Category Archives: mental health

My Fight with Anxiety

I have been in a constant state of anxiety for several days now.  My heart and thoughts are racing, I’m grinding my teeth, my sleep has been broken, I’m irritable and I can’t stop catastrophizing every situation I think about.  The most worrisome part of my anxiety is that my hallucinations are working overtime.  Not only am I hearing my ‘people’ (voices) again; I am also dealing with moderate visual hallucinations.  All I want to do is escape and find a quiet place where the world can’t touch me and I can curl up in a ball and be left alone.  I don’t want to deal with anything right now and I don’t want to face any of my fears.

The voices I experience have been with me as far back as I can remember.  The best way I can describe them is that one is a male and one is a female and they sit at the base of my brain just waiting to make life difficult for me.  They don’t have faces or anything like that; the way I see them is as silhouetted heads something like this…

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They are always there facing one another but I never see their lips move when they talk however I can always tell whether it’s the male or female communicating with me.  My voices never tell me to harm myself or others or do things that I normally wouldn’t do; they just like to have an input into my thought pattern when I’m stressed, anxious or overwhelmed.  We do have two-way conversations but no one would ever know this just to look at me.  The dialogue only goes on inside my head and my lips only actually move from time to time.  It sounds funny but that’s how our relationship is.  No, I am not psychotic nor do I suffer from any sort of schizophrenia.  I just experience these voices because of my bipolar disorder and my anxiety.

My visual hallucinations are not as significant as my voices.  Basically I see things move and run across the floor or dart across my field of vision.  I see things with my peripheral vision that aren’t there but I still turn to look as though they are as a knee-jerk reaction.  I have trouble with my visions, too, when I’m stressed and overwhelmed or when I’m overstimulated like I tend to be in the grocery store or large department stores.  All the colors and images and different sounds and smells make it a chore for me and it becomes nearly impossible for me to concentrate in this type of environment.

I can start feeling anxious out of the blue, however I have learned over the course of my mental illnesses to identify certain situations that may make me anxious.  I don’t like to be around a large group of people whether I know them or not.  It’s not so much the people but the barrage of images and movements that make me anxious when I’m around a lot of people.  I can also be anxious in a small group of people if I don’t know the people in the group.  Unlike a large group, I can get to a point where I’m relatively OK in a small group once I get to know the other people though I still experience some anxiety.  New situations or how I perceive a new situation might go are two more times when I will experience a lot of anxiety.  I have to use a lot of self-talk when I’m going into a new situation so that I can get to a point where I can still function.  This is a fairly common situation for me seeing as new experiences are a part of daily life but because of this I’m often preoccupied and inside my own head.  I get anxious when I have to make a phone call I’ve never made before, opening new mail, driving to a destination I’ve never been to, watching the news on television and even praying.  I know right; yes, praying can cause me a great deal of anxiety.

It would seem that it would be easy to combat my anxiety if I know when I might be anxious or I can identify it when it comes but it’s not that easy.  Having anxiety and being aware of it doesn’t make it that easy to deal with.  Life would be so sweet if I could just identify the anxiety, label the source of it and then take the necessary steps to make it go away.  NOT!  It doesn’t work anything like that.  For some years I was on Xanax to help combat my anxiety however that was the worst thing that a not medicated, bipolar alcoholic/addict with borderline personality disorder could possibly do.  When I made the serious decision to get sober and deal with my mental illness I had to make the decision to go at my anxiety from a different direction.  Now I use both CBT (Cognitive Behavioral Therapy) and DBT (Dialectical Behavioral Therapy) tools to combat my bouts of anxiety.

The tools that I have been taught are not foolproof however they do help me to get a better hold on my anxiety when it comes.  I still shy away from many people and situations because of my anxiety but, at least now, I know that I can get passed it when I’m ready to.  I say ready because no matter how hard I may try to combat anxiety in any of its many forms, unless I’m ready to face whatever situation is giving me anxiety that anxiety will still be there.  Anxiety keeps me from experiencing many things in life that I’m positive are probably pretty amazing and I want to be a part of any number of them however my battle with anxiety will be ongoing and on my terms.  I just have to be patient with myself and that’s the best I can do.

 

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Running In Place

My bipolar disorder causes me to experience something called racing thoughts.  Actually, racing doesn’t even begin to define what my brain is doing every waking moment of every day of my life.  Even when I say I’m going to lie down for a bit and rest or take a nap my mind is still racing.  I have racing thoughts while I’m showering, while I’m cleaning, when I’m feeding the dogs even when I’m talking on the phone.  My mind and thoughts are always racing and it gets to be pretty damned exhausting.

My racing thoughts make it hard for me to complete tasks despite how sincere my intentions are to finish them.  I can’t even begin to count the number of projects and personal commitments I have on my plate right now that are only half done because of my racing thoughts.  It doesn’t help that there are some things that I must do every day no matter what; record blood glucose readings, record what I eat, complete DBT diary cards, take my medication, I could go on but that’s enough to get an idea of what my day is like and to see how all of this contributes to my racing thought issues.  Just having to do these things daily is enough to send me into a tailspin of racing thoughts and it would seem that this would be enough for me but it never is.  In addition to the things I do daily I am always taking on more and more tasks to do, sadly many of them go unfinished.   Right now I have a half-finished blanket I’ve crocheted, I have my first novel that I started editing sitting unfinished, without finishing my first novel I’ve already started on my second one, I’ve been working on a book of short stories that consists of two undone novellas, and so on and so on.  I really do want to finish all of these things unfortunately my racing thoughts and mind only let me get to a certain point and then it seems that I just run out of steam.

It’s funny; you would think that a racing mind would be conducive to finishing things but, quite the opposite.  My mind races so much and so often that when I try to do something the myriad of musings that bombard me constantly has me throwing up my hands in frustration rather than crossing the finish line over and over on a regular basis.  Sometimes I just sit looking around in a stupor because I don’t know where to begin trying to tame and satisfy the constant buzzing in my brain.  Now everyone gets a little overwhelmed from time to time having things to do but nothing compares to true racing thoughts.  I have even tried using daily planners, hourly planners and setting alarms on my cell phone to try and make some sense and put some order to my racing thoughts but, often, this tends to have the opposite effect.  I get so worked up trying to stay on task or being on edge knowing that one of my many alarms may be going off at any moment that I find myself abandoning one thing after another out of sheer anxiety.  This just makes my racing thoughts move that much faster.

Racing thoughts are frustrating to me because they make me that much more distracted in general.  Already battling against myself to stay focused, racing thoughts make staying on point a Herculean task.  I have a hard time watching a movie or television program, reading, writing, holding a conversation to name only a few things that my racing thoughts interfere with.  Life is hard enough with all that we are told to like, buy, do, see, acquire, listen to and such but pair this with chronic racing thoughts and the world is a rambling chasm of constant overstimulation.  A lot of the time I wish I could just put my hands over my ears and close my eyes and make it all go away, unfortunately that wouldn’t help to calm my racing mind.  I’ve only found a couple of things to help me with this; medication and working on mindfulness.

Since I take medication for my bipolar disorder I already have a tool available to me to help quell my racing mind.  Another tool that I’ve learned I can have at my disposal, if I work at it, is mindfulness.  Mindfulness includes a lot of different things such as meditation, focusing on the moment, experiencing my feelings without judgement and, most importantly, working with one thought at a time.  This is not something that is a quick fix; I have to constantly work on being mindful so that I can gain some sort of control over my racing thoughts.  Under my breath I’m constantly telling myself to focus, sit still, do one thing at a time, finish this first, stop moving around and the list goes on.  At this moment, I’m trying to write, listen to a program on the National Geographic channel, absorb the smell coming from a fragrant candle, get ready for a visit from a longtime friend, drink a cup of hot chocolate and watch the birds eating bread outside my window; all this going on as a result of my racing thoughts.  Needless to say my focus level is on the negative side right now but I’m pushing on ahead like I do all the time.

It has taken me a matter of hours to write a measly thousand words all because of my racing thoughts and what they do to me.  Popping up and down like a jack-in-the-box and moving from one thing to another several times over these few hours has made getting this done pretty hard.  Though my goal the whole time was to complete this I’ve been unable to just sit in one place and work from start to finish.  Now that I can look back and see the progress I’m capable of it lets me see that even with this handicap I’m still quite a peach!

 

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Grateful for Gratitude

A few weeks ago I decided to start a gratitude journal.  Instead of getting caught up in the highs and lows of my bipolar disorder I figured I’d redirect my focus and look at the good things working for me in life.  There was just one problem; I didn’t count on something getting in the way.  That something is borderline personality disorder.

In addition to my bipolar disorder I have a daily struggle to keep myself balanced because of my BPD.   In short, having borderline personality disorder means that I have a hard time living a life of balance.  It is my disorder inside a disorder and it can make life very complicated for me.  BPD is the reason I often overreact to any given situation and have ongoing unhealthy relationships and thought patterns.  I typically only see life in terms of black and white not realizing that life is full of areas of gray.  I tend to fly off the handle at seemingly benign situations and my interactions with people are often based on pure emotion which, in and of itself, is quite detrimental to living life on an even keel.  Borderline personality disorder can also make it hard for me to balance my emotions and react appropriately to them.  For instance, I can get happy about something good happening to me and instead of just being content with the situation; I may go out and spend money that I really can’t spare as a reaction to it.  If something upsets me I may go into a deep depression and start toying with thoughts of self-harm or even suicide.  Often when a relationship is unhealthy or toxic I may still try to keep the relationship going because; in my thought process, some relationship is better than no relationship.

Earlier I said that this is my disorder inside of a disorder; let me explain.  Bipolar disorder is characterized by intense highs and lows, mania and depression, light and dark.  Well borderline personality makes these instances even more intense. I often suffer from extended periods of anxiety and I have trouble with major bouts of low self-esteem and overall self-loathing.  The mania and depression of my bipolar disorder are made more intense as a result of my BPD.  Already being overly stimulated, borderline personality disorder can make me appear like the Incredible Hulk when it comes to emotions.  One minute I’m fine and the next minute, after seeing a disturbing story on the evening news, I’m a wasted pile of tears and despair.  I know, this may sound extreme but that’s the nature of borderline personality disorder.  BPD is a constant struggle to maintain emotional equilibrium and avoid unhealthy situations and relationships.

I say all of this to make the point that starting a gratitude journal was more of a challenge than I ever thought it would be.  Because my view of reality is often skewed, it’s hard for me to be mindful and find things to be grateful for since I’m always in an extreme emotional state.  This being true, I was even more determined to be able to use mindfulness and find things in life to be grateful for no matter how small or mundane.  Even though mentally I tend to be in a state of flux, I have to realize that if I can compose myself and focus I’ll be able to see that there is just plain good in life.  I’ve decided that I will be grateful despite my diagnosis and I’m going to start that journal no matter what.

 

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Back At It

Bipolar disorder can be a bitch, thus the reason I haven’t posted anything to my blog since last July.  I was doing great and the ideas were flowing and I loved seeing the results of my productivity and focus and then, BAM, without warning; nothing.  It was like all the potential and creativity that I had in me just dried up and flew south.  Frustrating does not begin to describe the feeling of sitting down in front of the computer all set to peck out my next great revelation only to find that all the thoughts in my head were a garbled mess of nothingness.  I wanted to write, really I did, but nothing would happen.  I would wake up in the morning with the mindset that today would be the day and, just as quickly as it came; it was gone, back to the endless chasm of emptiness.   I ranted, I screamed, I cried, I did it all from one end of up to the dark side of down but nothing would make the ideas or expression come to fruition before my eyes.  I couldn’t understand what was happening.  I had been on a roll and I was so proud of myself.  I had endless reserves of gumption and I enjoyed what I was doing, I had the upper hand against my mental illness.  I had ‘mastered’ bipolar disorder and I vowed bipolar disorder would never again keep me paralyzed and confused and lost in a sea of uncertainty.  Hell, just looking at my blog I knew that I could beat this beast.  Surprise, surprise I couldn’t have been further from the truth.  That’s not the nature of bipolar disorder and that’s really not the way it works.  Even with all my reading and researching I didn’t want to realize that I would forever battle with bipolar disorder.  For a minute I believed that maybe it had gone away to the furthest recesses of my mind to be stored as an afterthought.  No.  Bipolar disorder will forever be my Achilles heel and I’m going to have to get to a place where I’m OK with that.  Having bipolar disorder doesn’t make me any less of a person than anyone else and the pitfalls that come with it don’t make me a failure.  I just have to work a little bit harder at life than some people and, actually, that’s OK.  That just strengthens my character and enhances my already engaging personality.  All I have to remember is that I have bipolar disorder, it doesn’t have me.

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Mental Illness and Two Types of Therapy

I have been in and out of treatment for my bipolar disorder and substance abuse for nearly fifteen years and I have gained a lot of knowledge about different treatment therapies.  Most recently I have been exposed to two types of therapy that have helped me tremendously. Following is a brief summary of each one of these therapy models.  I encourage further research on both.

The first of these is DBT (Dialectical Behavioral Therapy). DBT was developed by Marsha Linehan to help people suffering severely with BPD (Borderline Personality Disorder). DBT deals with helping to reshape detrimental behaviors that can stand in the way of effectively living with BPD and, over the course of its history; it has been expanded to treat other mental illnesses and recovery from a number of addictions and disorders.

DBT is made up of four specific skill sets being taught that help with the stabilization of extreme moods and addictive behaviors.  These skill sets are mindfulness; being fully present and aware in the moment, distress tolerance; how to tolerate uncomfortable situations without the need to change them, interpersonal effectiveness; how to ask for what you want and learn to say no while maintaining positive relationships and emotion regulation; how to change emotions that need to be changed when you want to change them.

The dialectic module of treatment focuses on self-acceptance but also realizing that some behaviors need to change in order to facilitate mood stabilization and recovery.

The second therapy I have been in is CBT (Cognitive Behavioral Therapy).  This was developed by Dr. Aaron T. Beck and it deals with helping people with depression combat “automatic [negative] thoughts” that can increase this depression.  CBT helps patients to realize that how we see the world will affect how we feel; this, in turn, can increase or decrease depression.  Therapists help patients with anticipated challenging situations that may arise, and they help them to come up with a plan to combat these situations in a positive way.

Of all the different types of therapy and groups I have been a part of I would have to say that these two have been the most beneficial to my current journey towards recovery.  They have also helped me to develop skills that help me to deal with everyday life situations with bipolar disorder.  I highly recommend these therapy models to anyone suffering from mental illness and substance addiction.

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Medication and Mental Illness

To those of you, who have been recently diagnosed with any sort of mental illness, riding the roller coaster of medication regulation; hang in there.  I know how frustrating and nerve wracking it can be those first months trying to find the right medication or combination of medications to get you stabilized.  Let me tell you that, in the beginning, you will most often feel worse before you feel better.  You will feel like giving up and going off your medications altogether; don’t do it.  Finding the right recipe for your illness and circumstances will take time.

I know too well the ups and downs of medication management.  One drug is meant to stabilize your mood and is supposed to make you feel better while causing you to gain ungodly amounts of weight which just makes you feel horrible all over again.  Then there are those medications that zoot you out so much you can barely keep your eyes open causing you to spend hours in bed.  During this time you wonder how in the world these medications can be helping you.  You ask yourself why you even bother to keep up with something that can make you feel so bad.  This is par for the course unfortunately.  Fortunately, the longer you still with the prescribed medications the sooner you’ll start feeling better.

Initially all I had to worry about was finding the right medications for my bipolar disorder but during this time I developed several physical ailments which have made my journey quite challenging.  I suffer from diabetes, diabetic neuropathy, hypertension, hypothyroidism, pernicious anemia, severe acid reflux in addition to my bipolar disorder and anxiety.  I also had a neuroendocrine gastrinoma causing me to need major surgery during which a portion of my stomach and small intestine was removed and now I suffer from major nausea and vomiting at one time or another.  Because of all of this, finding the right combination of mental health medications has been an ongoing battle for me.  Since I have to take medications for what is wrong with me physically there is a delicate balance that must be reached in managing these medications and any medications I take for my bipolar disorder.

To date I have been on all of the following at one time or another; Effexor, Paxil, Zyprexa, Seroquel, Prozac, Latuda, Saboxone, Geodon, Cymbalta, Haldol, Lamictal, Trazadone, Topomax, Risperdal, Invega, Abilify, Saphris, Depakote, Xanax, Buspar, Pristiq and Neurontin (for my mood and pain).  I’m quite sure that this list will change and probably increase as my bipolar disorder and other physical ailments change their faces.  I say this simply to encourage you and let you know that you’re not alone and to appeal to you to stick with your medications.  It may take some time but the right medication or combination of medications is out there for you.  Try to look at the big picture and not get so consumed with how you may be feeling at this moment.   Over time you will find that you are feeling more balanced and you will see the benefit to sticking with your prescribed medication(s).  It may not be easy at times but, trust me, it is worth the fight.

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Finding Myself in A Dual Diagnosis

My life with a dual diagnosis of bipolar disorder and substance abuse is a challenging one but I am glad that I am, again, on the road to recovery.

I can remember, looking back, being a young child exhibiting bipolar characteristics but not being able to verbalize to my mother what was wrong.  I remember getting up in the middle of the night at five years old remaking my bed so that it was neat and orderly then getting back in it in such a way as to maintain perfection.  I remember organizing and reorganizing my toy chest putting toys in complete order then not wanting to pull anything out because it would mess up the order of things.  At any given time I could be found cleaning and creating order around me; I started helping my mother clean the house as early as seven years old.

When I became a teenager my bipolar disorder changed its face and I spent night after night crying, throwing fits in private and engaging in self-mutilation.  I was a latch-key kid so I was home alone for hours before my mother came home from work.  Being alone gave me the chance to totally demolish my bedroom taking my clothes out of drawers and the closet throwing them all around.  I would tear pictures off the walls; break all my fingernails off, engage in cutting myself and screaming at the top of my lungs.  I was able to hide all of this from my mother because I had time to throw a major tantrum then clean up from it before she got home.  My mother was, however, able to see some of my pain because of the numerous occasions when I would just break down into tears in front of her.  I could never really put into words how I was feeling; the closest thing I could think to say was that I was ‘tired’.  Throughout the years my need for order in my surroundings escalated so I did a lot of cleaning late into the nights which, unbeknownst to me, was a sign of the manic side of my bipolar disorder.

In my late teens my mother started taking me to the doctor to try to figure out what was wrong with me.  At that time bipolar disorder was not a common diagnosis so I was simply diagnosed with depression.  I was switched from one antidepressant to another trying to get me well.  At the same time I was diagnosed with pernicious anemia; an inability to process B12 in the body due to a lack of intrinsic factor in the stomach.  Ironically a lack of B12 can cause major disruptions in the nervous system which, in turn, was actually making the undiagnosed bipolar disorder worse.  Over time I was on and off B12 injections.  Eventually I was taken off these injections all together and this just helped my bipolar disorder to quickly progress.  I am currently on a regular schedule of B12.

Another aspect of my life that was a symptom of my undiagnosed bipolar disorder was the fact that, at the age of twelve, I’d started experimenting with drugs and alcohol.  Of course I hid this from my mother for years and years.  Any time I could get a hold of any type of drug or alcohol I did it.  I did this on quite a regular basis well into my teenage years and early twenties.  Before I was old enough to purchase alcohol on my own I had adults who would provide it to me.  As for drugs, I often got them from friends who lived in my neighborhood.  I did drugs and alcohol throughout my high school years and into college.

When I entered college I was very heavy into my addictions.  I had advanced to drinking and getting high every day.  My drink of choice was gin and I would smoke marijuana and snort cocaine every chance I got.  At this point I’d still not been diagnosed with more than depression.  Though I was typically under the influence at all times I was able to get my degree in communications.  During this time being under the influence of drugs and alcohol was my normal and I couldn’t function without them.  For many years after college my drug and alcohol use escalated and I eventually got addicted to pain killers along with the drugs and alcohol I used on a daily basis.  My life continued to spiral out of control for many years until my mother came to visit me.

When my mother came to visit she questioned me about my alcohol use; she was not aware of my addiction to drugs.  At this point I had graduated to drinking a case of beer and a fifth of whiskey a day every day.  Though I was always under the influence of something I managed to maintain my home, handle business and hold down a job.  After questioning me about my habits my mother took it upon herself to get me help for my addictions.  It was at this time, in my early thirties, that my bipolar disorder was finally diagnosed.  Because of my drug and alcohol abuse along with my bipolar disorder I have what is known as a dual diagnosis.

Over the years I have struggled with my bipolar disorder and drug and alcohol abuse on a daily basis.  I have had many periods of sobriety as well as suffering relapse after relapse.  I have been in intensive therapy and I have been on several different depression and bipolar medications.  Currently I am coming up on a year sober and I think that, with the help of my doctor and psychiatrist, I may be onto a promising path of stabilization with my bipolar disorder.  I attend group therapy three days a week and I go to individual therapy at least two to three times a month.  I do get overwhelmed from time to time but I know I have to continue doing what I’m doing if I want to overcome my addictions and my mental health disorder.

This road to recovery is not always easy but I will continue to put in the work so that I can finally find success.  A dual diagnosis is not a diagnosis for failure; life can go on with hard work and dedication.

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