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.

There are no words

I have read a number of stories, blog posts, etc. about Chris Cornell and depression over the past few days. His death is an incredibly sad cultural loss and personal loss for his loved ones. It also exemplifies the simple truth that depression is indiscriminate. It does not affect a certain type of person; it is not the result of a character flaw or a lack of personal ambition; it does not care what you have achieved or how much you are loved. It is an illness caused by a chemical imbalance in the brain, a chemical imbalance that exists among millionaires and rock stars as well as the people who live next door. It effects the moms and dads and grandparents and teenagers who you know and even love. It is so much more common than you realize. Knowing this fact, really internalizing it, is a very important, powerful step towards de-stigmatizing mental illness and providing true support, even empathy, to those who suffer from it.

Even so, simply recognizing that depression is an illness is not enough. We need you to believe that depression is not something that can be “fixed” through personal effort or optimism. We need you to acknowledge that dealing with depression requires serious, often long-term treatment. It also requires fucking hard work just to survive. Many people who suffer from depression, myself included, put in more emotional work just to get to “normal” each day, than many people expend simply living their lives.  Having someone we love truly believe these truths about depression is an incredibly validating experience. It makes us feel seen and heard. It makes us feel less alone.

I have found the most difficult part in bridging the gap of understanding between myself and my loved ones is my inability to adequately describe what my depression feels like. Yes, it is caused by a chemical imbalance, but an imbalance that doesn’t cause any adverse feelings would be irrelevant. It is the feelings caused by the imbalance that make depression what it is. And those feelings are different for each person. However, in an effort to give some sense, some words to what depression can be like, I offer up my personal experience and feelings:

  • Depression takes me back; it examines every mistake I’ve ever made and forces me to physically and emotionally experience those past events. I feel the chest tightening, heart-wrenching pain of every loss. I feel the waves of shame starting in the pit of my stomach, traveling through my chest and then my face. I examine every major decision I ever made and sob at the imagined joy I may have missed.
  • Depression critically examines my current life circumstances and meticulously points out every area in which I am failing. It tells me, viciously and repeatedly, that I should be a better, more patient and loving mother who spends more quality time with her children. It tells me I spend far too much time on the mundane tasks of day-to-day household management rather than with my family. It make me feel like an inferior partner to my husband, who I now depend on financially; that I ask too much; that I don’t contribute enough; that I am a burden; that eventually he will leave me.
  • Depression also robs me of hope for the future. It tells me that my pain and regrets will never go away. I feel as though nothing will ever change or get better; that I will spend the rest of my life feeling overwhelmed by mothering three children, satisfying my husband’s emotional needs and keeping my own head above water. Depression makes me feel like no matter what treatment I seek, or how religiously I adhere to any doctor’s recommendations, I will never feel better, not in a sustained way.

Depression makes me feel all of the above, day in and day out, nearly everyday of my life. It is exhausting. It feels so unfair. Even though I know it is not my fault, even though I constantly preach that message, I still feel like it is my fault much of the time. How can I not? It is my own mind after all. Why can’t I just control it?

But I can’t, I can’t control it, or stop it, or fix it. Believe me, I’ve tried. Depression is part of who I am. It always will be. It is my monster. My internal demon that I will never be able to truly share with anyone else. I bear the burden. I will carry it, always. I will carry it as far and as long as I can.

 

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).

 

 

 

 

 

Everybody Panic

**Note to the Reader: I started writing this post a couple of weeks ago, while in the throes of a severe episode of anxiety. Ultimately, I found writing the post at the same time I was experiencing these symptoms too triggering, so I set it aside. I finished the post just recently.**

In the last 72 hours, I have felt more anxious, uneasy, fearful, on edge, [insert additional synonyms for anxious here] than I have felt in months, maybe even since I left treatment. We’re talking, “Hold please, I think I’m going to have a panic attack now . . . uh, okay, I guess not, that’s a relief. Let’s . . . wait, I think it’s really going to happen now; I just need a minute to sit down, maybe lie down actually . . . ,” kind of anxiety. Every single waking moment. I have been so eager to be alone in my bedroom the past three days, I have gone to bed directly after tucking in my four-year old.

I don’t know why this is happening. I mean, I know I have a mood disorder, so duh, I have crazy mood swings, but usually there is some sort of identifiable trigger — like it’s the weekend.

I remember when I used to love weekends. I would be so excited for that two-day break in my work-week to exercise, hang out with friends, go out to eat or see a movie. After our oldest was born, weekends become more complicated but my husband and I managed to maintain most of our prior activities, by taking turns with the baby or having one of my husband’s parents babysit. Sure we went out less but we still managed one or two dates a month, including dinner and a movie, if we could stay up that late.

Weekends are now the hardest part of my week. They involve two adults trying to keep three very mobile, loud and irrational toddlers from maiming themselves or each other, shattering eardrums or eating things that are not food. For me, it is the perfect storm of wanting to keep everyone safe and happy and nobody being safe or happy (at least not at the same time). While I constantly feel like I need to do something, I also feel like I can’t do anything right and that it’s going to be this way forever because we will always be outnumbered and the kids will only become more willful and unpredictable. Basically, I get super freaked out, am no fun at all and spend most of our family activity time wanting to run home and hide in my bedroom closet until Monday.

So weekends are a trigger. But the last three days have been a Wednesday, Thursday and Friday. These days are usually pretty low-stress for me (unless I have to go to the pediatrician’s office three times or find out my husband is flying to the Middle East for work next week). I have gone running each morning, to therapy and to visit a good friend. I have spent time outside in the warm weather, played with the twins in the backyard and taken them for walks. We went to baby swim lessons and watched the Muppets during lunch (yes, I am raising my kids to appreciate the classics). I even sat down and finally made a list of potential book projects.

But none of this self-care, socializing or meaningful activity has helped. I am jumpy, my heart races constantly and I am always too hot. My hands shake and I have trouble sitting still. I am impatient with everyone, including my children, so I find myself spending as much time alone as possible. I don’t want to eat. I don’t want to listen to anyone talk. I don’t want to talk to anyone. I don’t want to make any decisions. Every single thing feels like too much.

Living with this level of anxiety for the past three days has been particularly frustrating because I saw my psychiatrist a few weeks ago and we tweaked my meds to specifically address my anxiety symptoms. And I felt better. I really did. But now I do not. Definitely not. So I suppose it could be a meds thing, maybe we tweaked too much, or not enough. Medicating a mental illness involves a great deal of trial and error and, unfortunately, the errors affect your brain, which is a pretty big part of who you are and how well you function.

Another possible reason for this spike in my anxiety is that my mom and step-dad are here to help out while my husband is out of town. Last year, when I was still misdiagnosed and improperly medicated, I would often have my most severe panic attacks and most debilitating episodes of depression when my parents were in town. I was spending most of my days holding on for dear life, trying to manage work, a household of six and mothering three small children. My husband works a billion hours a week, so I was responsible for the lion’s share of household management and parenting-related stuff. But, when my parents showed up, there was suddenly, magically two additional people whom I trusted to do much of the work I was doing. And once that safety net was in place, I couldn’t help but let go.

It wasn’t that their visits made me more sick; the anxiety and depression had always been there, I just held them in as best I could because I had to take care of my family and perform well at my job. Once I felt my most important people, my children, were safe without me, I could stop trying to hold it all together and instead fall apart. My parents’ visits were like a safety valve for my sanity. So maybe having my parents here now, despite all the positive changes in my mental health, weekly schedule, self-care, etc., is triggering a relapse to the anxiety symptoms I had before; a sort of pavlovian relapse (because clearly I wasn’t enough of a science experiment already).

There is also the fact that their visit has completely thrown off my weekly structure. My brain, like all Bipolar brains, really, really benefits from structure, structured days, structured weeks; we just like knowing what’s going to happen next. But my parents really, really like helping, so they basically took over 90 percent or more of my regular, daily tasks. While this sounds lovely and was certainly done with the best intentions, it definitely threw me off my game. The tasks they were doing were part of my daily schedule and my contribution to the household. Suddenly, I had nothing to do and having nothing to do is a very bad thing when your mind is your enemy. I ended up spending far too much time in my mind, which, as Anne Lamott once quipped, “. . . is like a bad neighborhood, I try not to go there alone.”

Another possible factor is that my husband was away for almost a week. His absence can be hard and anxiety producing, especially in the evenings and at night. Being the only parent in the house, even when there are other adults present, feels like so much responsibility — sometimes more than I can bear. At night, every cry, every bump, every “mommy” makes me jump out of my skin, and the quiet feels even worse because I can only anticipate the next noise. It’s excruciating. When my husband is home, even if I am the one on night duty, I don’t experience any of this agitation or fear. Having another parent present makes me feel like I can screw up and someone of equal responsibility and love for our kids will be there to fix it. Also, our oldest child will freely harass me with bedtime-related requests for hours and won’t stop no matter what I say or do or refuse to do. But my husband shuts that kind of thing down like a boss. Particularly on days when my anxiety is really high, knowing I have a human hammer when it comes to bedtime is a huge relief. And after my husband got home, I did start feeling somewhat better.

I talked with my therapist the following week and we agreed that the lack of structure, or the significant, unanticipated change in my structure, was likely the biggest contributing factor to my anxiety attack. Although I’ve known for some time that I feel better with structure, I did not realize, until now, that lack of structure or a significant change in structure could be so devastating.

It seems I will need to create alternative structures or schedules for any visits, vacations, schools breaks, etc., of sufficient length to throw my brain into its unhappy place. In other words, my life is now, in large part, an administrative project. Fortunately, I enjoy making tables and spreadsheets more than the average bear. Peanut butter and jelly sandwiches are also nice.

 

 

 

 

 

 

20 Reasons why parenting with mental illness is hard

Many of these reasons are not limited to parents with mental illness but apply to parents generally. This shit is hard, whether you are certifiable or not. So I present to you, in no particular order, the following 20 reasons why parenting with mental illness is hard:

  1. Even when you wake up knowing it is going to be a shit day, you still have to get out of bed.
  2. Crying in front of your kids.
  3. Having to explain to your kids, in a non-scary way, why you are crying.
  4. The screaming (mostly theirs).
  5. The guilt (all yours).
  6. Feeling scared and incompetent, which leads to acting irritated and impatient with your kids and your partner.
  7. Medical need for consistent, uninterrupted, 7-8 hour sleep periods vs. teething, illness, nightmares, diaper fails, thirst, scary noises, heat, cold, etc.
  8. Feeling afraid of spending time with your own kids, especially when there is no other adult around to help in case you mess up or break down.
  9. Not being able to chase a tough day of parenting with a glass of wine.
  10. Having weekends become a trigger.
  11. Missing good parts.
  12. Wondering whether you have passed on your illness to your child; and wondering whether it will pass on to one of your grandchildren.
  13. Being hypomanic at your kid’s birthday party.
  14. Feeling socially dysfunctional and/or terrified at all the other birthday parties.
  15. Having to ask your spouse to carry the parenting load alone when you just can’t, not for one more minute.
  16. Being the overzealous, annoying safety patrol person at the park, because you can’t not say something.
  17. Feeling overwhelmed with love and anxiety, simultaneously, every waking minute of your day and knowing this feeling will last for years, if not forever.
  18. Being very, very organized (e.g. meals planned, bags packed, weekly schedule on paper), but inevitably becoming increasingly unorganized until you can barely remember what day it is. Repeat ad nauseam.
  19. Wondering whether your struggles as a parent are truly related to your mental illness, or if you’re just not very good at parenting.
  20. Questioning your decision to have children at all, given the hereditary nature of most mental illnesses and the likelihood that you would be less debilitated by your illness if you were not a parent.

*Credit for awesome card pictured above goes to Emily McDowell Studio

 

We can do better.

My mother graduated from high school in California in the mid-1960s. She was a hippie. She took college classes. She worked at a technology company and lived on a commune (at the same time). My mother lived independently and non-traditionally.

My mother married my father when she was 26 years old. My father was older than her but not old-fashioned by any means. As an electrical engineer, he was certainly not part of my mother’s usual crowd but they met, fell in love, moved to Idaho, started living together and were eventually convinced by some friends to get married in their backyard during a brief visit back to California.

My parents were not conventional people, then or now. Still, as far back as I can remember, their roles in our family were exactly that: conventional. Generally, my father worked five days a week at his office or in court, while my mother worked seven days a week, mostly at home, taking care of me and my younger brother. (Note: my mother did return to work when I was 12 and my bother was 9). My parents’ division of household work also followed custom. My father mowed the law, took out the trash and grilled. He also cooked big breakfasts on the weekends. My mother did everything else: the cleaning, the laundry, the grocery shopping, the cooking, the school shopping, the lunch packing, the doctor appointments, the dentist appointments, the birthday party planning, the presents from Santa wrapping, the listening, the tear-wiping, the holding on and the letting go.

I am sure some of you had very different childhood experiences, but I would bet many of you had parents a lot like mine: kind, loving, intelligent, funny, progressive people who provided their children with a not-so-progressive model for the division of labor at home. And, as all of us parents know, children do what you do, not what you say. So, regardless of my parents’ non-traditional lives prior to marriage or their progressive dinner-table talk about everything from abortion to the Vatican (my father was raised Catholic), what I saw them do was generally adhere to the same gender-based division of roles and responsibilities followed since post-World War II.

In all fairness, I had no idea at the time that my parents were modeling a distinctly non-progressive approach to creating and sustaining a home together. It is only now, after ten years of marriage and three children, that I see my parents’ dynamic for what it was. I am able to see it because I recognize it as the same dynamic in my own life, maybe not exactly the same but close enough to be unsettling.

We have two sons and a daughter. I do not want a single one of them to grow up thinking that dads take care of the lawn, trash and bbq, while moms take care of everything else. I want my sons to learn how to do their own laundry from their father. I want my daughter to learn how to break down a box and take out the trash and recycling from me. I want to teach my boys how to bake and run the vacuum. I want my husband to teach my daughter how to grill a great burger and flip the perfect pancake on Saturday morning. I want everyone to clean up after him or herself, whether that means toys, shoes, clothes, wet towels, or toenail clippings.

I refuse to continue to operate in accordance with the unwritten, unspoken agreement that  the women (i.e. the wives and the mothers) will be responsible for the  majority of the family/household shit (in some cases, actual shit is involved). Everyone, no matter their age, should do for themselves as much as they are capable of doing. Obviously there is a lot children cannot do, at least at first. As to these tasks, we parents need to make sure that we share them (as much as is practically possible) equally and without regard to role or gender.

 

To those of you who (like me) grew up in a home were your father worked outside of the home five days a week for money and did some chores around the house, while your mother worked inside the home every minute of every day for no money doing all the things your father did not, I say: We can do better. We cannot be perfect. We cannot ignore reality or attempt to force our families to function in an unworkable system. But we can focus more on what we do rather than what we say. We can consciously model for our children what an equal, neutral division of labor looks like for our particular family. And we can hope that, by doing so, our sons and daughters will move forward in life expecting such equality in their personal relationships, their professional pursuits, and from their government.

 

 

 

Thankful

Two weeks post-camp, I am thankful (in no particular order) for:

  • Finding my voice and the courage to use it;
  • Friends who encourage me to push harder and friends who help me to see when I need to let go;
  • My adorable, silly, sweet, loud, messy, exhausting children;
  • My adorable, silly, sweet, messy, exhausting husband;
  • My au pair (and friend and general holder together of my sanity);
  • Good doctors;
  • Meds;
  • My (kick ass) therapist;
  • Running;
  • Yoga;
  • Writing;
  • Music (particularly 90s hip-hop);
  • Impromptu dance parties; 
  • Chocolate;
  • Finally learning to meditate and not hate it;
  • That my 15 month old daughter loves Beyoncé as much as I do;
  • Take out for dinner;
  • Long walks with good listeners;
  • Having options;
  • Long baby naps;
  • Unseasonably warm weather;
  • Sweatpants;
  • Libraries;
  • Baby Tylenol and Baby Advil;
  • Every person who is also telling their truth about mental illness out loud and without shame.