Present Day, October 8, 2017

There are a lot of things that have headed in the right direction for my life over the past 90 days blogging hiatus. Including the avoidance of some pretty significant pitfalls and traps. I have come through all of them relatively unscathed. However, one area has not gone so well. In fact, it has gone down right horribly. My weight.

10 pounds in 90 days. 20 pounds in 9 months. 30 pounds since being placed on medications and being released from the hospital in September of 2016.

This would come as no surprise to any educated psychiatric provider. In fact, I was warned of it during my last psych review at the hospital. Even warned it would amount to 20 to 30 pounds on average. Guess they called that one.

It is one of the catch 22s of bipolar medications. Feeling depressed? Don’t worry, your meds will help you feel groggy and lethargic. Bad self-image? Don’t sweat it, your meds will help you put on weight and feel even less good about yourself. Uncertainty an issue? No biggie, your meds will leave you trembling and nauseous. In other words, the stuff you need to help you can just as easily hurt you. Or best case scenario, greatly frustrate you.

In the case of my weight, other frustrations are at work. I made a commitment roughly three weeks ago to begin exercising on a regular basis. According to my Fitbit, have managed to log a decent workout 17 of the last 20 days. That’s pretty damn good. But the weight keeps climbing.

I downloaded “My Fitness Pal” to my phone and began counting calories. This was about 10 pounds ago. Back when I thought to be 20 up was enough and it was time to turn the tide. Granted, I have been far from legalistic with it, but I have paid attention which is more than I had done. But the weight keeps climbing.

I had to go through the degraded process last week of updated the wardrobe. Maybe you have been there. The waist gets too tight, and to avoid complete discomfort, it becomes necessary to hit the Goodwills and upsize a bit. Goodwills rather than new retail because you are convincing yourself that this is not going to be a permanent change. The weight will come back off. You’ll figure this out. But in the back of your head, you are wondering if that is true. You are wondering if this is even where it stops.

I am within five pounds of my all-time high. That weight was not medication driven. Just too much time not taking care of myself while sitting at a desk. One morning while going through the struggle of tying my shoes I decided enough was enough. The journey began, and over the next few months (I can’t really remember how long) I dropped just short of 50 pounds. And most of them stayed off until being hospitalized last fall. Now they are almost all back, and I have to try again.

I recently received blood work back from an annual physical. I am pre-diabetic. My kidney function has dropped (maybe related to the massive stone and surgery earlier this year…maybe not). My bad cholesterol (at least, I think it is the bad one) is up a bit. There are plenty of reasons to drop some weight. And tomorrow I will start the journey again.

Maybe past success will provide hope for the future path. One thing is for sure, of all the things that are on my side…the medications are not on the list.

Present Day, February 26th, 2017

The Big Three: Medications. Sleep. Therapy.

I have heard it time and time again. These are not the ONLY secrets to managing Bipolar or just about any other mental illness. However, they are three CRITICAL ones. In other words, do these three things right…and you are heading down a good path. Neglect them…and just about all other efforts will not likely make up the difference.

There is a catch tough. Probably more than one. But the one I am thinking of today is that they each carry a degree of humiliation to them.

Medications? I take a disgusting amount of pills every day, am practically a zombie by 10 p.m. at night, and live my life in the position of having to be held accountable to the periodical question “Have you taken your meds?”

Sleep? I take naps like a toddler. I wear a Fitbit to make sure I average out the necessary amount to keep my sanity somewhat in check. Like a teenager with an early curfew, I rarely get to “stay up late” and often pay a price if I do.

Even therapy has its humiliation. And I am not even talking about the phrases that exist in my life referring to having my own personal “therapist” or having to get to a “doctor appointment” every other week or sharing how “therapy went today.”

I am talking about the cold realities that therapy can put you through during the best of times. Because it is a reminder. Sometimes a slap in the face, that I am fucked up between the ears, as well as somewhere extending down into my heart (or soul, or wherever you ascribe as the seat of our feelings).

That was especially the case this past week. My wife joins me for therapy roughly once a quarter. It is a chance to make sure everyone is on the same page, and for my therapist (who…let me be clear, I greatly appreciate and enjoy meeting with) to see if there are any hidden issues that should be addressed. This time around I knew we would be addressing the management and handling of my next crisis experience. That’s right, no matter how good I was going to be feeling walking into those doors, we were going to address the when…not the if…of me losing my shit again. Because we all know I will.

As is often the case, following the session my wife and I grabbed an early dinner. A chance to debrief. To unwind from the tension the session can create.

By that point, I had entered a rather sober, somewhat discouraged place. We had just spent an hour talking about how my keys would be taken from me and locked in a safe that I didn’t have the combination to in order to ensure that I didn’t run away or park my truck in the garage with the door closed and a hose in the window. We had talked about whether I had the ability to load any of the antique guns in the house and blow my own brains out. We had talked about how I was allowed to sequester myself in the bedroom, but if I walked out the door my wife would have an acceptable authority to call the police and notify them that I was a danger to myself…and possibly others.

I’m pretty sure that you aren’t normal (and truly are insane) if that type of a conversation doesn’t sober you up a bit. Was it necessary? You bet. But so is sleep and medication. Doesn’t keep any of them from being at least somewhat humiliating.

Present Day, February 8th, 2017

I need him to like me best. Not want. Not wish. Need.

No amount of study regarding rational emotions. No therapy. No medication. It does not appear that anything will change that. And that isn’t even the worst part.

He is a cat. A type of animal I have distained all my life and vowed never to share a domicile with. He’s not even my cat. My wife’s Valentine’s Day gift cat. And it gets even worse.

The moment prompting this reflection involved an elementary school age daughter. It appears that during the previous night when I was thoroughly drugged and thought the loyal feline was by my side, he had ventured to her room. Spent some time with her. Checked out some of the other relational options in the house.

Nope. We aren’t there yet. But we are getting closer. This  information saddened me. Then it frustrated me. Then…wait for it…it angered me. All within a rapidly escalatory matter of moments. So I attempted to come to the rescue of my absurd emotions.

“Well, you might have to start closing your door when you go to bed. We can’t have him waking you up on school nights.”

If you think this sounds like ridiculously childish behavior for a grown man, you’re right. It is. And now we have arrived.

Upon reflecting on these emotions for this cat and the subsequent interaction with my daughter, the internal humiliation begins. The loathing. The anger. The self-hatred.

It is a life cycle for myself. For thousands of us with Bipolar. For millions of us with a mental illness. We experience immature, over reaching, inappropriate emotions for a given situation. All of our therapy and treatment goes out the window as onlookers think we should just “grow up” or “get over” ourselves. Then, later, we do. And the knife cuts very deep. The knife of misunderstanding of what drove our motives. The knife of embarrassment. The knife of shame.

This time I started to binge eat. Some pretzels. A peanut butter and jelly roll-up. A Ding Dong. Child food for the grown man who had behaved like a child. And with each bite, I had another reason to hate himself.

Saturday, August 27th, 6 a.m.

I awoke fairly restless. Unlike the day of my capture (okay…”taken into protective custody”), the night before was the first I had been provided with medication. Not sure how that got missed on the day of my intake, but it did. I’ll let it slide, as that was literally about the only negative thing I could ever come up with for the mental health team at Northwestern Memorial Hospital.

However, last night I was medicated. Which means that for the first time in many days, to some extent weeks, I had a fairly quality night of sleep. Which also means that my mind was clearing, my emotions were coming into balance, and I was starting to feel normal. At least, as normal as a 47-year-old, married, father of five can feel in a psych ward multiple states and hundreds of miles from home. Which also means one more thing…I was doing what I have always done in the past…shifting my focus from the fact that I am significantly fucked up to all the other problems outside these walls that are in need of my attention. Like, now!

Here’s the thing (or at least one of them): if you are never willing to stop and look at what is broken on the inside, then you tend to get angry at anything getting in the way of your trying to fix what is broken on the outside. (I know I’m in no position to offer advice, but read that sentence again. Trust me on this one.)

Almost a week from now a psychologist will sit down with some test results and ask me to reflect on the following: “Tell me a time when you weren’t angry.” After a rather significant, long, and awkwardly silent pause I will end up saying, “Actually, I can’t remember a time when I wasn’t angry.”

Back to that early Saturday morning. This also was not such a time.

Now that I had survived my period of suicidal angst. Now that I felt ready to be trusted to return home (though it was probably a 50/50 toss-up as to whether I really would have). Now that my mind was clear and my emotions stabilized (as would only be perceived to be so by myself and no trained professional). Now that I had managed to fully immerse myself in the denial of my situation, it was time to move to anger and get down right pissed.

I have committed no crime. I have threatened no one. I’m not walking around screaming profanities to unseen ghosts in the halls of this psych ward. And forget the negatives. What about the positives? I own my own business (at least, I thought at that point that I still might). I have a masters degree. Property. Financial holdings.

What the hell am I doing sitting in this sterile room, on this plastic mattress, without so much as a shoestring or hoodie drawstring to even think about harming myself with? What am I doing in Chicago, Illinois on this late summer day?

My blood began to boil. My rage began to burn. And then it struck me, that will never work. No one will ever believe I am okay behaving like that.

Knowing that a nurse would be around at any moment to take my blood pressure and vitals, ask me how I slept and check in on my overall mood…I took a few deep breaths. It was time to do what I have always done in public throughout these many years of internal struggle and done quite well.

It was time to push that Bipolar self deep down where no one could see it. It was time to put on my game face. It was showtime…

Saturday, August 27th (Hospitalization Day 3)

Typically I prefer to refrain from all-inclusive terminology: every, none, always, never, everyone, no one…you get the idea. I’ll stick to my leaning in that regard while suggesting that it might work in this particular instance.

When it comes to individuals with certain mental illnesses, such as Bipolar II in my case, most of us of a fairly reliable list of warning signs that things are about to go really bad. In fact, to take it a step further, the list is usually not even a short one.

Which means that as I entered my third day of hospitalization it was no surprise to begin reflecting on what went wrong, how it might have been avoided, and discover a rather lengthy list. It flowed easily, and for each item on the list…there were plenty of warnings!

warning-signs

I have been told the “Big Three” for Bipolar are Medications, Therapy, and Sleep. Well, since I was not on any medication, or in any therapy (yeah, I know) that only left sleep or it was three strikes and I’m out.

For me, seven hours a night will generally cut it. An average of seven and a half is better, and under seven…things are probably going to get a bit dicey. Quickly. Especially over any extended period of time.

I wear a FitBit to try and keep me honest and make sure I’m somewhere close to on track. And I wasn’t. Over the previous month just under seven hours had slid. First to six-and-a-half hours. Then to six, but that was largely due to five-hour nights getting supplemented with 60 to 90-minute naps. By the week before my hospitalization, I was pushing almost five days at right around four-and-a-half–hours a day…total.

One of the reasons sleep makes the Big 3 is due to the chain reactions created by a lack of it. For me, headaches ensue. My temper shortens. My hands start to shake. Under stress, I’ll experience chest pains and shortness of breath (fairly alarming for a man who survived a heart attack back in early 2015). Nothing in life seems to bring pleasure or fulfillment. And all while the mind is racing, thoughts are spiraling out of control, and hope of things feeling normal is plummeting.

Let’s face it, no one likes to be tired. I get that. People with mental illness are not special in that regard. Here seems to be the difference as I have experienced it. Without the illness, finding a way to catch up (sleeping in on the weekend, taking a nap, going to bed early, etc.) can get you back on track pretty quickly. With the illness, in a very short period of time, everything can start misfiring to where lack of sleep isn’t even recognized as the problem. Even if you do see it and find extra time in bed, lethargy sets in with its best friend depression. Life falls into a quicksand. Sleep wise you feel damned if you do and damned if you don’t.

All the while our world’s shift. Rationality disappears. Very smart people can begin to lose their grip on very rational, even simple solutions to what is taking place. And the ability to write…to process…to even come up with the list I sat down and wrote above seems so very far away.