Suicide

The following link reveals statistics of suicide in the US according to the National Institute of Mental Health (NIMH):

Suicide in the US

1.8% of deaths throughout the world are a result of suicide. This is 1.8% too many! Suicide is a tragedy that ends one life too soon and leaves countless others to suffer in the aftermath. No one in their right mind would dare perform such a horrific act.

The problem is, we are not in our right minds when we have thoughts of suicide.

In the midst of a severe depression, our senses are slurred and reality is overshadowed by the pain of the moment. All that can be felt is an endless overdose of misery; nothing seems worthwhile. We feel detached from our loved ones, and may even convince ourselves that they will be better off without us. Terrible circumstances may arise, such as sudden loss of income, divorce, death of a loved one, a permanent handicap, or any number of other tragedies, that make one doubt any feasible method of relief besides death. For someone who is contemplating suicide, the living world represents a burden that can no longer be endured, and death exhibits an end to suffering.

The truth is, you are needed here. Your life is worth far too much to throw it away. No matter how big your problems are, no matter how terrible you feel, no matter how lonely you are, or how stressed, or scared, or diseased; even if your whole family has told you they hate you, or you've lost everything and everyone you cared for, THERE IS STILL A REASON TO CARRY ON!

I can't tell you what that reason is. You have to find it on your own. But I promise, you will find the reason to keep living if you vow to not give up.

After I was released from the hospital after my first suicide attempt, I was still feeling quite suicidal. I decided to make a Life Box. I placed items that were a threat to me (sleeping pills, knives, etc.) in the box, and then on the top of the lid I taped a picture of my two daughters. They were my reasons to live, and I knew if I had to look at that picture and imagine someone telling them that their mom has died, I would not open that box. The box was symbolic, because obviously there were ways to off myself that would not fit into a box. It gave me something visual to focus on when I was feeling my worst.

I no longer have an actual Life Box, but I adhere to making lists when I am feeling suicidal now. Sometimes I write the stuff down, or something I just go through it in my head, but the object is to list things that give me reason to live. Examples are

• People you love, or who love/depend on you (children, parents, siblings, friends)
• Things that make you laugh (TV show, your pet, your children)
• Things you are proud of (promotion at work, your blog, getting out of bed)
• Things you enjoy (reading, long walks, singing in the shower, puzzles)

The lists can be anything you want them to be; the point is to get your mind focused on living things, and away from the reasons you want to die.  What works for one person may not work as well for another, so play around with ideas while you are feeling well so that you will be ready with things to try when you are under the attack of suicidal thoughts.

My fiance had the pleasure of meeting Steve Fugate a while back, and when he told me about Mr. Fugate's cause I looked up his website trailtherapy.org. I was very glad I did. His story touched me deeply, and I encourage you to read about his story and his choice to LOVE LIFE.

What ideas can you think of to help you or someone else choose life instead of suicide?

Hug Your Therapist-Well, Not Literally, As That May Lead to a Restraining Order

I have often wondered what it is like to be a therapist. I figure it must be one of the hardest jobs in the world. All day long they listen to people's problems. Some are giant, horrific problems; others are petty and trite. Somehow these gifted individuals have to show the same level of concern for someone who is complaining about their husband never doing the laundry as they did to the person who just confessed being a childhood victim of incest. I wonder how many individuals admit to feeling suicidal on any given day, or how many actually describe a plan to die in full detail, and the therapist has to convince those people of reasons to stay alive, or else make the decision to have them hospitalized for their safety. I wonder how often they have to learn that one of their patients has already killed themselves. I wonder how many blatantly criticize their therapist, or blame them for something, or just stop showing up so the therapist has to wonder what happened to them. I wonder how therapists shut off all the to be continued stories they have heard throughout the day and go home to their own lives and enjoy their evenings after knowing so much about what others are going through. I wonder how they sleep at night.

I wonder if  therapists have to have therapists of their own just to keep from going crazy themselves. 

I have had four different therapists since I was diagnosed with Bipolar Disorder.  My first one, V, will always remain my favorite. She was easy to open up to, and she had a very kind and wise aura about her. It was not unheard of for her to give me a reassuring hug at the end of an emotional session, and once she even prayed with me. I liked her because she didn't give advice, but simply listened and gave me enough guidance to figure things out on my own. There were times when I would go to her office in such a state of depression that I said nothing the whole session. She would soothe me with the simplicity of silence; it's hard to explain, but she had a way of radiating peace to me, and I would always leave feeling better than when I came in. Other times, she would help me through panic attacks (brought on by all the people in the waiting room). I would be in a wonderful state of calm by the end of my session. I saw V on a weekly basis for three years, until she left for Boston because her husband received a job offer there. The grief I felt when she left was as if she had died. How was I to carry on without her? After all, she had helped me through one of the most difficult eras of my life. I still miss her to this day.

The therapist who came to take V's place after she left was...different. She actually reminded me a lot of a friend I once had, and that was not a good thing, as this particular friend had been very critical and condescending. I did like how she made a point of me writing down my dreams each morning and sharing them with her at my sessions. She felt that dreams revealed a lot about our subconscious, and I tend to agree. Yet, through no true fault of her own, this therapist and I just didn't mesh well. I only saw her a few times before I asked about seeing someone else.

R was next in line. I liked R fairly well since at the time I was a smoker, and we would often go outside and smoke during my session. It made me feel like I was leisurely talking to a friend rather than being cooped up in a stuffy office forced to tell my secrets. She helped me through the grief I was feeling for losing V, and through an even harder grief when later I lost my dad to cancer. During many sessions she would give me a pen and paper and leave the room so I could write out letters to my dad, and then she would come back in and I would read what I had written. This was very helpful to me, and it brought out pent up emotions I had about things that I didn't even realize. At some points I didn't like her, because I didn't like admitting any negative feelings toward my deceased father, and I didn't like her telling me I needed to leave my verbally abusive husband (though, let's face it, she was right).  R was not a coaxer. She was more blunt and to the point. Sometimes this was good; sometimes bad. Whatever the case, after a couple of years I stopped seeing her for a while, only to return and find out she was gone. I never found out why she left, but I never grieved her absence like I did that of V. By then, I had come to expect it. Therapists are not a constant. They come and go just like patients do.

My next therapist was L. She was just so cute! So young and innocent. At first, I didn't want to admit anything too harsh to her, for fear of deflowering her of all that supposed innocence. Eventually, I did start opening up more about the less-than-pretty parts of my life. She was a very good listener, and she liked writing things down in lists and charts-like pros and cons, for instance-and she was very organized so she pleased my OCD tendencies for order. Her guidance helped me safely leave my abusive marriage and gain confidence in my ability to take care of myself. I randomly stopped going to see her, as well as my psychiatrist, for a couple of years because (as I tend to do occasionally) I felt "healed" and didn't think I needed any more help. As we all know, we are never completely healed from Bipolar Disorder; we just think we are sometimes. As symptoms started creeping back up I realized I needed to get back in therapy, so I have returned to L and am seeing her cute (and now pregnant) self on a weekly basis again. I was amazed at how much she remembered about me since two years had passed, which brings me to another pondering of mine: how do therapists keep up with all the personal details about their patients so well??  L will be going on maternity leave in a couple of months, if not sooner, so I will have the fabulous joy of seeing whoever is going to fill in for her. It's a scary thought, seeing someone new again, but hopefully L will return eventually.

While each of my therapists were vastly different in personalities and methods of psychiatry, I gained something of interest from all of them. It is difficult to endure starting all over with a new therapist if your old one leaves; all that history, mixed with the apprehension of getting used to someone else, plus the chore of retelling your story all over again...it's enough to make you want to give up going to therapy at all. I do believe that the benefits of therapy are worth the trial of turnover, however, as each new therapist will have a brand new perspective on your circumstances. If you keep an open mind, you are sure to gain something useful from each encounter.

I am sure there are really terrible therapists out there. Perhaps they have become burned out from all the non-stop melancholy of their patients, or perhaps they never truly cared to begin with. If you are seeing such a character, I recommend finding someone else. It won't do you any good to talk into a dead phone. If you have a good therapist, though-and I certainly hope you do!-how about letting them know how much you appreciate them. It can be something as simple as saying "thanks for listening". Remember, most are not allowed to accept gifts, and many have personal or legal reserves on physical contact such as hugging, so a heartfelt "thank you" will suffice. Maybe some gratitude will brighten their day and give them a little confidence and feeling of purpose to carry them through the rest of their day.

Decision Making

You've heard it time and time again. "Just follow your heart." This is the answer people give you when you are pressed with making a gut wrenching decision. If this is the best they can offer they would do well to just say nothing, as it is useless, even dangerous, advice.

Following your heart is equivalent to following feelings, and not only are feelings unreliable, but they change from moment to moment. It is ultimately wiser to follow your head. Reasoning. Facts. Evidence. History. Only as a last resort add the input of feelings into the equation. Gut instincts are sometimes right, sometimes wrong. Facts are undeniable.

Differentiating between facts and emotions is not always a simple task, however. It's not like they are color-coded for us.

This is especially true for sufferers of Bipolar Disorder. So many times our moods dictate our decisions. I know mine certainly have! It is only after the period of intensity has passed that our emotions subside and we are stuck with whatever decisions we made in that moment. Often those decisions cannot be reversed, so we must live with the consequences of what seemed like a good idea at the time. It is difficult to take a step back and think clearly when we are upset, angry, manic, or depressed. Those feelings consume us and taint reality. Sometimes it helps to have a trusted friend or family member who knows about your condition to help pull in the reins when you go to one extreme or another. This is a risky set up, since you are bound to hate that person from time to time for trying to tell you what to do and what not to do when you are feeling quite capable of making reasonable decisions yourself. It takes finesse and patience in that individual, and it takes a great deal of trust and listening power in you. I'm fortunate to have a good support system in my life. My fiance is the biggest help. His voice telling me "breathe, just breathe" may resonate an annoying tune during the moment of angst, but it truly is what I need to hear, as it helps me center on what is necessary (hint:breathing) and push aside the emotions that have my panties all in a wad (wow, I hate that phrase). It is essential for my sake to have him available to walk me through decisions. That is not to say that I am always incapable of making sane, educated choices on my own, but I know from past experiences that I do not have the most adequate thinking power while I am depressed, and I tend to fly off the handle or make terribly irrational decisions when manic.

Do you struggle with making good decisions when you are manic or depressed? What tips do you have for others?

Working Through Roadblocks

I have not posted a new article in several days. Considering I've been at this Bipolarly thing for less than a month, how ludicrous of me to skip nearly a week without publishing something-anything-on here! My excuses are:

1. I have a baby, and he's rather self-centered. He is under the impression that I, being his mother, should center all- read that as A L L in spaced out capital letters-of my attention on him 24/7. It does not matter if he is just sitting there looking cute, or is grunting out a massive poop in his pants, or is trying to chew a hole to China via his playpen, my eyes should be on him, not the computer screen. And that is reasonable, sure. He is, after all, the most adorable baby I have ever feasted my eyes on, even when he is making that grunty poop face, or even when he is screaming out his disappointment in me because oh my god I took my eyes off of him for one minute to go to the bathroom (he fails to understand why I can't just poop my pants like he does). I am slowly getting him to realize that I still love him even if I leave him to his own (safe, of course!) devices here and there, but it is a slow process. I am proud of him for allowing me to write the previous paragraph without crying out for me. 
2. Depression. For those of you who have experienced depression, I need not go any further in explanation. In fact, the #1 and #3 of this list will not even seem necessary. I began this site in a passionate mania-induced state, and if I had stayed in that realm I'm sure there would be 99+ articles written by now. But the reality is, I have Bipolar Disorder, and that means what goes up must eventually come down, and for me those come-downs are abrupt and severe. Just the other night I was considering canning the whole site and pretending it never existed. Who am I to add another site about Bipolar Disorder to the other million trillion already out there when I can't even function enough to get out of bed some days, let alone write something that makes half a lick of sense?? But I vowed to myself when I started Bipolarly to stick with it for at least a year, and not just because I've paid for a domain name for that long, but because I have a vision of helping people. If something I write can give hope to one person, then it's worth it. And that is why I did not hit the delete button that night, and why I am trying so hard to write through the fog in my head at this moment. Even in the grips of depression, I know I still have a job to do. I may suck at it, but I owe it to everyone to at least give it my all, just in case someone out there needs to hear exactly what I have to say.
3. Vertigo. I'm not sure if it is an ear infection or what, but it's making sitting up quite difficult. I am gripping the side of the chair with one hand as I type this. I blame the neighbors for cutting their grass this week. It must have kicked up a despicable amount of pollen.

I am the queen of excuses, by the way.

The truth of the matter is, life happens. No matter what we set our mind to do, manic or not, there are going to be obstacles. Some will be as cute as babies, and others will be as ugly as depression, but it is important to resist the urge to throw your hands up and walk away. Everyone has struggles to overcome, but it is my observation that mental illness (which is a struggle within itself) makes us a little more prone to frustration and fatigue than the average person. Some of us also tend to be perfectionists (surely not I!) and give in to the belief that if it isn't done right the first time in congruence with our own personal standards then it's not worth doing at all. We don't allow ourselves setbacks or failures. But guess what! Sometimes you will have setbacks. Sometimes you will fail. When those failures occur we have two options: get back on the horse, or wallow in the dirt. Try viewing those obstacles as learning blocks, rather than stumbling blocks. I can learn from things that go wrong. I can figure out new ways of doing things. It's not easy, and there's never a promise of success with anything, but often success is not in the outcome; it's in the process.

Perhaps you have reentered the workforce after being out of commission for a while due to your illness. If you have an altercation with someone or your performance is criticized by your boss, you are likely to feel like you aren't ready for the job world yet, or that you will never be able to function well in society again...

Maybe you joined the gym, all pumped to get into shape, but after two weeks of diligent workouts you skip a day, and then another, and another. You decide at this point it's not worth the effort. You feel like you will never be able to stick to anything you want to do...

Maybe you are considering dating again after a break-up or divorce, but you fear you will never be good enough for someone to want to spend his or her life with. After all, you feel like it's your own moodiness and flaws that always causes the problems in your relationships... 

These and many other scenarios may apply to your current situation. Faced with the experience of past failures and the fear of future failures, it's easy to see why you don't want to try again. What's the use, right? But we've gotta stop thinking that way! Instead, we should try seizing the small victories along the way, and strive to keep our heads above water at all times. Why, you ask? Because we're worth it! You may not believe this, but you are an important individual. You have thoughts and ideas that no one else has. You have gifts and talents that are unique and useful in one way or another. Your influence is crucial to the ones around you, and your participation in daily life makes a difference in ways so tiny you may not see them, but it's a difference none-the-less. To cease your efforts would be a detriment to all. It would be a waste. And none of us belong in the wastebasket.

So keep trying. Keep failing if that's what it takes, but know that all failures are still a success of some sort. The only real failure is not trying.

Don't believe me? Ask Michael Jordon: "If you're trying to achieve, there will be roadblocks. I've had them; everybody has had them. But obstacles don't have to stop you. If you run into a wall, don't turn around and give up. Figure out how to climb it, go through it, or work around it."

Good ol' Mr. Jordon also said "I can accept failure, everyone fails at something. But I can't accept not trying."


I think he would know a thing or two about success, eh? 


Or perhaps you would rather take advice from a Pixar character: "“When life gets you down, you know whatcha gotta do? Just keep swimming, just keep swimming, just keep swimming swimming swimming.” (Dory from Finding Nemo)


The bible has something to say about keeping at it too: “And not only that, but we also glory in tribulations, knowing that tribulation produces perseverance; and perseverance, character; and character, hope.” (Romans 5:3-4)

So there you have it. Take it from me, Michael Jordan, Dory, or God-whoever you feel has more credibility. The fact is, we all believe in you. So believe in yourself. And keep swimming!

Depression

I wonder if depression can truly be defined. I know some sufferers describe it as a complete void of emotion, or an emptiness, while others refer to it as a heaviness, a grief, or an unexplained overload of all the worst feelings imaginable. I would have to concur that it feels like all of these rolled into one giant nasty, and yet even that doesn't really touch upon what it's precisely like, does it? I am at a loss as to how best pen the nuts and bolts of depression. Many writers much greater than I can ever aspire to be have taken a stab at it over the centuries.  One of my favorite passages that I have come across regarding depression is from Elizabeth Wurtzel's Prozac Nation:

 “Some catastrophic moments invite clarity, explode in split moments: You smash your hand through a windowpane and then there is blood and shattered glass stained with red all over the place; you fall out a window and break some bones and scrape some skin. Stitches and casts and bandages and antiseptic solve and salve the wounds. But depression is not a sudden disaster. It is more like a cancer: At first its tumorous mass is not even noticeable to the careful eye, and then one day -- wham! -- there is a huge, deadly seven-pound lump lodged in your brain or your stomach or your shoulder blade, and this thing that your own body has produced is actually trying to kill you. Depression is a lot like that: Slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearable. But you won't even notice it coming on, thinking that it is somehow normal, something about getting older, about turning eight or turning twelve or turning fifteen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live.

In my case, I was not frightened in the least bit at the thought that I might live because I was certain, quite certain, that I was already dead. The actual dying part, the withering away of my physical body, was a mere formality. My spirit, my emotional being, whatever you want to call all that inner turmoil that has nothing to do with physical existence, were long gone, dead and gone, and only a mass of the most fucking god-awful excruciating pain like a pair of boiling hot tongs clamped tight around my spine and pressing on all my nerves was left in its wake.

That's the thing I want to make clear about depression: It's got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal -- unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of effect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature's part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

And the scariest part is that if you ask anyone in the throes of depression how he got there, to pin down the turning point, he'll never know. There is a classic moment in The Sun Also Rises when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, 'Gradually and then suddenly.' When someone asks how I lost my mind, that is all I can say too.”

I certainly can't explain it any better than that. I only know when it's here, there is no escaping it. People will say Keep yourself busy. Do something you enjoy. Find a good friend to talk to. But nothing can really make it go away until it has run its course, much like the achings of a flu. The clear liquid friends may make it a little more bearable but they don't hold the answers any more than you do. And I think people who have never experienced depression are the worst individuals you could possibly cling to at a moment like this. They're going to be the ones that tell you about all the things in their life that have made them sad and how they felt better after a cup of hot chocolate. They're going to tell you to get over it. Grin and bear it. Snap out of it. Stop being selfish. But a friend who knows what it's like will understand why you feel so lonely and yet why you want to be alone at the same time. They will know that their silence or a quick "I love you" is all you need to hear. They'll know that holding you while you cry and not asking what the hell is wrong with you for the 12th time, but instead just being there, is a lot more important than trying to understand it. Those friends will know that they can't possibly understand what you are going through any more than you can when they are going through it, because it's different for everybody. I think I usually want to just know there are people who care. I don't want to see them, I don't want to talk to them, I just want to know they care about me and they'll be there when I get better.

Now it's your turn: How do YOU describe depression, and what helps you through it? Discuss below!

I Am Not My Diagnosis

When I think back to my youth, I know the signs were there. While I did not have words like depression and mania in my vocabulary yet, I certainly felt them. I recall sitting in the back of my father's parked truck one day and feeling this overwhelming thing come over me. I was eleven years old, and it felt like a light had went out in my brain. Everything was thick and void and dirty, as if all my innocence and vitality had been sucked out and replaced with musty cotton. I sat there paralyzed in my new rag doll form, unable to cry, to move, to comprehend. I sat there and experienced depression, true depression, for the first time. And that was only the beginning.

By age sixteen, I found myself plummeting into a terrifying hole of despair. I barely spoke to friends. I cared nothing about school work or extracurricular activities. I practically starved myself because I didn't see the point in eating. I went through the motions of every day life in a fog, and I would go home to my dark room, immediately climb into bed, pull the covers over my head, and try to forget I even existed. I rarely slept; instead I would cry until my eyes were too dry to produce tears, and I would have delusions and visions of dead poets who came to visit me in those long, dank hours before dawn. My parents were unaware of the internal war that was going on in their daughter's bedroom. Not a day went by that I didn't think seriously hard about killing myself.

I stayed physically sick a good portion of that year, and it was not long before my primary doctor began asking me questions about depression. He urged my parents to let him try me on an antidepressant, but it was the nineties and recent hype about the dangers of psychiatric drugs had them too worried to give in. The doctor suggested participating in outdoor activities every day to allow for adequate absorption of sunlight, and so my dad began taking me along on his evening strolls. I don't know if it was the exercise and sunlight that did the trick, or just the natural course of the illness, but eventually I climbed out of the awful hole I was in, picked the cotton out of my brain, and tried to remember how to be a live human being again. My parents hoped, as did I, that it was just a teenage phase I had gone through and now that it was over we could get on with our lives.

The next decade of my life would have appeared fairly normal to any outsider. Even my family and closest friends would have been hard pressed to know anything sinister was going on behind my I'm fine facade. Sometimes I really was fine! Other times, I was falling apart at the seams. The old rag doll would come take its place inside me at times, but in between I was having new problems occur. My mind would race, I couldn't sleep, I couldn't concentrate. I would start five different elaborate projects and not finish any of them. I was irritable, restless, and prone to angry outbursts. It caused strain in my marriage, and it made parenting my two young daughters very difficult. In 2006, I was referred by my primary doctor to a mental health facility, and it was there that I was diagnosed with Bipolar Disorder. Upon further analysis, it was determined I had also been a lifelong sufferer of Obsessive-Compulsive Disorder and Social Anxiety. Finally, a name (well, three names) to place on what I had been experiencing for a good portion of my life.

The relief that one feels to have a cause to the effect is often short lived. The spark of hope from my new diagnosis quickly gave way to fear, then dread, then anger and denial. In a way, being diagnosed with a mental illness opens the gate to many of the same stages of grief, as if our old self has died and we must learn to accept the disoriented aftermath. I didn't like being told I was broken, especially when there was no one-step cure. What good was a diagnosis if it wasn't going to fix me? After all, I just wanted to be normal!

For a while I felt like I had a poster stuck to my backside. "Bipolar" it proclaimed in red bold faced letters. My husband was a pastor at a small Baptist church, where the congregation was filled predominantly with older generations who had little faith in modern psychiatry. Any mental malfunction would be quickly chalked up to me straying from the chosen path of God, I presumed, so I decided I would keep my troubles to myself. Only, it wasn't that easy to hide the varying stages of turmoil I was experiencing. I began missing a lot of church services. My absence meant there was no one to teach Sunday School to my class, or to keep nursery, or to shake hands and smile pretty like appropriate pastor's wives do. I would lie in bed those Sunday mornings, long after my husband had left with our girls in tow, and I would sob my eyes out. I was ashamed of myself. I was ashamed of missing church, of letting down my family, of letting down the congregation. I was ashamed of my diagnosis, of being bipolar, of being a complete and utter wreck inside.

Here is the message I want you readers to take from this: We are not our diagnosis. I detest the proclamation of "I'm Bipolar" or hearing someone's quip of "she's so bipolar". No. I'm not Bipolar. I have Bipolar Disorder. There is a difference! This illness affects so much of our lives; in fact, I can't think of a single facet that it does not, sooner or later, affect to some varying degree. But it is important to recognize that we may have a debilitating illness, but that illness does not make up who we are as a whole. Bipolar Disorder is not a death sentence to who we are and what we enjoy. It can certainly get in the way of those things! It's easy to get confused about where the disorder ends and a person begins. When I received my diagnosis, I thought that label described me-all of me! As if it replaced who I had been living as all the years prior, and would determine who I was for the rest of my life.  I believed this, and became ashamed of myself, and instead of reaching out for support, I just burrowed myself into a hole.

It took me a long time to accept the cards I have been dealt. I have an illness, just like cancer or diabetes or lupus, or a million other diseases. The part of my body it attacks is my mind. I did not bring it on myself. It was not a sign of weakness or a falling away from God. It does not make me a bad spouse or a bad mother. I am not broken. I am not my diagnosis.

I have certainly made mistakes. The problem with mental illness is that it alters your ability to reason, to rationalize, and to determine reality from delusions. Decisions end up being made in a rash manner, based on feelings more than common sense. The decisions I have made in states of depression or mania have altered my life forever. Six years ago I left my husband and two young daughters. This is something that, to this day, haunts me on a daily basis, and I know it always will. Looking back, I fully realize I was in a psychotic state and my rationalizations at the time were not sane. At the time, I thought I was doing the right thing, as if the whole universe had opened up to me on some higher level and shown me what I was supposed to do and how it would make my family's life so much better. Crazy. Yeah. I can see that now, but at the time I thought I was doing a super thing. And that breaks my heart.

I still struggle to forgive myself for that era in my life. I have made mistakes since that time, some derived from bipolar symptoms, and some from just regular human error, but none have affected me and my children as much. 

Mistakes will be made. Our emotions will get the best of us, and our reality will be warped at times. It takes a lot of effort and years of learning to recognize triggers and signs of an off-the-deep-end phase, and our disorder will never be completely predictable, or 100% manageable 100% of the time. But we can choose to allow Bipolar Disorder to define us, or we can make a conscious effort to define ourselves. I am Amy. I am a mother. I am a daughter. I am a writer. I am loved by some special people in this world, and I love them with all of my being. I have dreams, and hopes, and aspirations. I have flaws, like impatience, procrastination, and low self-esteem. I have many insecurities. I have regrets. I have hurt, and I have been hurt. I have good days and bad days. I am kind to others, and I have a great deal of compassion. I like to help others. I make my kids laugh. I am a decent cook (most of the time). I am creative and insightful and perceptive.

I will not allow Bipolar Disorder to rob me of my gifts or personality. I will not use it as an excuse to act out or as a means to get what I want from someone. I will not accept defeat when I am at my lowest. I will not lose myself.

I am not my diagnosis.


-Amy Purdy

Breaking Down the Communication Barrier Between Psychiatrists and Patients

“The greatest communication barrier known to man is the lack of the common core of experience "When’s the last time you had a Manic Episode Doctor"?” ~Stanley Victor Paskavich


Perhaps the most frightening truth about doctors is that they are human. That's right, folks; the person sitting comfortably on the other side of the desk in his or her crisp white coat, staring with beady eyes at your apparent wreck of a self, belongs to the same classification of species as you do. Psychiatrists have bad days, marital troubles, ulcers, sleepless nights, bad Chinese for dinner, and fights with their teenage daughters just like the average Joe. They don't always know the answer, or the right thing to say, and sometimes their mind wanders while you are trying oh so hard to find the perfect way to tell them how you really feel deep, deep inside. Trouble is, we look at our doctors like they should know all of this stuff already. They should understand that our past week was spent in a whirling manic blender, spinning so fast that we can't find any sane words to describe it. They should know when we've been so depressed we don't want to exert the effort to breathe, let alone try to piece together an intelligent blow-by-blow account. They should be able to just look at us and know exactly what medication is going to be our own personal one-way ticket back to sanity, minus the grueling side effects, thank you very much. They should know what to do, what to say. That's their job. That's what they went to school for. That Ph. D means they should know and what's more, actually care, right?

I've had the same Psychiatrist for the past five years and I can't stand him, to tell you the truth. He barely speaks English, for one thing, so I can't understand half of what he says, and he appears to have trouble understanding my dialect as well. He never acts like he remembers me from the last visit; in fact, half the time he picks up the wrong chart and asks me if I am still taking a medication that I have never even been prescribed, and he has an annoying habit of asking me each visit how long I have been clean and sober. If he picked the right chart and actually read it, he would realize I have-fortunately!-never had a drug or alcohol problem. And he never smiles. How can you trust someone who never smiles? How do you open up and tell this person what symptoms are really bothering you when you can't even get them to show you their teeth?

Go find another doctor, you say. But this is the only one I can afford, and the only other Psychiatrist at this establishment speaks even less English than my current doctor does, not to mention he is hideous to look at, and permeates a weird rotten fruit scent. 

These are not the only two Psychiatrists I have met with. My first one came across as crazier than I was. Her whole persona screamed mania and disorder, and she asked me directions to the same store every time I saw her. I tried to assume it was a psychiatric test of some sort, but I think she actually wanted to go to that Dollar General very badly. My Obsessive-Compulsive tendencies were thrown into overdrive each time I stepped into her chaotic office; she had gym equipment and smelly sneakers and work out clothes spread haphazardly upon the floor and on any other surface imaginable, except for her desk, which was piled high with messily stacked papers and Diet Coke cans. She urged me to start a work out program to help with my moods, and I would have, only every time I tried to get physical at home I was overcome by the memory of her sweaty shoes and I would have to go lie down from nausea.

I saw another female Psychiatrist in between Smelly Manic Woman and Frowning Clean and Sober Guy, and she was by far the worst. When I tried to explain to her that my current medication was not only failing to tame my symptoms, but was also making me gain five pounds a week and see dead people, she said I would just have to deal with the side effects or not bother coming back. I totally did not go back to see her.

All of these less-than-ideal experiences have made me wonder what it's really like to have a good Psychiatrist. Are there any good ones out there?? If so, why did I get stuck with the bad apples (one fully equipped with the smell)? Ah yes, it's quite possible that the good doctors all flock to the nicer medical office buildings and steer clear of state-funded mental health facilities geared toward lower-income individuals such as myself. What a shame. But hey, you get what you pay for, eh?

A shame, indeed.

I have a feeling that even under the best circumstances, it is still quite a difficult task to communicate with a doctor about the struggles of Bipolar Disorder, or any other mental illness. While I'm sure a few of them may actually suffer from these types of illnesses themselves, I would speculate that the vast majority of Psychiatrists do not have personal experience with it. And anyone with Bipolar Disorder knows firsthand how nearly impossible it is to make a non-sufferer understand what it's truly like. Still, these doctors went into this particular field of medicine for a reason. Hopefully, it was because they have a passion for treating patients. They want to help...we've just gotta help them help us.

So how do we do that? Well, here are a couple of things to keep in mind:

1. Doctors can't read your mind. Yeah, you would think with all the schooling they've went through they would have picked up on that skill somewhere along the way, but that's just not the way it works. This means if you have had a new symptom to crop up, or an old one has resurfaced, your Psychiatrist won't know it unless you tell him.
2. Patients can't remember everything. No matter how good your memory is, or how many times you've went over in your mind what you need to make your Psychiatrist aware of, you are bound to forget a key element of your story in the rush of that 15 minute window of opportunity during your appointment. I have found the most useful tool ever, for both therapy sessions and doctor visits, is to keep a well documented mood journal. Jotting down your daily mood status along with a bit of detail about the day will help you have a better idea of how your illness is really affecting you, and it will alert you to triggers that you may have otherwise missed. Bringing this journal with you to your appointment can act as a checklist for the issues you want to bring to your doctor or therapist's attention. If you have a nervous personality like I do, highlighting certain parts that you want to go over, or even handing the whole thing over to the doctor to read, will ensure that all the bases are covered. The following is an example of the type of mood journal I am referring to, and is an actual excerpt from my own journal:

Amy's Mood Journal for July 1-16, 2006

July 1--good mood

July 2--irritable, yelled and screamed at my family and then had a bad crying fit and felt very suicidal.

July 3--antsy, annoyed, want to do a million things all at once, cynical.

July 4--irritable, paranoid, feel like everyone around me is crazy and stupid. Ended up with a migraine. Couldn’t get any rest or sleep because my mind was racing so badly.

July 5--very irritable, wanted to be left alone but felt very lonely at the same time. Suicidal. Excerpt from my journal doesn't make much sense: “I would rather be depressed than to feel like this. Everything moves too fast and too slow at the same time. It’s all too loud but I can’t hear it. The lights are too bright but I can’t see. Racing thoughts. Heart beating out of my chest. I want to cry but I’m too angry to cry. Too happy to feel happy. There’s no way to explain it. I just want it to stop. I want it to stop no matter what it takes to make it stop. I want it to stop.”

July 6--felt better, calmer, got a lot done. “I’m so happy!”

July 7--very up and down, crying spells in between feeling really good. A little paranoid toward the end of the day

July 8--great mood, got a lot accomplished

July 9--felt really good, then crashed, became depressed and ashamed of myself for being so self-centered.

July 10--irritable, perhaps a little delusional because I kept seeing and hearing things that my husband swore wasn’t there (hearing it pour down rain when it wasn’t raining at all, saw my husband crying with tears running down his face but he said he wasn’t crying, kept thinking I saw someone dart across the room in the corner of my eye but when I looked there was no one there-very creepy feeling). I became hyper and energetic that night and didn’t sleep.

July 11--felt terrific, still hyper and energetic, but began to feel really sped up, frustrated, extremely irritable, wanting to do too many things at one time but I couldn’t concentrate on anything long enough to do it, racing thoughts, constant appetite.

July 12--started out in a mixed elated/sad, uncomfortable, anxious feeling, became a little depressed, in a fog.

July 13--was feeling better, then had a panic attack, then became wired and spent the whole night writing because it was the only thing I could concentrate on doing.

July 14--nerves were completely shot, in a panic, shaking, very agitated, irritable, wanted to hurt somebody, couldn’t concentrate. Late that night I felt suicidal because I couldn’t sleep or calm down. I wanted to die just so I could rest. The whole day and night was like a never ending panic attack.

July 15--tired, wired, and confused

July 16--felt more mellowed out but still anxious.

It also helps to compile a summary from your mood journal:

July 1-16 felt terrible for the most part, not because I was depressed but because I was too happy, sped up, very anxious. Hardly any sleep. Haven’t had more than 6 hours sleep a night in at least 3 weeks, often more like 3 or 4, and that was only after taking Tylenol PM or alcohol to help calm me down. I’m exhausted but I just can’t sleep and when I do go to sleep I have very confusing, vivid dreams so that when I wake up I don’t know what’s real or what was just a dream I had.

Something that seems to be getting worse is that I have these disturbing images of me killing myself. For instance, if I am in the bathtub I get this image of the water being red with blood because I have slit my wrists. If I am driving I imagine myself running off the road on purpose. If I am cutting vegetables I see myself cutting myself and blood going everywhere. These are just a couple of examples, there are many more. While I rarely get to the point that I would actually act on a suicidal impulse, I see these images in my head more and more. I flinch and try to block them out of my head but I can’t seem to make them go away. It bothers me a lot.

See what I mean? Remembering all of those emotions and details off the tip of my head would have been impossible. If I had went in to see the doctor without these notes, I would have most likely mumbled something vague to the effect of "I've just been all over the place with my moods" and that would not have revealed much about the extent of what I was dealing with. With the details laid out before us, though, my doctor was able to piece together that I was graduating into a psychotic episode at the time and needed my medication adjusted.

What if, despite your journal, the doctor just doesn't get it? What if he or she still comes across as stern and apathetic to your concerns? This does not mean you are a lost cause. On the contrary, your doctor is. Okay, no, I take that back! Seriously, though, if you have the option to switch doctors, then do so. It's a gamble; you may end up with someone better, worse, or the same. You won't know until you try. If you are in the same fashion of raft as me, however, and the option to change doctors is void, you may want to consider getting another staff member to converse with him or her on your behalf. Case in point: I discussed my problem with being listened to and understood with my therapist, and she actually arranged to discuss (with my permission, of course) my treatment needs with him. If your therapist cannot or is not willing to take this step for you, ask the front desk what your options are. They may be able to direct you to someone who can help you with breaking down the communication barrier. Persistence is key. Don't give up until you are thoroughly heard by your doctor. Your well being depends on it.

-Amy Purdy