two-faced

Impostor. Pretender. Phony. Fraud.

Everywhere I go, I feel disingenuous. I’m always pretending, whether I am at work, or with friends, or even in the mental health community. I’m good at faking wellness; I work hard to seem normal enough on the outside while I am struggling on the inside. However I always feel dishonest wherever I find myself.

I hide my mental illness from my employer, even though by law they are not supposed to discriminate based on health conditions. But because they have designated my job a “safety sensitive” position, I have to be “fit for duty” when working. If I told my employer, would they be afraid I could suddenly snap? Would I be forced off work until I could demonstrate I had recovered (as if that is even possible)?

I don’t tell my coworkers or my few friends about my mental health, and I dissemble when the subject comes up in conversation. Would they not believe me because I act “normal”, or would they overreact because they wonder if I could “go nuts” on any given day? Would people suddenly avoid me for fear of being associated with the crazy dude, or would they tell my employer that I was hiding the truth? I’m not willing to take the risk.

I avoid settings like group therapy meetings, forums, and online communities because I don’t want to face reverse stigma. Would people who are truly struggling not accept me because I don’t seem to be as ill as they are? Would people judge me for being “high functioning” and feel like I was just looking for attention? Even in the hospital mental health ward, someone told me I seemed the most normal out of everyone, and that bothered me.

In the past I have wondered if my psychiatrist takes me less seriously because I’m not as sick as his other patients. I think that was the case several years ago with Dr. PrescriptionPad and his 7-minute appointments. [Fortunately, I think my current doctor does take me seriously and seems to listen to me when I describe how I am feeling.]

I guess this is why all my mental health issues come out in my blog, because I have an outlet where people can come or go, read or not, and I never hear about it if they think I’m only doing it for attention. I can be honest here, even though I am doing so under a fake name in the hope no one in real life ever finds me (which is a story for another day).

Note: here’s a post by Meghan which discusses similar feelings.

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that was unexpected

Every so often, something happens when I am least ready for it, and it unleashes a torrent of negativity and self-loathing that is usually restrained. I think that’s what happened the other night when a backlog of frustration and mental fatigue burst forth all at once.

Negative things seem to affect me more than “normal” people, and this is one of those instances. Some people would simply solve the problem, where I turn it into a metaphor equating one event with all the negative feelings I have about myself. I don’t react well when events happen that I’m not prepared for. I turn temporary setbacks into catastrophes.

I am truly worn down by a lot of things. I am very dissatisfied with life right now for many reasons. At the same time, my life is not all bad. I need to remember to even out my emotions when I am capable; try not to get too high or too low when events affect my mood.

up, down, sideways

Life has been up and down and a little out of control the past couple of weeks, like an old wooden roller coaster that is falling apart and miraculously hasn’t maimed or killed anyone yet..

Several negative events: a rough conversation with my daughter resulting in her hating me; bad health news; depression; procrastination and laziness; giving up on something I would love to do for myself; back and neck pain; cancellation of best-laid plans for my wife’s birthday; and the ever-present exhaustion.

On the plus side, the LA Dodgers are out of the playoffs, and I hope the fans feel miserable. The other thing that brought a smile this morning was the story of the Tennessee goalposts. Google it or search for videos; you’ll be entertained.

I’m trying to find something interesting to write about, but it’s just not there. I should go for a walk, shower for the first time in a week, and then try to accomplish something before going to dinner with Annie and her parents. Instead I feel like wallowing for a while and taking a nap.

the cost of bipolar

I’ve had bipolar disorder since I was a pre-teen, and the costs of my illness have been eye-opening. I have lost educational opportunities and had instability in my career, resulting in a loss of many tens of thousands of dollars over the years. There have been the financial costs due to unnecessary purchases and moving to different places. There are significant costs for ongoing mental health treatment. I have lost or damaged several important relationships, and I nearly lost my life on a few occasions.

There are also the physical health costs associated with bipolar disorder. There is the weight gain associated with the meds I take, which causes me problems such as high blood pressure, the potential for heart disease, and lack of mobility. I have sleep problems, decreased libido, and ongoing gastrointestinal problems, all of which decrease my quality of life. Bipolar medication may one day cost me my intellect, if the potential for early dementia becomes a reality (I wrote a previous post about memory problems).

My bipolar has inflicted harm on the family as well. My wife has stayed with me despite over 30 years of instability and unpredictability, and it has cost her emotionally, including unhappiness, fear, and anxiety. She had to be responsible for raising the kids while I was unable to help due to my illness. She has felt like she has to work harder to make more money to pay for the medical bills (she doesn’t at this time), so she continues to work at a physical job and often has debilitating aches and pains.

My son and daughter grew up in an unstable home where I wasn’t mentally present for long periods, which in my opinion caused ongoing mental health issues. My son has battled depression, but seems to have dealt with it pretty well. My daughter has been diagnosed with bipolar, schizoaffective disorder, and anxiety disorder. Her illness has cost her most of her friends, dreams of a normal life, two potential career paths, and many thousands of dollars in medical bills. She struggles with emotional issues in addition to her other physical and mental problems.

rear view

I was looking back at my posts from early 2021 that followed the arc of a long manic episode. The posts from that time aren’t scary like some of the deep depression posts from the old blog, but they are interesting to me.

My episode started with the side effects of starting on Latuda in November of 2020; I felt pretty good for a few weeks, but I started climbing the hill in December. By January 2021, I was frequently staying up in the middle of the night, my anxiety was climbing, and my OCD symptoms became overwhelming. I couldn’t concentrate at home or at work, I was having panic attacks, and I almost left my job out of frustration. After quitting Latuda and returning to Abilify, there was a long downslope where my symptoms were decreasing steadily, but were still there. I was afraid something had permanently changed in my brain. It wasn’t until May when a solo mini-vacation brought some relief from the storm.

Looking back from a year later, I am reminded how much I was struggling. This manic episode seems odd because on one level I knew what was happening and how dangerous it was, but at the same time I was very much caught in its uncontrollable grip. I didn’t think I could fly, but I believed that my life would be better if I tore everything down at work and at home. Had I followed through with my late-night schemes, it could have damaged my family relationships, cost me tens of thousands of dollars, and jeopardized the continued treatment for myself and for Nicole. I think I escaped the episode just in time, because I don’t know what I would have done if I had remained manic for a longer period.

My bipolar experience has been mostly depression, with very brief manias or mixed episodes followed by a deep spiral. This episode was different in that it had a long buildup and a long letdown, and I didn’t crash in the same way I had in the past. Since that time I have had no mania and a few depressions, and not with the abruptness and intensity as in the past. I know mania will happen again in the future, but I think having been through this most recent episode makes me better equipped to deal with it.

broken

You can only beat your head against the wall so many times before you crack, spilling your hopes onto the floor. You struggle to pay the price of existence, and the costs are staggering. Damaged and broken, you barely survive the day, and get no relief from a fitful sleep before waking up again. The cycle of hopelessness is not a circle but a downward spiral, a black hole from which positive things never escape. Your carefully constructed life is shattered by a disease with no empathy. The beast is not satisfied until its victims lie on the floor, crushed by its destructive power.

inadequate

I don’t feel like I’m good enough for anyone – not as a husband, a father, a son, a friend, or a worker. I’m not good enough for my own standards of what I want my life to be. I feel like I let everyone down on a consistent basis, and that I’m not trying hard enough. I’m just a substitute until the right person comes to replace me, and they will do everything better.

I define my self-worth by how useful or helpful I am to others, and right now it seems like I’m not useful or helpful to anyone.

Sometimes you just have to face reality, and my reality is that no matter what meds I take, they can’t change the fact that I’m just not wired to be a happy, successful person. I want to be that guy, but I can only fake being that guy until I can’t fool anyone anymore.

thanks for the memories

My daughter and I both have memory problems, and I believe they are directly related to bipolar disorder. We were talking about this recently, and she said she has forgotten lots of things, but it also feels like she never made the memories at the time; there is simply nothing there to remember. I never thought about it that way, but when she said that, it completely made sense.

I’ve given this more thought since that conversation. Looking back at what I remember and what I’ve forgotten, it seems like my ability to make and retain memories correlates to how severe my bipolar mood swings were at the time, and the depressive moods in particular.

I remember some of the depression “highlights” over the years, but during the times I was severely depressed there seem to be large blank spaces in my mind. School happenings, kids’ milestones, and my own work life just blend into a grey fog. I also have some memorable manic or mixed moments, but I seem to remember mental images from those times rather than the context of what was happening on either side. These memory snapshots don’t do anything to help me remember the life events surrounding the moments I do remember.

The memory loss feels strange, but just as odd is my ability to retain many events from times when I was alone. For example, I can remember locations I delivered or picked up from while I was a truck driver. I can remember places I’ve been hiking or exploring or just driving around by myself. I can remember vivid details about places I visited many years ago. In addition, I can remember lots of useless information and trivia (people always told me I should try out for Jeopardy, but I never wanted to).

My memories are often triggered by something else, whether it is music, a photo, or a geographic location. If I can associate a moment in time with a particular song, I will remember it for many years. For example, I recently listened to some music by Wham! for the first time in a long time, and it triggered a memory of driving through the Sierras in the dark when I was 18. A Hall & Oates song reminds me of a railroad crossing on a main boulevard in San Jose. A Tears For Fears song reminds me of a girl I liked in 9th grade, but also specifically of one part of a highway in Sacramento when we were on a school trip together.

I guess the part that bothers me is that I don’t know what is normal and what is not in my bipolar-addled brain. I think most people make memory associations from photos or music. I realize that normal people don’t remember everything about their lives, and usually just the highlights are what they remember. But I don’t think people typically have long years of time where they forget virtually everything. People have told me I had a great memory because I can tell them obscure details from events long ago, but I feel like my memory is getting worse all the time. I don’t know if it is caused by bipolar brain chemistry, long-term effects of psychotropic drugs, or early dementia coming on.

i want a new drug

I want a new drug
One that won’t make me sick
One that won’t make me crash my car
Or make me feel three feet thick


I want a new drug
One that does what it should
One that won’t make me feel too bad
One that won’t make me feel too good

Huey Lewis and the News

I’ve been taking this new drug Vraylar for over 2 months now with good results. I have had very little depression since increasing the dosage last month. I feel like I’m right on the edge of being a little hypo most of the time. Maybe that’s how “normal” people feel all the time: positive, capable, resilient, and alive.

I’m a little unsure of how to take this new feeling. Only time will tell, but for a change I feel a little bit of optimism about my treatment. I’m apprehensive in thinking that I’ve really found a solution, and that it will last. I wonder if I have become so accustomed to depression that I simply accept it as how my brain is wired without having hope that things can change.

Unfortunately, this drug is under patent and is expensive. Under my prescription plan, a 30-day supply would have cost me over $300. The manufacturer has copay cards which cover that cost for a limited time, so I paid very little for now. However, my plan’s maximum annual out-of-pocket is about $1000, which is a lot to pay when the discount card runs out.

It sucks that a drug this effective is out of reach financially for many people, but I’ve finally found a combination that works. I understand that the drug companies spend many millions developing new drugs, but they make huge profits when a drug is successful. Maybe that covers the costs of the unsuccessful drugs, but when company executives make tens of millions of dollars per year it seems hard to justify that level of profit. I don’t know what the solution to that problem is.

the weekend update

Job update: I found out who was chosen for the job I interviewed for. She has no field experience and no design experience, but she was well known by the hiring manager. I was lied to, because I was told by that manager that they wanted someone with more field experience. I think I didn’t get the job because they didn’t know me personally and because I’m a middle-aged white male. I hate to be that way, but that’s the company culture. It’s not what you know, but who you know. I wasn’t bitter before, but I’m a little salty now.

Psych update: I saw the p-doc this week and told him I wasn’t having mood swings, but I’ve had a pretty good depression for weeks now. In addition, the Abilify makes me want to eat everything in sight. We are going to try a newer brand-name drug, Vraylar, because it treats both depression and mania, and weight gain is much less common. Hopefully I will have some good news to report.

Mindfulness update: I’m going to tell the therapist I want to concentrate on some other method of treatment. I’ve lost interest in the book, I can’t seem to get started on the exercises, and I don’t believe it will work for more than a few moments. What I need is to find a way to fight the social anxiety enough that I can actually exercise without thinking that everyone is looking at the fat guy trying to exercise.

Baseball update: I’m hoping the Giants can win today so they don’t have to play in the wild card game. I also hope the Cardinals beat the Dodgers in the wild card game. Fuck the Dodgers. If the Giants get to the World Series and lose, I’m afraid I will go into a deep depression like I did in 2002. It sounds silly, but I feel like I’m in a precarious place right now, and all I need is a trigger to push me into a spiral.

out of touch

I have been so busy in the past couple of months that I haven’t had time to think. Maybe that is a good thing, but I feel like I’m out of touch with myself. I’m not taking my emotional temperature, thinking deep thoughts, or working on feeling better. I’m not doing anything to improve my state of being. I’m just standing in place, waiting for the next storm to come through and buffet me with fear and self-loathing.

I don’t like my house anymore, but there’s nothing wrong with it. I don’t like my conservative friends or family, but they aren’t bad people. I don’t like my job, but it’s the best one I’ve had. There comes a point where I start hating everything and everyone and I start making changes just for the sake of changing things. I move to a new place, change houses, change cars, change jobs, change clothes, discard some people and meet others. When the dust settles, I realize I’ve changed nothing, because the one constant in my life is me.

I feel so damaged and defective right now. I am unable to solve my problems, or even some of them, and therapy isn’t helping. I can’t solve other people’s problems either, even though I keep trying. There is no one here who can cast a spell to keep the dementors away.

Ugh. Excuse me while I wallow for a while.

deleted [TW]

[This poem was written in the middle of the night when things were pretty dark and I was very unstable in February this year. I don’t feel the same way now, at least not in the stark and unflinching way as when I wrote this. I always think about death, no matter how light my mood is, but I rarely have concrete plans.]

If you are feeling hopeless and suicidal, please reach out to people or to a hotline. Depression lies to you. You are worth something to someone, and you will be missed forever.

TRIGGER WARNING – suicidal thoughts, death, hopelessness

 

 

 

 

memories I’ve deleted
wisps of smoke in the wind
disappearing vapor trails
something that was but is no more

people I’ve discarded
empty shells of flesh
devoid of substance and spirit
their essence is gone

places I’ve deserted
vistas left unseen
towns without a name
the spaces left behind

delusions I’ve denied
blind faith in gods
belief in myself
things that no longer matter

deleted
discarded
deserted
deluded

nothing to forget
no one to care for
nowhere to call home
nothing to believe in

maybe someday
I’ll delete myself

behind

I’m playing catch-up this week. I’m way behind on work projects, on reading blogs, on writing, on projects at home, on planning for the future, blah blah blah, yada yada. I made some progress on work stuff this week, so I feel a little better about that.

I also got my second vaccine shot, so I am fully juiced and ready to go. I’m ready to lick door handles and have someone cough on my airline food as I travel to a crowded city. Okay, maybe not, but I do feel more at ease knowing I have a little protection. I can see the possibility of everyone requiring a booster sometime in the next 12 months (I guess Pfizer has already indicated this). I was sore at the injection site until yesterday, and I was tired and achy for about 48 hours after the shot, which was about what I expected. Nothing serious, and I didn’t miss work.

I also saw my psychiatrist this week. I printed out part of this post and let him read it, and he said it was textbook OCD. (I also told him his “How are you doing” forms are crooked on the paper, and it mildly bothers me.) He said we can work on the anxiety first, and then see if the OCD symptoms need more attention. I agree with that, since the OCD gets worse with higher anxiety. In addition, he said I was much more stable when I was taking Abilify, so maybe we should go back to that. I had the same thought previously, so I told him that was fine. I’ll just have to eat better and get more exercise somehow. I’m also going to quit the Wellbutrin, since it can cause instability and maybe anxiety.

Last week I met with the therapist for the first time (same office as my p-doc). We got to know each other a little, and he was interested by some of my problems (social anxiety, lack of self-esteem, avoidant tendencies, inability to deal with stress, etc.) He said something that bothered me though: when I was explaining about being overwhelmed at work, he didn’t seem to accept the reality that I absolutely cannot take a week or more off work for my mental health right now – maybe an occasional day or two, but not an extended period. I also don’t feel like I can ask to have some work shifted to other people, because everyone I work with is swamped and unhappy and drowning in projects. The day after he suggested I ask for less work, I received two more projects. Yay. We’ll see what he has to say on Monday.

The weather is cool but nice, so I am going outside to enjoy some nature and not think about life for a while. But first, I need Second Breakfast (the best meal of the day).

running to stand still

Up. Down. Sideways.

Hopelessness. Defiance. Acceptance.

Spinning wheels, hit the brakes, stuck in first gear.

Restlessness. Depression. Mania. Fear. Anxiety. Psych meds with a whiskey chaser.

I don’t have a center right now. I can’t find balance. My brain is all over the place.

My doctor called me back tonight, and he is going to try a couple of things. My faith is wearing thin.

Work piling up, waiting for me to stop feeling overwhelmed and make my brain work properly. The forecast doesn’t look good for that at the moment.

I’m also calling a therapist tomorrow. Without help, I’m a train wreck waiting to happen, and I can’t crash right now. Actually I can’t ever, but that’s another discussion for later.