The End of Therapy… and what the hell do I do now?

2015-02-04 13.04.09First off, there’s a lot of stigma surrounding manic-depressive disorder. It’s as much a physical condition as anything, a lot like being born with a bum leg that acts up every now and then.  I see it vilified in stories, movies, and in the media – and it sort of pisses me off. If you need a character who goes off and kills someone for no reason, a man who beats his wife, etc., “bipolar” seems to be the way to go. I’ve only ever hit one person and it was in self defense and though I know it has affected my relationships (how could it not, it’s part of who I am), it’s never been in the way you’d see in movies. I’m not trying to start some whiny, “treat us better” campaign – I just thought I should clarify where I’m coming from. And, I doubt this post will help anyone. It will probably end up being an example of TL;DR, so I’m posting this more as a reminder to myself than anything else.

Right after I first started this blog, I started going to a shrink. I was diagnosed with this when I was seventeen, but decided to completely ignore it for years and years, self medicating along the way, if you know what I mean. Though he’d strongly suggested that I do it twice a week, I thought that he was being a little reactionary and I cut it down to once a week… and I went regularly for a year and a half.

I’d refused medication because unless it’s a life or death situation, I would rather not be saddled with a drug habit – even if it is voluntary. Some weeks it was just two people sitting and chatting about philosophy, music, and all sorts of other things that really had no direct impact on my health and other weeks I was so dead inside that I could barely put enough words together to form a sentence.

As time went on, I learned how to manage those times better. Well, that’s not exactly true. I learned how to manage how I felt about those times. I always have a lot going on and when I would hit my down times, I would barely have the energy to breath, much less engage my brain and write a new chapter, come up with another product for my side business, or be a productive member of society in any way. I would spend my seven to ten day stretch eating and watching Netflix. If they ever take Doctor Who, Sliders, or any of the many Star Trek series off there, I would be totally lost.

Two things would always bother me during those times:

1) The horribly ingrained Puritanical work-ethic that most Americans are saddled with. I’m not saying it’s a bad thing, but when you absolutely cannot move, it preys on your mind.

2)  The abject terror that this will be the time that the depression doesn’t stop. This is the biggest one.

I spent the latter part of my teen years in and out of psych hospitals because of suicidal tendencies and one suicide attempt. That’s a hard thing to shake off. I’m no longer in danger of having to live in my car, I’ve learned how to deal with the fact that my parents really don’t like me – not an exaggeration, they’re fundamentalists and I’m an out and proud fag, and really nothing’s the same as it was. I’ve learned how to bend the world around me to accommodate my eccentricities. But, I still vividly remember every second of what that felt like and at least a couple of times a year I would panic, just knowing that it was going to happen again.

Last month, my employer made us switch from very good insurance (Blue Cross) to overpriced, very poor insurance (United) and I had to stop seeing my shrink. When the news came, I was in a manic stage (damn I love those) and I thought, “Hey, I can do this. Hell, I could conquer the world by the end of winter if I wanted to!” (see why I love those spells?) And while I was right that I could do it on my own, it’s obviously not as easy as I would like. So, here are the things I learned in my year and half…

1) Get as much shit as possible done during a manic phase.

When this is going on, it’s easy to focus but hard to make decisions. Energy is coursing through my body like I’ve snorted an eight-ball of coke and chased it with a twelve pack of Red Bull and without a little pre-planning, something gets done on about a million projects and nothing really gets any closer to completion. So, I’ve set up a list of projects that need to be done with nothing but pure physical movement. If I need to make a sample for my side business, I already have the materials and detailed plans ready to go. If I have an extra super-duper cleaning project that needs to be done, this is the time. The key is to not have to think – have everything planned and ready to go. If I have to think about which project to work on, I’ll get distracted.

As far as writing goes, I can write a first draft but can’t edit.  And my mind buzzes around so easily to absolutely absurd things that this is a great time to outline a story. Asking yourself the “what if?” question during a manic phase leads to some excellent results.

2) Have things ready for the depressive stage too…

I still don’t do a lot during this time. At my regular day job, there are projects that get attention only when my energy level is low. They aren’t high priority and since they are cyclical and can be done on my own time frame, it’s ok for me to be a little slower with them. As for other stuff, I learned how to knit – a good skill to have with New England winters being a little tough – and I always have a project sitting by my television watching chair. There are other small things I have ready to work on too, the key is to make sure they are routine, take very little thought, and very little energy.

As for writing, this is when I get most of my reading done and I always have ideas when I read. So, I sit in my recliner, read, and jot down any ideas that come to mind… and then, with them safely down on paper, I completely ignore them until I am in a state of mind where I can flesh them out.

3) If I’m not able to do anything – I don’t feel guilt about it. As great as all this pre-planning is, there are still times when I just can’t move. So, what do I do? I don’t move. This used to fill me with guilt and a horrible feeling of worthlessness, which on top of a depressive state is like pouring the opposite of gasoline onto the opposite of a fire. It does nothing to increase productivity, it just heaps on shame. And (pardon my French), fuck that. I know that it won’t be long before I’m buzzing through the world again and it’s ok to take a break when one’s needed.

Nobody is sitting with bated breath waiting for my next product or a novel. All of this will get done in good time. There is not one person who will be affected by my not producing – so there’s no pressure. As long as I get work done when I’m able and the work is good, nothing else matters.

4) Absolutely more important than anything else – pay attention!

I have to know where I am in my cycle to be of any good to myself. I cycle very quickly. I get about ten days in each phase, from the ramping up to the dissipating, with about a week of even in between. I meditate every day… even in the manic phase when I’d rather be bouncing off the walls. I don’t do it for long, just enough to get an idea of where I am, what my mood is, and which direction to point myself.

Usually, the cycles aren’t extreme and I’m able to just function normally through everything. If I meditate and none of the signs I know to look for have happened in the last day… I go about my business. Sometimes I’m a few days into a cycle before I realize what’s going on and I just adjust when I realize it. Knowing where I am helps soooo much. But I make sure not to worry about duration. When I first started this, if a mood went over the ten day mark, I panicked. That doesn’t help anything.

5) Always remember – it will end.

That’s how I got through my twenties. “You’ll be ok for today. If things are absolutely unbearable, you can kill yourself tomorrow.” Morbid, right? Well, it kept me alive and at least started to put things into some sort of perspective. I now use a much less drastic version of this when the connections in my brain stall out, but it still works.

I haven’t been suicidal for about 15 years now (except during that unfortunate Chantix episode, but that passed when I threw that stuff away), because I know I have a lot of control over my life and I have to stick around to see how well I’m able to make this plot line come to a satisfying conclusion. Bipolar disorder is a chronic disease. Medications may help, I don’t want them unless I absolutely have to have them – and I hope it doesn’t come to that.

I will have these cycles until the day I die. At times I will be lethargic and stare slack-jawed, watching Captain Picard keep this quadrant of the galaxy safe and at other times, I will be conquering my corner of the world with super-human energy and focus. Either way, I think I’m ready to do this on my own. THB

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