(Photo courtesy of the Human Rights Campaign - Twitter)
The civil rights issue of the 21st century is finally having its day in court. Same-sex marriage has made its way to the Supreme Court. The justices will be deciding the fate of gay marriage based on the two laws in question. Proposition 8, which bans same-sex marriage in California, and the Defense of Marriage Act, which recognizes marriage as being defined between a man and a woman, will be discussed.
I recently received a comment from someone who is recently diagnosed with Bipolar Disorder. She just watched my video that I made regarding my struggle with bipolar disorder, here . I discuss how I was diagnosed in 2004, my struggles, how I relapsed in 2008, and how things have gotten better for me. I know that a new diagnosis is scary, and I wanted to share what it was like for me.
1) I knew something was wrong with me, as my mood was really low, I wanted to sleep all the time, and I was anxious about college. I would cry everyday regarding applications to college and it was to the point to where my parents stated it was okay if I didn’t go to college my first year. They said I could do some travelling or something for that first year if I needed to. I was, and am, lucky to have such supportive parents. We all didn’t really know what was going on. In December of that year, I thought I was better. ”Better” turned out to be hypomania, a lower and less severe form of mania. I wasn’t sleeping, I had all these great ideas. I was going to be a cryptogropher for the CIA and a bunch of other things that really excited me. Turns out the better that my parents and I were hoping for was actually the second side of my mental illness.
2) In March, we got a psychological evaluation done, and I was diagnosed with Bipolar Disorder, Type II. I was scared, but also thankful because I finally knew what was wrong. That did not make it any easier, though. People at school looked at me differently, I then had manic episode in April. I cut off my hair, I had a wonderful “scrapbooking” idea, which turned into me completely trashing my room unintentionally. I wasn’t able to perform in the last performance of my senior year musical, as I crashed from my high and hit depression again.
3) I really had no idea what was going on, until I went on Depakote. I tried Lithium and either through my manic thoughts or actually being allergic to it, I developed a bad rash. Depakote helped stablize me, and by the time I graduated in May 2004, I was in a stable mood state, neither depressed nor manic.
4) Fast forward to my senior year of college. That fall, I started having depressive episodes, but it wasn’t “clinical depression” because it did not last for more than two weeks. Turns out, I was cycling. It was like clockwork, actually, very strange, and makes the most sense that it was a chemical imbalance. It was also exacerbated by stress. I would feel fine for a few days a week and then depressed as hell for the other days. I blamed it on a particularly hard course, Psychology and Law, which was also my favorite course. In the Spring, I stressed out about Digital Photography. I know it was an elective, and I’m sure others didn’t understand, but it lacked structure, and with my cycling mood, I couldn’t handle a class that wasn’t structured. In May 2008, I graduated from college with a 3.97 GPA and I won an award at graduation. I was singing in the commencement chorale. It would have been a wonderful day, had I been stable. But, I was depressed. When I got the award, I smiled. All I could think, though, was “How am I going to hold my award (it was a trophy) and my diploma while singing the song where all the graduates file out?” I was nervous already, and then my cap started to fall of my head. Then, I had to hold my diploma in one hand, balance the cap, and hold the award in the other. Despite the wonderful occasion, I was a wreck. I’ve never really told anyone this, in this much detail.
5) So after a high stress job following graduation, I finally went to my psychiatrist and added another medication, Celexa. I take it at a low dose, and it helps with anxiety and depression. I realized that my anxiety over something fuels my depression; mainly, I get anxious about something, it paralyzes me, and that’s when I’m depressed.
Suggestions or things to think about:
1) start to track your mood. There are some good websites that have mood charts. Here’s one that I like because you mark your mood based on -3 to +3 with normal range being zero. Below that, you can write how many hours you slept, whether you took your medication, level of anxiety, and whether or not you used alcohol or nonprescription drugs. It goes like this for 31 days. I like to turn it sideways as I go to see the changes during a month. That way, you can see whether or not it has to do with your sleep cycle, or may be surrounding menstrual cycle (for females). This helped me catch that my mood was changing weekly. It coincided with my work schedule when I had a high stress job.
2)Once we are aware of how our mood changes, we can look for triggers. When do you notice yourself slipping, or getting happier? What is happening? For me, I had extreme anxiety surrounding my job, I noticed I would start to feel better during my last day of work, which signaled to me that I should probably have a job elsewhere.
Looking for our triggers can help us find ways to protect ourselves. For example, if I know that going to work can be a trigger for me, what I can do to counteract the trigger? For me, getting a good amount of sleep, or exercising can help counterbalance mood. Exercise releases serotonin and dopamine, two neurotransmitters that help stablize our mood. Exercise is just as important as medication.
3)Therapy can help us really recognize our triggers and develop safety plans. Cognitive Behavioral Therapy is helpful for us to analyze our thoughts, which ultimately lead to emotions. Our reactions to our thoughts and emotions lead to behaviors. Dialectical Behavior Therapy can help us develop coping skills. Specifically paying attention to the skills of regulating our emotions and utilizing distress tolerance skills for when we are in the throes of an episode and need something to change NOW.
I haven’t had a manic episode or hypomania in almost 10 years. I really think my mental illness has morphed into anxiety-related depression. Thankfully I haven’t felt depressed in three years. So, on paper, my diagnosis is Bipolar I Disorder, Sustained, Full Remission. It is great for me to see those words, not only because I am better and stable, but also because it lets me know what I have been through, what I have survived.
So for those of you out there that are in the midst of an episode, are unsure of how to explain yourself, don’t feel alone…know that it does get better. It is a hard battle, but it is possible. My heart goes out to you.
I feel like I’m slacking because I’m not studying, but in reality, I’ve just taken my licensing exam AND my graduation/exit exam last week. Last week was so intense, but months of studying definitely paid off. I feel like I passed both tests (yet I won’t know for another 6-8 weeks). Here’s to hoping that come December I will be a National Certified Counselor and on my way to be licensed in my state to practice as an Associate Professional Counselor. I am so excited! I really have only one class where I have assignments, and my midterm is due this Thursday, there is a brief paper, and then a final exam. These all consist of papers and role playing. I am very good at writing academic papers, so I believe I will do well; I’m sick of exams! 
I’m not quite sure what to do with my time; reading for pleasure is a foreign concept to me, but I’m loving it. I have read the Fifty Shades of Grey trilogy (yes, I’m one of those people), and I’m actually re-reading the 2nd and 3rd books. I really like the plot, and yes, I’ve cried a few times. B laughs at me, saying I’m the only person that cries at erotica, but whatever. I’m also reading Get Me Out of Here by Rachel Reiland, which is an excellent memoir of a woman who has overcome Borderline Personality Disorder. One of my clients has started reading it as well, and she finds it helpful as there is someone who has overcome/recovered from BPD, at least in terms of controlling symptoms. I’m also reading a memoir about anxiety (which was on hold for a month as I was studying) and I hope to start that again as soon as I finish Get Me Out of Here. B wants me to read House of Leaves, so that is also next on my list.
I’ve started making bracelets and anklets using hemp and bamboo cord. I am custom designing them. A link to my website is here:
Borderline personality disorder is a broad diagnosis.
Media outlets and some psychology websites paint patients with BPD as violent, impulsive, and prone to tumultuous relationships. But in reality, the disorder is far more complex. Its clinical definition includes nine symptoms, of which patients must have at least five. That calculates to 256 different symptom combinations -- 256 ways, if you will, to have BPD.
So if you read my last post, you’ll know I discussed Dream Theater’s Six Degrees of Inner Turbulence CD, which chronicles stories of numerous mental illnesses including PTSD, DID, Bipolar Disorder, Schizophrenia, post partum depression, and Asperger’s. Previously, when I worked on an inpatient unit, I played About to Crash and provided lyrics during a group. I had clients identify passages in the lyrics (much like what I did in my last post). One girl became very triggered, and we ended up ending the group early, and doing the electric slide and other music to help distract her and not let her slip into a suicidal place. These clients were in the highest level of care facility we have, and so they were acutely experiencing symptoms.
At my current place of work, I think it would be interesting to try this mindfulness exercise again. However, I am definitely cognizant of the fact that it is triggering. It does not trigger me anymore, but I have been stable for almost three years. I think if we’re covering distress tolerance in DBT and emotion regulation, it might be an appropriate mindfulness activity, but I do not want to do this if I feel my group isn’t ready. I know one core group I lead, would not be able to handle it, so I wouldn’t use it with them. My question is, for those of you that have mental illness and follow my blog, would you find this song triggering? If so, what would help you process the trigger?
I’m envisioning playing the song, talking about it, and then providing support for those that need it. In the instance of DBT skills group, we would be going over distress tolerance at the time. Personally, when I heard these songs, they helped me feel less alone, and I was like exactly! This is how I feel!. I’d like others’ opinions. I would not do this without first talking to my supervisor, and I’m still processing this; I may never use this exercise, but I thought it could be interesting for those that are stable enough to appreciate it.
Update:
After thinking more about it, I don’t think I’ll do this except on an individual basis.
So I absolutely love the band, Dream Theater. During my senior year of high school, when I was diagnosed with bipolar disorder, their CD Six Degrees of Inner Turbulence came out. The are six songs on it and they pertain to the following mental illnesses: (1) About to Crash [bipolar disorder] (2) War Inside My Head [PTSD] (3) The Test That Stumped Them All [schizophrenia] (4) Good Night Kiss [Post partum depression] (5) Solitary Shell [Asperger's syndrome] (6) About to Crash Reprise [mania aspect of bipolar disorder] (7) Losing Time [Dissociative Identity Disorder]
I love this CD as it really speaks to my experience. Here’s a Wiki article that describes the CD, and specifically, the songs as they chronicle bipolar disorder. Below are the lyrics of the song. I’ve bolded the parts that I identify with:
About to Crash
She can’t stop pacing
She never felt so alive
Her thoughts are racing
Set on overdrive
It takes a village
This she knows is true
they’re expecting her
And she’s got work to do
He helplessly stands by
It’s meaningless to try
As he rubs his red-rimmed eyes
He says I’ve never seen her get this bad
Even though she seems so high
He knows that she can’t fly
and when she falls out of the sky
He’ll be standing by
She was raised in a small midwestern town
By a charming and eccentric loving father
She was praised as the perfect teenage girl
And everyone thought highly of her
And she tried everyday
With endless drive
To make the grade
Then one day
She woke up to find
The perfect girl
Had lost her mind
Once barely taking a break
Now she sleeps the days away
She helplessly stands by
It’s meaningless to try
All she wants to do is cry
No one ever knew she was so sad
Cause even though she gets so high
And thinks that she can fly
She will fall out of the sky
But in the face of misery
She found hopefulness
Feeling better
She had weathered
This depression
Much to her advantage
She resumed her frantic pace
Boundless power
Midnight hour
She enjoyed the race
The Reprise:
I’m alive again
The darkness far behind me
I’m invincible
Despair will never find me
I feel strong
I’ve got a new sense of elation
Boundless energy
Euphoria fixation
Still it’s hard to just get by
It seems so meaningless to try
When all I want to do is cry
Who would ever know I felt so sad
Even though I get so high
I know that I will never fly
And when I fall out of the sky
Who’ll be standing by
Will you be standing by?
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So as you can see, I have a lot bolded. I love the Wiki article linked above because it describes each phase of depression and mania.
I grew up as a highly motivated and independent person, always trying my best, and I graduated Valedictorian of my high school class even with the immense depression and manic episode I experienced my senior year. When it was all over, I was so surprised I even graduated, as I felt like I had failed out my senior year (in reality, I only made on B, which was in weight training, and due to my having to miss classes because of psychiatry and therapist appts, and a car accident).
I feel my Dad and mom were definitely wondering how it got so bad. The way my depression was, it lasted three months, and then I was “better” but that turned out to be hypomania. I do not believe I had a “stable” aspect of that year until I got off Lithium and was put on Depakote.
For me waking up and losing my mind, it was gradual and did not just happen all at once. I started, I believe, right after I stopped attending a summer academy at a local university before my senior year. I wanted out of the conservative town I lived in, and I wanted to leave and go to college. The prospect of applying to colleges, is what triggered my mental illness. I had a presdisposition for it, but the stress is what “flipped the switch.”
The “No one ever know she was so sad” definitely embodies a lot of that year. I was able to hide it well, and my “friends” weren’t all that close anyway, so I would just stay home all weekend. I would do the family dinner/movie night, but I lost interest in everything, and yet, I was able to fake it well. (This also parallels an abusive relationship I was in, as even my own roommate wasn’t aware the abuse was really going on and as bad as it was, but that’s another story).
I was super excited in December 2003 when I felt better, I stopped sleeping and I went away to this church camp and I loved it. I felt I was attracted to this one girl and started opening back up to my feelings for women. (When I was depressed, I identified as a heterosexual/asexual). When I was hypomanic/manic, I was more in touch with those feelings, and also had to reign in the loss of impulse control when manic. I never did anything sexual, but for example, I wrote notes to this girl thinking she might like me too. In reality, she did not, and she probably thought I was crazy.
The next lines in the Reprise are about mania and hypomania, which I experienced both. Luckily, I’ve only had one manic episode. I had numerous hypomanic episodes, where I would cycle in and out in the period of a week or two. This can be called ultra rapid cycling bipolar disorder. It did not happen throughout the course of a day, which is more characteristic and one symptom of borderline personality disorder.
Who will be standing by? Will the people that I love still love me? My parents? Most definitely. My partner? She’s never experienced my change, but I know she will. Friends? In high school, I lost all of my friends. I scared them. Rightly so, they had never experienced anyone with mental illness. So as I become really close to someone, I tell them about my mental illness just in case I become symptomatic, so they will understand. Thankfully, now that I’m older, and in the mental health field, people understand more. If they didn’t, then they are not worth being my friend.
I created a video for my lifespan development class in graduate school chronicling my mental illness, so if you want to check it out, here and you won’t have to read this long post!
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I actually was not aware that Losing Time, the last song on the CD was about DID! But now I’m excited to listen to it again! I always thought it was depression. Those lyrics can come in another post. I’ve started reading blogs chronicling people’s lives with DID, so they may find it interesting. A link to the lyrics are here
So tonight, I awoke at 4am, and I’ve been unable to fall back asleep. I got up out of bed to try and do something to make tired, and that didn’t work. I then went back to bed and cuddled with my babies (Snoopy and Hotch), with one on each side of me. It’s comforting to feel them breathing next to me. I don’t know if I can’t stay asleep because B is gone for three nights, and so I wake up without her, or if it’s that my mind will not shut off once I wake up.
I took a leaf from a client’s book this morning, and took a hot shower for longer than I usually do (probably 15 min instead of 10 min) and just stayed in the present moment, by feeling the water and allowing it to calm and soothe me. I thought that while I was doing this, my mind was quiet(er) and not going back and forth about what I’m going to present to the treatment team today and so on.
I had a good supervision session yesterday, in which we discussed how I need to take care not to burn out, especially if I want to work full-time at my internship site once I graduate in December. I currently have 6 clients and 6 groups! We just expanded the schedule, so treatment is from 9-5 instead of 9-3 and the three different levels of care meet at different times. Thus, I’m leading two groups that I would not normally do. So I have 6 clients and 6 group in THREE days; I could definitely have more clients and so on when I am working full time and seeing clients/teaching groups/family sessions etc 5 days a week, but geez! So in two weeks, I go down to two days a week, and 2 of my groups will be led by my co-leader fully. Thus, I’ll have 6 clients and 3 groups. More doable, but still, no slot specifically for notes. Good thing I’ve become accustom to doing an entire clinician note, mental status exam and all, in 10 minutes in between sessions. I’ve also decided to only work (paid) at the residence on Saturdays and some Sundays from 3:00pm-11:30pm. Thus, I have almost all of Monday off (class from 3-4:30), Tuesday off, and Friday off. Wednesdays and Thursdays I’ll be gone from home from 8:00am-8:00pm with work and class, but I do get three days off to recover and work on homework
This semester should be easier at least courseload wise, because it’s my last semester in internship, so I am used to doing tapes and writing case conceptualizations. My second course is counseling seminar, which is only 8 weeks, to help prepare us for the licensing exam (National Counselor Examination), and then Play Therapy, which is with a professor that I really appreciate. She is more into experiential learning, intrinsic motivation, and so as long as we turn in assignments, complete them thoughtfully and try, we’ll get an A. I had her for Group Counseling, and at first I had no idea what to do….I’m so used to structure or What if I don’t do it exactly right??. And this is exactly what my professor was trying to get rid of. It was a much needed break in that it allowed me to appreciate learning the material for the material’s sake. I do remember the main concepts of Group Counseling, and I use it each week when I conduct process groups. Psychoeducational groups are a bit different, but I am still glad to have retained that information.
With play therapy, I’ve already bought Rory’s Story Cubes and Rory’s Story Cubes: Actions. These are amazing and I can’t wait to use them! There are nine dice with 54 images in totality and children/teens/adults can roll the dice and create a story based on the images. There’s also an Actions one which have pictures of actions. For example, lifting a box, digging, walking through a door; and some less obvious ones as well, which can lead to interesting stories. It’s considered usable for people 8yrs+ so I hope to be able to use them in my practice some day
So I’ve started reading some blogs of people with DID. I find it fasinating, as I was not taught a lot about DID in my psychopathology class. We did watch Sybil and wrote a paper on her diagnosis, prognosis and so on, but I have not met/read about anyone with DID until recently. Bourbon has written extensively on her system, protraying her alters throughout the blog. I have also seen others who comment on her blog, and I hope to have time to read theirs as well.
Bourbon mentioned “Today I’m Alice” as a good book to read, and I have started that over the last few days. It is enthralling and I’m so glad I’m reading it. When reading about Alice and her alters, I really want to punch her Dad in the face. I feel so outraged when I read about the abuse and trauma people go through. Yes, some do not develop DID, or borderline personality disorder (BPD) for example, but that does not invalidate those who do suffer abuse and become diagnosed with DID. I hope to learn more about DID and understand what it’s like (to the best of my ability, as I do not have DID).
