticker says.

Is that all I need right now? Can I persist with no goals, no hopes, no plans. No real purpose, even for my upcoming trip to Chicago. Is persisting enough?

Around the Cycle Goes

This week has been up and down and around as my mood, or more my thoughts, cycle through various mental phases.

I started the week with the ever popular Xmas delusion I get every year. Fortunately it lasted only several hours on Xmas Eve when I was in and out of touch with reality. My mood was still in the middle but dipping at times on Xmas Eve and Xmas Day.

Then December 26th, I was back! Mood perky and happy and optimistic. Mere fleeting thoughts of suicide (baseline for me to just have a few).

And then on the 27th, OCD thoughts kicked in and all I could tell myself was plans to kill me. All the time. And again I couldn’t talk about it or tell anyone until my NAMI support group meeting that night. Then I could articulate calling the ECT office to see if getting ECT earlier than scheduled might help. And I could note that I really needed to tell my mom about the OCD suicidal thoughts. And I was encouraged to contact my therapist, who did tell me to contact the ECT office and let them decide if I needed one.

You see, my mood was great! Stable, and in the middle. Not depressed. Not hypomanic. I just had obsessive, albeit dangerous, thoughts. I didn’t know if I would get to a point of having intent though.

When I called the ECT office today, the 28th, I thought the thoughts were less obsessive and therefore farther away from any intent. But later in the day they were just as obsessive and I worry about intent showing up. Or if obsession will finally give way to compulsion in OCD. It never has for me, but will there come a day that the pathology progresses?

My mood is still stable, happy, good, in the middle. It’s just my thoughts. I don’t want to kill myself, I just can’t stop holding it out as a possibility. Obsession. I suppose if I was worried enough, it would warrant a hospitalization. But, again, my mood is great! It’s just the obsessive thoughts.

Sigh.

I hate mental illness.

The Hardest Part of the Year

I’m trying not to over-anticipate the next 10 days. Right now my bipolar is stable and in the middle. (Yay!!) But there’s a full moon, a solstice and a Christmas delusion which all have strong possibilities of messing up my mood, sending me into delicious mania with hallucinations and delusions, or into fateful suicidal depression with plans and intent. Either pole is equally likely.

And full moons, solstices and equinoxes can all mess up my mood pretty good. There’s a moon event and a sun event on this coming weekend, right about the time my Christmas delusion likes to come into play with false beliefs about who I am and what my purpose in life is.

So how do I prepare for a messed up mood, yet take each moment as it comes and let these next 10 days be just another 10 days? I don’t even know how to ask for help for this!!! I feel if I just take each hour, each minute as it comes, and a mood disturbance/episode happens – And I Haven’t Prepared Myself For It – I could fall pretty far off the deep end and it could take months to recover. And to prepare for a mood disturbance/episode feels like walking on eggshells so that at least I’m not blindsided. I don’t know how else to prepare. Help!

Taking a Look Around

I did not go to the hospital for ECT this morning, for all the reasons given in yesterday’s post. I just don’t think the presence of suicidal thoughts that are part of my mind’s landscape on a normal day – given the lack of intent and concrete plans – warrants an ECT treatment. I’m not ruminating on suicide as I do when the pathology is present.

Today I’m taking a look around the landscape of my thoughts and feelings in this new and dazzling place of “somewhere in the middle.” What does it look like to have a sad thought but not be depressed??? I don’t know! But I had one today. What is it like to feel content and happy but not be euphoric and taking risks??? I don’t know! Yet I would use those words to describe my mood today: content, happy.

What else is going on in this mood state? I popped out of bed rather quickly this morning. I’m being more kind and helpful than ordinarily with grocery shopping and cooking and chores around the house. I made extra coffee just because instead of thinking I had no energy for extra anything.

I’m noticing that I have negative self-talk about myself and that I don’t believe the negative things any more. How weird is that? A coping skill since diagnosis over 8 years ago has been positive self-talk and changing negative self-images and thoughts to positive ones. I have found this skill elusive most of the time. I just don’t believe the positive stuff. But today! Today and this week so far, I have only positive things to tell myself. Even when I notice something negative, I’m quick to do a reality check and change what I’m telling myself. What is this new persona, that I tell myself positive things about my image and personality and worth as a human?

Revisiting Moving

So I’m going to Chicago-land next week for a vacation. I’ll see a lot of friends and I thought I’d see some sites I never saw when I lived there and revisit some too. I also researched a bunch of apartments I could afford in areas close to friends. Which brings up the idea of moving back to an area where I have friends and like the place and weather better.

My therapist reminded me that when I have repeated thoughts – or any thoughts really – I can decide whether to think about them and give them attention, or not.  I’m still wondering if I should move, especially back to Chicago. Hence, I have been looking at apartments in my old area. And maybe I should find a roommate so I wouldn’t be living alone.

Pros of Moving: culture and weather I enjoy, better situation for my cat, lots of friends in my life, good care team including excellent hospital, value of independence lived out, not living with family

Pros of Staying: live with supportive mother, partner in healthy behaviors,  money available for travel, good psychiatrist and therapist

Cons of Moving: extra cost and stress on mental health of moving, extra cost per month (less of an issue if have a roommate), take care of health alone, daily responsibilities harder cuz alone (unless have roommate, then this is not an issue)

Cons of Staying: living with family, not best place for cat, hate culture and weather, little independence, bad hospitals if needed, few friends

Either way I am taking care of my health and have a good care team, except for a hospital if I stay in Texas. With a roommate in Chicago I would still have some money for travel. With moving I would be living out my value of independence, though I would be starting fresh again which is hard on my mental health (changes are hard!).

What do you think is best with these pros and cons??

In other news, my doctor is confident the Abilify injection I started this month will have a HUGE impact on my mood swings – fewer and less intense. That has been his experience with many, many patients. He said that if I didn’t experience success with this treatment, I’d be the first. Yay! There is some hope?

Something to Fill the Time

So I’m thinking about that memoir I set aside and picking it back up again. Just for something to do. Maybe a way to put my mental health advocate hat on a little more firmly. I remember taking chapters of that initial draft to a writing critique group and thinking they didn’t understand the memoir genre. So I stopped going. Maybe time to look at those first couple chapters with new eyes? Develop a new plan and start writing?

I spent an hour and a half looking at what I had already written, and blog posts I had inserted to condense down later. Seems like I only got through the first 2 years out of the 7 I’ve lived with the diagnosis and the constant med changes. By looking through blog posts, I filled in the hospitalizations since January 2015 when I stopped the memoir, I guess. Turns out I have been hospitalized 40 times in 7 years. Good grief! I wish it would stop. I wish I wouldn’t feel guilty and embarrassed about the high number. I told my current psychiatrist that it was over 30. Guess I should update him.

So what do YOU think should be in the story of being Suddenly Bipolar? All suggestions welcome!