Weaving a parachute out of everything broken

Things have been rough the past few weeks. Major depressive episode plus extreme anxiety is the most awful mental state I have ever experienced. I walk around all day, every day worried, annoyed and even angry that everything in my life is a mess (e.g. my house, my backyard, my car, my kids, my professional life) but am too depressed to do anything about it. In other words, I am simultaneously furious about all the things that need to be “fixed” and overwhelmed by the idea of fixing any of them. It all feels too pointless to bother.

As I’ve struggled, my ruminations have gone from broad to very narrow. Now, my mind endlessly pleads to go back, back to being the person I used to be before all of this shit happened. I remember years of consistent psychological stability; kicking ass at multiple tough jobs; reading great big books because I could both concentrate and sit still. I remember eating amazing food on dates with my husband, making him laugh from across the table without having to consciously work at it. I remember being good and relatively content — as a person, a friend, a wife, a co-worker — without having to do anything except be myself.

All during the year leading up to my breakdown, I felt my confidence, my sense of self, my values and beliefs, slipping away. People close to me can readily attest to my abnormal behavior, including substance-abuse, lying, recklessness and poor work performance, assuming I showed up at all. There were days when I got up, got dressed, drove my son to preschool and then simply drove back home and went to bed, instead of going to work. By the end, all I could do without significant effort was sleep and cry.

Taking leave from work to go to treatment was a very hard and, to me at the time, a very shameful decision. It felt like admitting I was weak, like pulling back the curtain and revealing I wasn’t who everyone thought I was after all. I was an imposter, a fake and all my efforts to prove otherwise had not only failed but had broken me in some fundamental way.

Despite my misgivings, I left work and went to IOP and doing so probably saved my life. Without a proper diagnosis and proper medication, I doubt I would still be here. But that doesn’t mean things are easier now. Being diagnosed with late onset bipolar disorder 2 did not provide a map for getting back to who I was. It confirmed that the woman I was no longer exists.

Often, I feel I am walking around inside the shell of the person I used to be, looking at the world through her eyes, living in her house with her family, mothering her children and working to build a strong relationship with her husband. But I am not her.

We look quite similar on the outside, but on the inside we are two different people. The small cracks that appeared in my mind after the twins were born grew into canyons under the pressure of mothering, working and caring for our household, without taking any time to care for myself. Eventually, those canyons split entire continents of psychological existence apart and those continents floated away. I do not think about my life or live it the way she did. And it breaks my heart to know she is gone, that I will never be her again.

There is no going back in time to when I did not have a bipolar disorder, or three small children or a sense of ease and confidence in being myself. There is only me as I exist today. 

There is the hard work to stay well and to care for my kids. There is the hard work to dig deep into my marriage so it can be the rock our kids stand on to feel safe. There is the courage to be vulnerable in asking for what I need and expressing my disatisfsction with the status quo without knowing what the response will be. There is the constant internal battle between what I know I can do and what think I should do to contribute to our family’s well-being, while also respecting my own needs and health. There is guilt and relief, fear and freedom. Most of all, there is a lack of certainty about pretty much everything.

What I do know is that she, the woman I was before, is gone. And mourning her is wasted time and energy better spent living my life now. “Unanticipated” is not an inherently negative word. It is synonymous with, among other words, fortuitous, stunning and amazing. I plan do whatever it takes to eventually use one of those words to describe the result of the unanticipated turn of events in my life. 

I will weave my parachute out of everything broken; my scars will be my shield; and I will jump.

 (The italicized sentence above and the title of this post are paraphrased excerpts from William Stafford’s poem, Any Time, which, like all of his poetry, is fucking amazing).

 

 

 

 

 

Please describe the source of your condition

I’ve been wrangling with some insurance folks lately. The title of this post, or some iteration thereof, has appeared in every request for information I have received: Please describe the source of your condition. I suppose if I had a broken leg, this might be a reasonable request, but for any mental illness, this request is practically, and most likely scientifically, impossible to comply with.

The first time I received a form asking me to describe the source of my bipolar disorder, I just stared at the form for awhile and then laughed out loud. The absurdity of the request was confirmed when I realized the form provided less than four blank lines to write my answer. Since then, some forms with the same request have allowed for the attachment of additional pages “if needed.” The best idea I could come up with to be as accurate as possible was to write nothing except “see [most commonly used textbook on mood disorders, most current edition]” and also maybe “Talk to my doctors. You already know who they are and have signed releases to speak with them. However, even they probably can’t give you a comprehensive or entirely correct description of the source of my condition; but they are a hell of a lot more qualified to try than I am.”

Recently, a real live insurance company person asked me to provide this same information over the phone. I asked, only half-jokingly, how much time he had. I also told him I wasn’t qualified to answer the question and that he should speak to my doctors instead. He insisted that I provide an answer to the best of my ability and so I did. My unqualified, minimally researched, extremely speculative description of the source of my bipolar disorder went something like this:

My Genetics – I have a family history of bipolar disorder on my father’s side. While none of the people with this condition are part of my immediate family (e.g., father, mother, brother) they are only slightly removed. All of them are women. I also have a family history of substance abuse, an indicator of possible bipolarity.

My Brain Chemistry – Some researchers believe that neurotransmitters, like serotonin and dopamine, don’t function properly in people with bipolar disorder. Given that I was diagnosed with unipolar depression and have taken some kind of Selective Serotonin Reuptake Inhibitor (SSRI) since I was 18, it seems highly likely my neurotransmitters are dysfunctional.

My Postpartum Experiences – Some researchers believe that suffering from a postpartum illness like postpartum depression (PPD) or postpartum anxiety (PPA) is an indicator of bipolarity. I experienced significant PPA after our oldest was born and may have had significant PPD after our twins were born until that illness combined with other factors to become bipolar disorder. Also worth noting is the fact that women with bipolar disorder (known or unknown) who are pregnant or have recently given birth are seven times more likely than other women to be admitted to the hospital for their bipolar disorder.

My Hormones – In brief, pregnancy screws with your hormones in significant ways. Some go up, some go down, some make you puke, some make you super flexible, etc. Logically, a multiples pregnancy results in greater hormonal changes. Researchers believe that, particularly in women, hormones may play a role in the development and severity of bipolar disorder. Some possible examples of my hormonal train wreck after giving birth to the twins are that my pin-straight hair became wildly curly (hormones change the shape of hair follicles); I had no cycle despite not nursing; and, I had no acne, not one pimple, for over a year. Once I stared my bipolar meds, my hair became straight, my cycle regular and my acne plentiful.

My Life Circumstances – Bipolar is exacerbated by lack of sleep, an irregular life schedule or structure, and high levels of stress. Beginning in August 2015, I had two newborns plus a three year old, no predictability to my nights or days, very little sleep, and a great deal of stress, both home and work-related. Additionally, I took very little time for self-care because I believed my time was better spent doing other things.

Take the above five factors, put them in a cocktail shaker and shake for about 14 months. Open, pour and out comes my bipolar disorder II.

As you can tell from the above, I do not believe that I have always had a bipolar disorder and been misdiagnosed and improperly medicated for decades. For a long time, I experienced symptoms of depression, but so long as I took my Zoloft things were okay; often better than okay. After the twins were born, my Zoloft stopped working. We tried other antidepressants, antipsychotics, everything that seemed potentially helpful. None of it worked. Finally, I left work to enroll in an Intensive Outpatient Treatment Program (IOP) and that’s when I was first diagnosed with bipolar disorder II. Perhaps that diagnosis could have been made earlier in the year, but I don’t think it could have been made before August 2015. In short, I believe my genetic tendency for bipolar disorder was triggered by my physical, psychological and life circumstances at some point during the 14 months after my twins were born. This triggering resulted in a full-blown illness.

So that’s my description of the source of my condition. It is not well-supported by my educational background or research. I could not testify as an expert about it in court; but I am the best possible fact witness.

From what I can tell, there is very little known, as opposed to hypothesized, about the source(s) of bipolar disorder. The symptoms are often easy to spot but why those symptoms arise in a particular person is, at best, indeterminate. The above explanation of what happened feels correct; it makes sense to me. And that may be as much as I can hope for, as close to the truth about the source of my bipolar disorder as I will ever get.