Cognitive Behavioral Therapy
Wednesday, December 2, 2009
Sleeping through the night has become a bit problematic for me. I find myself deep in thinking and having hang-ups on certain portions of my life. My mind makes certain assumptions which leads to panic. When I was first diagnosed, my beginning psychotherapy included cognitive behavioral therapy to help me get a grasp on my thoughts. Cognitive behavioral therapy (CBT) works for thoughts not caused by external sources. I get these ideas which have the capability to freak me out, from nowhere but my own mind. For example, today I start thinking my life will never change. My thinking went something like this: “I will always get depressed during the holidays and dread them like a case of the flu. Misery will accompany me and there is a probability I may never feel happy for any extended period of time.” Left untouched this thinking becomes a part of my belief system. It spirals me through the panic, anxiety, mania, depression cycle. My first therapist helped me to change my thinking: even if my current situation never changed. The CBT involved work. I had to work at changing the negative thoughts. I am not and never will be one of those who believe in the so called “power of positive thinking.” The change I used, stemmed from reality to reality in a continual process. Here’s how I learned to deal with some of my thoughts, like, “You should be ashamed of what you came from. Even if you did not do the things your family members did, you are still a part of the most awful people in the world.” “You are disgusting.” I would feel those lousy feelings then tell myself “I can’t control what my family did.” “Their behavior was disgusting, but I was not a part of that.” “The truth is I am in control of my now and my future.” “My history will always be painful, but it is does not determine my future.” I mentally separate myself from the behaviors of others and the feelings they open up. It leads me out of the shame. With the panic attacks, I could tell myself, “This is scary. I am so frightened. It will not last forever. Very soon the feelings will go away and I will feel calm.” It would not take the attack away. but it helped me through it.
My best work was done through accountability. I selected friends to help me during the tough times. They would tell me to “stop!” I would then begin to tell myself to “stop!” If I had to say it out loud I would. Writing was another way to work through the thinking. I would allow myself a rant in my journal. I would re-read and write in the margins the truth. Sometimes I did not do it right away. I wallowed in my feelings for a time. Othertimes, I could quickly relieve the feelings with better thought choices. It was work and it got easier. I have gotten away from the behavior management. My current therapists uses more “talk therapy” she leads me to come around to the answers I need on my own. It has been what I have needed. Now, I can add some behavior modifications and get some better results.
You, know I may never know true joy, true happiness, and true love. My life doesn’t have to be empty and I can navigate it to calmness and peace. See? I am aware and slowly I can get there.
Chances
Wednesday, November 25, 2009
When my mom was given the diagnosis of cancer, it had spread and her health sped to a downward fall. As the doctors explained the situation, I knew by their faces her prognosis was grim. I asked, “What are her chances?” The oncologist replied, “There aren’t any, she will die and soon.” Two weeks later she was gone.
A year later, my dad was arrested stemming from what would be a chronic ongoing battle of addiction. The admission of it revealed years of a hidden war with himself and mistakes beyond repair. I asked his therapist, “What is the chance he will relapse?” I think I knew relapse was inevitable, I wanted to here the percentages. For some reason, I needed to hang on the 60% chance he wouldn’t return to the addiction that had destroyed his life and most of mine.
Then along came Bipolar. I was diagnosed while my dad was in jail serving out his mandated sentence. My family wanted to think it was reaction to the showck of my dad’s behavior. The psychiatrist said many people are diagnosed during a stressful event. For years you are able to prop yourself up and keep a hold on the disease. Along comes crisis and everything falls a part. I wanted to know my chances. Will the medication make it go away? Nope, it was mine now. Relapse would be chronic. Remission depends on correctly taking medication, remaining accountable through a doctor and therapist, and recognizing the signs. My chances are better if I am constantly aware of the triggers that hold me blind.
Next, came my husband’s illness. I stood against a wall in his doctors office sobbing as he went over the results of tests taken only the day before. The diagnosis what kidney failure. There is no chance of cure, only treatment options. Transplantation and dialysis were the only given opportunities. We chose the transplant. We are 4 years into a deceased donor placed kidney. The statistics say that kidney has a chance of living about 8 years with rejection always hovering waiting to pounce.
That is my future and those are my chances. Pretty poor future, huh? Currently, my dad has relapsed, mania is beating at my door, I miss my mother terribly, my husband has the flu, and I am thinking if I don’t start holding on the positive side of my chances I will fall head first into a major depression.
Franklin Roosevelt said, “When you get to the end of your rope, tie a knot and hang on.” I have never been great at tying knots. I’ll take my chances with what I can do. I still have some rope left, I won’t let go.
Panic Attack: A Description
Saturday, October 24, 2009
Ever so often, close family members (like about four in all) who are aware of my illness ask me what a panic attack is like. Is like? I can only tell about one particular attack. I can’t really put it into educated words. It is my experience I am able to tell them. “Do you want to hear about a mild one or a wild one?” I always ask. “The “wild” ones are few but they are the one the ones I remember most. Of course they want to hear about the wild ones.
I ran to the bathroom slammed the door and began to eject the dinner I had just eaten. Slumping down on the floor, slowly from within, I begin to shake. I lean against the wall and started to cry. Their back. My husband is knocking on the door he thinks it must have been something I ate. “In a minute,” I muffle. I stand and wash up. As I turn, I feel my heat burn in my chest and flame to my face. I walk out the bathroom into kitchen with a lightness in my head. “I am here, I think.” I sit at the table and a rush of voices come.Yes, their back. Former attacks, bad memories, and future fears are behind the voices. I can’t think. In my mind I am unable to finish a sentence. I see my husband walking over bringing me a glass of water. He speaks and his voice is far away. I sip some of the water and close my eyes. Once closed, my eyes bring blurs of lights. My mouth goes dry and I begin to feel as though I am being choked. I run back to the bathroom. Again, the liquid in my stomach flies out. I am so hot I strip myself of my clothes. My head falls onto the seat and I continue to vomit. I am now to weak to get up. Once finished, I fall to the floor. The tile brings me a chill. As I lay there, my body shakes. Finally, my body falls limp and I slowly begin to recover. I find my purse, swallow down my “Panic Attach Medicine.” Slowly, I return to what is called an “old self.”
That my sister, is a panic attack.
Falling into Health
Thursday, October 8, 2009
Autumn Within
It is autumn; not without
But within me is the cold.
Youth and spring are all about;
It is I that have grown old.
Birds are darting through the air,
Singing, building without rest;
Life is stirring everywhere,
Save within my lonely breast.
There is silence: the dead leaves
Fall and rustle and are still;
Beats no flail upon the sheaves,
Comes no murmur from the mill.
Henry Wadsworth Longfellow
Last autumn I was a MESS. I was overly medicated and two steps away from being in-patient for my treatment. I did not know it at the time, but the ability to stay as an out-patient would be something I would later embrace. I see now, I gained another save. My medical costs have mounted over the years. While I have great insurance, there is still a cap on how much can be used for in-patient mental health treatment. I realized it was not the same as regular medical treatment. That’s not fair, but for another post.
I am just happy it is Autumn and I can think back to this time last year and well up with gratitiude. I am not there yet, never will be, but I’m not what I was. Can I go back? No. I can have another episode. Going back means going back to something that is the same. For me, every episode is different. When will another occur? Wish I knew. I could plan for it. Not just financially, but I could get my hair done, clean the bathroom, and wax a few things. My hygeine goes away when I am depressed. If it was the other pole-mania, I could bookmark all my new found shopping sites, warn the UPS guy packages are coming, and find out the sizes of all my friends. It is such a pain to guess.
But, that is not where I am. Did I already say how grateful I was? Happy Autumn.
Still Standing
Sunday, September 27, 2009
Despite all my fears of undergoing the process of surgery, I managed to come out okay. The pain meds mixed with my bipolar meds left me feeling odd. I was told two different things about the medication. Either the bipolar medication would increase the potency of the pain meds or the pain meds would relieve the bipolar medication of its working strength. I still can’t figure out which happened. I did feel like some fog had settled over my brain. I tried to empty myself from the pain meds as soon as possible. Letting go of that medication was a mental relief.
Overall the whole ordeal was quite stressful. I survived and am still standing to tell about it. Anyone with a illness of the mind should always be concerned about other health procedures. It is so helpful when doctor and patient can communicate effectively. Finally, there has to be a letting go of any shame. I was and still am at times shameful of being Bipolar. For years I have battled this stigma that I have the crazies. When I went in for my surgery I had to tell what medications I was on to the equality of atleast four different times. Of course, they were all four different people. Most assumed, which is preferred by me, that I was bipolar and moved on. A couple asked, “And what are you taking this for?” I began to wonder if those askers had even been to medical school. I decided to answer, “Um, it’s in my chart.” It was a good assumption they could read.
I know it sounds judgemental, but I sometimes think when professionals ask about your medication they want you to elaborate on why you take it. Almost like, it is some juicy gossip.
I guess I took three posts to say, If you are bipolar and you have surgery. You will survive.
Control
Saturday, September 19, 2009
When my regular doctor began preparing me for the surgery I knew would be inevitable, he did not realize how worried I was about its effect on my bipolar illness. Worry that was left unrealized from my lack of its admission.
Individually, most of us have our concerns when we are about to undergo some knife work following the major drugs to knock us out. We don’t want to wake up during surgery and feel the whole thing. Certaintly, that has to be accomplished. Many of us fret over how we will wake back up. Stories of some yelling, cursing, and crying post- op have all found their way to our ears. Basically, by having surgery we are giving up control of our bodies.
I gave up control of my body years ago. I surrendered it to the diagnosis of bipolar. I had to, it was the only way to gain back some order in my life. I didn’t give up, I just gave in. I know that sounds like the same thing, but . . . Realizing I’d have to lose my life to save it, became my reality. I had to give up the life I had before my bipolar diagnosis. My life before the diagnosis was crazy. I was up. I was down. I was angry. I was sad. Spurts of energy led to bouts of sleeping. Finally, I decided I would rather die. I did not just have bad days. I had bad years. When I finally was told what was wrong with me, it was the first time I had felt hope in quite a while. Knowing there was a means to fixing myself, provided reason for a fight. I had to fight for my life and I needed something or someone to help me. Therapy showed me how to defend myself, but it was the medicine that gave me the means to box. The medication and therapy allowed me to punch the mania and depression right in the face.
My surgery doc knew about my medication. He was aware of all the bruising and near death conditions being bipolar had given me. I had fought and won. I was enjoying my victories. There is always that sleeper punch. Mine is admitting to what frightens me. I think if I say it aloud it might get bigger. I never told my surgery doc or my pdoc of my fright.
Would I continue to win my battle or would the surgery keep me down? It takes a lot to get me to sleep now. Without my antipsychotic drugs I can stay up for days. Would they not be able to get me out? Or would I get out and stay that way?
The sleeper punch was wide awake and heading straight at me. These were all the questions whirling in my mind. The closer the surgery got, the increasing anticipation became unbearable. I knew there would be no control, but would I stand back up?
Surgery and Bipolar
Monday, September 14, 2009
Having this blasted illness of bipolar, I often wished their was some kind of surgery doctors could do to rid me of it. But, that would have to do with the brain and I am just not going there. I had surgery about a year ago. It was on my bladder. I knew the surgery would be invasive and I’d be down about three weeks. That was no big deal to me. Having bipolar, my episodes have kept me down for months at the time. I was not worried about the surgery. My worries came from having the surgery AND having a propensity to implode or explode at any giving moment. I was afraid the anesthesia and pain medication would mix with my cocktail of bipolar drugs and create some kind of eruption. After finding out I had to have the surgery, I had a few weeks to let my mind prattle on with ideas of destruction.
First thing, I went to the net. Always my first stop. I really didn’t want a doc’s opinion on the matter. It was like child birth. I wanted to hear and maybe talk to someone who went through it AND survived. It did not have to be the same surgery, any surgery would suffice. I just needed to know that I would come out with my mental status resembling something like sanity. Forget the stitches and swelling and a little thing called a catheter. I needed mental assurance.
Interesting, I got nothing. When I say I searched, I totally mean it. Of course, I Googled. I refined my search. I checked out the archives of all my favorite comrades in the blogging world. Still, not a thing. Not even a had-to-get-my-wisdom-teeth out post. It was a bummer. So I stumbled my way through major surgery tugging the my mainstay of mental uncertainty with it.
For me and all the others who might face surgery while being bipolar, I am going to tell my story over the next few posts. I hope it helps someone. At least I will have it to go back to if the old bladder needs to be repaired again.
Spiders with Bipolar?
Friday, August 28, 2009
The Brown Recluse
Okay so, I am seeing some likeness between the spider and me.
I Mow Grass
Sunday, August 23, 2009
This is weird I know. I measure my health and wellness on my ability to cut grass. Not the smoking kind, the up-to-your-knees yard sort. It was mania that brought me to cutting grass. I wanted to prove I could do the work of a man. I think cutting grass is the ultimate male chore. To master it meant I was tough. During my mania I need to be tough. When I am depressed I am so weak. Not just in mind, but body also. Most depressives feel as though they have the flu. The weak feeling makes it almost impossible to get out of bed, let alone accomplish any other chore.
Mania also brings impulse purchasing. This episode produced a new lawnmower. I walked into my local Feed and Seed store declared, “I need a lawnmower that will crank every time and cut grass all day if I need it to.” Within 15 minutes I was loading it in my Jeep. I mowed my lawn as soon as I got home. When I was finished I can’t describe the high I felt. It was kinda like spending time with the other grass. . .
Of course, depression always follows my mania. I am always unable to complete chores. If I get dressed and out, that is a good day. This depression was no different. I would stare out my window watching my neighbors cut their grass and wishing. I remember telling myself, “As soon as I am better I am cutting the grass.” Then I began to believe getting better wasn’t a possibility. I apologized to the lawn mower.
As with all episodes, I slowly get better. Even with better feelings, I feel as though complete health will not define my wellness. Yet, I always find myself better without warning. In my lawnmower episode, I wake up one day and get dressed and pull the crank-every-time lawnmower out the garage.
All my senses come alive. My feelings of weakness trickle away. “I’m back,” I tell myself.
Writing for Wellness
Sunday, August 9, 2009
In “Writing Magic” by Gail Carson Levine, the author gives her secrets for how she has written such great books such as “Ella Enchanted” and “The Two Princesses of Bamarre.” In the beginning of the book, she gives her “vows,” an oath for writers (Pg. 6).
The Writer’s Oath
I promise solemnly:
1. to write as often as I can,
2. to respect my writing self, and
3. to nurture the writing of others.
I accept these responsibilities and shall honor them always.
Through this journey with bipolar illness, writing has been the one thing enabling me to express myself. It is the means which I express my concealed feelings. Newly diagnosed, writing was the first suggestion my therapist offered me. She had no idea of the number of years I spent quietly scripting my thoughts in notebooks, journals, and whatever scrap paper I could find. I generally keep my writing hidden away. I do not make and keep relationships well. Writing is my only one constant relationship. Opening it up could thwart my secret friend.
When I read the aforementioned oath, I promised myself I would honor it. The most necessary sentence for me is “to respect my writing self.” I do not consider myself a great writer or even a good writer. My desire to write comes from my desire to heal and stay away episodes of my illness. My need to respect myself is defined as: The certainty writing is an element of my overall wellness plan. As I have read and re-read the oath, saying it and believing works better in the first person. I apologize for liberties taken with the words.
1. I write as often as I can,
2. I respect my writing self, and
3. I nurture the writing of others.
I accept these responsibilities and shall honor them always.
