bipolarblurbz-blog

[bipolarblurbz-blog]

When You're Ashamed of the Number of Psychiatric Meds You're On

Imagine you visit your doctor for a surgical procedure and the nurse performing your intake is aghast as you discuss your current meds. “Five medications?! You have one to keep you awake and another to put you to sleep!” I uncomfortably try to explain so we can move on, but she interrupts me, “What is bipolar disorder II? Who is prescribing all of these?” You might guess why I withhold the truth when medical professionals ask me about my current medications. Throughout my life I have been judged for, and embarrassed by, my mental illness.

Bipolar disorder is difficult to treat. Doctors have the challenge of maintaining a steady mood, while reducing the highs and lows, without tipping the scale in either direction. Everyone responds differently to meds, too, making it even more difficult for doctors to properly prescribe to their patients. On top of that, people with bipolar disorder often take more than one medication due to the comorbidities associated with the illness. In treating bipolar disorder, a doctor may have to simultaneously treat depression and anxiety; both of which require their own drug. Statistically, people with my diagnosis are on anywhere from four to five different mediations. Although these meds may make me feel more “normal”, the reality is that they also make me feel shameful.

While rationally I understand why I’m prescribed the meds I take, it still pains me to be honest about it. In fact, I often ask my psychiatrist to reduce the number of meds that I’m prescribed simply because I’m ashamed. Yet I wouldn’t bat an eye at the amount of chemo and radiation my friend fighting colorectal cancer needs. Nor would I criticize a family member for taking eight different medications for her cystic fibrosis and diabetes. I wouldn’t judge them because I don’t see them as defective or flawed. I deserve that same compassion, especially from myself.

I will never forget what a mental health professional once told me about taking psychotropic medication. I was upset that I needed my meds and was contemplating how I could live without them. We were at a restaurant and she told me to bring a menu to the man next to us, take off his reading glasses, and ask him to read it to us. He had a visual impairment that impacted his ability to read. He had a disability, but one that is widely accepted by society. The same should be true for people with mental illness. We are not freaks of nature. We are human beings who struggle with an illness like so others many do.

Mental health discrimination includes both social stigma and perceived or self-stigma. I suffer from both, and stress about being judged for taking so many medications. But at the same time, these meds improve my quality of life exponentially, and enable me to live a healthy and productive life. I know from experience that my mental health would suffer considerably without them.

My hope is that the more I write about bipolar disorder, and the more educated people become about mental illness, the less stigmatized it will be. Often times I want to give up; exhausted from dealing with my illness. But it’s critical that people, including myself, push on and continue to open up about mental illness. Only in this way will society (and those with self-stigma) become more accepting and less judgmental. Because after all, I would someday like to go to my pharmacy to pick up my prescriptions without the clerk saying to me “Wow, these are a lot of medications. Are they all yours?”.

[bipolarblurbz-blog]

This was also posted on The Mighty site: https://themighty.com/2017/07/reasons-why-my-bipolar-disorder-impacts-my-chances-of-motherhood/

Why Bipolar Disorder Makes Deciding to Have a Child More Complicated

Why Bipolar Disorder Makes Deciding to Have a Child More Complicated I always thought I wanted to be a mom, but never imagined that anything other than finding the right partner would interfere with my decision of having a child. Even though I wanted to have children “later in life,” as I approach my 40s, I realize the odds are stacked against me, largely due to my mental illness. Bipolar II disorder is sneaky because on the outside it appears I have chosen not to have children, when in reality I feel robbed of something so many take for granted.

1. I recently posted a story on my blog describing the many ways that having bipolar has negatively affected my life, and having children is one of them. As a child of an alcoholic, I hid the truth and did anything and everything to appear “normal.” Romantic relationships are difficult for me, largely because I do not want anyone to see my weaknesses, so I always do my best to not show any. The closer I get to someone, the more difficult it becomes to hide my illness. I avoided men up until my mid-20s, and while there are many reasons for this, the shame of having a mental illness and my emotional immaturity due to my upbringing were simply too much to reveal.

By the time I was ready and emotionally available for a healthy partnership, I was well into my 30s and time was passing quickly. After years of therapy and a lot of work on my part, I’ve only recently begun to feel ready for something deeper, now just shy of my 40th birthday. “Later in life” did not imply my fourth decade; and, although more women are waiting to have children after establishing their careers and doing the things they want to do before starting a family, science does not lie about the difficulty of and higher risks associated with bearing children in your 40s. While research shows my chances of getting pregnant at my age is more challenging, the ultimate reason, in my opinion, is due to my mental illness. It took years to get properly diagnosed, emotionally stable and on a better medication regimen. This takes time and is a by-product of why I am nearly 40 years old and now ready to have a child.

2. Aside from the biological complications of getting pregnant in your 40s, the majority of women, in general, are not taking psychotropic medications that may or may not have been “proven” safe for pregnancy. Currently, I take six medications to treat my bipolar disorder, not all of which have been through clinical trials and approved by the FDA for use during pregnancy. To this day, I continue to adjust my medication regimen with my psychiatrist and regularly struggle with the withdrawals and side effects that come with it; I would have to do the same and perhaps experience worse if I chose to get pregnant, particularly because I would need to stop taking some of six medications.

I wonder, though: Who is this really about? Me or my child? Yes, I would have to deal with the tough withdrawal symptoms and emotional difficulties from weaning off my medications, but I do worry about exposing my child to several psychiatric medications, even if they have been FDA approved. On the flip side, there have been innumerable healthy children born to mothers who took medication for their mental illness throughout pregnancy. Just the same, there are many women who live with other illnesses who cannot and do not stop their medication for pregnancy. Why should mental illness be treated any differently? Why don’t I have the same rights or life wishes others get and desire to have? With that, though, I still have concerns that it could be selfish of me to potentially put my child at risk during pregnancy while I am on psychiatric medication because I would like to have a biological child.

3. We know that genetics can play a part in passing mental illness on to your children if a parent has one. But this is not the case every time or for everyone, and results often have too many confounders to associate any direct effect. Interestingly though, research does show that bipolar may be one of five major mental illnesses with a strong genetic component. Science gives us a few bites to chew on, but we do not know definitively where mental illness comes from. However, we would be ignorant not to worry about passing our illness to our children. My gene pool does not only include bipolar, but also generalized anxiety disorder (GAD), attention-deficit/hyperactivity disorder (ADHD) and addiction. I worry that any, a combination of, or all illnesses will genetically impact my child’s life like mine has been impacted. No one deserves to struggle with mental illness and, if my child does, the guilt and shame would debilitate me.

4. Of course, my illness has hardships and needs constant attention and care, but in the context of bipolar, it’s necessary I have enough sleep, consistent exercise and a healthy diet. A lack of any of these results in irritability, impatience and overwhelm, making it difficult for me to have what it takes to care for a child in the way she or he deserves. Will I have the energy for nightly feedings? Will I have the patience to soothe a crying baby? Will I be able to handle multiple things at one time? Child-related “crises” are the rite of passage to motherhood, but these episodes terrify me if I’m behind on self-care and a stable schedule.

But again, is it too complex for someone with bipolar to have children? Is it fair to the child? Is it fair to the mother? I believe each of these four reasons contributes to the difficulty for me to be a mom, and they are also illustrations that make bipolar invisible to the common person. I know I am not the first person with mental illness to productively and lovingly raise a child and that it’s possible for me to do so. For one, I do feel ready, regardless of what age I am and what happened in my past. I am deserving of being a mom. Secondly, there are psychotropic medications that are approved safe for a woman’s pregnancy. While it may be difficult for me to adjust my medications for a safe pregnancy, I’ve done it in the past and survived. If I choose to do so, it is worth it to me to have a child? Thirdly, genetics are a factor in any birth, but to single out mothers with mental illness is unfair and unnecessary.

I do not deny that my illness will interfere with nightly feedings and temper tantrums, but I do have support I will rely on during harder times; My husband is loving, caring and very supportive, and we will work together to find the best schedule that works for both of us. He needs less sleep than me so we can arrange feeding times that allow me to sleep without interruption for a longer period. My psychiatrist and I will find the best medication regimen for me, perhaps the one I was on before I had to adjust, to ensure I feel my best to be there for my children. I will continue to see my therapist who is and has been a large part of my healing and growth over the last several years. I will navigate motherhood with her assistance and encouragement. I will keep a healthy diet and regular exercise, and will ask for help from friends and family to watch my child so that I can make sure I get my self-care. It is only in this way I can be fully present, feel good and provide the best care for my family.

Don’t let your mental illness be the reason for not having children. Explore your options to have a child, and be comfortable with your decision that’s best for you, not in what other people believe you should do. Since bipolar is an illness not always seen as a reason why a person might not have children, if you’re asked why you don’t have a child, perhaps have a pre-planned response ready. Regardless, I believe a question asking why you don’t have children is socially inappropriate and none of anyone’s business. Although I note my own concerns for motherhood as a person with bipolar, I do not know one mother who didn’t have any fears about their child’s safety while pregnant, mental illness or not. And of those women, I have no idea what “illnesses,” if any, they have, even though they look as though they have everything together. I don’t want to know, as it’s their business and has no impact on me.

Remember that we didn’t ask to have a mental illness, but that doesn’t mean that we can’t ask for the same rights, as available to us, as others so easily have.

[bipolarblurbz-blog]

Where Would I Be if I Were Born 25 Years Later?

I wish I had known a long time ago about my mental illness. As the saying goes, “hindsight is 20/20” and my life played out as it should have, but I believe I would be “further along” intellectually, emotionally, and professionally had I been born 25 years later. I speak from an education perspective, because I believe that school is critical to a child’s neurodevelopmental, social growth, academic success, and ultimately their professional career. Today it appears that parents have a much better sense of their child’s character and surroundings, an awareness of potential psychological disorders and, perhaps most important, a closer relationship with their child’s teacher than years past. Teachers are privy to a child’s daily behavior and their associated developmental and learning disorders, and are often the first to recognize the need for intervention. Either way, it feels as though children are looked after and cared for in a way that I was not. And because of this, many get the support and help that they need to do their best in school, on the playground, and at home. I can still see my 3rd grade self being put in the corner for acting out. It was not until recently that I realized that I wasn’t a bad or misbehaved kid, I just couldn’t sit in my chair for an entire lesson. Had it been known that I had ADHD, then maybe I could have had the tools and, perhaps, medication to improve my school experience, and positively influence my life’s path. I always dreaded school assignments from elementary grades through college. Some people actually get enjoyment from learning! Unfortunately, that was not the case for me. I imagine this is because it was painfully difficult for me to focus to get work done; there is nothing enjoyable about that. People with ADHD are often quite bright and, because of this, the disorder goes unnoticed until the student can no longer “keep up.” This means that I was smart enough to get the work done even though I was comprehending far less than 100% of the lesson being taught. This explains my grades; both academic and conduct. I would soar academically and drown in conduct. Talking out of turn and to classmates, and getting out of your chair disrupted the class and are significant factors that affect conduct grades. I remember doing all of that. By junior high, my grades started to slip in some classes from A’s to B’s, spoiling my chances of getting into “honors-level” courses. I fell even further behind in high school. Courses were harder and more demanding, and I just couldn’t keep up. The student advisors were useless; we’d meet 1-2 times per year and accomplish next to nothing. They should be required to assess a student who isn’t doing well, and ask questions in an attempt to identify the potential cause and demand further evaluation, so that a proper diagnosis and treatment can be prescribed. Teachers working in my school didn’t talk to students or their parents about their progress, or lack thereof. Any news that got back to my parents was simply what I was telling them; and my report card of course. Neither of which told the whole story. But my home was chaotic and my mother didn’t have the time nor energy to understand and help all four of her children. My father was never involved; he was too busy being an alcoholic. My mother was the disciplinarian and caretaker. But she wasn’t able to see my poor grades as something beyond “laziness”, “misbehavior” and “carelessness” and to get me the help I needed to thrive in the school environment; ironic because my mother, herself, was a middle school teacher for 40 years. If I complained about school being hard or making me anxious, she would tell me something to the effect, “Well, I don’t know. You’re a bright girl and have a high IQ. You have the highest IQ of your three siblings.” But that didn’t help at all, nor did it matter to me. I was crying out for help, feeling as if I was drowning at school. Unfortunately, my calls for help went unanswered. My mom didn’t have anything to give; she was spent from the turmoil that was her life. It hurts my heart when I think about high school because I know I’m smart and could’ve done well. I could’ve learned and participated more, and ENJOYED the classes, but I had untreated ADHD, and symptoms of depression coupled with anxiety that began to significantly affect my performance. I remember having anxiety as early as junior high. That followed me into high school where it got worse, eventually becoming acute anxiety. Walking from the bus to homeroom was agonizing. Homeroom to first period, agonizing. Sitting at lunch, agonizing. Getting on the bus to home, agonizing still. I had no self-esteem; common for someone with ADHD who is often forgetful and clumsy and just can’t seem to “get it together”. Self-worthlessness shared space in my head with depression and anxiety. I managed to make friends, play sports, and make it through high school despite my struggles. I felt lucky that my state university accepted me -- I swear it was God working magic! My 2.8 GPA got me into their reputable business school. I chose a major in business administration because I was strong in math, and it seemed like a more functional degree to have when looking for a job after college. I remember arriving at college feeling clueless and terrified. My anxiety was debilitating, and coupled with my ADHD, I felt paralyzed. I was scared to go to class because I knew I could not pay attention and didn’t want the professor to call on me. I could not speak in class. I was horrified to give an oral presentation and would worry from the day I received the syllabus until the date of the presentation (usually 4 months in between!). I loathed working in groups and frequently didn’t produce my piece of the pie. (As a child of an alcoholic, you hide the truth and do anything you can to appear “normal.” Relationships are difficult to foster and hard to keep, and you don’t want anyone to see your weaknesses, so you do your best to not show any.). I skipped class often and would daydream during class; missing whatever the professor was saying. I would’ve been better off sleeping or going to the gym because I would’ve done something productive. I was so unbelievably not “present” that I FAILED the introductory course to my major! In the business school, you had to take an intro class for each department to confirm that the one you chose was something that you could succeed and were interested in (i.e. Intro to Marketing, Accounting, etc.). Since I could not pay attention in class, I would often not attend and would subsequently fail the exams. Consequently, I teetered my senior year on the seesaw of graduation or failure, while working my tail off to make that class up. Hard to believe I was taking an introductory course and the more challenging classes that are required just before you graduate at the same time. This was my life – a sad young woman who was lost and fearful, always trying to clean up her mess. I am a good example of what happens when mental illness goes unnoticed and untreated, while the person suffers, but either thinks it’s normal because they don’t know better or doesn’t understand why they feel the way they do. So, IF I were born 25 years later, my life might have looked like this: My parents and teachers would’ve gotten me help in elementary school where I would’ve been diagnosed with ADHD and put on a treatment plan. This wouldn’t necessarily include medication; however, as an adult I have responded very well to stimulants. I would’ve enjoyed school more and performed better. I imagine a chain reaction, with an early diagnosis and this newfound focus being my elixir to thrive academically, socially and emotionally.

Nothing is perfect though. I did develop depression (now diagnosed bipolar disorder II), anxiety, and PTSD, and those too would’ve had to be addressed as I reached my high school years. I would have had all my diagnoses and been treated consistently from high school to college and thereafter. I believe had my mental illness been cared for sooner, I would have chased my passion for languages. I started to learn Spanish and French and adored them both, but like anyone with ADHD, you start many “projects” and have 100 going at the same time, but you can’t ever complete any. Also with self-esteem and self-worth (squashed by untreated mental illness and an unhealthy home environment), I would have applied myself in all aspects of my life and progressed more quickly professionally and in my relationships. I never had a problem making or keeping friendships, but I also didn’t show them all of me, just a few. I was the friend who quietly listened, gave the feedback that they wanted to hear and shelled out compliments like candy to avoid talking about myself. The perfect people pleaser, typical of a child of an alcoholic. But I did have a social life and friends, that wasn’t my problem. I had a terror of boys and men and didn’t have my first boyfriend until I was 23 years old and I plan to marry in my 40’s. Maybe that’s the way it was going to be regardless, but I like to think that losing trust in men at a very young was a result of fearing my alcoholic father and growing up with parents in a dead marriage. I don’t attach mental illness to hiding myself from friends or being scared of males, but anxiety definitely contributed to feeling very uncomfortable around them, platonically or not. Doesn’t mental illness, though, impede life from moving forward? Not until recently did I no longer sense an immaturity (not naivety) that I had when thinking about being an “adult” (i.e. sustaining a serious relationship, getting married, having children, etc.) It took time for me to get a proper diagnosis, which had a negative effect succeeding in romantic relationships and jobs, and may have correlated to the relapses I had from stopping my medication. To me, mental illness, lack of self-esteem and self-worth, undoubtedly stunted me emotionally and affected my growth into adulthood.

But, this was my path and I am who I am as a result. And despite the lack of mental health intervention and my many struggles, I’ve managed to find my way to create a life for myself, rich with wonderful friends and a loving fiancé, and will continue to push myself to grow emotionally and spiritually. This is why I am bravely taking on the challenge of blogging my way through mental illness and pain in pursuit of mental health, just like how I eat well and exercise for my physical health. My hope is that I won’t allow fear to stop me even though each time I sit down to write, I am slapped with paralysis. I have to remind myself to write from the heart and the words will flow. “There is no shame in your story. There is no shame in your writing.” I imagine the more I write the better my writing will become and the prouder I’ll feel about my progress. There’s only going up from here!

[bipolarblurbz-blog]

I Always Forget Father’s Day

My dad was your non-traditional father, whose only presence in my life was ruined by alcohol-related trouble, most often at home. As long as I can remember, my father slurred, stumbled, vomited, and reeked of aftershave that he used to mask the smell of cigarettes and Miller Lite. As alcoholism does, it gets worse until a person hits bottom or it takes one’s life. For my dad, it was the latter. The complications from drinking daily for decades did a number on his body to the point of eventually failing him. He failed me too.

It is easy to imagine why I would forget the Hallmark holiday, Father’s Day, with a past like that. But it is on this day, when most people are celebrating a supportive and loving dad or father-figure, that I reflect on the man I really did not really know. When I was born, my father was 44 years old and a full-blown alcoholic. At around the age of 3 or 4, I have faint memories of him being “part of the family”, but anything beyond that is smeared with alcoholism. Yet I do recall a dry spell he had while I was in high school. In Alcoholics Anonymous (AA), a person is “dry” if they are not drinking, and, at the same time, are not getting the help they need for their emotional and spiritual growth to stay sober. If these two are true, alcoholics often continue to exhibit the unhealthy behaviors they had while they drank.* My father sure did. Since he could not and did not work, he, instead, spent his days sitting in a lawn chair in our den. He watched TV, drank liters of caffeine-free Diet Coke, slurped on boxes upon boxes of sugar-free fudgsicles, and talked out loud to our German Shepard, almost as if he were expecting her to answer. Why do I tell you this? Because, after years of scrutinizing my father’s behavior with my own mental health professionals, and having been diagnosed with mental illness myself, I am fairly certain he had it as well. His symptoms, while he was not drinking, manifested as low mood, insomnia, short temperament, and agitation. We cannot forget, either, that where there is substance abuse there is an increased likelihood of mental illness. Or is it the other way around – the chicken or the egg? So where did my illness come from? Do we or can we blame my father? Well, we know that genetics can play a part in passing mental illness on to your children if a parent has it. But this is not the case every time or for everyone, and results often have too many confounders to directly associate any effect. Interestingly though, research does show that bipolar disorder (BPD) is one of five major mental illnesses with a strong genetic component. For example, a study reported that if one of your parents has BPD then you have a 15 percent chance of having the illness. Your odds increase, of course, if both parents have it.** Research gives us a few bites to chew on, but we do not know definitively where mental illness comes from, and we may never. Yet I would be remiss not to add “nurture” and one’s environment to these hereditary factors (or a combination of the two) when we discuss the origin of mental illness, especially in my case. Alone or together, nature and nurture are critical to a child’s mental health. Regardless of the reason/s for or source/s of my illness, I do see similarities between my father and me, for better or for worse. I have confidence that my father and I share mental illness and substance abuse, although he was never diagnosed “officially” for the former. If we did share BPD, we will never know for sure. But what I do know is that I wish that mental illness was less stigmatized, and that help had been more accessible when my father was alive. I know I worry about stigma for my own illness, and finding good help can be a struggle. Plus, my dad had two additional strikes against him: (1) treatment was not as effective then and (2) he was male. Men seek treatment far less often than women do because society “raises” them to not talk about their feelings or show emotion; certainly, something all parents have a duty to teach differently these days. But despite all of this, I did write a small (Hallmark) note to my father on “his” day: Dear Dad,            I don’t blame you for having mental illness or for passing it on to me (if you did), just like I wish not to be discriminated against for my own illness. We did not ask for it, nor do we want it, like people with any illness (e.g. cystic fibrosis, cancer, etc.). But we fight like soldiers every day, in spite of the symptoms from the illness and the side effects from the medication. We pick up our 100lb. backpacks, strap them on and push forward. It is not an easy road, but we are stronger for it, and I love you for all of it. Happy Father’s Day,

Your daughter

*Disclaimer: AA is not for everyone and their principals do not stand as the only way for a person to get and remain sober. Twelve Step programs were central in my household so I merely write from my own experience.

**I do not mention my mother as a potential genetic “cause” because I am certain she did not have mental illness.

[bipolarblurbz-blog]

Why it Took 17 Years to Diagnose My Bipolar Disorder

“Do you ever shut up?!” “You’re either a zero or a 10! What is wrong with you?” My parents often hollered these comments to me as a child. I shared these memories with therapists and psychiatrists never to realize just how well they described my bipolar disorder, and neither did they.

The first time I visited a psychiatrist was when I was 20 years old, a junior in college. I did not know how to name it or what was wrong with me, but I sensed something was just not right. I had always felt this way, but I now had the courage to see a professional about it. The doctor told me I had all the signs of depression and anxiety and put me on medication for the first time in my life. I felt indifferent; in fact, I remember thinking I would not need medication for the long-term. Looking back 20 years now, I see a naive and ignorant younger me. It is hard to point blame, though, when I had always had these feelings and did not know any better. But also, there was little-to-no communication about anything, never mind feeling anxious or down, in my household so being unfamiliar with mental illness made sense.  

Throughout my 20’s I moved around and did not stay in one place long enough to maintain consistent medical treatment. I fell in and out of my medication routine and self-medicated with alcohol to numb the effects of my illness and the side effects of the medication. I was a young adult, confused about life, and even more confused about how to deal with my mental illness. I wanted nothing more than to feel like “everybody else”.

After over a decade of grudgingly taking medication, I desperately tried to prove to myself that I did not need it. On two separate occasions in my 30’s, I attempted to come off my medication completely and spiraled into deep depressions. Acute anxiety, racing thoughts, insomnia, weeping and lack of appetite were symptoms I experienced the most. The reason I note “acute anxiety” first is because this is how my illness significantly manifests both on and off medication (of course, it is far worse OFF medication). Anyway, I was afraid of my own shadow, but I had to go to work and I did. People would come into my office to ask me a benign question and would look at me weirdly, because I had the shakes, and would blush and look frozen with fear. I would try to “play it cool”, but it was impossible. I could not talk or participate in meetings and did not try to advance in the job because of utter fear. I was living in hell. That was the most recent time I stopped taking my medication and it will be the last, Inshallah. Both experiences made me realize that I need medication and that it is okay to need them to feel like me and to live a healthy life.

But that was when I thought I had clinical depression and anxiety. I did not feel alone because I had friends and knew people with depression. That all changed 17 years after my initial diagnosis. On a sunny August day in my psychiatrist’s office, she proceeded to tell me that I, in fact, had bipolar II disorder. I can remember the shock that ran through my body like you feel when you trip and fall. I had already come to terms with having depression and anxiety, but bipolar disorder sounded scary because I stereotyped this illness like many others do. I believed that people with bipolar disorder had something “seriously” wrong with them, and I was now one of them. (Even people with mental illness can stereotype ANOTHER kind of mental illness; I am human, but guilty -- pot calling the kettle…) After the new news, I walked around with a pit in my stomach and pain in my heart for a few weeks. But working with my psychiatrist showed me that the difference between clinical depression and bipolar disorder is nuanced; probably the reason why it can take ten years or more to get a proper diagnosis (in my case, 17 years). Often times, people with bipolar disorder inconsistently seek treatment and get help when displaying symptoms of depression, while avoiding the doctor when feeling good or high. This can lead to an incorrect and delayed diagnosis like it did for me.

What I have learned from the 20 past years is that every journey to a proper diagnosis and treatment plan has its ups and downs and is separate for that one person. While my path took me 17 years to get to a correct diagnosis, my hope for you is that yours will be shorter through seeking help sooner, proper self-care and a consistent treatment, as appropriate for you.