Hope does spring eternal

It's been a long, painful winter. The longest and darkest depression of recent memory, following rapidly on the heals of the most hypomanic episode I've experienced yet, has taken it's toll on body, mind and spirit. Things had gotten so bad that even my annual rite of spring - a hypomanic episode that I look forward to with anticipation all winter - was noticeably absent.

I'd fallen so deep into the dark pit of despair that I didn't think I'd ever be able to climb out again, and worse, I didn't think I had the energy or desire to try. I'm not proud of the days and nights that I cried out to God, feeling as Job must have felt, wondering why this? why me? why now? Despite it all, though I wasn't always there for God, He was there for me, even if I was too depressed to feel His presence.

Already, as the fog slowly starts to lift, I'm beginning to understand some of the lessons that this round of depression have taught me. While I recognize the biochemical nature of bipolar disorder, I also believe that when I'm facing either depression or hypomania, my thoughts, emotions, perceptions and decision-making capabilities are all impacted. So, while I believe that the proper dose of the correct medication can help level out the chemical imbalances, no pill is going to ultimately help me live my life to it's fullest potential. As a result, part of managing this disorder has got to include gaining insights and then using them to develop viable strategies for effective self-care.

After a long and largely unsuccessful job search, I was blessed on Friday to receive, and accept, a job offer for a wonderful new opportunity. Under other circumstances, the news would have driven me straight into hypomania. While it hasn't had that effect (yet), I am grateful and I feel something I haven't felt for a very long time - hope.

Hindsight really does have 20/20 vision. In retrospect, I'm beginning to see how the temp job that I've hated for much of the past 4 months has been integral in not only helping me find and get my new job, but in preparing me for some of the tasks at hand. Working home alone for the past 6 years, the temp job provided an opportunity to "practice" interacting with people again, and gave me lots of practice at relationship-building, a skill that's going to be invaluable in the new job.

In addition, losing the majority of my home business, and having to live on a lot less money, has also dragged me kicking and screaming into a new relationship with money, a new perspective that is much healthier and much more realistic. Now that I'm living by a monthly budget, I can't imagine how I ever survived without one. And although my expenses are high relative to my now-reduced income, I'm able to get by on a lot less than I'd imagined.

The lesson I suppose is that no matter how dismal life seems on our dark days, there's always hope. As several of you have reminded me, the dark days of depression are always eventually followed by the sun - maybe that's one of the advantages of having bipolar disorder - the realization that just like the weather, if you don't like your current mood, don't worry, it's bound to change sooner or later.

I think Dr. Martin Luther King Jr. must have had BP'ers in mind when he said that "we must accept finite disappointment, but never lose infinite hope."

Giving thanks

During periods of hypomania, I feel a direct line to God. I can't say that I hear His voice audibly, although I wish I could. But just as with love, lust, creativity, passion, and every other emotion, when I'm hypomanic, my spiritual connection is indescribably intense. When I'm hypomanic, I can see the touch of God's loving hand everywhere and in everything I do. Things seem to fall into place, prayers are answered, and life is good.

The recent diagnosis of atypical bipolar II sent me into a spiritual tailspin, questioning the depths and breadth of my faith. I didn't question God's existence, but I did question my relationship with Him (more on this later). I think that some of this soul searching was intellectual in nature - after all, in retrospect I realize that the intensely emotional attachments that I felt toward men in the past was driven more by hypomania than a real and lasting love-connection, so in my mind it stands to reason that it's worth at least asking the question if I've done the same thing in my relationship with God.

Add to that the deep depression that I've been in since last summer and the string of really rotten *luck* that I've had since coming out of my last hypomanic episode and I began to question whether or not I'd fallen out of favor with God. I asked "why me, why this, why now?" I begged and pleaded for relief - financial, career, health, medical insurance - and it just seemed as if God was noticeably silent. I knew that He heard my prayers, which made the fact that they weren't being answered even more painful and difficult to bear.

God has not forgotten me, nor has He failed me.... maybe it's even the other way around. I've spent so much time in the darkness lately that it's been very hard for me to see the light. But just as sometimes takes rainy days for us to appreciate the sunshine, even a little bit of light can illuminate the darkness and help us to see things more clearly.

So, for today, rather than focusing on all of the fears and losses I've experienced since being diagnosed, I need to pause and give thanks for the positive things that God has done in my life since then.

1. I had a job interview yesterday and today I was offered, and I gratefully and enthusiastically accepted the job! I start next week, and I'll post about it in an upcoming post, but thankfully, it is NOT an F-job.
2. With that job comes 100% paid medical insurance, which had been a major concern for me.
3. I'm now enrolled in a clinical research trial which provides very specialized care from a wonderfully supportive team of health care professionals.
4. I've found a surprisingly comforting group of virtual friends through this an other bipolar disorder blogs. In particular, I'm thankful for the almost daily words of encouragement from Susan, Marja, and Lucky Mud.
5. Although it's not a surprise, it's been wonderful to experience the support and comfort from my mother and my aunt.
6. I've had the opportunity to meet some fellow BP'ers in person through a local bipolar disorder support group.
7. Since losing my major client, I've since gotten 2 more smaller ones and over the past 2 months, I've earned more working 3-4 hours/week than I earned working full-time as a temp.
8. Even though I live in a non-pet building, because I casually mentioned that I needed a pet for therapy, I discovered a non-well-known law in my state that allowed me to get a kitten with a prescription from my doctor! I now have the coolest cat - Alex.
9. I've found a new church that focuses on people "with issues" - addictions , health concerns, mental health issues, divorce, family and relationship issues.
10. Even though I'll be leaving there next week, I've met some great new friends at the temp job I worked at for the past 4 months.
11. I found the courage to address a work-related issue that had really been a source of much angst over the past few months. It was difficult, but I did the right thing.
12. I found the courage to start this blog and people are actually reading it. It's been very therapeutic for me to write about all this and it's nice to know that at least some of what I'm writing about resonates with others. I'm anxiously looking forward to breaking the 500-view mark any day now! :)
13. The new job requires me to dress up. This will be the first job I've had in over 10 years where I had to do that. I can't think of a better way to celebrate the new job than to go out and buy a new business wardrobe! That's what I'll be doing tomorrow.
14. While there needs to me more, there's some good information on bipolar disorder, much of which has been very helpful in making sense of all this. I'm thankful for all of the books, blogs, websites and other resources that are available.
15. And, last but not least, as painful as it's been, I'm thankful to finally have a diagnosis. Not only can I now receive the treatment that I need, but so much of what never made sense before is now clearer to me.

Poor choices

One of the things that always puzzled me about myself is how I could be so "smart" intellectually and professionally, yet make so many stupid choices in my personal life. I had a therapist tell me years ago that while my IQ is very high, my EQ (emotional quotient) was much lower. That's putting it mildly. I haven't read the book on EQ, but I'd guess that if the standard is similar to that of IQ, my EQ level would render me at least mildly retarded.

According to Sam Shein, a Teaneck psychologist, "people who suffer from untreated bipolar disorder tend to make the most pleasurable and most convenient choices but not the most logical decisions in life... The problem with bipolar disorder is that, if we did an X-ray of the head and the mind, it would look like a switchboard with 20 calls coming in... They take the call that feels best emotionally. They don't do the logical thing. They don't do the thing that is the right behavior. They go to the feelings."

Boy, is that an understatement! The problem is that the feelings that people with bipolar disorder feel during episodes of mania or depression are not necessarily the same feelings, and certainly not with the same intensity, that we feel when our moods are more stable.

I often see the scenes in movies where the woman wakes up after a night of hot sex (much of which she probably doesn't even remember because she was drunk), and she rolls over and can't believe that she's in bed with the guy she just met the night before.

Now imagine a similar scenario, but instead, replace alcohol or drugs with the mania of bipolar disorder, and replace the night of hot sex with weeks or months of what seems like the "perfect" relationship with "Mr. Right". Then imagine gradually waking up to realize that Mr. Right is anything but right - for you - and imagine going so far as to marry the guy!

For me, it's not the hypomania that's the problem. It's a wonderful time when I'm in the midst of it. I feel as if I'm living my life in technicolor, rather than the many shades of gray that I live with most of the time. The choices I make seem perfectly logical at the time and I'm able to be quite persuasive in my ability to rationalize my decisions. The problem comes when the hypomania fades away and I'm left with the consequences of my hypomanic choices which all of a sudden don't seem so logical or rationale. I've learned the hard way that cleaning up a big mess is a lot harder than making one.

Goodbye dreams

I was going to be a successful writer. I was going to spend my days writing hugely successful non-fiction books, bringing a gentle, insightful, spiritual perspective to a number of life's tough topics. I was going to touch the lives of many and change the lives of some.

I was going to start and run a major non-profit organization to offer rape recovery retreats to women who were long-time survivors of sexual violence, given them a place of respite, of hope, and of healing. I was going to do some ground-breaking work in the use of knitting therapy to help these women heal.

I was going to design, build and spend my life in a beautiful Mediterranean-style villa overlooking the water in a place that was perpetually sunny and warm. I was going to rise to the bright morning sun and write from my office with the french doors wide open so that breezes could blow the crisp, sheer white curtains. Fresh cut flowers would fill the house and I'd walk barefoot on cool tiles in warm colors beneath my feet. The walls and shelves would have been filled with beautiful, colorful hand-crafted art. The outdoor room would be the place I spent my evenings, dining on freshly grilled seafood and vegetables under the stars, either alone or with my close circle of dear friends.

I was going to share my success and my sanctuary with the man I've always dreamed of. He was to be handsome, creative, spontaneous, supportive, trustworthy, generous, kind, loving and hopelessly romantic. He would have loved to cook, dine out, travel and dance. We would talk long walks along the beach and talk for hours in front of the fireplace or under the stars.

These were my dreams. I was hypomanic.

Of course I will miss the creativity, the flashes of brillance and the boundless energy of hypomania. But more than that, I will miss the hope hypomania offered. When I was hypomanic, I could look in the mirror and see a bright, brilliant, witty and charming woman who was approaching the second, and better, half of her life with renewed vigor, focus and passion. I could think of the suffering of my past as learning experiences that were merely part of a grander plan to prepare me for the incredibly bright future I had in store. There wasn't anything I couldn't accomplish if I put my mind to it, and the future was as bright as the sun.

Those dreams have all crashed and burned along with my hypomania. Where I once felt invincible, I now feel impotent. Before I could do anything, now it takes everything I have to make it through the day. I can't seem to find a way to look at the future as anything more than countless hours, days, weeks, months and years of the same deep, dark pain that I've been feeling for the past several months. I'm not suicidal, but is it any wonder that I often imagining going to sleep and just not waking up?

That's the odd thing about sleep, or the lack of it. When I'm hypomanic, I don't need to sleep. It's a waste of precious time. With so much to do, why waste it on sleep? But when I'm depressed, I don't want to sleep. I think it's because I don't want to wake up and go through another Groundhog Day existence. What's the point?

I understand now that hypomania is not *healthy* and I can see that my dreams weren't realistic, but at least they gave me hope. The alternative really sucks.

Update: 10/9/2007

Today I'm in the process of moving all of my previous posts from Wordpress to Blogger. It's a tedious and time-consuming process, but the one benefit has been the necessity of re-reading each post to decide which to move and which to delete. I debated on deleting this one because I no longer feel the pain I felt when I wrote this 6 months ago.

But I decided to keep it because it is a great example of the cyclical nature of bipolar disorder and of life in general. A lot has happened since I wrote the original post and as dark as those days were at the time, they did not last. Had anyone told me that back then, and some tried, I would not have believed it. I didn't see any way possible to come out of the darkness. But I did. Was it easy, not at all. But with the right combination of medication, a supportive health care team, a wonderful friend/mentor who also has bipolar depression, and a lot of hard, focused work on my part, I've made it into the light. And in the process, I've been blogging about what I'm doing and what I'm learning, with the hope that not only can I help myself the next time I'm depressed, but hopefully that I can help someone else as well. I imagine that I will face more episodes of depression in the future, but now I know I can stare it directly in the eyes and that I will prevail.

A long, hard look in the mirror

Thanks to Lucky Mud for sharing some tips on self-care from a book she's reading. She says that

The authors have put together a 4-step plan: (1) Medications and Supplements; (2) Lifestyle Changes; (3) Behavioural Changes; and (4) Asking for Help. What they stress is that in order to create lasting stability, we must treat bipolar first - manage the illness before work, relationships and everything else...The first step in the book is to list your major symptoms. This is to help in identifying a good treatment plan and to be able to talk to your doctor about your experience with the illness.

It was helpful, and very illuminating, to read Lucky Mud's list of symptoms. I saw so much of myself there. So, I decided to take the plunge and create my own list of symptoms as the first step in the self-care process. Be forewarned - the list is a long one:

Depression

• Sadness, unhappiness, feelings of despair and hopelessness
• Irritability, frustration, low tolerance, anger, pessimism
• Apathy, lethargy, lack of energy and enthusiasm
• Hypersensitivity - overly emotional, crying easily
• Feeling easily overwhelmed
• Complete loss of sex drive, sometimes to the point of revulsion at the thought of sex
• Insomnia at night, sometimes sleeping too much during the day
• Poor memory and concentration
• Slow pace - thoughts and physical movements are slow and require much more energy
• Inability to work efficiently, or at all, easily distracted, hard to focus
• Difficulty meeting obligations
• Low self-esteem, feeling worthless or inadequate, loss of self-confidence
• Ruminating over past mistakes/failures - constant questioning of and examining of my life, choices and behaviors, excessive feelings of guilt
• Difficulty making even the simplist of decisions
• Social isolation
• Thoughts about death and dying, not suicide, just dying from an accident or natural causes

Hypomania

• A profound feeling of love, wonder, and physical and mental well-being
• Feeling positive or optimistic no matter what happens - always seeing the bright side
• Significantly decreased need for sleep
• Increased energy
• Gregariousness; talkativeness, especially with strangers
• Increased productivity, very goal-oriented
• Racing thoughts; increased, but fleeting interest in random topics
• Thinking and speaking so quickly that others can't keep up - getting irritated that they can't
• Increased sexual desire - feel sexy
• Increased self-esteem or grandiosity; an unrealistically inflated sense of self-worth
• Believing that I can do anything, even things that I have no experience or skill at
• Increased involvement in, and obsession with, goal-related activities
• Starting new projects I'm confident will change the world
• Highly distractable - jumping from topic to topic, obsession to obsession
• Lots of ideas on how to make a lot of money
• Planning how to spend money that I don't have yet

Anxiety

Nervousness, tension or restlessness

Increased heart rate, chest pains

Excessive worry

Difficulty recalling words; words are on the tip of my tongue but I can’t find them

Starting a conversation and forgetting what I was going to say

The tragedy at VT - what does it mean?

Like most of the world, I've been stunned and heartbroken about the tragic events that unfolded at VA Tech on Monday. It brought back horrible memories of the Columbine incident years ago, and more recently the killings at the Amish school. What's different with the Va Tech horror is that it's the first incident of this type that I've viewed through the eyes of someone who has no officially been tagged with a mental illness.

I have never, nor could I imagine, ever feeling the kind of blinding rage, social isolation and utter despair that Cho must have felt, but I do find myself with conflicted feelings about this case. While I cannot imagine how this could have happened, I feel a glimmer of empathy for this tragic young man and his family. I wonder about the extent to which the mental health community failed him and the innocent victims whose lives he destroyed. I wonder what, if anything could have been done to avert this disaster, and I wonder the extent to which we as a society have lost sight of our need to be "our brother's keeper". I wonder where evil ends and madness begins.

Selfishly, I also fear the implications for people living with mental illnesses. I fear that many kind, caring, thoughtful, law-abiding people will be painted with the same broad brush that the media is using to describe in vivid detail the complexities of Cho's mental state. I fear that this situation, and others like it, fuel the fires of ignorance and fearmongering, adding to the stereotypes that suggest that all people with mental illness are unstable, dangerous loose cannons just waiting to erupt with the slightest bit of provocation, or with none at all. I share the sentiments of Nurse Ratched in today's post.

For a more hopeful spin on this story in the media, here's a news release from the National Institutes of Mental Health. Of course you'll never see this one on the front page of your local newspaper.

While it would certainly be easier and less risky to go back into the closet about living with a mental illness, I believe that situations like this one make it even more imperative that we tell our stories and make ourselves known. Only then can the world understand that living with a mental illness doesn't automatically and necessarily make one a monster.

Darkness falls

I've experienced chronic physical pain and I've experienced deep and chronic depression. Given the choice, I'd choose physical pain any day.

Physical pain is tangible. It has a beginning, a middle and an end. When my body hurts, I can articulate where it hurts and how it hurts, and I can usually take a pill or two to make it stop. When I have a headache or a backache, other people get it. They can understand and empathize. They don't expect me to grin and bear it or to think positively to make it go away. They don't tell me that it's all in my head.

Emotional pain is different. It doesn't have a predictable course or a quick fix. I can't take a painkiller, or wear a brace, or use an ice pack or a heating pad for relief. Sometimes I can pinpoint a specific trigger, but many times I can't. The pain is just there, and nothing I do, think or say will make it go away.

This weekend was like that. My heart and my head were dark. There was a blankness, a blackness in my soul that draped me like the heavy blanket that the dental technician places over my chest before I have my teeth x-rayed. Only instead of keeping harmful x-rays out, the blanket of depression that covers me like a shroud keeps all the painful, harmful stuff inside.

When I'm feeling dark, helpless and hopeless like this, I miss my hypomania. I need it like an addict needs a fix. I look at the dishes piled up in the sink, the mountains of dirty clothes, and the stacks of unread newspapers and mail and I wish for a fraction of the energy that I have when I'm hypomanic. I know I'd feel better if I could bring myself to straighten things up, but I just can't find the strength. I'd like to curl up an read some of the dozens of books that line the shelves of my home office, just waiting to take me to far away places, but I can't find the energy to do that either.

Intellectually, I know that this too shall pass. There will be brighter days, I know. But right now, all I can see is day after day of darkness, with no sunshine in sight. The emptiness in my soul is so vast that I can't imagine the hole ever being filled.

There is a bit of hope though. Like a single candle flickering in an otherwise pitch blackness, I try my best to hold on to my faith, my belief that even though I don't understand it, there is a reason for all things, even this. No matter how depressed I am, I know that my life, my salvation, is a gift from God, and that to attempt to end the pain of this life would only bring an eternity of suffering that would be far worse than anything I can imagine in this life.

So, there you have it. The choice doesn't seem fair, but it is a choice nonetheless. I choose to live with the pain of this life. I choose to believe that no matter how things appear today, there's hope that tomorrow will be better.

Permission granted

I wonder how my life would have been different if I wasn't bipolar. I'll go a step further and say that I wonder how my life would be different if I'd known I was bipolar 30 years ago. Perhaps I wouldn't have made many of the poor choices I made. Perhaps I wouldn't have gone from one disasterous relationship to the next, or sabatoged every decent job I had, or moved with the frequency of a gypsy. But then, maybe I would have. I guess I'll never know.

What I do know is that had I known about my bipolar tendencies years ago, I would have been much kinder and gentler with myself. I would have figured out a way to flow with my moods rather than fighting them. I would have tried harder to resist making major life decisions when I was either severely depressed or exquisitely hypomanic. I would have spent less time beating myself up for not being able to think my way out of depression and for not being able to sustain those exuberant, exhilirating, and incredibly productive bursts of creative energy that I know now were not healthy. I would have been more patient with colleagues who simply could not keep up with my boundless energy and lightening -ast thinking when I was hypomanic. I would not have dragged so many decent, but ill-suited men through the emotional roller coaster that is my life.

I cannot go back in time to change the past. Nor can I fast-forward and predict or micro-manage the future. But what I can do is accept the reality of my fate and learn to ride the tide rather than resist it. I give myself permission to be who I am.

Permission granted... to do what I need to do to take care of myself, even if that means being by myself for a while. Hopefully friends and family will understand, but if they don't, that's their issue, not mine.

Permission granted... to acknowledge my depression and to exert the limited energy I have during those times to resting and healing, rather than pretending that everything is okay when clearly it is not.

Permission granted... to accept the fact that my hypomanic episodes are not healthy and are not a state to strive for.

Permission granted... to honestly identify my triggers and to make a conscious decision, on an on-going basis, to minimize their ability to exacerbate my symptoms.

Permission granted... to explore the creative aspects of my being and to celebrate that gift in ways that are wholesome and healthy.

Permission granted... to take whatever meds are necessarily to help stabilize my moods so that I can function more consistently.

Permission granted... to stop trying to be the person that others think I am or want me to be. It's exhausting, and it simply does not work.

Permission granted... to forgive myself... to let go of the past, warts and all, realizing at last that I really did do the best that I could given the circumstances.

Permission granted... to be myself, just as I am.

Walk a mile in my shoes

There's something to be said for that old adage about walking a mile in another man's (or woman's) shoes. According to a recent article, scientists are saying that "traditional drug regimes for people with bipolar disorder could be increasingly replaced with therapies to treat the "triggers" of manic episodes." Spoken by people who clearly haven't lived with BP.

I don't relish the idea of taking medication for the rest of my life and I don't know many people who do. I've even been known to offer a pharameutical company conspiracy theory or two from time to time. But this brilliant idea is reminiscent of all the times that well-meaning but ill-informed family members and friends have suggested that by merely thinking positively and changing my attitude, I can end my depression. Call me paranoid, but I believe that underneath these seemingly thoughtful and optimistic suggestions lies an unstated assumption that I am somehow responsible for my depression. I caused it by "lazy" thinking, so I can get rid of it if only I'd try hard enough.

I agree, to an extent, that there is a strong mind-body connection, acknowledging that some are much better than others at being able to access it. But I don't hear anybody suggesting that a diabetic think his or her way out of the need for insulin or that someone who suffers from seizures should stop taking their anti-seizure medication and hope for the best.

For as long as I can remember, I have been dismissed and disregarded by family members, friends and co-workers, and most painfully, by doctors who have downplayed or even disputed my persistent claims that something was *wrong* with me. I found that if my symptoms could not be validated by a blood test or an X-ray, then they must not be real. In an attempt to convince me that my chronic fatigue, aches and pains, insomnia and depression were all figments of my over-stressed imagination, I've seen doctors with the audacity to ask me about my sex life - as if sex, or the lack of it, were somehow responsible for my physical symptoms. If I said that I had a boyfriend/husband, they suggested that I might want to get rid of him. If I said I didn't, they'd suggest that I get one. Is it any wonder that I never stayed with one doctor for very long?

In my decidedly non-medical opinion, even if people with bipolar disorder can learn to more successfully deal with external stressors such as unhealthy relationships, a new job or loss of one, seasonal changes or the death of a loved one, this approach negates the fact that while stress may exacerbate bipolar disorder, it doesn't cause it. Where does the concept of a chemical imbalance in the brain fit into this new model for living with bipolar disorder? Excuse my ignorance, but even if I were able to handle every ounce of stress in my life (NOT) and I stopped taking meds, what happens when the naturally occurring chemical imbalance rears it's ugly head again? But wait... if I'm doing my job of managing stress in my life, I shouldn't have depressed or hypomanic moods any more right? So, this really is my fault then... if I can cause it I can stop it right? It just doesn't make sense.

If doctors can find a way to treat my triggers... a history of toxic family issues, losing my business to cheaper labor in India, a so-far unsuccessful job search, very expensive health insurance premiums that offer minimal benefits, 10 years of chronic insomnia, just to name a few... then I'll be the first to sign up. If not, stop expecting me to fix something that I didn't break and start working on more effective meds with less dangerous side-effects, and make sure they're affordable too. And while you're at it, convince health insurance companies to cover this long-term therapy that's supposed to help so much.

If only these white coats could walk a mile in my shoes.

Triggers

If stress triggers bipolar disorder, then eliminating (or at least reducing) stress should minimize the frequency and severity of bipolar episodes, right? Easier said than done... especially when life seems to be a string of stressful events, the perfect storm of anxiety, fear, and depression with lots of poor decisions thrown into the mix. I wonder if my reactions, responses and decisions in the wake of these major life events would have been different if it weren't for the bipolar component of my personality, but I realize that's a purely academic exercise that doesn't help me in the here and now.

Of course there are those situations that I couldn't control, like being assaulted at gunpoint when I was 19, the tragic death of my brother, losing a job when my employer filed bankruptcy, being diagnosed with a potentially fatal disease (only to learn years later than I had been misdiagnosed). I don't worry so much about the role of bipolar disorder in my reactions to these things... the fact that I'm still alive, and sane, and not abusing drugs or alcohol in their wake is significant.

But then there's the other stuff, like being unable to sustain a long-term relationship or a job no matter how hard I try, or the need to move frequently to start a new life in new surroundings - only to find that wherever I go, I'm always there. There's this obsession with workplace intregrity (see previous post), the exhilirating rush I feel when in the early stages of a new relationship, and the intensely emotional, but equally sporadic, spiritual phases I go through. How much of that is me and how much is mania? Not being able to answer that question makes me confused, fearful, untrusting of myself and very, very sad.

I imagine that everyone has triggers that are unique to them. I'd also guess that the list grows and wans over time but is a constant work in progress. Nonetheless, being aware of the triggers that we are aware of has got to be helpful in identifying when we are headed towards a bipolar episode. Maybe we can avoid the trigger altogether, perhaps we can minimize it's effect on us, or if nothing else, at least we can begin our emotional evacuation strategy to keep us as sheltered as possible from the rages of bipolar disorder.

So here's a first stab at my list of triggers:

For depression:

• stress at work (usually frustration at incompetence, lack of integrity, or working with people who don't want to do their job)
• conversations with certain family members who are in denial about some very serious issues
• job-hunting, interviewing, waiting, being rejected, especially when I know I'm qualified
  stresses of owning my own business (dealing with difficult clients, losing clients, financial uncertainties)
• settings where everybody seems to be part of a couple or a family and I'm alone
  chronic physical pain, particularly when it's cause is undiagnosed
• persistent thoughts of past personal failures
• the death of a loved one
• the end of a significant relationship, particularly if the break-up is handled poorly
• being financially unstable
• the loss of a job
• unsuccessful shopping trips, especially when I really need something and can't find it
• gaining weight or not being able to lose what I've gained
• insomnia
• unresolved anger, about anything
• working at a job that I hate
• having a cluttered home and not having the energy to unclutter it
• winter (cold, dark and damp days and long nights)
• disasters (9/11 left me emotionally paralyzed for weeks)
• setting unrealistic, and often unattainable, goals for myself and getting frustrated with myself when I don't have the energy to follow through

For mania:

• a new romantic relationship (this is #1)
• a promotion or major new project at work
• moving to a new home
• a new job
• a new business opportunity or idea

It's obvious to me from this process that I have much less experience with manic episodes, I would consider those that I've had to by hypomanic rather than full-blown mania. I think that part of the reason that it took so long for me to be diagnosed is because until recently, I didn't think any thing was wrong with my hypomanic episodes. To be honest, I actually enjoyed them... so much so that I've spent most of my adult life trying to recreate them.

I've never done non-prescription drugs, but I suspect that the genuine rush I get when I'm cycling upward out of a depression feels very much the same. I can't remember, I may not even know, what it feels like to have a "normal" mood state, so my upswings are probably even more pronounced because they come at the end of a long period of depression. All I know is that when I'm "up", I'm creative, energetic, optimistic, self-confident, productive, playful, joyful, and social. Sleep is no longer as necessary, and in fact, becomes a waste of precious time. When I'm manic, I can get more done in the first few hours of the day than most people get done all day. Who wouldn't want to live like that?

It's only now that I've been diagnosed and researching mania that I'm able to recognize the downside to those manic episodes. I'm beginning to see why the relationships that started out with such ferocious intensity fizzled out just as quickly, why I get so frustrated with co-workers who appear to me to be either incompenent or lazy, why I set such unrealistic goals for myself but still beat myself up when I can't reach them, why I have dozens of unfinished projects hiding away in closets, or why I've spent a small fortune and can't really explain where the money went and certainly don't have much to show for it.

There are so many things I find odd about manic episodes... odd as in fascinating, but also odd as in scary-as-hell. When I'm manic, it seems like the most normal state for me. My actions and reactions feel perfectly normal. It's only when I "crash" that I feel as if I'm waking up from weeks of sleep-walking and I think "my God, what was I thinking?"

I liked life better when I didn't know that those high places weren't good for me. On one hand, I wonder if medication will dull my senses to the point that I lose that creative and productive spark that defined so much of who I am. Yet, on the other hand, I wonder what will happen if medication can't even out those high spots and, like a hot air balloon that's lost it's lead, I float completely out of control. I know that ignorance isn't really bliss, but it would be nice, wouldn't it?

Lonely is as loney does

I wonder why it is that I never feel "lonely" until I go out in public? There was a time when I was afraid to be alone, but not anymore. In fact, I actually enjoy living alone. I appreciate the opportunity to decorate in a way that suits my tastes, I'm glad I can cook, clean, watch tv, or sleep (or not) whenever I please. I like not having to be (or not be) for the sake of accommodating another person.

That said, I know that social isolation and bipolar disorder (particularly during depressed episodes) do not mix, so I really do try to maintain contact with other people. But when I do, something strange and painful happens. It is the very act of seeking to minimize my aloneness that makes me feel alone the most.

When I'm by myself, there's no one to compare myself with, but when I'm out, I'm constantly reminded of the human connections that nearly everyone around me seems to have. Intellectually, I know that every couple isn't blissfully in love, and every family isn't like the Cleavers or the Huxtables, but they appear that way to me. I know that envy is a very ugly character trait, but I often find myself envious of couples who remain happily married for long periods of time. I envy the memories they've created through the years and I envy the plans they share for their future. I envy those who have chosen their partners wisely, or at least committed to the partners they chose. I envy those whose partners chose to stick by them, even through the bad times.

Because being "in love" is my most significant trigger, it is my Achilles heel. I can see rather clearly now how most of my hypomanic periods involved the start of a new relationship - and many of my most depressed periods involved the ending of a relationship, which in turn lead to another period of hypomania. I can see that I made very poor choices and for that reason, the outcome of those relationships was assured - they were doomed from the start. I planted so many seeds, but none in fertile soil.

The deep dark loneliness I feel now is not grief over the loss of a particular relationship and it's not an unfulfilled desire to be in a romantic relationship. It's more of a "who would mourn my loss if I died?" sort of sadness. I have a small but strong support network, my mother, my daughter, my aunt and a few close friends, but I know I sit at the edges of their busy and fulfilled lives. Of course I know that Jesus loves me, and for that I am eternally grateful, but I can't exactly invite him over to play Scrabble on a lonely Friday night.

As big as this hole in my heart was before my diagnosis, it seems to have grown even bigger since then. What would fill it? I have no idea... But I think David Foster Wallace had it right when he said "We're all lonely for something we don't know we're lonely for. How else to explain the curious feeling that goes around feeling like missing somebody we've never even met?"

The glass is half full

If we're willing to look for it, we can always find cause for celebration, even in our darkest days. If you doubt that, read this post at Bipolar Wellness Writer. I'm inspired by Susan's honesty and clarity and I share many of her sentiments.

I was particularly struck by the way she describes hypomania:

"In a hypomania I feel a kind of aliveness and joy that I think few "normal" people ever experience. When I'm hypomanic and I walk outside and feel the sun on my face, it literally warms my heart. When I look at trees, I notice the color and texture of their bark and leaves. When I walk around the park, I hear the birds chirping, the whack of golf clubs hitting golf balls, the scratching sound of squirrels climbing trees. When I'm with people I care about, I feel a love that is so pure and full that my heart feels like it might burst with happiness. When I am hypomanic, I feel a level of energy that is truly blissful."

It's ironic that medical science has determined that to feel these things is to suffer from a "mental illness", a mild form yes, but a mental illness nonetheless. I just can't seem to wrap my mind around the notion that this isn't what life is supposed to be like. So what exactly is "normal" and who gets to decide? Is a view of life that is less than what Susan describes the accepted norm because the majority of people experience it that way?

What's so wrong with seeing the world in living color, knowing that your senses are alive to all the sights, sounds, tastes, textures and fragrances that surround us? What's wrong with laughing with reckless abandon just because, or feeling love with such an overwhelming force that it brings tears of joy to your eyes?

As much as depression sucks, I'd rather have bouts of depression sprinkled with liberal doses of hypomania than to never have experienced life in technicolor.

Things I love about hypomania

Bipolar disorder isn't all bad... in fact, there is one thing about it that's quite good, in moderation of course. That's hypomania, a mildly euphoric mood which for me is characterized by an excess of energy, creativity, enthusiasm, optimism and productivity. Here's a list of some of the many things I love about hypomania:

1. Jumping out of bed ready to face the day
2. Not being jerked out of already elusive sleep by the awful sound of an alarm clock
3. Seeing everything "in color" instead of the usual shades of gray
4. Having boundless energy
5. Great creative ideas
6. Motivation to get things done
7. Connecting with old friends that I didn't feel like talking to when I was depressed
8. Cleaning my house and keeping it clean (at least for a while)
9. Not crying at the drop of a hat (which can be very embarrassing)
10. Getting twice as much done in half the time, then having even more time because I don't have to waste it sleeping
11. Losing weight because of all the activity
12. Feeling happy for no particular reason
13. Feeling hopeful and optimistic about the future
14. Being able to laugh
15. Not being depressed

Feel free to post your own list.

The Emporer is naked!

I've had more jobs in my life so far than I'd like to admit. Early on in my career, I attributed changing jobs to an on-going quest for career advancement. After all, in the circles that I traveled in back then, nearly all the people I knew were on the fast track to one place or another, and I wasn't about to be left behind.

But somewhere along the way, the train got derailed. The upward momentum I once had came to a screeching halt. The pressure became overwhelming and I stepped off the train, thinking I'd be able to get back on after taking some time out to rest. At the time I was working for a Fortune 100 corporation, earning a healthy almost-six-figure income, and I simply walked away.

Since then, I've had many jobs, some good, some not-so-good, and certainly none earning anywhere near what I'd been making before. But regardless of whether the company was large or small, white-collar or blue, there's a disturbing pattern I've noticed that is slowly (or perhaps not so slowly) driving me insane.

Simply put, it's a lack of integrity in the workplace, which by it's very nature transcends into personal character. Unlike so many Bill Clinton supporters who extolled the virtue of compartmentalization during the Lewinsky affair (pardon the pun, I couldn't resist), I cannot except the notion that one's professional character is separate and apart from who they are as a person. If you lie, cheat and steal from your employer, you're a liar, a cheat and thief, regardless of how decent you claim to be around your family and friends.

Wherever I've worked, if there's a department that's cooking the books, misappropriating corporate funds, fudging numbers or outright lying in order to appease a client, I end up working in it. I feel like that Peanuts cartoon character, with a cloud of corruption following me everywhere I go. I know I may sound histrionic, but I'm not making this up.

Early in my career, I worked for what was then one of the largest accounting firms in the country, who went belly-up for a host of racketeering and other assorted financial misdeeds, leaving 3,000 employees standing in the unemployment line the day before Thanksgiving. Another very major corporation I worked for ended up being fined millions (and I do mean millions) for unethical bookkeeping practices and other assorted irregularities. I left another firm when my largest client told me that the work my company was providing would very likely be material to a potential lawsuit and that I (me personally) needed to be prepared to testify to it's validity in a court of law. NOT!

I've come to accept the fact that there are unscrupulous people out there and that they can be found in every facet of life. But what I struggle with constantly is the apathy and appeasement that cause so many people to go along for the ride or to simply look the other way. I'm stunned at how many seemingly educated, intelligent and professional people are willing to ignore the fact that the Emporer is wearing no clothes. While everyone else is busy telling him how beautiful his robes are, I'm standing there screaming "BUT HE'S NAKED!!!!!!" Isn't it fascinating that the attitude that makes work life bearable for so many people is the same one that makes me want to implode.

I'm so tired of trying to do the right thing while surrounded by people who couldn't care less. It never ceases to amaze me how many people in leadership positions would rather stick their heads in the sand than acknowledge what's going on in their own shops. Perhaps that's because admitting there's a problem usually requires doing something about it.

Looking back, I'm beginning to understand now why I haven't been able to stay on a job for very long. Integrity is a core value of mine and when it's thrown to the wind, I feel an overwhelming sense of righteous indignation. I get anxious, I obsess over the indiscretions, becoming hypersensitive to how they manifest in the workplace, I get agitated and try to stir up the masses to do something - ANYTHING - to make it stop. When that doesn't happen, I get irritated, and then angry, and then depressed. Before I know it, insomnia settles in again. I don't want to go to sleep because that means I'll have to wake up in the morning and do it all over again. Finally, the very thought of going to work makes me physically ill. And if that wasn't bad enought, next comes the anxiety and stress of job-hunting, which is even less appealing to me than root canal surgery. Let me just say that I find the process of searching, applying and interviewing for a job to be one of the most dehumanizing and anxiety-ridden processes I've ever encountered... But, you guessed it. Thanks exactly what I'm doing right now.

As if stardom wasn't enough

I am not star-struck and although I'd love to be rich, I have no desire to be famous. Nonetheless, I decided to do a a bit of research to see who else had (or has) bipolar disorder - after all, the only people I "know" who live in the same boat are the 4 people I met at the first support group meeting I attended last week.

How did we ever manage without google? In a mere second I found a very interesting list of Famous People with Bipolar Disorder. There were some names that were not particularly surprising... perhaps because I'd heard or read somewhere that they lived with bipolar disorder long before I understood what that really meant. I felt a sudden surge of sadness and an almost overwhelming sense of empathy when seeing names like van Gogh, Virginia Woolfe and Phyllis Hyman, an amazing R&B stylist who committed suicide years ago. I remember vividly attending what no one ever imagined would be her last concert, in the prime of her career, only 5 days before she ended her life. I had no idea before that night that she'd endured so much, but the pain in her eyes and her voice was undeniable as she sang her heart out that night.

It would have been easy to become fearful and depressed at first glance. But the more I looked at the list, I was also struck by an entirely different emotion - hope. I was surprised and encouraged to see the names of many people who despite their struggles have found a way to harness the creative aspects of bipolar disorder and craft them into successful and significant careers... Jane Pauley, Alvin Ailey, Sting, Patricia Cornwell and Tracy Ullman to name a few. If they can pursue their dreams in spite of bipolar disorder, then maybe so can I.

Root Causes

I love the concept of synchronicity. Dictionary.com defines it as "the coincidental occurrence of events and especially psychic events (as similar thoughts in widely separated persons or a mental image of an unexpected event before it happens) that seem related but are not explained by conventional mechanisms of causality —used especially in the psychology of C. G. Jung."

I provide that definition to help explain the concept, although I don't believe the technical definition does the term justice. As a Christian, I firmly believe there are no coincidences and it comes as no surprise to me that certain events, in fact many events, cannot be explained by "conventional mechanisms of causality." That's the beauty of synchronicity to me... In the moments that I am consciously aware of them, synchronistic moments remind me that there is a much bigger plan, that my life has a purpose, even if I'm not fully aware of it, and that no matter how dismal things may seem, there is always hope.

I had one of those moments this morning. I felt compelled to visit a new church today, one that I first heard of a year ago, and that I was reminded of again 2 weeks ago. Despite my not-so-pleasant church experience yesterday (see previous post), I decided to step out again, not on a search to meet new people, but because I just had a feeling that I needed to be there today.

The message was exactly what I needed to hear today... a day that started out with me questioning whether I'm really ready to tackle the process of untangling the bipolar mess that is my life. I decided that I have to face my diagnosis and adjust my life accordingly, but I don't have to start right now... Maybe in a few days... or a week... or next month...

The topic of this morning's message was "Do you really want to take a Spring Break?" The pastor likened dealing with the difficult and painful issues of our lives (past and present) to tending a garden - a timely analogy as spring is upon us. The pastor reminded us that during this time of year we have two choices when it comes to preparing our yards for pleasant weather. We can chose to take a weed-whacker, chop off all of the dead plants and the new weeds, throw some mulch over everything and move on to the next project, or preferably, go do something fun.

Sounds quick and easy, doesn't it? It is, and that's what so many of us have spent much of our lives doing. The problem is that within a few weeks, those weeds have not only grown back, but because the roots were left in tact, they start to multiply. All of a sudden, our beautifully mulched garden is full of healthy, hearty weeds who threaten to strangle the life out of the new flowers that are trying to bloom there.

There is an alternative, one that serious gardeners employ... taking the time up front to clear away all of the dead stuff so that they can paintstakingly pull up the weeds... roots and all, conducting soil analyses to see what essential nutrients are lacking, and then preparing the soil to maximize it's ability to produce beautiful and healthy plants. I'll be the first to admit that this approach requires much more time, patience, perserverance and in many cases, aches and pains. But imagine the pay off. Later in the spring when you're standing in front of your beautiful garden and admiring the literal fruits of your labor, do you really complain about how much trouble it was? Not likely.

I've spent most of my life throwing mulch on my problems, focusing more on what the pastor this morning called "appearance management". Although I didn't have a name for what ailed me, I've always known that something was "wrong", I just didn't know what. So I filled that vacuum of ignorance with a never-ending parade of band-aids and emotional prosthetics in order to appear "normal" and to fit in. For the most part, I did a pretty darn good job of convincing others that all was well, in fact, for periods of time I even convinced myself.

In retrospect, it's no surprise that I was always physically and emotionally exhausted... I was like the duck swimming in the pond - smooth and calm on the surface, but paddling like crazy underneath. Rather than acknowledging and dealing with the whirlwind of emotions that were whipping around inside, I focused instead on maintaining that calm, steady exterior. I know now that I did myself much more harm than good.

So, now that I'm beginning to understand the realities of bipolar disorder and how it affects my life, it's time to chose a different path... one that will be much harder, but that must certainly be more productive than the path I'd been on. It's time to clear away the dead stuff that no longer works, dig up those ugly painful roots that run so deep and so wide, and prepare my soil for the types of flowers that I want to grow.