Finding Balance with Bipolar Disorder

Hello my mad lovelies – it has been a very, very long time since I have published anything on here. I find writing while in bipolar remission (that’s my term, not scientific) can be challenging because I struggle to find topics to write about. However, some exciting news for those of you who don’t know – I’m pregnant! I’m currently 6 months pregnant with a little girl and this journey has inspired a litany of topics surrounding mental health, pregnancy and motherhood that I hope to start posting on here more regularly over the next few months.

To get things started again, this is the basis for a talk I gave on September 12, 2019 as part of the Concordia University Centre of Clinical Research’s Lived Experience conversation series.

This was an opportunity for me to share my story with students in the clinical psychology program at Concordia, as well as faculty members and members of the public. I was paired with Concordia psychology faculty member and CCRH core member, Andrew Ryder, who did a Q&A with me and presented a more scientific perspective on bipolar disorder.

Enjoy!

We, as a society, talk a lot about balance. Achieving work-life balance. Eating a balanced diet. Balance seems to be the ultimate wellness goal. Now, I’m about to try and achieve the most difficult balancing act – and honestly, I’ve been told it’s impossible – motherhood and work-life balance! 

But, what does balance mean when you have an illness whose thrust is destabilize you? Is balance even possible and what does it look like?

I have been diagnosed with Bipolar Disorder II. Although there are 4 basic types of Bipolar Disorder, I’m going to break down the two more common ones: Bipolar I & Bipolar II. And I’m sure Professor Ryder can fill in some more technical gaps.

It’s really important for me to explain that Bipolar Disorder has nothing to do with multiple personalities. I’m not two different people. It’s always me, but just more extreme depending on the episode. 

Bipolar Disorder is characterized by extreme moods – highs and lows – that are normally broken down into manic episodes and depressive episodes. The main difference between Bipolar I and II is the severity of the manic episodes. The basic symptoms are: high mood, inflated self-esteem, decreased need for sleep, racing thoughts, “risky behaviour” like excessive drinking, drug use or spending. A full blown manic episode will severely interfere with a person’s life. Some people with Bipolar DIsorder I experience psychosis and hallucinations – this is something that I have never experienced.

As someone with Bipolar II, I experience what is called hypomania which, is essentially a less severe version of a full-blown manic episode. For me, a hypomanic episode causes me to talk really fast, I’m extremely excitable, I become very goal oriented and driven, I’m more more energetic, I sleep less and generally tend to be more extroverted than normal. It’s usually when I commit to a bunch of social events or take on a lot of projects that “balanced me” would recognize as a bad idea and overloading myself.

You’re probably thinking hypomania symptoms sound useful and not terrible, And honestly, you’re not wrong. When I was in graduate school, hypomania served me very well. For a while, I was one of the few students in my class that managed to keep up with readings, got a head start on papers and got my PhD applications in on time. 

But the idea that hypomania is useful is because we live in a culture that praises “busynes.” Being busy is the ultimate achievement of adulthood. If you’re not run ragged, forgetting to eat and pulling all nighters – you aren’t doing enough. We idolize men like Twitter CEO Jack Dorsey who claims that fasting is a way to “hack” the human body. 

Presenting at the CCRH Lived Experience conversation series on September 12, 2019

But the idea that hypomania is useful is because we live in a culture that praises “busynes.” Being busy is the ultimate achievement of adulthood. If you’re not run ragged, forgetting to eat and pulling all nighters – you aren’t doing enough. We idolize men like Twitter CEO Jack Dorsey who claims that fasting is a way to “hack” the human body.

So, the idea that hypomania is a desirable state isn’t unfounded. North American society practically encourages the state. Even when I find myself on the borderline of a hypomanic state I look at my calendar and wonder: “Would this be the worst time for this to happen?”

And then my husband or psychiatrist always reminds me of the depression that is inevitably going to follow. The light and speed of hypomania always ends with a crash. Then I’m drowning in the languid darkness of depression. And for me, these depressive episodes usually span weeks and months. I have had to take extended absences from work. During graduate school, I had to take a semester off which stopped me from graduating on time to attend that PhD program I so desperately wanted to attend during my hypomanic state.

And because we idealize the hypomanic state, whether consciously or subconsciously, we judge the depressed person. What do you mean you can’t summon the energy to brush your teeth? How dare you not make my birthday party? What do you mean you’re too sad to come to work? And I’m not going to lie, most of these questions I have repeatedly asked myself. Berating myself during a depressive episode for not being able to accomplish basic tasks. They are recorded messages being replayed over and over in my brain until I drive myself crazy.

In total I have been through three hospitalizations for depression. I’ve seen more psychiatrists and psychologists than I can keep track of. I’ve taken anti-depressants, sleeping pills, anti-anxiety medications, anti-psychotics and anti-convulsants. I’ve gone through in-patient and out-patient treatment. I’ve hurt myself physically, I’ve hurt others emotionally, and I’ve thought about suicide way too often.

Q&A with Dr. Andrew Ryder of the CCRH and psychology faculty member at Concordia Univeristy

Bipolar Disorder is a chronic illness, but it doesn’t make me any less capable than someone without it. Despite what TV and movies depict, I’m not deranged or dangerous. I just have to navigate my life a little differently, and despite my struggles with my illness, wonderful things have happened in my life. I completed two university degrees. I travelled. I got married. I moved provinces. I got a job I excel in. I have great friends. I became a mental health advocate. And this year, I’m going to be a mom for the first time.

Despite all of the successes and accomplishments of my life, all the things that neurotypical people consider a full life, I still have faced stigma because of Bipolar Disorder. The funny thing is, I’ve rarely encountered stigma from family, friends or colleagues. Of course there’s always the off colour joke, but nothing that I felt was directly targeted at me. I’ve never lost a professional opportunity because of my illness. Stigma has never come from the layperson. The biggest offenders have been mental health professionals, people who should know better.

One psychiatrist told me I was pretending to have a mental illness because he found me too well dressed and clean to be suffering from depression. Another said that my self-harm and suicidal thoughts were just attention-seeking behaviour. Another told me, I didn’t actually have Bipolar Disorder but that my real problem was that I needed to laugh more, have more sex and love my husband.

But, the one that sticks with me the most, is when a psychiatrist told me I shouldn’t ever have children. Obviously, I’ve chosen to ignore that piece of “advice.” This happened at my first consultation with this doctor and I had no idea it would be one of the worst visits of my life. We went through the retelling of my mental health history, he took notes and when I was fishing for a tissue he asked suddenly: “Are you thinking of becoming pregnant?”

At the time, I hadn’t thought about it much. I was in my mid-twenties and felt like I had a ton of time to make that decision. He ran through the risks to a fetus on my current medication regimen. And then he laid the low blow, “Do you know that your disease is genetic? Your child could be like you.”

His words knocked the wind out of me. I don’t really remember what happened after that. I just know I left his office in tears.

It took me years to get over what he said and even though I’m pregnant now, I still wonder: how will I feel if my daughter is diagnosed with bipolar disorder? I wouldn’t wish the disease on her, but my life isn’t horrible.

Despite the issues I’ve had with psychiatrists and after years of trial and error, I have found an amazingly compassionate psychiatrist who, when I was ready, helped me achieve my goal of becoming a mother. But like I said earlier, having Bipolar Disorder means navigating life a little differently. Due to my age and marital status, my current psychiatrist reminded me that if I ever decided to get pregnant he’d need 9 months to a year to change my medications to ensure they were safe to a fetus.

When I asked him: “Is it even a good idea for me to be pregnant having bipolar disorder?”

He just laughed and said, “I could run a daycare as a side business from all my bipolar patients with babies.”

Getting pregnant took time, patience and planning. My psychiatrist warned against unplanned pregnancies because of the risk to the fetus, but he also acknowledged, sometimes it happens and not to panic. Working with him for the past 4 years, I feel like I have made the most progress in managing my illness and it’s mainly because I’m working with someone I trust.

So, I come back to my original question, is balance possible with bipolar disorder? Honestly, I’m skeptical. But, to be fair, I’m skeptical of the whole concept of balance regardless if you have a mental illness or are neurotypical. I think life is all about give and take. Sometimes certain areas of your life require more energy and other things are going to suffer.

The reality is, my psychiatrist put me on preventative leave from my job 2 weeks ago. The stress of being pregnant, other life circumstances, coupled with regular work stress were putting me into a precarious position. I had no desire to become unpregnant and the anxiety of being a first time mom wasn’t going to go away. So, the only thing we could cut out was work. And as someone who is extremely dedicated to my job, type-A, perfectionist – this was a struggle. I suffered for almost 2 months before I agreed to go on leave.

The lesson here is that at the end of the day, for me balance is unachieveable. But, I can set boundaries that help better filter my energy. That does mean saying no to opportunities even if they seem like one in a million, taking a mental health day or leave of absence from work. These boundaries help maintain my mental health and allow me to live a life that I’m happy with.

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We need to stop calling Donald Trump mentally ill

On Friday night, I was watching Real Time with Bill Maher and the panel discussion inevitably went to the subject of Donald Trump. For those of you living under a rock, Donald Trump is the Republican nominee for President. His campaign has been filled with so many gaffs that it’s no longer funny to make fun of him. It’s a frightening reality that he could potentially be the next President of the United States.

So as Bill Maher’s panel, featuring Rob Reiner, went in to discuss this particularly ridiculous week in Trump’s campaign, I settled in for a few laughs (because if we don’t laugh, we might have to cry over this new reality). So here I was, all ready to laugh, when Rob Reiner exclaimed: “He’s mentally ill!” Reiner repeatedly and emphatically called Donald Trump mentally ill. Maher went one step further and joked: “This is the first Presidential candidate that has been nominated from the loony bin.”

Trump

In terms of discussing Donald Trump, this isn’t anything new. Actually, at least Reiner and Maher were joking. There’s been rampant speculation in the media on whether or not Trump has Narcissistic Personality Disorder or if he’s a sociopath. Headlines talking about Trump often have the words “crazy” and “insane” in them. Additionally, California Democratic Representative, Karen Bass, actually launched a Change.org petition calling for mental health professionals to demand that the GOP evaluate Trump’s mental health. This launched the #DiagnoseTrump hashtag, which quickly started trending.

MarilynNow, I’ll be the last person to rush to Trump’s defense. I find him a reprehensible individual. His policies are a joke. His xenophobia, racism, bigotry, and misogyny are frightening. I’m also not necessarily ruling out the fact that he might be suffering from some sort of personality disorder either. But we need to stop the arm chair diagnosing and stop calling him mentally ill in the media.

When we equate a person like Trump with mental illness we’re creating a false equivalency. We’re saying that Trump’s vile actions and words is what mental illness looks like, which is patently untrue. Those of us who suffer from a mental illness are generally kind, compassionate, and sensitive people and to be lumped in with a disgusting person like Trump is unfair. His behaviour and ideologies are embedded in xenophobia, racism, bigotry, and misogyny and not in some underlying mental illness.

Calling Trump mentally ill also further stigmatizes an already marginalized group of people. People living with a mental illness often live in secret because they’re afraid of what coming forward about their illness might mean for their relationships and careers. Equating mental illness with Donald Trump further perpetuates the idea that mental illness is something “bad” or negative and should be hidden. This may stop people from seeking help they desperately need because they don’t want to be associated in the same category as Trump.

Finally, by calling Donald Trump mentally ill as a means of explaining why he’s unfit for the presidency we’re suggesting that a mental illness makes people ill-equipped for leadership positions in general. Now, I’m not saying Trump isn’t unfit for the presidency. That’s not up for debate in my opinion. He is. But it’s not because he has a mental illness. The reality is that people who suffer from a mental illness are no less capable than people without a mental illness. Just because you have bipolar disorder doesn’t mean you can’t become the CEO of a company. Your depression won’t stop you from becoming a doctor. Your anxiety won’t stop you from being a teacher. If you have a mental illness you should still be able to be the damn President of the United States. We need to stop equating mental illness with incompetency.

So, once and for all, can we stop calling Donald Trump mentally ill?

Back-to-work anxieties

I’m going back to work.

Starting the week of July 25th I will be re-entering the workforce for the first time in over a year. I’m going back to work. The words fill me with excitement and anxiety. I’m excited about feeling like a contributing member of society again. I’m excited about having something that gives me purpose. But I’m also anxious.

What if work doesn’t want me? What if my boss thinks I’m a liability? What if my coworkers think I’ve been faking it? What will it be like walking into the office again after all of this time? Will everyone stare? Will they ask me how I am? Do they even care? What if they try to fire me? What if they like my replacement more than me? What if there’s no longer any place for me there? They’ve done so well without me for over a year.

These are the (irrational) thoughts that are cycling through my brain. I try and remind myself that there are policies in place that protect me from being fired due to illness. I try and remind myself that my boss is a kind and caring individual. I try and remind myself that colleagues are probably too focused on their own lives to even think about me. I try and remind myself that people are generally kind and will have more concern for my well-being than being cruel.

Anxiety

Unfortunately this doesn’t stop the anxiety from creeping up. I’ll be watching TV or riding my bike and suddenly my chest tightens, my throat constricts, and my arms tingle. And yes, I’ve tried talking about my fears with various people. I tried talking it out with my therapist who simply told me, “These aren’t productive thoughts to have.” Like, oh shit, I’m so fucking enlightened now. My husband reminds me of the rational counterpoints to my irrational fears. And although I appreciate it, it still doesn’t stop the thoughts from coming back. My friends, who are also colleagues, remind me of the kindness and understanding that people can have towards those of us who suffer from a mental illness. But these aren’t the people I’m worried about. These are the people who know me and my illness. I’m worried about the people who don’t.

And these are just the tip of the ice berg of fears that I have about going back to work. There’s also the thoughts that are about my recovery and my mental health. What if I’m not ready? What if I fail? What if I go back only to relapse all over again? I don’t think I could take such a huge set back. It’s only been five months since I was hospitalized because of my depression. Only fives months ago I was seriously thinking about suicide. Only five months ago I had thoughts of self-harm.

Then I have to stop and remind myself that that was five months ago. That was then, this is now. I remind myself that my psychiatrist, who helped me through that depression, thinks I’m ready.

I feel ready.

lets do thisI’ve been stable for three months. My medication is working. I sleep well. I’m working out. I’m socializing. I’m cooking and eating like a normal person. I’m happy and healthy.

I know my anxieties about returning to work won’t go away. Actually, I expect them to increase incrementally as my start date approaches. Despite all of this there’s one major shift that has happened over the past year that I know will ensure that my return-to-work is successful.

I’ve acknowledged that my mental health has to be a priority.

Bipolar disorder isn’t something that I can ignore and expect to be healthy. My mental health is something that I need to work at everyday. I need to find productive ways to manage my stress, like working out and asking for help when I need it. I need to make sure I’m eating well. I need to make sure I’m sleeping well. I need to make sure I’m making time for fun and not working all of the time.

If I can manage all of this, despite my anxieties about returning, I know I can make my return to work successful. So wish me luck!

I’m not fucking crazy

Language is a powerful tool. It has the ability to rouse people into a frenzy. It can inspire people to create. It can touch people’s souls. But sometimes, language has the ability to hurt. The old adage goes: “sticks and stones can break my bones, but words can never hurt me.” Well in my experience that just isn’t true. Words can cut to the bone. And sometimes it’s the most benign situations that can incite the most hurt.

I was in a situation recently where someone said some careless things. The conversation revolved around a new mental health and addiction facility that was being built. The facility was across the street from this person’s home. That’s when the word crazy was thrown around. Someone said:

“You’re going to have all of those crazies in your backyard now.”

I sat there, shifting in my seat uncomfortably, as their words sunk in. In this person’s mind, people who access services offered by a mental health and addiction facility were crazy. This means, as someone who routinely accesses mental health services, I am crazy.

Fuck you

I’m not fucking crazy.

I have a mental illness.

People who access mental health services are not fucking crazy. They have a disease that is no different than having cancer or diabetes. Why is it okay to throw around the word crazy like it’s no big fucking deal?

Stop talkingNow, I’m not suggesting this particular individual had any ill intention behind their word choice. It was a casual remark, made in jest. Had they known about my situation, maybe they wouldn’t have made the remark. But that’s sort of the point. We shouldn’t only care about the language that we use when we personally know someone who may be hurt or offended by our words. We should be consciously choosing our words to ensure that no one is hurt or offended by them — whether we know their situation or not.

Now you may be thinking that I’m being oversensitive and should learn to take a joke. But the truth is, using words like crazy, lunatic, or psycho stigmatizes a group of people who were among the unlucky that got stuck with a disease. Using words like crazy can prevent people from seeking help because they’re afraid of being called crazy. Or, they may already think they’re crazy because of the stigma associated with having a mental illness. The fact that people can laugh so easily when the word crazy is thrown around to describe people with serious mental health issues illustrates the pervasive stigma that is associated with having a mental illness. You wouldn’t make fun of a person who had diabetes, cancer, or any other illness. So why is it okay to make fun of people who suffer from a mental illness?

Over time there have been many words that we no longer use because they’re offensive or derogatory to a group of people. I think it’s high time we retired the word crazy when talking about people who suffer from a mental illness. The reality is mental health problems are pervasive. Every Canadian will be touched by mental illness through a family member, friend, or colleague. 1 in 5 Canadians will suffer from some form of mental illness or addiction in their lifetime. So the next time you’re thinking about calling someone a lunatic, psycho, or crazy take a moment to reflect on who you’re with and that it’s very likely that someone in the room suffers from a mental illness. You wouldn’t call your friend with depression crazy, would you?

Can we stop blaming mass shootings on mental illness?

On Sunday, June 12 a gunman killed 49 people at a gay nightclub, Pulse, in Orlando, Florida. It’s being called the worst mass shooting in U.S. history. The perpetrator has been identified as Omar Mateen. In an attempt to explain this tragedy, reports have said that he had ties to ISIS.

Eye rollBut it never stops there. It was inevitable. Reports started coming out that Omar Mateen was bipolar and “mentally unstable.” Of course. Of course he is. It’s bad enough that a mass shooting happens on a semi-regular basis in the U.S., but it’s even worse when every single one of them are attributed to some form of mental illness. He was Schizophrenic. Bipolar. Depressed.

Well, I’m really tired of being lumped in with people who commit atrocious acts. I have bipolar disorder and I have never taken a gun and gone on a shooting rampage. In my worst mania or depression, I have never even had a violent thought. And then there are these comments: “Of course he had a mental illness. You need to be crazy to do what he did.” Well, I’m also really fucking tired of people equating the word crazy with having a serious mental illness. We’re not fucking crazy, we’re sick.

Let’s go over the facts about mental illness, violence, and more specifically, gun violence. First, experts have reported that “people with a mental illness like schizophrenia or severe depression are no more likely to commit gun violence than anyone else.” Second, people with a mental illness are no more violent than anyone else. Third, a person with a mental illness is actually more likely to be a victim of violence rather than a perpetrator of it. You heard that right. A VICTIM OF VIOLENCE.

The media often portrays those of us suffering from a mental illness as dangerous or scary and when reports allege that a shooter was bipolar, or more commonly, schizophrenic, we start to equate these illnesses with violence. This in turn furthers the stigma about people with a mental illness. The underlying message is that a psychotic break makes someone go on a shooting rampage. But, violence and psychosis, hallucinations, or paranoia don’t go hand in hand. Someone who is receiving effective treatment for their disorder is no more prone to violence than anyone else.

Over it.gifSo can we just stop blaming mental illness on mass shootings already? Mass shootings are a complex subject. The truth is, we’re too quick to jump on the “of course he was crazy” bandwagon. Instead why don’t we talk about how issues like misogyny, bigotry, and radical religious beliefs (Christian or Islamic) are often at the root of these mass shootings? Because it’s just easier to say that “he was crazy” and continue on with your day.

I didn’t want to write this piece because I was afraid of co-opting a tragedy from a community that is still in grief. But, the reality is, LGBTQ youth are 4 times more likely to attempt suicide than their heterosexual peers. LGBTQ people are at a greater risk of having mental health problems than the general population. So, blaming this shooting, or any other, on mental illness further stigmatizes an already marginalized community and I think that’s worth talking about.