Mental Health Update

Just about six months out from making my diagnosis known, and a bit over four months from when I got to a therapeutic dose, and things are going really well. I’ve gone through a stressful period in the last few months: Dad’s job situation changing, then mine not long after that. Have there been absolutely awful days? Yes. There isn’t a hangover, though. I don’t go through a run of just really, really, really shitty days where I can’t drag my mood out of the gutter if my life depended on doing so. I also don’t go through a week or two or eight where I think I can just rule the world, sleep four hours a night, and generally be a one-legged man in an ass-kicking contest.

I just feel normal.

I’ll tell y’all, it’s really weird to feel normal after you’ve not been right for a decade or more. I’ve tried to figure out when the onset of my depression set in for me. I’ve just about pinpointed it to late in middle school or early in high school. I honestly don’t know how I got through high school and college like this, but I must admit that it was getting worse—way worse. That was the really bad thing about taking a while to get to a diagnosis—even though that is just going to happen, you know? I felt like we were doing a lot of the right things, and we were, but then it would go all apeshit and be even worse, and man … for a while there it just seemed like there was no fucking point to it all, really. Here I was, doing the right things, and it was getting worse? Really, God?

At this point, my blog is the only way that I know that the month of June 2009 exists in my world. I honestly don’t remember anything from about mid-May forward until early July. I don’t think I’m ready to face all that just yet. I realized a few weeks ago that I was anxious merely about going back down in that hole. Hell, it still scares me some as I’m sitting here thinking about it now. But it’s not anything that I can’t live through.

Self-Tracking: Sleep Cycle iPhone App

I mentioned yesterday that I’ve been doing a little self-tracking. That has been courtesy of the Sleep Cycle iPhone app from LexWare Labs AB.

You can see that last night was pretty ugh: some dreaming early on, but not much time in deep sleep.

I have found a pretty strong correlation with what this app gives me and how I feel the next day. My Really Good Days last week were when I had really good sleep according to this app, regardless of how long I’d actually slept. I’ve been tired the last few days, and have been attempting to sleep longer to catch up [9+ hours last night!], but it’s not been working because I haven’t been sleeping as well. Grrr.

Why is this important to me? I know from watching my mood over the last two years that my depression issues are directly correlated to poor sleep. I don’t know which is the cause and which is the effect, but I do know that there is correlation.

As for all my friends who question whether this would work in a two-person sleeping situation, apparently it will. It’s a $.99 app, and if you want to try it and it doesn’t work, I’ll give you the dang buck. 😉

I Kinda Hope My Doctor Googles Me

Dave Pell, on the excellent Tweetage Wasteland, writes about doctors Googling their patients:

During a recent session, I brought up this topic with my own shrink. He rarely interacts with the web and is as renown for his cynicism about academic essays as he is for being an excellent doctor. I fully expected him to dismiss the issue with a wave of the hand and then gently guide us back to our more prolific and productive conversations about being the child of Holocaust survivors or the upcoming NFL draft.

Instead, he surprised me with this response: “Everyone Googles everyone these days. Why would this be any different?”

He Googles me, he really Googles me.

I actually challenged my therapist about this, and she either 1) has a really good poker face or 2) hadn’t thought to look. But maybe now she’s reading. If so, hi! 🙂

Dave also wrote about the end of privacy being the end of shame, which is, I think, a central theme here. Vis: re-opening my Twitter account, arguing for the (re)presentation of self, or wondering about my friend who ended up in sexual misconduct. I personally feel that privacy is a crutch in life. When I live more transparently, I find myself more free to exhibit my personality in an uninhibited manner. It’s about being comfortable with my flaws.

Better Living Through Chemistry

In case you’ve been wondering how I’ve been doing with my bipolar depression, here’s an update.

  1. Starting Monday, I’ll be at the therapeutic dose of my mood stabilizer. Right now, I’m at 75% of that, and I feel great.
  2. Do I still have good days and bad days? Sure, we all have them. But my bad days aren’t so bad, and my good days aren’t so good that I want to quit the drugs and go back to the highs of hypomania.
  3. Speaking of those highs: what I’ve come to understand is that a lot of my negative self-image stems from the fact that the only times I’ve felt right the past few years have been when I’ve been hypomanic. Let’s be honest: I’m a high-functioning overachiever. My hypomania maximized my potential for awesome, which is why I liked it so much. But I’ll also be honest in that the highs are not worth the lows that I have. Not in the slightest. Further expanding on this point: I’m aware that people really value me, but I don’t feel that way. There are some roots to this problem, and I’m exploring them. It’s hard work, but it’s so necessary to getting my head straightened out.
  4. Therapy continues to be good, if hard. [See above.] A lot of my actions in the last 20 years have been to insulate myself from pain. Fixing this is not unlike debriding a burn: painful, but necessary. I’m just starting to unlock things inside my head, and it’s so good.
  5. I had to get biochemically balanced to make therapy be fully efficacious. This isn’t to say that the last eight months have been a waste, because they haven’t, but I’m feeling like I’m just now starting to get somewhere. We’ve been laying the foundation, and now it’s time to raise the walls. [Or, well, lower them, as it were.]

And if you didn’t care, well, you read this far anyway, eh? 😉

311

I only wish I was talking about the band. No, that’s my DSM-IV diagnosis as of this moment. I can now see the pattern all the way back through college: I’ve been an undiagnosed bipolar depressive. I’m more of a bi-polar II type, really—I never go into full-blown mania, but I do go hypomanic, often for long periods.

This explains so much about me, and yet I am not even close to settled with it.

I can choose to be my diagnosis, or I can choose to treat the symptomology and see myself as a whole person. Once we came to the idea that this might be what it is—before Christmas, if you must know—I strongly defined myself by that diagnosis. I went into a shell of myself, honestly, living this whole meta-life where I overanalyzed everything. The only reason I was functional at all during this time was because I spent December in hypomania: I wasn’t ten foot tall and bulletproof, but I was at least eight feet high and ready to run through brick walls.

Running through brick walls. That’s a common act here on my end. I get convinced that I can do anything, and being a generally capable chap, I find that I’m able to accomplish much of what I set my mind to—but only when I’m hypomanic. When I’m depressed, I do very well to get out of bed in the morning and put one foot in front of the other. Imagine, then, when I came off that hypomania back to the depths while my good friends Kat and Sean were in town. That first weekend, the only thing that got me out of bed was the knowledge that I’d get to spend some time with them. Spend a lot of time with them, I did; then I’d drive home and the blackness would settle back in.

So, I did what any smart depressive does: ask for help. I met with my psychiatrist a couple days early, then started on a new drug regimen. By the end of the week, I was feeling much better, but the last few days … well, let’s just say that I’m happy that I titrate up to the next dose of the mood stabilizer tomorrow.

This is not easy. In fact, it’s quite hard. But doing nothing would be worse, for me. I can’t go on living like I was, with the antidepressants working some of the time and fighting some of the depression, except when it got worse, and then it would get better again, and that would be because I was hypomanic, and while I never quit my drugs or even stopped the dosages, I’d take my eyes off the prize, thinking I was Fixed.

I wasn’t Fixed. I’m trying to learn how to manage this, this which is so clearly my life and has been for a decade, though maybe I’ve not wanted to face it. But here in my thirties, I’d rather face my demons than be owned by them. I’d rather fight them and lose and lick my wounds than just lie in a pile in bed, unable to move, crushed by the biochemistry being off in my head.

And why the hell am I writing about this on the Internet? In a few hours, Facebook will import this as a note, and all 1200+ of my friends can confirm what they’ve long suspected—that I’m batshit insane at times. Isn’t this a bit of an overshare?

No.

I want the stigma of mental illness to go away. I want people to understand that people they know and love can struggle with these things, publicly, unafraid of who might know or find out. When I took time off at work back in June, everyone there really didn’t want to talk about it. I understood that, but man, seriously … I needed it. I realize now that I was coming off of some hypomania and plunging really, really far down in the hole, to a place where the antidepressants didn’t begin to touch things.

Yes, I need to talk about these things—not out of narcissism, but because others need to know that they’re not alone in this struggle. I’ve had at least two friends who, because I’ve written about my depression in the past, have sought help themselves, saying to me that they felt emboldened because I’d been public with it. In the light of that, how can I not share this fight with you?

I won’t get into specifics on meds or anything, but I’m combining an antidepressant with a mood stabilizer. It takes eight weeks to get to a therapeutic dose of the latter, and that’s proving to be hard, but I’m at least functional. That’s how most people end up fighting this: both barrels. The goal is to get to a normal person’s ups and downs, because those can be handled. I also see a therapist in addition to my psychiatrist, and if you ask if it’s worth it, I’ll tell you that I pay her out of pocket, and when I was seeing her every week last year, it was 10% of my takehome pay. It was worth every penny. I’ve unlocked a lot of wrong thinking in my head, and it makes me a lot more equipped to handle this. Talk therapy is not for everyone, but it’s definitely been for me.

So that’s what I’ve got, and that’s what I do about it. Got questions?

On Church, Early 2010

Brandi is struggling with church and why we do it, and I wrote this comment, which I’ll repost here because I think it’s highly relevant to my main consumer of this site: me.

I’m glad that you’ve made the choice to stick it out. Twice, I’ve become overwhelmed and left churches to start anew, for exactly the reasons you’ve alluded to here [although unlike you, I’ve never been on staff; but I did get asked to be the youth director once when I was in college, but anyway]. I find in the results of this that the problem lies, well, with me: how I balance my life, how I react when challenged by others, etc. Unlike you, I’m still single, so I don’t even have the marriage relationship to remind me that these rough patches are worth trucking through. I envy you that.

I am currently between church congregations for a number of reasons. One, which seems quite silly, is that my overwork at work and at my previous congregation got me to a point where I was overwhelmed and ultimately depressed, and I gave up the thing I could afford financially to give up. Sad, but true.

And yet while I’ve been out of a congregation for more than a year now, I find myself yearning for corporate worship and study. I find that I don’t challenge myself—rightly or wrongly!—in solitude. I find that small groups can often end up having herd mentalities, and I need something bigger than that so I don’t get into those mentalities.

And … in the course of writing this, I think I just talked myself into going to the local megachurch on Sunday. Heh.

I want to expand on that last point a little bit. I’ve long resisted large congregations, thinking they should plant. Part of this comes from my reading of Dunbar’s number and my desire to know and be known by a community of believers. But as I wrote that about small groups, I realized that my need for community can be met at that level while my need for larger corporate worship and accountability can be met by a larger congregation. You know, as long as I don’t buy into herd mentalities and “us v. them” thinking.

I’ve resisted visiting Asbury UMC, Madison’s large Methodist congregation, for all those reasons. But sitting here, I feel this tug on my heart that all that is just flippin’ silly. So… okay, God.

Feelings … whoooa, feelings.

Somewhere in my MSMS days, I took the Myers-Briggs Type Indicator, and I came up as an ENTP, which was jokingly called the ENgineering Type Personality. “Cool,” I thought, “I’m going into the right field.”

As it turns out, my T score really was, as I now understand it, a repression of just how much I am ruled by emotion rather than logic. Some of you who know me may dispute this, but let me tell you … here inside me, my heart wins out over my head all the doggone time. I really am an ENFP, or what the Keirsey folks call a champion.

Where this plays out as a problem with me is that I often end up feeling overwhelmed by the intensity of the emotions that I feel about things. A case in point is today: Misty posts a photo of Eli on the way to his first day of school, and well, it makes me cry. Misty was incredulous, but I yam what I yam.

This is, perhaps, the most important thing that I’ve learned about myself in therapy. I sabotage myself when I get overly emotional, because I think I can’t handle it and/or shouldn’t be feeling this [sadness|happiness|fear|anger] so intensely, and so I try to cut it off. That’s acting against type, and honestly, it’s just about the worst response that I can give myself—because then I seek to numb things out a bit. And if you’ve taken one look at me, you might imagine that I do this by stuffing something in my pie hole.

I’m learning to just ride the waves as they come, because they will eventually go away. If I try to cut it off—or worse, bottle it—it gets even worse. I’m tired of it being worse.

And so concludes this introspection that you didn’t really ask for me to perform. Now, don’t ask me about the bullshit decision by the CCHA today—I’m still too angry to talk about that rationally.

Shorn

Before [well, a couple weeks ago; I’d let it grow since then]:

Before

After:

After

I grew the beard in my 20s to look older at work. I had plenty of reasons for this, but the main one is that I was way younger than my peers and wanted to fit in a bit more visually. Now that I’m 30, though, I don’t really care about that kind of thing as much—plus, I’m established in my position. Also, I associate the growth of the beard with the growth of my gut over the same period of time. I’m trying to get rid of one, so why not both?

It’s all in how you choose to see things. This I have learned lately. And I now choose to see myself as a cleanshaven individual. [But yes, I will Whiskerino in three months. No worries there.]

Let’s just call this “six in a row”.

I wrote on Monday that I was auditioning for the Huntsville Master Chorale. My audition was this afternoon, and I was told that I had “a perfect choral sound” and that “I would love to have you in our group”. I mean, that’s not, “You’re in,” but it’s pretty close. Needless to say, I’m happy with it, even though I thought my sight-reading stunk on ice. [She demurred and argued that it was a challenging piece to sight read, which I grant you that it was, but still … I missed notes! I don’t like missing notes!] I was nervous, mainly because the last time I tried out for anything was ACDA All-State my senior year at MSMS.

Also, things continue to be good. I had a dream last night that I went back to work today, where I got yelled at by everyone involved for coming back early. :chuckle: Today was actually the first day I was eligible to go back, as the leave I’m on requires that you be gone at least two weeks. Admittedly, I am tempted, but there are some things I want to get done around the house and with myself before I start back to work. I meet with my shrink again tomorrow, and I think she’ll be happy with my results. I know that I am.

Four Good Days in a Row

If you follow the mood chart I started mainly for my doctor, you’ll see that I’ve had four good days in a row. The combination of the medical changes I’ve made are really making a difference in my mood and energy levels, and it’s awesome, y’all.

I’ve also been thinking about what I was doing wrong, because hell, it’s not all the drugs, man. To argue that my choices have no effect on my mood is just such utter bullshit, and turns meds into the crutch that so many people are afraid they’ll be. I strongly suspect that one of my friends who is struggling with depression right now fears meds because of the crutch concept. I want to tell you that they are not a crutch but a restorative—and you need that to keep the car on the road, but at the end of the day, you still have to drive, dammit. Kari sparked the thoughts that I’d had going to mind in writing about her issues with overcommitting.

Simply put, I got so busy at work that my fear of overcommitting—which has burned me out in the past—lead me to undercommit to anything that was not my job. Church, family, friends, self … all of you got sacrificed on the altar of my career. It was good for my career, but eventually left me such a broken shell of a person that I couldn’t hold it together to do the one thing I was theoretically trying to save.

It is entirely true that I am an aerospace engineer turned project manager. But to argue that this is all I am is just so, so wrong. I have long prided myself—rightly, I think—on being a well-rounded person. But the only way in which I can be considered well-rounded is in my physical appearance, which is not what I would call a Good Thing. [Just ask my knees and hips, which are both really barking tonight as I sit here in my desk chair.] I’m working on this, though. I plan on going flat out for the 40 [sometimes 45, sometimes 50] hours a week that my job asks of me, but I’ve got to do other things besides that lest I go absolutely batshit insane.

I’ve been working on this in two ways: one is, of course, seeking to get back into a church home. The other is something that finally came to mind today: auditioning for the Huntsville Master Chorale. I go on Wednesday. The time commitment may prove, ultimately, to be too much, but I owe it to myself and my baritone to stretch myself a little bit and have some fun.