An Important Note On Blog For Mental Health 2013

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RubyPlease, everyone:  If you want to be included on our Blog For Mental Health 2013 Official Blogroll, and have your post shared by us via facebook, Twitter, and Pinterest, you must leave a comment on the page with a link to your Blog For Mental Health post specifically.  Make sure to read the original Blog For Mental Health 2013 launch post, it explains the concept behind this project and gives you an idea of what your post should contain.

I really want to include everyone, but a comment on the blogroll page with the link to your Blog For Mental Health 2013 post is necessary for this (just a link to your site doesn’t help me!).  Thank you so much for participating, and for helping me out here by following these three simple steps:

  1. Read the Blog For Mental Health 2013 original launch post.
  2. Write a post of your own that follows the directions for making your Blog For Mental Health 2013 pledge.
  3. Copy and paste the link to that specific post into a comment on the Blog For Mental Health 2013 Official Blogroll page.  You won’t see your comment, but I will comment back to you on that post on your blog so you know you’ve been added and had your post shared by us.

Also, as you write your posts, please make sure you pass this message along.  You’ll want the people whom you pledge to have their posts shared through Canvas as well!

Love,
Ruby

© Ruby Tuesday and A Canvas Of The Minds 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and A Canvas Of The Minds with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

This Is My Brain On Pain

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RubyAs you likely know if you read my posts here regularly, I am no longer taking any real mood-stabilizers for my bipolar disorder.  It isn’t an anti-medication stance, it’s actually just a place I ultimately came to through very little choice of my own (you can read a bit more about it here).

Now, being Bipolar I with psychotic features, unmedicated is a pretty daunting place to be, and I’m learning all the angles I need to cover.  Some I already knew and had accounted for: exercise, sleep, stress, and situations I knew were very high on the potential trigger list.  Others I knew, but didn’t really think about planning for, because they just didn’t come to mind when thinking of the day-to-day and what I needed to be vigilant about.

One major issue I’m suddenly finding myself scrambling to deal with is being in pain.  More specifically, being in a great deal of pain for a prolonged period of time, without too many resources to treat it.  Right now I am traveling, having a visit with family back in my hometown of Pittsburgh, PA.  In a rather unfortunate pre-trip packing incident, I turned my back in exactly the wrong way.  It hurt at the time (this would have been Monday last), but not too incredibly.  After several hours on a plane, as well as lugging a 48 pound suitcase around — getting it in and out of the car, carrying it up the stairs both to the room and in the room — I was in a fairly severe state of pain.  Tuesday night on a hotel mattress ensured that by Wednesday, I was eating Vicodin, muscle relaxers, and prescription anti-inflammatories in greater quantities than the really delicious chocolate thumbprint cookies I can only get on these trips.

Chocolate thumbprint cookies of deliciously addicting evil.

Chocolate thumbprint cookies of deliciously addicting evil.

Fortunately for me, I was able to get my doctor on the phone and am now taking a steroid that is very rapidly mitigating the pain.  Which is great for two reasons.  The first, obviously, is that I’m not in such intense pain that three prescription medications can only take the edge off.  The second is the way being in pain, particularly severe pain lasting for days (or longer), completely messes up my moods and my thinking.

I get irritable.  I become easily stressed.  I slip into a depressive state, and often begin to think things like I am worthless, a burden to the people in my life, and I have no value whatsoever.  I never become suicidal, but I do still believe most everyone I love would be better off if they had never met me, even when I am told things directly to the contrary.

Now, I know that pain can affect the moods of those who have no mental illness at all.  Just within the past day, my poor mom has done something to cause her back to become most painful (we’re a fine family for back issues), and she and I talked about this very thing.  But when you have any kind of affective disorder (bipolar or depression, or anything that’s in their extended family, like cyclothymia), being in pain seems to pose a much more severe, long-term risk, a risk to overall mood stability.

I have experienced these same issues when I get truly epic migraines.  Dealing with a migraine for a day or so is certainly no picnic, but I can handle it, and very rarely do I feel any effect on my moods or perceptions.  But when I get one that lasts for three days, sometimes a week. . .  I learned the hard way that when I’m unsure whether I should take my prescription opiates or try to ride it out with an over-the-counter NSAID, it’s better to choose the former and risk a bit of over-medicating.  But then, I’m lucky, and I have never had issues with addiction or dependence in the 18 years I have been taking Vicodin for my migraines.

I have read numerous studies on how those with a firm bipolar diagnosis are much more likely to have migraines as well.  I have also read studies linking fibromyalgia with depression, and not specifically in a “being in constant pain and having a lifelong physical illness makes you depressed” way, either — though that certainly doesn’t help depression.  And premenstrual dysphoric disorder (PMDD) can bring on horrible “menstrual migraines” for those who don’t already deal with these types of headaches all month long.

I guess my purpose in writing this piece is twofold.  First, it’s a bit of a “lesson learned, need to be vigilant about this as well if I want to maintain relative stability” post, and maybe it may even cause a few of you, my loves, to realize that pain has destabilized you in the past, and that it’s vital to make sure you think carefully about “toughing it out” if it has.  Of course, I know not all cases are straightforward, sometimes medications for pain interact with other medications, sometimes you can’t take anything because of past issues with substance abuse, and sometimes (too often) all the options for treating ongoing pain have been exhausted — with limited success, or no success at all.

My second aim is to get your own input and experiences.  Do you also find that pain can cause or exacerbate a mood state?  Do you find it can distort your perceptions as well?  What strategies have you developed for managing, mitigating, or ultimately preventing pain that others might find helpful?

Any way you slice it, the psychological and somatic aspects of our health are too intimately linked to be treated as though they existed as two separate, discrete problems.  The whole individual needs to be treated, whether you are dealing with an uncooperative back or a badly malfunctioning brain.

And on that note, this particular individual needs to take her a.m. dose of Medrol (the magic steroid) — along with her gabapentin and clonazepam, of course!  ;)

© Ruby Tuesday and A Canvas Of The Minds 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and A Canvas Of The Minds with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Is this what getting better mean?

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SSG

Anxiety.

I am having frequent anxiety attacks.

An entirely new thing to me. I even blogged about it last year. Or maybe it was a comment on someone else’s blog? I don’t remember. But the sentiment was one of gratitude for never having experienced those crippling moments.

My therapist says it actually means I’m improving. Go figure. That instead of dissociating and withdrawing, like I used to do, now I’m staying in the real world. And staying in the real world means dealing with the problem at hand. By going  into anxiety episodes.

Makes sense.

But I am at a loss here. I don’t know how to deal with that. I don’t have the coping mechanisms. I know them. In theory. Somewhat in practice too, I guess, since my daughter had severe anxiety episodes while growing up. I helped her and she learned how to cope. She doesn’t even need medication anymore.

Bottom line, I never had to apply them to me!

I will learn how, of course. Eventually I will, I have no doubt. I will get a handle on this.

But right now, it’s hard.

The end result is the same. Stuff doesn’t get done.

But instead of being blissfully oblivious of it like I used to, I now get this pain in my stomach like someone is punching me. There’s sweating and more generalized pain as well. Tremors too. Nausea. You know what I’m talking about.

We’ll see how it goes. I hope I don’t have to add yet another medication but I’ll do what it takes because I certainly don’t like the way I feel.

In the mean time, feel free to offer advice. I’d be interested in knowing what has worked for you. maybe it will work for me as well. It’s worth a try, right?

So far, having the cats around is good. Hearing them purr, stroking their soft fur and feeling their warmth helps a lot. Talking to my best friend too, of course. I am incredibly lucky I have that.

© Summer Solstice Girl and A Canvas Of The Minds 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Summer Solstice Girl and A Canvas Of The Minds with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Goals Are For Losers

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DeeDee newTime flies, fun or not. A week, a month, a year simply…vanishes. I graduated a year ago, and it has taken most of that year to recover enough to think about next steps. Another job search, and probably moving. Continuing efforts to improve my health. Things like that.

But then my therapist (a.k.a. Hippie Dude) started asking about long-term goals, after discussing the issue of career choices for ages and getting nowhere. So goals might help, right? I gave it a try despite my doubts and made lists of “goals” for various part of my life. At the following session, Hippie Dude told me that those weren’t goals per se. Goals focus on set outcomes, while I focused almost exclusively on processes. Out of two dozen items on the list, only four were true goals!

I hope someday that my extra-large pillbox will be filled with only vitamins and supplements. And Adderall, because I'm realistic.

Filling my extra-large pillbox with only vitamins and supplements is an unrealistic delusion goal. Reducing prescriptions to a minimum is an ongoing process.

The rest of my Not-Goals were actually processes that will help me “live long and prosper”, which is my real goal and always has been. Hippie Dude says they belong in a Treatment/Wellness Plan – practicing mindfulness and yoga, minimizing Rx’s, getting and staying fit, knitting an Aran sweater, and hiking more long-distance trails. The only thing remotely career-related was “write a book”, which is also a process (publishing a book would be a goal).

So why must I have goals when they trigger anxious, neurotic behavior? DBT says I need goals. My therapist says I need goals. All of my professional mentors say I need goals. Goals seem to really help some people. But I’ve never been comfortable setting goals. A great blog post on ZenHabits, Achieving Without Goals, highlights what makes me so uncomfortable:

  • Goals box me in
  • I don’t know what the future will bring, so planning for fantasies goals is basically useless
  • Failing at goals makes me feel bad miserable and despondent but achieving them doesn’t necessarily usually satisfy
  • If I’m always focused on the future, I can’t live in the moment, nor be content with where and who I am

This is exactly why I find goal-setting so wrong-headed. I was a lot happier when I had no goals or ambitions beyond living a decent life. These days, practicing mindfulness helps more than anything else. Mindfulness is all about being here and now, and life is simply more enjoyable that way. The contentment that mindfulness brings is something I’ve come to cherish.

Goals don’t allow that contentment. The goal of getting my next job creates future-focused tunnel vision complete with crushing anxiety, dissatisfaction with my current job, and indecision ad nauseum. It steals my attention constantly; I obsess, fret, ruminate, and talk myself out of what I thought I wanted because others also impose their goals on me. But in reality, all my jobs have come to me, not me to them – so why do I keep worrying about it? Because it’s a goal, and I become practically possessed when I take goals. They turn me into an ambitious, anxious, twitchy wreck. They make me feel like a loser.

Left to my own devices, I rarely make specific goals. Backpacking is different: we make the goal of reaching the final trailhead when what we really care about is the journey. Signing out on the last trail register is indeed a victory, but that’s because our feet are tired — that moment is not why we go backpacking. It’s every step between the trailheads that matters. It’s a decent metaphor for life, because although I really want a hot shower when we hit the finish line, what I want even more is to keep going. That’s what a life well lived should feel like, right?

The Buddha taught that desire is the root of all suffering. I think he was right. Goals are desires, and they’re inordinately good at causing suffering – clearly more so for some of us than others. As time passes, principles become ever more important to me, while goals quickly become obsolete, over and over. Living according to principles rather than goals will never make me feel like a loser, and that sounds like good medicine to me.

© DeeDee and A Canvas Of The Minds 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to DeeDee and A Canvas Of The Minds with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Preparations

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RubyI have to go see my psychiatrist today.

Which means I have to do some work, prepare myself like I haven’t in a long time, not since I ended things with my last doctor almost two years ago.

Back then it was pulling myself together, checking the anger and rage I felt towards him for the ECT thing, ending the relationship cordially, making my exit like a lady.

My primary gave me a great strategy there.  He told me, “You’re a great actress, act.”

(The fact that he could see behind the facade sometimes only undermined his words a little.)

And I went in, and I was Grace Kelly in every way: calm, patient, kind, understanding. . . graceful.

In the end, I was a lady, though I often wonder if that designation should ever be applied to me.

But, in the end, I left head high, knowing I had done the right thing.

Today will involve fewer “dramatics”, in every sense — well, perhaps almost every sense.

I have to get refills on three benzos in one visit.

It will be a neat trick indeed, if I can pull it off.

It’s a psychiatric trifecta: Klonopin, Xanax, and Valium, in ample quantities each.

My doctor is no longer watching me regularly.  And he knows I have never been suicidal.  Right now I’m not even depressed, or overly anxious, that feeling broke.

But I have a trip coming up, and for many reasons, for many people, I have to have in my possession all of the tools to seem downright docile in a pressure-cooker of a situation.

Which means that, despite how I may have appeared at the last of the real appointments – and I don’t deny I probably seemed a trifle. . . low. . .

At this appointment, I need to be together, I need to be convincing, I need to be winning, I need to be responsible, I need to look and act just exactly so, and most of all, I need to be strong, to show the good doctor he can trust me and he takes no risk with prescribing large quantities of heavy-hitters — all in 15 minutes or less.

Any bets?

Addendum: I won. Triple Crown. ;)

© Ruby Tuesday and A Canvas Of The Minds 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Ruby Tuesday and A Canvas Of The Minds with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.

Lines and Colours

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SailorIn my mind, I am normal. This is because I live with me twenty-four seven (OK, not always twenty-four seven because some of those hours I am asleep).

I have BPD. In the past, I never realised that I feel emotions more easily, more deeply, and for longer than others do. I thought the intensity of my emotions was normal. Turns out, it’s not. I read somewhere that in non-BPD people an emotion typically fires for 12 seconds. In BPD’ers it can last up to 20 percent longer. BPD’ers emotions also repeatedly re-fire, or re-live, or recur, however you want to say it, so emotional reactions occur for even longer. I do. I go over and over and over the emotions, pinging from one to another like a steel ball in a pinball machine.

Emotions are extreme, intense feelings for me. Especially the negative ones, but I can feel entirely euphoric, which is often followed by more extreme lows, so I try to avoid them.

Emotions are also a bit confusing.

I remember one of my first CBT appointments Kerry (my psychologist) gave me a sheet of A4 paper with a thermometer on it and a scale of one to ten. For the scale of one to ten I had to write the feelings and emotions leading up to anger, anger being at the top where the thermometer ran out.

I couldn’t do it. I still can’t.

I remember feeling really stupid. I’m (usually) an intelligent person, I should be able to figure out the feelings or emotions that lead to anger, but I couldn’t. That was when I realised that although I am factually intelligent, my general knowledge of things is bordering on useless, I am not emotionally intelligent.

Why couldn’t I figure it out?

To me an emotion is, or it isn’t. I’m extremely angry or I’m not. There is no build up. Classic all or nothing Borderline behaviour. I’m sad or I’m not. I’m happy or I’m not. I’m bored or I’m not. I hate you or I love you.

To this day I can’t even begin to figure out the emotional thermometer. I’m still one emotion or another, there is no build up. It just is or it isn’t, but I recognise that now.

I’ve been trying to figure out if I can feel more than one emotion at once. I don’t think I can.

It’s not often I feel ambivalence towards someone or something. Sorry, for me it is either love something to the extreme (sharks) or hate every single thing about it and fly into a rage at the mere mention of it (Micheal Buble, emotional thermometers). There is the third thing that is “I don’t care about it so it doesn’t even register on my radar”. I guess that is ambivalence, but can you have that emotion if it doesn’t exist to you?

The only way I would love Micheal Buble is if he got eaten by a shark

BPD emotions cycle rapidly (not on a bicycle). Euphoria can go to anger in an instant. But I don’t think I feel more than one emotion at once, the emotion cycles rapidly from one extreme to the next. It’s quite simple if you think about it, the emotions are rudimentary and uncomplicated because they are pure and unfiltered, but they are also extreme.

So I’ve explained how complicatedley-basic emotions are to me. Now I want to explain how complex the rest of the world is.

Fuck those HD TV’s with surround sound, my life is in HD with surround sound.

There are days where I experience hyperacusis – this is where I’m sensitive to noise, and it happens frequently, almost daily so I’m quite excited when I get a day off.

The world is a noisy, fast paced place. From what I understand, loud sounds drown out other sounds.

I can hear all of the sounds and then my brain separates them out. It’s not just a noise. I hear dogs bark and birds sing and traffic and airplanes and the autoclave and the buzz from the light bulb above the heating is on and there is that high-pitched noise just coming from behind the music on the radio as well as people’s voices. Sounds on top of sounds on top of sounds. It’s not one noise drowning out another, it’s somehow my brain’s fascination and concentration of separating the sounds out. Sometimes the sounds are processed in order of closest to furthest away.

I long for quiet, or even just the sound of my heart beating in my chest and the woosh of sea without the complicated layers of other sounds.

My sense of smell is sensitive to things others can’t smell. It also doesn’t help that memories (good and bad) are triggered by smells, but that is besides the point because we all know that BPD’ers are prone to PTSD.

I see everything. Sometimes there is too much to take in, I feel like a pigeon. I only realised this today when I was talking to colleagues about details in things I noticed and they don’t, or never thought of. Maybe I’m just super observant, but I think maybe it is the BPD. Painting, in some ways, helps me get away from seeing the detail, even if I hardly ever see the big picture and see all the tiny brush strokes and lines.

Photo: Lines and colours and white space.

Lines and colours and white space.

Sometimes my skin hurts. Even the gentlest touch sets me on edge, no matter how much I long to be hugged some days (even if the PTSD and fear of abandonment didn’t kick in). It’s a different feeling to an ache or a pain, it’s like I need to peel my skin off or scrape it or burn it because it is too much, it’s too tight, it’s too skin-y, almost like there are too many nerve endings.

Sometimes I come home from a busy day at work and there is a tinnitus ringing in my ears, I want to peel my skin off just so it stops hurting, I want to eat dry toast with nothing on it so I can just taste the simplicity of the bread and nothing else. I just want to turn all of the lights out and put my head under the duvet and close my eyes so I can’t see and hear and be seen.

Some people think I am lazy because of this. It’s not lazy, its needing to get away from the stimulation of everyday life and the rapid emotions.

Some people think I should go and achieve something and that will make me feel better. It won’t, the over stimulation makes things worse and I’m less able to concentrate.

Some people just don’t get it when I explain it to them and look at me with a puzzled look on their face. I don’t really care if they don’t get it, I have to look after myself.

I’m getting used to the fact that I am not some-people. I’m getting used to my normal not being everyone elses normal. While I sometimes get cross and frustrated with that fact, talking about it in the real world is getting easier and I am gaining more understanding about myself, and other people, and just how fascinating, as well as bizarre, BPD is.

Love Sailor xox

Want to read more? -

Fun pigeon facts – Super vision

Black and white thinking in BPD

Rapid cycling – The differences between BPD and Bipolar

Ultra confusing anger thermometer

© Hellosailor and A Canvas Of The Minds 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Hellosailor and A Canvas Of The Minds with appropriate and specific direction to the original content. This work is protected under a Creative Commons Attribution-Non-Commercial-NoDerivs 3.0 Unported License.