dumped by my doc

I found out yesterday that my P-doc has moved to another city, and I have to find a new provider. It is a pain in the ass for me to find someone new, but it is no emergency. In a city this size, you would think there would be more doctors accepting new patients, but apparently not.

I don’t know how I am supposed to feel about this. I know it can be traumatic for some people with mental health problems when the need to change doctors. I’m not in a crisis mode, so I have time to wait while I can be scheduled (March, one potential new doctor said). But what if I was feeling bad, or needed someone right away? I know there are the crisis centers or the hospitals, but it’s not like having a relationship with someone who knows you.

Despite the inconvenience, I had been wondering if it was time to look for another pair of eyes to review my symptoms and get a different perspective. I guess that time has come.

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wide awake

Yes, it’s way past my bedtime, but sleep isn’t happening. I’ve been in a stress-induced hypomania for several days now, and it shows no sign of stopping. I’m anxious, twitchy, my head hurts, my eyes hurt, and despite being very tired, I can’t sleep.

I’ve been working 10-hour days this past week, 8 on Saturday, with the promise of more long days this next week. The overtime money will be nice (it will pay for my Christmas present, a new computer), but being able to sleep is good too.

I have several worries spinning around in my head, none I wish to write about, and I don’t think I could form coherent sentences even if I tried. Thoughts of doom and inevitability and negativity are pervasive right now.

Finally, and this may be connected, I have been tinkering with the dosages on my medication. I am trying to cut back a little just to see if I can manage at lesser amounts of chemicals, but I think that plan has been unsuccessful. I plan on riding this hypo a few more days until a project deadline passes, then I will go back to my normal dosage. I’ll be okay in the meantime as long as I watch myself.

the bipolar gender gap

I have noticed the bipolar blogging world seems to be populated by more women than men. I don’t really know why there seems to be many women blogging about mental health, but maybe I can guess why there are fewer men here. I think there is a greater stigma among men for mental health problems, more so than women.

I think there is a different process for men when they come to terms with having a mental illness. Based on my own experience, I think went through phases of anger, sadness, anger again, denial, suicidality, defeatism, a little more anger, and shame … but also a little bit of strength and resistance on the good days.

I wonder how many guys make the effort to reach out for help to a doctor, or a friend, or a wife/girlfriend; maybe they don’t for various reasons. My perception is that men are less likely to write journals or talk about feelings and fears in any semi-public manner (like support groups or blogging). Those men that do write about their mental health range from angry and defeated to strong and uplifting.

I think some guys are a little more in touch with the more emotional and introspective side of ourselves, and those are the men who are more likely to write about their own mental health. I don’t think that makes us less masculine in any way, even though we may experience depression in a stereotypically feminine way.

I think everyone has their unique experience with mental health issues, and it has little to do with being male or female. I realize I may be criticized for laying out several stereotypes here, but this is just my perception of the gender divide among bipolar bloggers. Let me know if I’m right or wrong or somewhere in between.

the manic road trip of 2004

One of my undiagnosed manic episodes centered around a road trip in May of 2004. I was sent to training course in Las Vegas by my employer at the time, and instead of flying there, I decided to drive our trusty van 2000 miles. Driving has always been therapeutic for me, as have the Sierra Nevada mountains. I had been in a severe funk prior to taking the trip, so I thought a long drive through beautiful scenery would be a great pick-me-up.

I drove through Sacramento to Lake Tahoe in snow, then south to the tufa formations of Mono Lake. I climbed a cinder cone and visited an obsidian formation in the forest near Mammoth Lakes. I couldn’t sleep that night, due to cold and excitement, so I ended up hanging out at an all-night gas station. At first light I headed for the Bristlecone Pine forest in the White Mountains, then continued through the desert to Vegas.

After my last day of training, I won about $250 in the casino, then I couldn’t fall asleep (still slightly manic). I checked out of the hotel and went to the old downtown casinos at 2 in the morning, then took off for home at 4am. I started falling asleep while driving through the Nevada desert; the song “Time” by Pink Floyd probably saved my life by waking me up when the alarm bell sounded. I drove straight through to home in about 21 hours, stopping at Death Valley and Yosemite National Parks, and being dangerously tired on the way.

I didn’t have a crash or a spiral after the trip, more like a slow letdown. After having a great experience, returning to the everyday world was deflating and depressing. I returned to work, wishing I was in the mountains again.

I’m glad I took the opportunity to get away by myself for a few days when I really needed it. I will always have the memories and the photos of that trip, and it reminds me that even in the middle of a chaotic time in my life, I was able to have such an enjoyable experience. However, I made some poor decisions during the trip. Who lets a manic person loose at a casino, and why was I climbing granite outcrops in Yosemite? I could have lost a lot of money, I could have fallen off the rocks and died, and I could have fallen asleep while driving and killed someone else.

At the time, I wrote:

I think the trip was in general the most uplifting and healing time of my life. Right when I really needed it, I got the opportunity to be alone in the landscape I love so much, to take some beautiful pictures to look at later, but more than anything to just let the pressures and demands and negativity just slip away … feeling the beauty in the landscape and in the forest that honestly I think many people can never feel … I was exploring everything – forests, valleys, plants, small furry creatures, large outcrops of basalt and tuff and obsidian, volcanic craters and peaks, joshua trees, lizards and cactus surviving at 10,000 feet, 4,000-year-old trees, earthquake faults, tufa deposits, glacier-carved canyons, alluvial fans, rain shadows, playa lakes, microclimates, glacial erratics. I was so unafraid and content and free, I actually found it safe to let myself talk to people … At those times it doesn’t matter what anyone else thinks or says, you are simply enjoying life in that moment.

[When I arrived in] Las Vegas, I had a little anxiety episode … After the beauty and solitude of the natural world, [it] was quite a shock to me. That feeling passed soon, but it was interesting to me how shocking it was, letting me know that I was totally immersed in the escape mode of my trip. I walked the Strip, looked inside a few places, but really returned to feeling alone, detached, and invisible while I was there. … I could have done stuff with other people attending the class, but I didn’t feel comfortable, I just wanted to be alone.

I will eventually post some photos of the trip so all 3.2 of you readers can see some of my favorite places. [here’s the link.]

the costs of bipolar

I’ve had bipolar disorder since I was a pre-teen. It has cost me several important relationships, educational and job opportunities, and tens of thousands of dollars over the years. It has nearly cost me my life on multiple occasions. Besides the monetary cost of the medicine I take, there is the weight gain associated with the Abilify, which causes me problems such as high blood pressure, the potential for heart disease, lack of mobility, and embarrassment. It may one day cost me my intellect, if the potential for early dementia becomes a reality.

My bipolar has also inflicted a toll on the family. My wife has stayed with me despite 25 years of instability and unpredictability, and it has cost her happiness and many sleepless nights ridden with fear and anxiety. She constantly feels like she has to work harder to make more money to pay for the medical bills, so she works at a physical job and always has sometimes debilitating aches and pains.

My son and daughter grew up in a home riddled with turmoil, which in my opinion has caused them both psychological issues which remain unaddressed. My defective genes surfaced in my daughter, who had first been diagnosed with bipolar, and now schizoaffective 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 for us to pay.

your wildest dreams

My daughter told me that when she dreams of me, I am always angry, volatile, moody, or closed off emotionally. She said she can’t remember a dream where I was happy or supportive. I didn’t tell her, but it made me very sad.

I have struggled to be a father to my two kids despite having bipolar, and I’m afraid it hasn’t worked out very well. During the first half of their lives I was completely uncontrolled, and I brought chaos and instability to their lives. After my diagnosis I was doing a better job of managing my illness, but I was also very absent emotionally (and physically at times).

I think the biggest change is in my level of anger that I brought with me since childhood. I love my family very much, but I was so angry that it was damaging my relationships, nearly to the breaking point. At the same time I have been mostly depressed due to the bipolar, and the combination of angry bipolar was very chaotic for me and my family. This was the environment my kids grew up in, and they learned their behaviors partly from me.

It has taken me 40 years to release the pent-up feelings that were so toxic earlier in life. I think I am in a much more accepting place with respect to my past experiences. I have finally learned to allow what happened to remain in the past. Unfortunately there was damage done that I can never undo. The best I can do is move forward and try to be a better person for my adult children.

bipolar and cognitive impairment

I’ve been reading a little about the effect of bipolar on mental functioning, especially the effect of bipolar depression on cognition and the potential for dementia in bipolar patients as we age. The news doesn’t look promising at this time.

Cognitive impairment, in simple terms, means your brain is less able to function normally in terms of memory, attention span, and input processing. A study showed that bipolar patients do worse on standardized tests* than people without bipolar, and those cognitive deficits are worse when the subject has bipolar depression.

I used to be a borderline genius, but now I don’t feel as smart, especially related to listening skills and verbal thought processes. I have difficulty listening to people for more that a few moments, and I comprehend less of the conversation. I also find myself less able to respond quickly; I have to think a little bit before I speak, then sometimes my words come out jumbled. In addition, my short-term memory is getting worse, although many long-term memories are still very clear. A few times at work, I have completely blanked out when someone wants to discuss a project only a couple months old, and I can’t recall ever working on it. I may be overthinking this, but it seems like I can feel an increase in these problems in the past few years.

I’m concerned about the potential for these effects to become worse over time. I wondered if some of the people who have dementia became that way due to the effects of bipolar. A couple of articles seem to agree with that theory. Natasha Tracy writes that 19 percent of older bipolar patients had dementia, and it seems to occur earlier in life that people without bipolar.

Apparently there are few options to prevent the slide into early dementia. In another article, she quotes a PubMed paper that says “no pharmacotherapies substantially improve cognition in bipolar disorder, although preliminary findings suggest some potential value for adjunct stimulants such as modafinil [Provigil] and novel experimental agents.” However, another article says that lithium has “neuroprotective properties that may help preserve cognitive function in patients with bipolar disorder.”

I worry about the possibility of losing brain function as I get older. I’m not pretty, not rich, not physically active, not artistic, and not successful in social situations. My brain power is the only positive thing I have going for me. It is my source of income in an intellectual job, and it is the source of my writing and reading hobbies. It allows me to enjoy the music I love so much. It lets me tinker with computers and blog and research my next vacation.

My intellectual function is my reason for living. I don’t want to be a mental vegetable. I don’t want to sit and stare at the wall for hours, then in a moment of clarity think about everything I have lost. The thought of all the memories, all the thought, all the pleasures of an intellectual existence being lost in a fog … it makes me fear for my future. I hope I am overreacting.

More articles:
Dementia Risk for Bipolar Patients
Depression and bipolar disorder linked to an increased risk of developing dementia
Can Bipolar Disorder Cause Dementia?

* These tests include assessments of attention, motor speed, working memory, verbal memory, reasoning and problem solving, verbal fluency, affective interference, and emotion inhibition.

**Updated from my original post in 2015.

runaway

It used to be easy to fake your death, run away, and never look back. It’s more difficult now in the information age. The surveillance state we live in ensures that you will be photographed somewhere, whether the airport, train station, or in public places. It’s illegal to do so many things which don’t hurt anyone – faking your death, getting fake identification, sneaking into a tropical country with lots of money – and you can’t live cheaply anywhere anymore. It takes a lot more knowledge and resources to run away now.

There have been many times when I just wanted to run away from my life and pretend I didn’t exist. Most people want to run away and hide in some sun-drenched paradise like Fiji or Mallorca or the Virgin Islands. I probably would have ended up somewhere totally gray and depressing, like southeast Alaska or Labrador, where the only people are those who want to get away and those who are hiding from something.

I wanted to fake my death and run away, but I knew my family would be devastated. I also knew I didn’t have the resources or the advance planning needed to disappear without a trace. Instead I hung my head, forced myself to get up the next day, and continued living life.

Thankfully I’m no longer in that dire circumstance where I spent my time always thinking about death or hiding or leaving my family. My bipolar was really out of control at that time, and it was not easy or fun to be in that mental space.

10 Things Bipolar People DON’T Want You To Know

I don’t often reblog, but I felt compelled to share this. This post by Michelle really captures the feelings of bipolar people who don’t want to scare away everyone else. We never tell our loved ones the whole truth because of the fear it might be too much for them to handle. Michelle writes some of the things we want to keep secret from everyone.

To Be an Equal

I can’t count the number of articles I’ve come across with the title # Things Bipolar People Want/Wish You Knew or the List Of Things People With Mental Illnesses Wish People Understood. And for the most part, they’re pretty spot on. But I want to come at it from a different angle. I’ve done my best to keep it pretty similar in format, but if you feel I got something wrong, or missed a key point, drop me a comment! (Images thanks to Google-I own nothing.)

  1. We’re scared of our symptoms too.

bp2There’s nothing quite like the dive between (hypo)mania and depression when you feel like you can see the world crumbling around you. Or the emptiness that makes you feel like a dead (wo)man walking-no cares, no love, nothing. Or the darkest parts of depression when it hurts to cry because you’re trying not to wake anyone, so you…

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self-centered

My bipolar makes me self-centered, and not in a healthy way. Sometimes I obsess over my depression and anxiety and insecurities, and the inner dialog becomes all about me-me-me. In those times I really don’t care about other people and their problems.

It’s difficult when I spend so much energy managing my own health, and there is so little energy left for anything outside myself. Sometimes I feel like I have to protect my fragile psyche when events become too overwhelming, and my thoughts focus inward. It is good to take care of myself, but I’m not very empathetic unless something affects me personally.