Enough

There is a merry-go-round inside my head where I sit for hours each day, spinning around, past, and between the question: what do I want? More specifically, what do I want to do with my time given the things that I must do and how I want to do them and what I feel will give me the greatest chance at happiness or, looked at another way, the best possibility of a living a life of which I am proud and with which I am content, more often than not.

The answer to date: I have no fucking idea.

First, let me acknowledge the uber first-world-problems nature of this question. I have a choice. I have so many choices in terms of what I might do and when and how I might do it. I don’t have to work a full-time job. I could probably get away with mostly volunteering. And, while I do have three small children, I also have a lot of help with caring for them. I am a full-time mom — we all are — but I do not provide their minute-by-minute care day in and day out (praise be).

Counterpoint: money and time and help do not fix anything unless you actively use them to make your life better, like really better in a sustained, worthy, purposeful way.

Currently, I spend my not-immediate-mom-or-other-household-related time at work. I don’t love my job but going to work, even a few days a week, flips a switch for me that says I am useful, to my family and others, I am earning money to pay (some) of my family’s cost of living, I am using the graduate degree I spent years attaining, and pursuing the career I’ve spent over a decade building. Which would all be great, except that going to work is also a massive trigger for my anxiety and depression, so much so that I’ve had to take two leaves of absence in the past three years, one that lasted over a year, and the other of which started after I sent an email asking for leave from a hospital bed in the ICU. Obviously, work is not the cause of my illness(es) but working, especially since my twins were born, has been a major precipitating factor in some of the very worst periods of my life.

And yet, I keep going back, like some punch-drunk boxer who thinks if she just keeps getting up, keeps staggering back to the center of the ring, that somehow she won’t get knocked down again. This time, it will be different. I will take on less, take more breaks, only do certain kinds of projects for certain people, work from home on Fridays, and so on and so forth, as if it’s all a matter of (illusory) work-life balance and not life and death.

But it is a matter of life and death and on the days I can hold that truth steady in my mind and heart, I know I need to quit. And yet, god damn it, I am not a quitter. I refuse to concede defeat. I can do this, this thing where you do all the things and be happy more often than not. I see it being done all around me. All of the lovely lives with make-up and fashionable clothes and eyes that aren’t red from crying, with children who get haircuts and use cutlery and probably don’t have to listen to their mom begging them to please just stop because she can’t, she just can’t right now (or ever). Women with multiple kids, full-time jobs, and husbands who work long hours and travel and, yet, somehow they just can, when I can’t.

I understand that comparison is the death of joy. That I don’t know other women’s lives. But the idea of quitting my job tears open in a me a wound of profound sadness and shame. A wound I want to plaster over as quickly as possible and by whatever means so that I don’t have to feel that pain. The pain of failure.

It was not supposed to be this way. I am not supposed to be this way. Somewhere along the way something went terribly wrong and it must be my fault. This is how it feels when I think about quitting.

But, in actuality, quitting my current job is, at its core, accepting that my life is the way it is and that I am the way I am and that working is not helping me create a life worth living. It is doing the opposite. It is taking the hard parts of my life and making them harder and taking so many of the good parts away.

My life is just as it is and was meant to be for a million different reasons none of which can be changed because they already happened and were themselves a result of a million things that came before. I am failing my life only to the extent that I am choosing not to live it in the way I know will best protect me and provide me with the most happiness. Not walking away from a form of work that continues, for whatever reason, to break me because I am afraid of doing the wrong thing is not merely ironic; it is heartbreaking. I am breaking my own heart.

And I have had enough. I will turn 40 years old in two weeks and I am no longer willing to live my life worried about what other people might think, or, more importantly, what I might think about myself because I can’t tell the difference between what I think I should do and what I actually want. I have to find my wants, to listen and feel for them every day, until I have one in my hand and then run with it, as fast and as far as I can, before I can convince myself it’s not real or good or right. I have to learn how best to love myself so that I can embrace a life that grows that love. I need to quit failing myself by pushing through rather than pulling back to my center. Because I am enough. And I have had enough of my own bullshit. It’s time to get off the merry-go-around, to do the terrifying, first right thing.

A less good dog mom

In 2007, one year into our marriage, my husband and I adopted a dog. She was a one-year-old, chocolate lab. We picked her up in a town north of Davis, California, where she was being fostered pending adoption. She spent most of her time outside in an old horse corral of red dirt. When her foster dad brought her inside, she immediately climbed onto the couch to cuddle with her blue blanket. A blue electric blanket, for obvious reasons. He told us, accurately, that she was very sweet, easy going, and never barked. He also told us she would eat anything, except eggs. This was a lie. She ate eggs.

We drove the hour or so back to Oakland with Sadie in the backseat, cuddled up with my best girl, Stefanie. Except at that point, Sadie wasn’t Sadie. She was Angel. And since that was not happening, the three of us spent the drive rattling off all the people/dog names we could think of until Sadie, and that was it. (We also gave her a middle name, Apples, which was what my husband had wanted to name his childhood dog but had been outvoted).

We arrived home with a new dog and a backseat completely covered in red dirt. I refused to let Sadie inside her new house. Instead, we walked her around to the backyard and gave her the most gloriously transformative dog bath ever. Rivulets of red dirt covered the green grass and when she coughed little puffs of it escaped her mouth. Sadie turned about five shades darker during the course of that bath. She was a dark chocolate chocolate, like 72 percent cacao.

At first, since we didn’t know much about Sadie except that she used an electric blanket and didn’t eat eggs (allegedly), we decided not to give her free run of the house when we were gone during the day. Instead, we would pen her in the kitchen with access to the backyard through a dog door. This idea worked better in our heads. After Sadie had eaten through a variety of impediments, including the backdoor, a soft crate, and part of a bookshelf, we decided to just let her have the house. Apart from her trying to bury a rawhide bone in the leather couch, this proved to be the better approach.

At the time we adopted Sadie, Matt was in business school and I was working obscene hours at a large law firm. I took her running with me in the morning. Matt checked in on her during the day. I did evening walk. Etc. We also hired our landlord’s son to walk her once, sometimes twice, a day. We were extremely eager first time dog parents.

One night, Matt had to travel for a business school competition, I had to work later than anticipated, and I couldn’t uber/tinder/amazon services someone to walk my dog because 2007, so Sadie had to wait. And she did. While slowly eating through three hardcover books, toppling the coat rack, and chewing the foam core of Matt’s bike helmet into teeny-tiny bits. She missed us.

Having no human babies, I was very enthusiastic about caring for and educating my dog baby. I did extensive food-related research and sampling before deciding on the perfect organic, easily digestible, hipster-approved brand of chicken and rice dry dog food. Leather leash, check. Charming designer collar (chocolate cupcakes on a pink background), check. Engraved name tag, check. Ridiculously expensive poofy circle bed with bolster, check. You see where I’m going here.

As for the training, I read many, many books about how to be my dog’s best friend, which I ultimately boiled down to walking around the neighborthood feeding her hotdog bits as she sat before crossing each intersection. Then, I got distracted and, basically, the sitting at corners thing became the only properly-trained dog behavior in her repotiore.

Oh, and because we were worried about her being lonely, we started taking her to doggy daycare two days a week. Like you do when you have no children and time to transport a dog across town multiple times a week. They gave her a name tag: Sadie B. Because there was another Sadie in her class.

The daycare had cameras set up so you could watch your dog and make sure she was doing okay and making friends and taking good naps. The picture quality wasn’t great but I could always tell which dog was Sadie B. because she would spend most of the day right by the gate, hopping, checking to see if we had arrived for pick-up.

Sadie’s love of hopping was exceeded only by her love of hopping into water. She loved the bay. She loved her kiddie pool in the backyard (I know). Perhaps most of all, she loved the disgusting, homemade coy pond in the yard nextdoor to Matt’s grandparent’s house in Sacramento. Wet dog plus dirt plus fish equals all the windows down all the way home.

After two years in Oakland, we moved to Denver. I flew out after a crazy month of trial work, which included me sitting on a box in our empty dining room furiously typing on my laptop while the movers carried our things out to the truck. Matt and Sadie, on the other hand, took a leisurely drive cross-country, making multiple river-adjacent stops along the way so she could swim. Did I mention my husband was her favorite parent? Which worked out, as I soon became the favorite parent of our first human child because I am the mom. I also became a less good dog mom after our son was born.

Motherhood freaked me the fuck out. I had heard of postpartum depression, but nobody mentioned postpartum anxiety, which would have helpfully explained why I was spending naptime checking the expiration dates on and then cleaning all of the cans in our pantry. I put “empty the dishwasher” on my to-do list and then panicked a little about it. Also: nearly dying whenever Henry touched a grocery cart handle or restaurant high chair; nursing only in the nursing chair, with the nursing pillow, at the nursing time (I would walk away mid-conversation to make this happen); buying multiple weather-related carseat covers appropriate for Alaska; vacuuming everyday; preferring never to leave the house; and crying. Crying all the time.

I spent five months on maternity leave. Sadie was there through all of it and I am so ashamed that she often bore the brunt of my fear. I started running again too soon after having Henry and would take Sadie with us. Me, the baby, the stroller, the dog. Running. It was so plainly a terrible idea and yet, when the inevitable happened — Sadie pulled, I staggered, the stroller tipped, and Henry fell — I let loose all of my guilt and fear and rage at that fear on Sadie. As it if were her fault, being a dog who pulls at a leash.

I yelled when she made a mess because I did not have cleaning up Sadie’s mess within the scope of my abilities most days. I put her outside. I told her to go, to get away from me. I told her she was a bad dog.

But she wasn’t a bad dog. She was such a good, sweet older sister to Henry. One of my all time favorite moments — which should have set off red flares of anxiety — was when Henry was eating one of his first solid foods, a mum-mum, and he shared it with Sadie. One slobbery bite for Henry, one slobbery bite for Sadie. And so forth. The video of this on my phone is shaky because I could not not laugh. And Sadie only ever snapped at baby Henry once, when he pulled her whiskers, which I thought was totally justified and scolded Henry, not her, for what had happened. We taught Henry to give Sadie gentle touches, and she dutifully let herself be gently touched.

Gentle touches for Sadie.

We had our lovely moments. But not enough, not nearly enough. And then the twins were born.

Having twins blew me apart, as extensively chronicled in this blog, such that even now, almost four years later, I am still picking up my pieces and fitting them back together. I lost my mind and with it my moral compass. Apart from my children and my marriage, I wanted to burn it all down, and some days nothing seemed worth saving, least of all myself, least of all my dog. My dog who seemed to do nothing but decimate our lovely wooden interiors and puke on the carpet. My dog who brazenly stole food from my toddler’s hand as it was moving towards his mouth. My dog who needed to be fed, walked, let outside in the middle of the night, and taken to the vet to have her teeth cleaned. She was like the fourth child when I had wanted only two. I seethed at her.

Sadie asked less of me than anyone else and yet I resented her the most. Except when I didn’t. Except when I would catch myself about to point and yell and say bad dog and would instead crumple to the floor, wrap my arms around her neck, and whisper cry my apologies into her ear. I’m so sorry, Sadie. You are such a good girl. Such a good girl. And she would nuzzle right back, as if to say none of the horrible things I had done made me less worthy of her love.

As the kids got older, things got better and better between us. They could never be what they were, with the hotdog bits and weekend outings to the bay just to see how big of a stick she could carry back to shore, but I tried to love her as best I could no matter how many bagels she stole from the breakfast table. I walked her, brushed her, and let the kids feed her too many treats. I made sure she had all of her check ups. I scratched her just right behind her ears. I helped her get up when she was stiff after a nap. I placed and replaced the carpet strips on the back stairs so she wouldn’t slip going outside.

About a year ago, Sadie developed a fatty tumor on her right hind leg. Nothing to get excited about. But it kept growing and eventually the vet recommended we have it removed, just in case. They came to do bloodwork on a Monday and she threw up. Labs came back normal and surgery was set for Wednesday. She threw up that morning, surgery was canceled, and she stopped eating. Friday’s ultrasound found cancer in her liver and spleen. I drove to meet my husband at the hospital, shaking with grief, tears and snot streaming down my face, making no effort to wipe them away.

We spent about 30 minutes with her before ringing the little button to let the doctor know we were ready even though we weren’t ready at all. She came. She explained what she was going to do with the white vial and then the pink. My husband couldn’t stay. He had loved her best of all and was too heartbroken to be in that room at the end. I stayed.

I stayed because I am her person and you need your person when it is time. I held her close and we touched noses as if to say I’m sorry and I forgive you and I love you and I will miss you. Then, she was gone. I may have been a less good dog mom after becoming a human mom but I was there for her. I loved her. Always.

ABC DBT

This past winter I decided to break up with my therapist, which was a terrible idea except it wasn’t. It was terrible because breaking up with your therapist is the WORST. It’s like breaking up with a really good friend, someone you have an established relationship with, who knows all of your deepest, darkest shit, and who has invested time and brain power in helping get said shit sorted out. And then you break up. I chose to break up based on the hope that I might find a friend I liked better and who liked me and who might be able to help with the sorting more effectively.

There’s no real good way to find a therapist, at least I haven’t found one yet. My insurance company directory is entirely unhelpful because most mental health care providers don’t take insurance. The system is prohibitively complicated and costly, in terms of time and resources, for sole practitioners, and even groups of therapists, to become certified as “in network.” So there’s Google and Yelp and Psychology Today and word-of-mouth and referrals. I found my very favorite therapist in the whole wide world through her ad on Psychology Today. But eventually she broke up with me because I was too crazy. I mean, she made a very thoughtful, professional, and kind decision to recommend I seek treatment from someone with expertise in bipolar disorder and even found me someone with such expertise, but samesies.

Still, she is my very favorite and if I couldn’t have her I wanted to know who she thought I should have. She gave me two names. One had a waitlist, the other is my new best therapist friend since January.

I like my new friend for many reasons but a huge plus has been the fact that she is a DBT therapist. DBT, or Dialectical Behavior Therapy, is a modified form of your standard, white bread Cognitive Behavioral Therapy developed in the 1980s to treat people with Borderline Personality Disorder (BPD). It has since been expanded to treat all sorts of disorders, including mood disorders like bipolar. It’s also super helpful with substance abuse and suicidal ideation, so I’ve got my bases covered.

DBT involves working with both acceptance and change through the principle of dialectics. Dialectics, in really basic non-philosophical terms, means two things that appear to be opposites, or at lease contradictory, that can both be accepted as true or reconciled in some fashion. My favorite starter example from DBT is: (1) I am doing the best I can, and (2) I can do better. These are both true. For me and, I’d wager, for most of us.

DBT is chock full of these seeming conundrums that are actually simply true. Two which are particularly apropos to me are the concepts of active passivity and apparent competence. Active passivity means I work really hard to get other people to make decisions for me. Apparent competence means I am really competent at certain parts of life and, therefore, appear to be competent at most parts, when in fact I am not competent at all. Fun!

DBT has four major components or “modules,” which are core mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. You had me at distress tolerance. 

Tolerate distress? Yes, please. Sign me up for how to do that because I have a zero tolerance policy when it comes to distress, particularly distress related to my marriage or my children. Also, my job and body image. Pretty much bad tolerance all around. Lucky for me, this was one of the first modules covered in my DBT skills group. 

To start, I was a bit dismayed to learn I couldn’t just distress tolerate my way through daily life, but was supposed to use my skills only for significant emotional crises. Apparently, living at crisis-level anxiety all the time requires making significant life changes. Go figure. Still, I have a lot of significant emotional crises and the skills I’ve learned have come in quite handy. Some also make great party tricks.

For instance, there is the TIP skill (DBT loves it some acronyms). The T in TIP stands for temperature. It’s based on something called the mammalian diving reflex and is a way to calm down quickly. So, if you’re having a panic attack, or want to impress your friends, grab a big bowl, fill it with ice and water, make sure your fitness tracker is working, hold your breath, and stick your face in. Stay down for at least 30 but as close to 60 seconds as you can get. Assuming you are a mammal, your heart rate will drop immediately and your parasympathetic nervous system will be activated, further prompting a relaxation response. It works. I’ve tried it. A number of times. Obviously, its not always possible or convenient to stick your face in a big bowl of ice water but when it is, do it. 

Another, less intense but perhaps even more useful distress tolerance skill is STOP. Now, this is probably going to sound really simple but in my experience it is not simple at all. It is not easy to do it or even remember to do it when things seem to be going to hell in a hand basket. But I try. 

For example, I have a tumor in my shoulder. A very small, very benign tumor that really, really hurts a lot of the time. I have not had surgery yet because my insurance company sucks (double bird salute Empire BCBS). In the mean time, I have been prescribed Valium, both for my anxiety and for the muscle spasms associated with the tumor. I was prescribed 3 pills a day but taking that much was really messing with my depression, among other things, so I decided to cut back to two. Except holy hell it really hurts.

So, this was my crisis. Pain. Physical pain and all of the emotional and psychological pain that I like to pile on top of it. A pain hamburger, with the works, plus fries. When it hits, and all I want to do is take that third pill, I try (not always successfully, but more often than not) to STOP. I stop, freeze, just stand there in the middle of the room half way to my prescription bottle. I take a step back, mentally and sometimes physically, from where I was going and from the overall situation. I observe, what I’m feeling, thinking, doing, what’s going on in my environment and with the people around me. I also think about my options (I know, cheating with the two o’s). What might I do do instead of taking medication that could possibly help me feel better/less overwhelmed/more able to get through the rest of my day? Finally, I proceed mindfully. I take all the inputs, thoughts, feelings and I choose a path that seems right.

My favorite/least favorite distress tolerance skill is radical acceptance. Again, radical acceptance is deceptively simple. Basically, you accept life as it is. But by that I mean you really accept it, mind, body, and heart, not only as it is but also as it is not. You accept reality is not and cannot be something else. There are no shoulds with radical acceptance. There are no whys or if onlys or buts or what ifs. What has happened is not reality. What might happen is not reality. Reality is the present moment, the present minute, and it is what it is. Period.

You must accept reality because (1) you have no choice and (2) it is the only way forward. You can only effectively live your life grounded in what is real and true and present. Flailing around because what is real and true and present isn’t fair or right or something you can handle because-you-just-can’t-with-it-right-now-so-please-make-it stop won’t work. It is just flailing. Even if reality isn’t fair or right or something you can handle, it is still true. And the only hope you have of changing it is to start from that truth. Otherwise, you’re just titling at windwills.

I struggle with radical acceptance. A lot. I like to tantrum about life, the big parts and the small. For six years, I have been having a low-grade panic attack because I have failed to accept that my house cannot be as clean as it was before I had children. I am currently failing to accept that returning to my job is is negatively affecting my mental health and my relationships. Instead, I show up each day conviced that its me, not them, and if I can just be better it will work out.

Once, I spent about six weeks not fully accepting the fact that I had two newborns. I kept talking about how much easier things would be if there was only one red-faced, screaming banshee attached to my chest or failing to sleep through the night until finally my mom took me (gently) by the shoulders and whispered-screamed, “There are two. You have two babies and, unless you plan on taking one back, you will always have two. So stop. You are only making it harder.” And I was making it harder, with my constant imagined scenarios of easy outings with a single stroller, or god forbid, a baby  bjorn, instead of a truckload of gear requiring two sherpas and a donkey. So, I stopped. And, eventually, it got better. It was still really, really hard to have two newborns, but at least I wasn’t living side-by-side with the imaginary world in which I had only one. It was hard, but not harder in comparison to what wasn’t real.  

There is so much more to DBT than distress tolerance. So many modules! So many skills! I go to therapy for three hours every week: one hour individual therapy and two hours group. I have skills homework due each Monday. I complete a diary card with approximately 15 categories of how I’m feeling and what I’m thinking on a scale of 0-5 every night. I talk to or text my therapist throughout the week. I am often exhausted of my own thoughts and feelings and distress and tolerance of said distress (or not). But it’s helping. I feel better in the sense that I see more of what’s happening and I can name it and be less judgy and instead give myself some grace and a better place to settle and regroup before I try again. I get up. Then I get knocked down, or I knock myself down. I get up again. I accept that this is my life right now. I am doing the best I can and I can do better. 

Reboot

Um, hi. It’s been awhile. Like maybe a year-and-a-half while. Which is totally my fault. Obviously. I stopped writing. And I probably worried some of you, and I am so sorry. I’m okay. I’ve been (mostly) okay since my last post in the fall of 2017. I’ve had a couple of really not okay moments and I will get to those eventually, but for now I wanted to try and explain why I stopped writing and why I am starting to write again and how I hope you’ll be interested in reading.

I stopped writing, largely, because I started to feel better and I felt less and less like talking about being sick. I didn’t have to think about or feel my illness every minute of every day for the first time in over a year. Continuing to blog about it felt counterproductive.

While I could have written about getting well, frankly, it felt boring and also more like purposeless navel-gazing than writing about being sick. Writing about being sick felt like it might be helpful; it made some meaning out of the madness (pun aboslutely intended). Without that larger purpose, I felt lost in terms of what to write about or why to write it.

I also had a bit of a shame hangover (hat tip, Brené Brown). I shared a lot on this blog, about my mental health, my guilt/fear/shame as a parent, partner, and human, and my struggle to accept and make my way through life as a person with “late onset,” or at least late-diagnosed, biopolar disorder. I was broken when I started this blog and I stopped writing when I had reassembled enough pieces to feel capable of moving forward from not exactly where I left off but close enough to be my life.

And I did move forward, and I do, but I’ve also taken like a million steps back and fallen once so hard I almost died. But I didn’t and I’m okay but not always or in the way that I’d like to be. Being well is a struggle, every goddamn day, it’s a struggle. And I’ve found some things that are really, really helpful to me. Also, things that are particularly unhelpful. I’ve got some thoughts and ideas and tips and tricks and questions and answers and questions without answers that are still useful to ask. I’m back at work. My oldest is about to finish kinder and the twins will start pre-K this fall (?!). I am the ringmaster of the shit show that is our family of five. I’ve started taking epic hikes and gone to two meditation retreats and one in-patient psych ward and my weekly pill organizer could kill a horse.

I am okay and not okay every day and most often at the same time. And I’ve been thinking I’d like to write about that. That it might be helpful to know that getting better is always just that and sometimes it involves getting worse, at least for awhile. I have absolutely no answers to Any of the Things, but I can point them out and write about them in a way that might make them more approachable, less scary, sometimes funny, and always shared. It’s not just me and it’s not just you and none of us can do this alone.

So, if you’re not still totally pissed at my for disappearing for 19 months, please come back. I promise I’ll write as often as a mentally-ill, working mother of three kids six and under can, which I hope is often. XOXO, A

Next Question

I started writing this blog in the fall of 2015. Over the past two years, I have used it to ask and answer questions about my life, some vital, some less so. In large part, writing a post is, for me, a means of spitballing with the world, and myself, about whatever question is making the most noise in my head at the time. Today that question is this: What’s next?

Now that I have been stablish on my medication for about a month, what is the next step, the next thing to be done, the next goal to achieve before moving on to the one after that until I finally reach the place where it all feels like normal to me again?

I had recently spent a great deal of time trying to figure this out for myself before remembering I have paid experts who can tell me these things. So, I asked my therapist. Specifically, because it is football season and I am a dork, I asked her if there is a goal post now and, if so, where is it? Unfortunately, her answer was basically to punt (ha!) and say that, at this point, what well and good looks like to me is for me to decide and then work towards. I considered objecting as non-responsive but thought better of it because (a) not a lawyer anymore and (b) she’s most likely giving me the most responsive answer there is. I just don’t like it.

For more than a year now, I have had a relatively detailed map to follow away from sickness and towards wellness. I went to treatment. I changed medications. I resigned from my job. I went to therapy. I changed therapists. I changed doctors. I changed medications, again. I lived many, many weeks focused on making it from my bed in the morning back to my bed at night without doing or saying anything harmful to myself or others. It may have looked like I was just puttering around the house and hanging out with my family but, believe me, I was fighting for my life some of those days. A lot of those days. That’s the thing, or one of the many things, that’s hard about mental illness, right? Other people can’t see it. They can’t see the pain or anger or fear or sadness. They can’t feel those things either. They can’t feel what it is like to fight back against those things using the same weapon that is trying to kill you: your mind. It is a fucked-up thing to be fighting with your own mind, not to mention your heart and your soul. It hurts so much you want to die. And some of us do.

I didn’t die, obviously. And now I’m not on the front lines everyday battling for my sanity. So, what do I do now? Obviously, maintaining my mental health requires a myriad of tasks, daily and weekly, but does not fill up every minute of my day. Those extra minutes are currently filled with kid stuff and house stuff. I’m also trying to write more, more on this blog but mostly for other platforms like mental health websites. I’m also in the very early stages of maybe sort of pitching a book but I’m not fully committed and so mostly it doesn’t get worked on. And, really, that’s my problem, or my question. Does well and good look to me like a mom who writes from home in between drop-off and pick-up? Or a full-time attorney who is also a mom and a wife and a human in her spare time? Or a part-time attorney trying not to work full-time hours? Or something else entirely?

Does it look like a person with the ridiculous good fortune to workout (mostly outdoors) five to seven days a week? And who gets to go to hour-long therapy sessions weekly? And doesn’t have to worry about when to squeeze in her med checks or her (three!) children’s doctor and dentist appointments?

What do I want to be when I grow up? That seems to be the question I’m asking, which feels a bit childish, but also appropriate. I did grow up to be a full-time attorney, mother, wife, and individual. Then, due to genetics and circumstances, that life, my life, fell apart, it disappeared, and now it’s gone. So the question is do I want to re-build it, or do I want to build something else? Of course, this is all assuming I have the financial ability and buy-in from my partner to do something else which I am hopeful I do; also there’s the practicality of having the expenses but also the time and emotional resources required to care for three kids who are not even in school yet.

The more I think about it the more my doctor’s question seems to be an appropriate one for deciding what I want to do next: what does well and good look like to me?

Well and good, to me, looks like a whole day of feeling like a pretty good mom who wasn’t too stuck in her own head to notice what the little heads around her were up to, who didn’t yell or cry (much) because of stress or symptoms of her illness, who said yes as much as she reasonably could, and laughed.

Well and good looks like waking up without a sense of dread or panic because of ALL THE THINGS that need to be done within the span of that single day. I spent years waking up like this and whether it was a symptom of my illness or a cause I don’t miss it and I don’t want it back. I want to wake up feeling ready to do what needs to be done but not overwhelmed by it. I also want to have space in my days that make me curious, time that I’m not sure how I will spend but will (most likely) get to spend the way I want to, or the way I need to because of some unforeseen emergency that would normally throw my whole, tightly-knit plan the day into a tailspin of anxiety.

Well and good looks, to me, like being a wife who is more often happy then angry with her husband because of who did or did not do what needed to be done. It also looks like having the time and emotional resources to be the one who does all the things because her husband simply can’t due to work commitments (and vice versa). It looks like having the time and inclination to be something other than co-parents and financial partners.

To me, well and good is purpose and meaning consistent with my mental wellness but not too cautious to be truly challenging and even a bit scary. Well and good is, in large part, taking care of family. But well and good is not a life of regularly scheduled, relatively manageable tasks with a few surprise challenges sprinkled in. Purpose and meaning come from being a mother and wife but also from being myself, from doing something, or many things, that give me pleasure and a sense of accomplishment.

Now, I just need to figure out what that something, or many things, are. Next question.

 

 

 

 

 

Would I choose?

I recently re-read An Unquiet Mind by Kay Redfield Jamison. Dr. Jamison is notable for, among other reasons, having written the best-selling memoir on living with bipolar disorder and co-authoring the definitive textbook on the same illness.

I read An Unquiet Mind for the first time nearly 20 years ago, in hopes that it might help me help a newly diagnosed friend. It did not, for a number of reasons mostly unrelated to the book. My second reading was far more personal, meaningful, and difficult. Having been diagnosed just a year ago, and having spent most of the past year struggling for stability, I have not had the ability or desire to think about whether and how this illness may have impacted my life for a greater period of time than the past two years. Dr. Jamison’s account of her decades-long, often tortuous dance with mania, hypomania, and depression made clear to me that my own illness existed long before its diagnosis. In my unscientific, but very fact-based, opinion, my bipolar disorder first emerged when I was 18 years old and a freshman in college.

My episodes of depression started just a bit before college and have carried forward to today. Those episodes I have always been aware of. Now, from a more medically-stable, knowledgable perspective, I can also see the episodes of hypomania, glittering like stars in a constellation that stretches from 18-year-old me to 38-year-old me. I am tethered to my much younger self by this illness, which I didn’t even know I had until last year.

Reflecting on both my depressive and hypomanic episodes — during college, during graduate school, after my first child was born, after my second and third child were born — is enlightening and heartbreaking.

Particularly for my college, graduate school, and early work experiences, I have no doubt that much of my creativity, endless amounts of energy, and near-perfect work product was the result of hypomania. It was also the result of me. It was hypomanic me. Alison on chemically-imbalanced speed. I was and am a very good student. I was and am a very good attorney. But I believe I was and am those things, in part, because of my illness.

My hypomania has also played a significant role in my personal relationships. I have been very good at falling in love, with friends and lovers. Over and over, I have jumped without looking, expecting to be caught. And I have been given such love that my heart would burst. And I have been let down so low that I wanted to die. But I have loved hard and true and again. Some people I have loved with my whole self and yet hurt them callously. I have been reckless. I have done things that were terribly wrong. I have lied. I have betrayed. I have become very, very lost from the person I believe I am, or wish to be. In short, and thanks, in part, to my illness, I have brought to my relationships the biggest heart and, sometimes, the sharpest knife.

Motherhood, which likely exacerbated my bipolar symptoms, has likewise been a devastatingly beautiful and overwhelming fearful experience. I have never loved so much, laughed so hard, or been so heart-burstingly proud. I am in awe of my children’s kindness, character, and resiliency. They are each unbelievably funny and extremely thoughtful in their own unique way. Of course, they are also three huge pains in my butt, but mostly in an age-appropriate way. What has made motherhood difficult for me is not my children but me and, most likely, my mental illness.

Bipolar disorder had taken what I assume are some of the normal insecurities of motherhood and magnified them. As a mother, I have never been so convinced of my inability to know and do the right thing; whether they are sad, shy, rude, angry, hurtful, careless, sick, or just plain annoying. Given my fear and hesitancy, among other things, I feel I am fucking up my children every single day, and have felt that way for almost five years now, although adding the twins to the toddler was particularly difficult. With one child, I could carry all my crazy around, keep him alive, and still otherwise function like a mostly normal person. After the twins arrived, I didn’t have a snowball’s chance in hell.

As detailed in prior posts, the two years since my twins were born have been the most difficult of my life in terms of mental and emotional stability. Basically, there has been no stability until just recently. Instead, I had horribly irritable, anxious hypomanic periods that built and built and built until I hadn’t slept and could’t stop talking or thinking or trying to do ALL THE THINGS. Then my head and heart would explode in the form of a massive panic attack, typically in my parked car just before work on a Monday. I would then spend the next three to five days in a coma of depression, not able to leave my bed even to make my small son lunch or my even smaller children bottles. I would sleep and cry and sleep some more, until eventually I felt more or less human, at which point I would head right back to work and mothering and household management until it all became a frenetic explosion in waiting, again. Thankfully, I finally realized I would not survive many more trips around the crazy merry-go-round and let go. I quit work, went to treatment, and started, slowly, to get better.

Flash forward other year and here we are. In just the past few weeks, I have stopped experiencing a near constant mixed-state of hypomania and depression that made me furious with everyone all the time and also want to kill myself for being such an awful mother, partner, and human. For the first time in two years, I am feeling mostly okay. My marriage is intact. My kids seem fine. And I am starting to feel safe enough (most days) to think about where I have been and what impact bipolar disorder has had on my life.

In the epilogue of her memoir, Dr. Jamison poses the question whether, given the choice, she would choose to have manic-depressive illness. (Dr. Jamison prefers the original name to the subsequent and supposedly less stigmatizing term bipolar disorder). Her answer (with the assumption that lithium is available to her as an effective treatment) is yes.

My reaction when I first read this statement was to immediately distinguish her situation from my own because she had, as described in the book, repeated, euphoric manic episodes during which she traveled the cosmos and heard the singing of the spheres (I’m paraphrasing, of course, but she did pass by Saturn). She must feel that those moments of ecstasy made it all worth it, I thought. I was wrong. Instead, she writes:

I honestly believe that as a result of it [manic-depressive illness] I have felt more things, more deeply; had more experiences, more intensely; loved more, and been loved more; laughed more often for having cried more often; appreciated more the springs, for all the winters; worn death “as close as dungarees,” appreciated it–and life–more; seen the finest and the most terrible in people, and slowly learned the values of caring, loyalty, and seeing things through. . . . Depressed, I have crawled on my hands and knees in order to get across a room and have done it for month after month. But, normal or manic, I have run faster, thought faster, and loved faster than most I know.

This was not what I was expecting; it hits much closer to home. Not all, but much of what Dr. Jamison describes as being the result of her illness are feelings and experiences I have had over the course of my adult life: the intensity of life and love, the arms-wide-open lunge towards  light and funny and new, and the implicit knowledge that compassion, loyalty and determination will always get me home. I have literally and actually crawled on my knees across rooms of my life. I have literally and actually run fast, thought fast and loved fast, faster than was wise, perhaps, but as fast as I needed to go.

So, with the same assumptions about lithium in place, were I given a choice, would I choose to have bipolar disorder?

No.

For all the added emotional depth it may have brought to my life and any added mental acuity, bipolar disorder has made my life as a wife and mother indescribably painful much of the time. In the worst throes of a hypomanic or depressive episode, I have done unspeakable things, risking not only my own health and happiness but that of the people of I love most in the world. I have done terrible things but, more significantly, I have done nothing; I have absented myself from the lives of my husband and children, no matter how much they needed me. I just could not be there for them. I think I will always struggle to accept that this happened and that it is okay.

The other struggle I will continue to face is my near-constant, immutable belief that I am continuing to fail everyone in some terrible, unforgivable way. I recognize there are times when I have actually done something horrific, but I am often unable to distinguish between those times and every other time I fail to meet my husband or child’s need or want. I am so accustomed to being the person in the wrong, who forgot something, or lost it, or took it when it wasn’t hers; who didn’t show up, or canceled at the last minute, or had to go to bed because she was just too tired to be alive. Having bipolar disorder, especially at the exacerbated level that I had it over the past two years, has altered my relationship with my family and myself. I don’t trust my instincts, value my intuitions, or make firm choices. I feel so horribly indebted to everyone for the hurt I have caused, I assume I will never be able to pay them back but keep trying anyway, of course.

When I was actively sick, the only thing I could focus on was just that: I was sick; I was going to get better. Day in and day out this was my one, cogent thought. Now, I can see so much more of what is and has been going on around me. And I am devastated. I am actively working on being less devastated. I know that my mind and my moods are exaggerating the negative impact that I have on my loved ones. But knowing and feeling are two very, very different things, especially when one suffers from a mood disorder.

So, no, Dr. Jamison, I would not choose to have bipolar disorder, even if I did get to visit Saturn once or twice. Thanks in large part to your book I now see my illness has some value. It has brought me some extraordinarily beautiful gifts at various points in my life. But what matters to me most is my life as it is now together with my family. And we both know that no matter how stable I may become, this business of being bipolar is not over. It will never be over for me, or for my loved ones, whether it be my illness, that of one of my children, or one of my grandchildren. We will all always be waiting for the other shoe to drop. That is not the way I would choose for us to live.

One Week

It has been one week since I stopped taking the last med prescribed by my former psychiatrist that is counter-indicated for my illness. While my episodes of hypomania and depression became severe and rapid-cycling in 2015, I am on day seven of being both properly diagnosed with bipolar disorder 2 and properly medicated. I feel hopeful and devastated, thankful and furious.

While I still feel somewhat fragile, my mood seems to be settling down somewhere near where it used to live. I am still prone to emotional outbursts, both sad and angry, but those outbursts occur less and less often. The other day I put on make up for no particular reason, something I have not done in close to a year. I have laughed until I couldn’t breathe at something my husband said and at something one of my children has done. I make jokes. I can’t remember the last time I laughed, or expressed any happy emotion, spontaneously and without it feeling at least a little bit forced. I am reading books that are not for my children and are not about bipolar disorder. I listen to music and sometimes I even dance a bit around the kitchen. My husband and I are going to a concert in two weeks, our first since L and C were born. I think about going back to work, not in the near term but as an actual possibility to be considered. All of these things give me hope. These things also devastate me.

I am devastated by the days and months and years I have lost; by the moments I missed because I was to anxious or angry or depressed to be present. I am devastated that I don’t remember a great deal of L and C’s first two years, not in a “two newborns and a toddler whirlwind” sort of way but in a “I have no memory of significant spans of time during which I was ill but not properly treated” sort of way. I have wept over baby book entries I could not complete. And H, I am devastated that he is old enough, has been old enough all along, to remember what these years have been like. I am crushed by having been truly mean to him, by having frightened him with my instability, by having pushed him to his father when he came to me because I just could not do it. I am also devastated by the toll my illness and my ongoing recovery have taken on my marriage and my husband. I have suffered and he has had to watch. He has tried to help and I have rejected his offers, angrily insisting he read my mind and provide me with something else entirely. Writing about these emotions and events wrenches my heart and makes it difficult to breathe. But this is what happened. I can’t change it. My only and best option is self-compassion.

Thankfully, self-compassion is one of the many new skills acquired during my intensive outpatient treatment and therapy since leaving treatment. Also helpful are self-differentiation, boundaries and value-based living. But self-compassion, loving myself regardless of what I do or fail to do each day, whether as a mother, wife, patient or human, is by far one of the most important (and most difficult) lessons I have ever learned. Honestly, it’s still a work in progress, but I’m getting better, and I love myself even if I’m not. I am thankful for the many healthcare providers who did their best to keep me safe along the way, even if they didn’t get it exactly right. I am particularly thankful for my last therapist, who steered me finally in the right direction. Thanks to her, I now have both a psychologist and a psychiatrist eminently qualified to treat bipolar disorder 2. Thanks to her, and to my new psychiatrist, I have been taking the proper medication for my condition for seven days.

However, the fact that it took just under two years for me to get to this place of near stability is infuriating. How many fucking PhDs and M.D.s does it take to properly diagnosis and medicate a single person? More than it should, my friends, more than it should. I spent over a year being treated for “treatment resistant postpartum depression” which I did not have. I spent nearly two years being prescribed medications that made my actual illness significantly worse. My panic attacks and, likely, many of my hypomanic and depressive episodes were triggered, at least in part, because of my medication. Because I did what my doctors told me to do, I got sicker. And sicker. So sick that I came much closer to the edge than I would like to admit, particularly as a mother. Bless whatever small part of me was able to pull back and run the other way in search of help. Of course, the help properly diagnosed me but failed to properly medicated me and sent me back to the same doctor who screwed up to begin with. But, I could have said no. I could have asked more questions. I could have said this doesn’t seem right; I don’t feel like I’m getting better. But I did not do those things. I just kept going, trusting that, eventually, the motions would get me home. And so they have, at least they’ve gotten me damn close.

I have felt better before. There have been days in a row when it seemed everything was finally, mostly okay again. But it wasn’t. I am hopeful this is not one of those times.  Given the hellish medication changes I have gone through to get here, I think this time will be different. We may need to tweak things but, fingers-crossed, the worst is over. Of course, I still have much to learn about managing my symptoms and avoiding or minimize future episodes. And I still have to mother three toddlers and be a wife and figure out what to do about work and about a million other things. But for now, I am just going to be here in this unfamiliar place of near normalcy. It’s been a long time coming.