Present Day, July 12th, 2017

Quality of life.

An improved quality of life.

Sitting in my therapist office, reflecting on his traditional opening question (“So, what are we going to talk about today?”), I found myself giving that answer. Because that is what I had reflected on recently. That is what my mind had been on during the drive over. That was what I had come to believe needed to be a significant goal for me going forward.

As the one year anniversary of my hospitalization (and subsequent release) approaches, I have been faced with the reality of having survived the breakdown. Since the first week of September last year, I have avoided any episodes along the lines or magnitude of that horrific week. It has not been easy. At times, harder than hell. But I have managed. I have given intense focus to the big three (Sleep, Therapy, Medications), and have tried to consider most other things the minors to those majors. I have attempted to reward myself more, punish myself less, recognize small accomplishments, and let other takers be my worst enemy rather than fulfilling that role myself. But that all has left me with the question, “Now what?”

That is what has been stuck in my craw (because in Kentucky, we use phrases like that). Now what? Or, put another way. Possibly a more negative way. The question might go like this: “Is this really as good as it gets?” Is this the way I need to anticipate living the rest of my life? Is this the best I can do? This combination of drugs providing this baseline of emotions just this side of depression. This cycle of sleep merging nights and naps and zombie like periods of awake. This week after week battle to get out of bed and knock another seven days off the calendar.Having survived the big scare, it seems logical that my attention might shift to the year after. And dare I venture to let my mind explore the possibility not merely of having survived, but now attempting to find a way to thrive.

Having survived the big scare, it seems logical that my attention might shift to the year after. And dare I venture to let my mind explore the possibility not merely of having survived, but now attempting to find a way to thrive.

I have set some goals as to what this might look like. First, I have more than five months left in the insurance year with my out-of-pocket limit reached. Therefore, I will be meeting with my medications coordinator next Tuesday and asking her if we might experiment a bit. Venture away from the only cocktail I have utilized since leaving the hospital in an effort to find something that leaves me a little less comatose. A little less down. A little less fat!

Second, the employment situation simply does not seem sustainable for the long haul of my life. The doctors in Chicago didn’t think it was. The team at home seems to question whether it is. My own physical and mental stability seems to doubt it. Granted, for us bipolar, few employment situations seem sustainable for the long haul, but I do think there are three standards I can improve on: a) a later wake-up time than 3 a.m., b) weekends off, and c) the ability to accrue some paid time off (i.e. vacation). Seems reasonable, right? In four more weeks, I will have two children living out-of-state, and I need the opportunity to visit them. This job simply does not afford that. Financially, or time wise.

Finally, and this one is so hard, I have to lose some weight. I’m up 20 lbs since leaving the hospital…as the staff there suggested it would be easy to be. I’m up 30 lbs since losing almost 50 roughly three years ago. It takes a toll on me physically, emotionally, and motivationally. So as much as I disdain working out and dieting…I have to lose weight if I want to improve my quality of life.

For much of this, I have less idea of how to make it happen than I do the need for it to happen. But this is the next year before me. A year of quality of life. A year of improved quality of life. As long as I’m going to stick around, seems like I might as well enjoy doing so.

 

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.