Mental Health Awareness Month: This Blog

My 2008 bipolar diagnosis suddenly made sense of all the weirdnesses floating around in my head: plunging depressions, paranoias, social anxieties, impulsive behaviors, suicidal ideation, big ideas without consequences alarms, racing thoughts, abject terror in social situations (I once had a full-on panic attack when I opened a party invitation that came in the mail) (remember getting party invitations in the mail?) …

Newly armed with a name for the collective demons I faced, I started fighting back (or at least trying to manage my world) with everything I had at my disposal—which at the beginning wasn't much because my doctor didn’t think I needed medication. So I launched into a homemade cocktail of deep breaths, internal pep talks, more-informed behaviors and decisions, reading everything I could find, looking for a new doctor who might have more powerful (i.e., pharmaceutical) tools for me to use … and the expectation that I might at any moment need to just retreat to the safety of my condo in the sky to regroup and start again the next day.

I also became self-aware enough to start being embarrassed by things I did in public … mostly bouncing around as though I were on fire, being so down I’d no-show at events I promised to attend, and in more than one instance literally running away when someone tried to introduce me to a friend.
So I did what any self-respecting writer would do: I turned to social media to start explaining myself and apologizing for being so damn weird. And to my surprise, I almost immediately started getting understanding, support … and thanks from people in similar situations for being so open about my mental illness and the challenges it brought me.

Eventually someone suggested that I start a blog to document my thoughts, feelings, experiences, and the highs and lows of my journey. So I launched TMIpolar (get it? It’s BI polar but I overshare so it’s TMI polar, which I will go to my grave thinking is one of my most clever linguistic inventions) and backfilled it with everything I’d posted and started filling it with my new adventures.

There is also a book in the works, but the prospect of organizing my thoughts into something approaching legitimate book form is so overwhelming that you shouldn’t start looking for it in bookstores until 2095.

In a weird way to think this is unfortunate, I unfortunately have been so stable in the last few years that I haven’t had much to post about any noteworthy ups and downs of my personal journey. But I’ve aggregated all my Mental Health Awareness Month essays along with other essays/thoughts/reviews/etc here for my own—along with anyone else’s—reference.

So scroll through my ramblings and even bookmark the site if you want. I’ve spent ridiculous amounts of time organizing things by keywords for your perusing convenience. And I hope it helps (or at the very least entertains) you if you find you need it.

Mental Health Awareness Month: NAMI

The National Alliance On Mental Illness (NAMI) is a nationwide organization that provides informational and emotional support for the caregivers who work to keep people with mental illnesses on track and stable—or at the very least it lets the caregivers know they're not alone.

The organization has 1,000 state and local affiliates across all 50 states, Washington, D.C., and Puerto Rico. To keep it accessible to everyone who needs it, NAMI is funded through pharmaceutical company donations, individual donors, sponsorships and grants.

My parents found a lifeline in NAMI when I was diagnosed as bipolar over a decade ago. Now my mom—a retired teacher, so this is totally in her wheelhouse—has taught classes to help NAMI members better manage the situations they face and has undergone formal training to be a group meeting leader. I'm so thankful for everything my parents and my sister's family have done to support me in my bipolar adventures. NAMI has helped them help me manage my life with a considerable degree of success and relative normalcy.

If you’re interested in learning more or finding a NAMI group to attend, please visit nami.org.

Mental Health Awareness Month: An Unquiet Mind

An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison is a fearlessly, brutally honest 1995 memoir examining the exhilarating highs and soul-crushing lows of bipolar disorder (which was clinically called manic-depressive illness during the events of this book) from the perspective of a psychiatrist trapped in the disease. Her frank and intimately personal insights bring bipolar disorder’s cycles of terror, elation and crushing, abject despair into stark and sometimes heartbreaking clarity.

The book was recommended to me soon after I was diagnosed as bipolar in 2008, and it grabbed me on every level—from its smart writing to the recognizable, relatable, almost comforting details of its narrative—and I all but literally didn’t put the book down until I’d finished it.

I have an indelible memory of reading it on the Red Line EL train home from work one night in Chicago, and a man who’d clearly seen me reading it made sure we made eye contact as he stood up to leave and then he patted me reassuringly on the shoulder as he got off at the Sheridan stop. That encounter—a direct extension of this book—made me literally weep the rest of the way home as I was coming to grips with the label “mentally ill” and discovering the signs I’d never thought to notice until then that I wasn’t alone … and realizing that everywhere I go I’d never be alone.

If you are or love someone who is bipolar—or struggling with any mental illness—this book will make you weep, give you hope and quite possibly change your life.

Mental Health Awareness Month: Tardive Dyskenesia

As if mental illness itself weren’t embarrassing and exhausting enough—and as if the spectrum of side effects from psych meds weren’t even more embarrassing and exhausting—along comes tardive dyskenesia.

Aside from sounding like an antebellum flowering vine, tardive dyskenesia is also a range of involuntary, repetitive neuromuscular movements of the tongue, lips, face, torso and extremities that occur in people treated with long-term antipsychotics and other dopamine-receptor-blocking medications. If you’ve ever stood or sat near me for an extended period of time, you’ve no doubt seen the full compendium of symptoms: grimacing, lip chewing and pursing, heavy blinking, face touching (and I deserve seven gold medals for fighting back the compulsion to touch my face 75 times a minute in the Coronavirus Olympics), arm swinging, leg hitting, rocking, fidgeting, shaking, and—oddest of all—being on tiptoe whenever I’m sitting down. I continue to cringe every time I see video footage of me talking or singing with my lower jaw weirdly askew. My foot also pulses on the gas pedal when I drive, and a number of people have told me it almost makes them carsick when they ride with me.

I’m rather lucky in that my flailing and wiggling are more embarrassing than physically problematic, but about 20% of the population living with the disorder literally can’t function; it can prevent them from walking, eating and even breathing.

And as a point of clarification, these symptoms are the opposite of those from Parkinson’s Disease. People with Parkinson's have difficulty moving, whereas people with tardive dyskenesia have difficulty not moving.

Tardive dyskenesia symptoms can lessen, change or even go away over time after a person stops taking neuroleptic medications, though more often than not they’re permanent. My symptoms have noticeably changed over the last decade, but I’ve traded making alarming sucking sounds on my lips for making an entire room tremble from my violently shaking legs.


There are many medications that can be used to manage the symptoms to varying degrees. After five-plus years of needless misery, I successfully weaned myself off the anticonvulsant Gabapentin, which did or didn't work depending on the way the wind blew and the leg trembled. It also tended to make me drowsy and sometimes even confused, which makes me especially surprised that it’s used recreationally—under the totally lame street name Gabbies—for its supposed euphoric effects that I absolutely NEVER experienced.

One more thing: You may have seen the commercials for the prohibitively expensive tardive dyskenesia medications Ingrezza and Austedo … the commercials where they call tardive dyskenesia “TD” like it’s some cool brand of earphones or energy drink. Dear Ingrezza-makers Neurocrine Biosciences and Austedo-makers Teva Pharmaceuticals: I’ve had tardive dyskenesia for over a decade. I’ve been seeing psychiatrists and neurologists about it for over a decade. I’ve read everything I could read about it for over a decade. I’ve been on medications for it for over a decade. And NOBODY outside of medical publications and pharmacy websites calls it TD. STOP TRYING TO MAKE TD HAPPEN.

Mental Health Awareness Month: Psychotropics

 

Aside from being an objectively cool band name for people with mental illnesses, psychotropics is an umbrella term for the classes of drugs used to treat mental disorders and control moods, behaviors, thoughts or perceptions.

There are five categories (and multiple subcategories) of psychotropic medications: antidepressants, anti-anxiety medications, stimulants, antipsychotics and mood stabilizers. And like many of my fellow mental-illness travelers, I’ve tried damn near all of them.

Here’s a brief rundown:

ANTIDEPRESSANTS, as you might surmise, are used to treat a range of depression symptoms. They include:

• Selective serotonin reuptake inhibitors (SSRIs), which steadily increase the amount of serotonin in your brain. Serotonin is a powerful neurotransmitter that regulates things like mood, sleep, blood clotting and even bowel movements. (Aren’t you glad you know that last part?)
• Selective norepinephrine reuptake inhibitors (SNRIs), which gradually increase the amount of norepinephrine in your brain. Norepinephrine makes you feel awake and alert. After over a decade of trial and error, my doctor finally landed on the SNRI Fetzima as my magic bullet, and aside from a blackout-go-boom-get-concussion on the tile floor a few days after I started it, it’s been a complete game-changer for me.
• Bupropion, which promotes important brain activity and can be used to treat seasonal affective disorder (SAD) or to help people quit smoking.

Antidepressants come with a range of frustrating side effects, including drowsiness, insomnia (how fun to have both!), constipation (more poop stuff!), weight gain, sexual issues, tremors and dry mouth.


ANTI-ANXIETY MEDICATIONS are used to treat panic attacks, phobias, generalized anxiety, and various anxiety-related symptoms.

This class of psychotropics includes beta blockers that help treat the physical symptoms of anxiety, including increased heartbeat, nausea, sweating and trembling.

Because they typically cause drowsiness, some tranquilizers and sleep medications are also used to treat anxiety and insomnia. These tend to be prescribed for only a short time to prevent dependency.

These drugs’ side effects can include nausea, blurry vision, headaches, confusion, fatigue and graphic nightmares. And oh, have I had some doozy graphic nightmares on my find-the-right-psychotropics journey.


STIMULANTS help manage unorganized behavior by improving concentration and providing a general sense of calm. They’re often prescribed for people with attention deficit hyperactivity disorder (ADHD).

Their most notable side effects include insomnia, decreased appetite and weight loss.


ANTIPSYCHOTICS help manage psychosis, which separates people’s perceptions from reality and drowns them in delusions or hallucinations.

Antipsychotics can help people with psychosis think more clearly, feel calmer, sleep better and communicate more effectively. They’re also used to treat ADHD, depression, post-traumatic stress disorder, obsessive-compulsive disorder and eating disorders.

Their side effects are primarily drowsiness, upset stomach, increased appetite and weight gain.


MOOD STABILIZERS help regulate extreme emotions. They may rob you of feeling the extreme excitement or extreme sadness that everyone experiences—which is my case—but they help manage massive bipolar swings and extreme mood swings, which is a tradeoff I’m happy to live with.

I regularly experience all their usual side effects: drowsiness, weight gain, dizziness, tremors, blurry vision and occasional confusion. I’m especially unhappy with the weight gain, but thanks to an effective mood stabilizer (in my case, the relatively common drug Lamotrigine) I can consistently and reliably participate in everyday living. Even though I have to have a damn Santa tummy to do it.


THE SIDE EFFECTS OF THESE MEDICATIONS can be powerful and overwhelming. There’s one set of side effects that present when you’re ramping up a dosage, there’s another set of side effects that come with daily use of a drug, and there’s another (often excruciating) set of side effects that come with weaning off a drug. Which is why I’ll never understand the mindset that some people get where they decide they feel fine and they’re just gonna stop taking their meds.

Mental Health Awareness Month: Mania

 

Mania (or being manic) is the opposite of depression in the up-and-down swings of bipolar disorder. It’s also the other half of the no-longer-used term manic depression, which was changed to bipolar disorder in the 1980 third edition of the Diagnostic and Statistical Manual of Mental Disorders (or DSM) in the interest of reducing stigmas related to the words manic and depression.

Bipolar disorder is subdivided into bipolar I (which has more extreme swings in each direction) and bipolar II (which manifests with lower levels of mania—clinically called hypomania—and deeper depressions). I’m bipolar II.

Like depression, mania can manifest itself over different lengths of time in any number or combination of symptoms, including these:

• High, uncontrollable energy
• Extreme, rapid talkativeness
• Racing thoughts or flights of ideas
• Feelings of elation or euphoria
• Feelings of irritation or agitation
• High distractibility and inability to focus
• Decreased need for sleep while still feeling rested
• Inflated self-esteem or grandiosity
• Feeling full of great new ideas, important plans or exciting activities
• Involvement in risky activities—like extravagant shopping, improbable commercial schemes, recreational drugs, hypersexuality—with a high likelihood of negative consequences

Some bipolar people claim they like or actually love their manic episodes. I can understand that sentiment from the perspective of having a little more energy or euphoria, but I find that anything more than that can be terrifying. And exhausting.

It’s terrifying because I know from experience I’m prone to do impulsive things with no consequences alarms going off in my head. After more than a decade on the bipolar coaster, I’m finally self-aware enough that I know I’m doing (or at least reminding myself not to do) those impulsive things and I need to summon the alarms myself because they won’t go off on their own. Thankfully my impulsive behaviors tend to be rather benign and fixable, like buying shoes and clothing online. But there’s always the possibility I might escalate, and who knows what my impulsive brain could be capable of.

It’s also terrifying because my manic episodes often plummet directly into the deepest of my depressive episodes. Again: I’m finally self-aware enough to know that the depressive episodes are coming and I can do what little I’m able to do to prepare for them, like canceling plans and setting out Tylenol PM to help me hopefully sleep through the worst of them.

Everyone experiences mania and depression differently—to different degrees, for different lengths of time, at different intervals and even in different environmental conditions. Neither is better or easier than the other, and both in their own way can control or disrupt your life.

You’ll probably never encounter me in a depressive state because I become immediately reclusive. But if I’m talking rapidly and visibly distracted by everything and more jittery than normal, please do your best to keep me away from the Nordstrom website.

Mental Health Awareness Month: Depression

Everyone can feel occasionally sad, lonely or unmotivated as a result of anything from grief to just having an off day. But when these feelings become exponential and overwhelming and prevent you from functioning, you could be suffering from clinical depression.

And there isn’t a single kind of depression. It’s diagnosed when you present any long-term combination of symptoms including feelings of worthlessness and hopelessness, trouble concentrating, insomnia, fatigue, loss of interest in pleasurable things, restlessness, suicidal ideation—and even physical symptoms including body aches, digestive problems and appetite loss. Depression symptoms also vary widely based on age, gender and personal circumstances.

There isn’t a single kind of treatment either; depression can be managed with any combination of psychotherapy, antidepressants, exercise, certain supplements (vitamin D and fish oil have noticeably increased the efficacy of my meds) and in extreme cases electroconvulsive therapy (ECT)—with focused attention paid to people expressing suicidal thoughts and reckless behaviors.

Depression can also present itself along with other clinical disorders including psychosis, bipolar disorder and seasonal affective disorder. In my case, I have both bipolar II disorder and major depressive disorder—which means my shutdowns are almost always epic: I collapse into a deep, deep hole of despondency, exhaustion, physical pain, dull panic, slurred speech, a metallic taste on my tongue, and a fog that feels like a hot, wet, suffocating blanket I can’t find a way out of. All I can do is sleep in a drenching sweat, lose all track of time and frequently wake up with the pain of an oncoming migraine that thankfully never fully manifests itself.

Plus I’m totally no fun at parties. :-)

On a personal note, I have serious issues with the word “depression” in itself. I know it’s impossible to find a word that succinctly encompasses all these symptoms, but colloquial English has appropriated depression to mean feeling kinda blah, and people also associate the word with low spots in the ground, dips in the road and economic slumps, so they tend to think that clinical depression is just sadness. And if we depressed people had a nickel for every time someone told us to cheer up or decide to be happy, we just might be rich enough to actually BE happy. I know people who say these things are often coming from a place of not understanding and of just trying to be helpful, but the word depression is exactly the reason they’re confused and ultimately unhelpful.

And on that note, if you know someone who’s depressed or struggling through a depressive episode and you want to help, just ask what you can do. Some of us want to be left alone, but some people may want you to sit quietly with them so they don’t feel alone … or bring them some ice water … or call 911 … or some people may genuinely want you to try to cheer them up.

This is way off-topic and completely unhelpful given most of what I’ve just said, but if the latter request is the case, I recommend you start with my all-time favorite joke:

What’s brown and sticky?

A stick.

Mental Health Awareness Month: Bipolar Disorder

I’m starting my series of essays with something I know on a cellular level: I was diagnosed bipolar II over a decade ago, and I’ve spent a lot of time since then trying to learn everything about the illness, how the medical community’s understanding of it is evolving, and how we all can work to manage it both day-to-day and long-term.

Bipolar disorder in general involves one- to two-week swings between two opposite poles of mood, energy, focus and function. The top pole is mania, which manifests itself with elation, irritability, energized behavior and lack of impulse control. People in manic episodes experience racing thoughts; an inability to focus or stay physically still; and delusions and hallucinations that can inspire irrational or risky behaviors including gambling, sexual activity and drug use without regard for what can be catastrophic consequences. The bottom pole is depression, which manifests itself with hopelessness, indifference and despondency. People in depressive episodes experience extreme sadness; suicidal ideation and attempts; and difficulty functioning, thinking or experiencing pleasure (which is called anhedonia).

There are three types of bipolar disorder. Bipolar I Disorder involves swings between both poles—sometimes both at once—that are so severe they can require hospitalization. Bipolar II Disorder—sometimes called bipolar depression—involves mild manic episodes (called hypomania) and often more profound depressive episodes. Cyclothymic Disorder, which isn’t as common, involves hypomanic and depressive episodes that last at least two years.

As I’ve said, I’m bipolar II, where my hypomanic episodes involve restlessness, fast (well, faster than normal) talking and thinking, and buying shoes online that I don’t need. I usually post these purchases on here to broadcast that 1) I bought awesome new shoes and 2) I’m currently hypomanic off my ass. My depressive episodes are soul-crushing in their extremity. I can’t think, I struggle to breathe, my vision is blurred, I feel like I’m wrapped in a wet wool blanket that I can’t kick my way out of, I sometimes have visual or aural hallucinations (including seeing people in black clothing lunging at me and hearing stupid, irritating circus music coming from another room), and I often contemplate suicide but I have no energy or initiative to carry it out … I generally feel like everything is completely hopeless and I just want to have never existed. And when I emerge from these episodes I’m exhausted to my core.

Bipolar disorders can be managed with psychotherapy (talking with a therapist), psychiatry (drug therapies) or a combination of both. I’ve never found much benefit from my visits with various psychologists, but I’m a HUGE believer in better living through chemistry. Psych meds (which are awesomely called psychotropics) affect me strongly, for better or worse. They involve a lot of trial and error, but I’ve been highly functional for the last five years after finally finding a magic cocktail of three psychotropics (there’s that cool word again).

I do want to stress, though, that what works for me is indicative only of what works for ME. If you’re living with a mental illness, don’t abandon a combination of therapies that might be working for you just because someone else is thriving on a different combination of therapies. And for God’s sake, ALWAYS TAKE YOUR MEDS.

Bipolar disorders were classified as manic depression through most of the 1900s. In 1980, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (called DSM-III), officially changed the classification to bipolar disorder to reflect a wider range of nuance and understanding of the disease. This paragraph is a broad generalization of the naming history, but I wanted to explain that manic depression and bipolar disorder are essentially the same thing.

There is a lot more I could discuss here, but I want to keep these essays short(er than this one) and digestible for anyone who cares to read them. Feel free to share this with anyone you think might be interested, and I hope to have another short(er than this one) essay posted soon. Stay healthy!

Mental Health Awareness Month

May is Mental Health Awareness Month, and as your designated Bipolar Friend Who Can’t Seem To Shut Up About It, I’ll be spending the month posting short essays on a broad range of mental-illness topics and issues that I hope—if you want to read them—will provide helpful information and insight to give you a more nuanced understanding of the world occupied by people living with mental illnesses and the sainted people who take care of us.

I was diagnosed bipolar over a decade ago, when a friend’s suicide made me suddenly aware that—instead of mourning the loss of him like everyone else around me—I was jealous that he actually killed himself … and I’d been living in a state of just-under-the-radar suicidal ideation for as far back as I could remember. When fantasizing about when and how to kill yourself is your everyday normal, it doesn’t raise any interior red flags until something jolts you into the objectivity you need to stand outside your head and realize that you have a problem. A very serious problem. So going on nothing more than the foggy, horrifying, embarrassing realization that I had this problem, I wandered into what would prove to be a long, frustrating, flying-blind journey to erase—or learn how to manage—the crashing malfunctions in my poorly wired head.

As with most people living with mental illnesses, I’ve been to hell and back many times trying to figure out the magic cocktail of therapists and therapies and medications I need to achieve some sense of normalcy. And since there’s no basic training on what to look for or how to find a competent, ethical, moral mental-health doctor—especially when you’re yet-undiagnosed mentally ill—I stumbled into some even deeper horrors before I finally found a doctor who knew what she was doing and who had my overall health and best interests at heart.

So here I am with my fancy green-and-white Mental Health Awareness Month graphic and my list of topics to cover, and if you’re interested I hope I can give you something useful and meaningful to know this month whether you’re living with a mental illness, caring for someone with a mental illness, or just looking to understand more about the roller coasters lurching in and out of Mental Illness Land.

Part of a weird, disconcerting, sometimes terrifying world

Facebook just reminded me that eight years ago I played King Triton in a big, splashy (ahem) production of The Little Mermaid and made my first appearance onstage on a wheeled platform with a Botticelli shell and nothing to hold on to for dear life.

Oh—and my doctor and I decided that playing a principal role in a show that involved being wheeled onstage on a small, Botticelli-shelled platform was the PERFECT time to wean myseof off the demon drug Cymbalta.

If you've never been on Cymbalta, I do not recommend starting. If you've ever stopped taking Cymbalta, you know that doing it in this context was just bonkers. I was always unsure of what exact direction I could find gravity. I was in a constant state of thick, memory-clouding fog. I got what everyone coming off of Cymbalta calls "brain zaps," which is the best attempt at a collective name for an impossible-to-describe colleciton of alarming things happening in my head.

And it didn't help that practically every entrance I made began with me angrily shouting ARIEL! and then struggling to remember what came next.

I barely felt present the entire run. You might say I was notter under the water. But you shouldn't. Nobody should ever say that.

There Will Be Light

Next to Normal—a searing, brilliant, Pulitzer-winning rock opera examining the lives of a family whose mother is desperately struggling with bipolar depression—opened on Broadway 15 years ago today. The show beautifully captures the swings between the ridiculous highs and the soul-crushing lows the disease brings to those of us living in its fogs and terrors ... and to the selfless teams of people who care for us.

I’m fortunate enough to have seen the original production, very soon after I’d been diagnosed as bipolar and had found myself caught in a rather terrifying struggle to wrap my confused, exhausted brain around the fact that mental illness was no longer a mysterious entity in other people’s lives; it was MY life, and I had no idea how to manage it or what potential and very real horrors to expect from it.

The musical is rough to experience from any perspective, but seeing it for the first time tore me apart ... and then put me back together with its closing anthem, “Light,” which features an almost casually placed lyric that is at once devastating and hopeful and never fails to sneak up on me and emotionally gut me even though I know it’s coming: “The price of love is loss / but still we pay / we love anyway.”

Back when I saw the show on Broadway, selfies were new and weird and shameful—and for you young folks, it was the Middle Ages when our smartphones had cameras that faced only one way and didn’t let us see on our screens what our selfies would look like so we just had to hold our phones in the air and hope for the best—so I took this one-try selfie as quickly and discreetly as I could to ensure an entire city of complete strangers wouldn’t judge me. It turned out rather well, although I cut off the last letter of the sign. Which means as far as any of you know, I actually just saw a knockoff production called Next to Norma.

I've been invited to be the Bipolar Person in Residence and talk to the casts and audiences of Next to Normal productions at two local theaters over the last decade. And while I hope it was helpful for the actors as they rehearsed and found their characters' realities, it was extremely helpful for me to have an opportunity to articulate the swings and uncertainties and terrors of living with a mental illness—both so I could explain any weirdness I've personally exhibited and to help the actors help their audiences better understand these realities.

While every bipolar mind is different and therefore every moment of Next to Normal doesn't exactly mirror my experiences, every note and every word of the show is brilliant and hits brilliantly close to home. And that closing anthem—sung by the characters not to each other but to the audience and to the present and to the future—encapsulates the struggles and hopes I live with every day in astute prose and powerful, emotional, wall-of-sound vocals:

Day after day,

We'll find the will to find our way.

Knowing that the darkest skies

Will someday see the sun.

When our long night is done,

There will be light.

Timber!

Seven years ago today—three years after leaving the hospital and just hours after taking the very first dose of yet another new bipolar med added to my ever-evolving cocktail—I stood up from a chair, walked a couple steps, blacked completely the hell out, fell Timber! onto the tile floor (which I cracked with my face because GO BIG OR GO HOME), shredded myself eyebrow-to-chin on my shattered glasses, bit most of the way through my lip, loosened some teeth, got a concussion, and woke up in my sister's car holding a huge bloody rag to my face too confused to remember that Christmas had happened (or, for just a few glorious moments, that I was even bipolar) as she rushed me to the ER, where I looked so brutally horrifying that the nurses assumed I was the victim of a violent assault and three police officers were dispatched my room to question me well before the doctor showed up to assess the damage, declare me not dead and give me double-digit stitches.

I came home covered in swelling and bruises and scabs and stitches and glue—after telling the ER doctor in my foggy haze that my modeling days were over and I didn't care if he left scars all over my face but I vaguely remember him informing me that he still had a professional obligation to do his best—and filled eyeballs-to-spine with a deep, not-for-amateurs headache that brought crippling new levels to my understanding of pain ... and yet I still found a way to take time out of my busy schedule for a quick selfie to document the occasion for future biographers. (You're welcome, posterity!)
This Timber! event was directly linked to my new drug (called Fetzima, who sounds like a possibly immodest resident of the Anatevka demimonde in Fiddler on the Roof) that, as with all psychotropics, came with an alarming list of ramp-up side effects ... including abrupt blackouts. But I knew from a decade-plus of trial-and-error experience that I needed to tough out the first three or four weeks until the side effects subsided and the drug's level (or not level) of efficacy manifested (or didn't manifest) itself.

And despite its hyperdramatic entrance into the madcap musical of my life, Fetzima more-or-less quickly proved itself to be perhaps the drug that effectively balances my serotonin and norepinephrine and keeps me (more or less) stable and engaged and functional and capable and able to go to work and do shows and take care of my parents and run races and do handyman projects (quite well, if I can toot my own horn, which I shamelessly will) and practice the piano and buy shoes and buy more shoes and here I am seven years later, scar-free (thanks, conscientiously ethical ER doctor!) (though it took a good six months for the scars to heal and the scar tissue where I bit through my lip to subside to the point that I could drink out of a straw again) and concussion-free (pro tip: you DO. NOT. EVER. want a concussion), and clearly in possession of an added year's mouth wrinkles and silver foxiness.

[Super-fun side note: Aetna, in its infinite wisdom, abruptly stopped covering my Fetzima for two years and summarily rejected all three of my doctor’s allotted appeals. Because apparently risking sending me to the psych ward for another week was far more cost-effective than covering a proven psychotropic. So my doctor hoarded samples for me in the hope that Aetna would finally get its head out of its fetz (which it finally did this year) and/or Fetzima’s patent would expire, it went generic and it stopped costing $700/month out of pocket (which has yet to happen.]

Anyway, if you're inclined, raise a glass and yell Timber! in my scab-free, concussion-free, fog-free, not-functional-free honor today. I'm gonna go out and keep living. Timber!

Inpatient

After a year of unemployment in Chicago where I half-assedly looked for jobs and shuffled back and forth from Cedar Rapids, I more or less officially moved home nine years ago this month.

My bipolar disorder was escalating and I was seeing what I now understand was a hack psychiatrist (because how can you know what to look for and who’s competent when you’re new at finding mental health professionals and you’re crippled by a mental illness?) who kept prescribing medication after medication (including the anticonvulsant Depakote that I had NO business being on due to its highly problematic interactions with my Lamictal mood stabilizer) without following up or even letting me know what catastrophic side effects to look for. And my unmanaged Depakote cocktail was a living nightmare of day-long blackouts, terrifying hallucinations, and sleepwalking through what was thankfully benign but could have been fatal odd behavior.

Every psychotropic drug gives you temporary—sometimes awful—side effects as you ramp up on a new prescription and wean off of it when you find out it doesn’t work. And thanks to this doctor’s random changes of drugs and cocktails, I was in a constant state of up-and-down side effects that left me miserable and confused and unable to function in a multitude of ways.

On top of all that, I was newly single and living alone for the first time in seven years, which meant I didn’t have an extra brain in the house to remind me to take that litany of changing meds on their prescribed schedules.

So by the time I decided I was moving home, I was a mess. A catastrophic, dissociative, emotional-train-crash mess.

And as Christmas drew nearer and nearer, I found myself more and more overcome with panic and dread about holding myself together through our family activities, worrying that I’d ruin them for everyone and inevitably escalating even more.

I couldn’t breathe. I couldn’t think. I couldn’t comprehend.

I didn’t want to live.

So nine years ago today, my parents—my terrified, confused, helpless parents—and I together made the heart-wrenching decision that I needed to be hospitalized. Two days before Christmas.

The ensuing details are still hazy to me, but from what I can remember: I sobbed on our couch in Greek-tragedy emotional pain as I slowly wrapped my muddled brain around what I was about to do. Mom and Dad came with me to the emergency room. I was evaluated by a doctor. We were put in an empty holding room for four hours while they looked for an open bed, which they eventually—thankfully—found right there instead of in a hospital 200 miles away. We were taken to the mental ward where we first had to go through a room where Mom and Dad had to leave their coats and Mom had to leave her purse.

When we got in, I had to forfeit my coat and clothes and phone and basically everything but my glasses. I was given scrubs and hospital socks. I met privately with a doctor, who took me off every drug I was on and prescribed yet another new cocktail of drugs. Which meant more simultaneous ramping-up-and-down side effects.

And when I was finally done being triaged, I was given an opportunity to say goodbye to my parents and then I was escorted to my room.

I made one last look back as I was halfway down the hallway, and the looks on my parents’ faces—their anguish, fear and inconsolable sadness—will be forever seared in my memory.

And so will my feeling of complete, comforting relief from accepting the fact that all of this was bigger than I was, I could finally release the demons fighting inside me, and I was in the protective, hopefully healing care of people who could manage whatever it was that was tearing me apart.

Nine years ago today I launched into an unknown of what ended up being a full week in a locked mental ward in a hospital.

Nine years ago today I started yet another roller coaster of the disorienting, miserable side effects of changing medicines.

Nine years ago today I finally knew I was safe from myself, I was being cared for by experts, and for some reason what I found to be the most important: I wouldn’t ruin my family’s Christmas. I knew that not being there would be disruptive. But I also knew that being there would have been even worse.

Nine years ago today, I started what would still be a long, bumpy road to healing, but I knew I was at least on the road to healing. It was one of the worst things I’ve been through and one of the best things I’ve ever done.

If you’re struggling with the out-of-control pain and confusion of mental illness, please know there’s no shame in asking for help—even to the point of being hospitalized—and putting yourself in the focused care of others.

There most likely won’t be immediate healing. But there will be hope. For you, your family and your support network.

There will be calming, restorative, essential hope.

World Mental Health Day

Today is World Mental Health Day, an annual global event started in 1992 at the World Federation of Mental Health to promote awareness, education, understanding and advocacy for those of us suffering from mental disorders, the caregivers we sometimes desperately rely on, and the larger populations in which we live and often struggle to navigate every day of our lives.

In this spirit of awareness, education, understanding and advocacy, I'm offering here a view from inside the bipolar volcano hurricane that I wrote years ago as I was emerging from a distinctively catastrophic episode:

Sometimes being bipolar means waking up with your head covered in a gray wool blanket in the middle of a hot drenching rain and the weight of it is practically crippling but you know you're not depressed and you know you're not confused and you know you can breathe and you know you're invested in fighting your way out so you treat every blink and every word and every thought as fuel that sparks the next blink and the next word and the next thought and even though you're foggy and slow and maybe even late you're MOVING and no matter how long it takes and how hard you have to work just to achieve your minimum for now you know that it's just for now and you'll sooner than later find your way out of that hot wet scratchy gray wool blanket and you'll know from hard-fought experience that you may not have the power to make the rain go away but you have the tenacity and the fortitude to outlast it and find your clarity and focus again in the warm, restorative sunlight it was trying to hide from you and even though you're never entirely sure you know exactly what that unclouded sunlight feels like you'll always get close enough to know what you're fighting for and how to be stronger and smarter and even more certain of your indestructibility the next time.

The natural progression of bipolar disorder:

depression > deep depression > despondency > recovery > fogginess > exhaustion > functionality > public panic attacks > Oreos

Cymbalta withdrawal is a bitch. Bitch Kitty is a bitch.

Cymbalta withdrawal gives me brain zaps, which are like blackouts with extra dizziness and lip tingles and confusion and disorientation but no actual blacking out. Bitch Kitty gives me the come-pet-my-soft-warm-exposed-tummy fakeout, which is like a real come-pet-my-soft-warm-exposed-tummy invitation but with growling and hissing and swatting and running away as fast as her waddly soft warm tummy will allow but with no actual soft warm tummy petting.

 
Cymbalta withdrawal brain zaps hit me then fade away then hit me then fade away until I'm exhausted. Bitch Kitty swats at me then runs away then swats at me then runs away until I'm tired of her bullshit.

 
Cymbalta withdrawal brain zaps will eventually go away and I will dance on their grave. Bitch Kitty will eventually go away and I'll actually kinda miss her.

Another crash

I was supposed to leave this morning for my annual summer vacation to visit friends in D.C. and stay at their best-porch-on-the-planet beach house in Rehoboth, DE, but I had to cancel a few weeks ago due to work issues. A lot of cool things have popped up on my calendar here in Cedar Rapids this weekend though, so I'm more or less OK with missing my trip.

But I still missed work this morning thanks to a rough descent into a bipolar depressive episode that started last night. I talk a lot about being bipolar on here, and every time I think I should stop someone messages me out of the blue to thank me for being so open and honest about it. Enough people have confided in me the stories of their struggles with mental illness that I sometimes worry I won't remember everyone in my mental checklist of kindred, struggling spirits. I've developed close, supportive friendships with a lot of these people though, and our check-ins and conversations and even drives across town just to give hugs are so dear and so valuable to me that I'll probably never stop talking about my own struggles.

So here's this morning's report: I woke up at 6:00 in a motivational black hole with a fiery headache and enough disorientation that I knew enough to skip the gym—which is huge because some days working out is the only thing that keeps me human—and to let my boss know that I'd come in after lunch, if at all today. Then I went back to the kind of non-sleep that feels like you're staying awake getting more and more exhausted compounded by the stress of feeling worried about getting more and more exhausted. But when I woke up around 11:00 my head was clear enough that I could look at the episode objectively and summon the coping and pushing-through skills I've learned over the last decade and I showered and ate and made it to work, where I've been surprisingly productive ... albeit profoundly exhausted.

So to all the people I know who are dealing with mental illness and to all the people I don't know who are dealing with mental illness and to all the rest of you curious enough about my struggles today to have read this far: You will fight this battle all your life. You will get meds that don't work, you will get meds that actually make things worse and you will find meds that you'll notice start to make improvements ... though you'll spend ages waiting cynically for them to fail you. In the mean time, learn what helps you stabilize yourself and what helps you push your way out of the wet wool blankets and the rolling fogs that trap you. As soon as I felt coherent this morning, I texted one friend who right now is in a bottomless depressive episode so we could both not feel alone in our struggles and I texted another friend who as far as I know is not having an episode just so I'd know that someone who deeply understands what I'm going through is at the very least thinking about me. And then I picked out a shirt that says carpe diem on it and I know that it's totally goofy bordering on stupid, but if I'm wearing a shirt that means something to me on a certain day or in a certain situation, I feel compelled to go out in the world and show it to everybody.

And after what my head put me through this morning, I need everyone to know—no, I need to SHOW everyone—that I'm seizing the hell out of the rest of my today.

Why is the waiting-room music at my psychiatrist’s office playing “Send in the Clowns”?

Addy Noma isn't just a mediocre drag name

FUN FACT: Bipolar disorder often comes as a set with a small benign pituitary tumor called an adenoma. And I've been lucky enough over all these years to have collected the whole set. My little adenoma—which would be a great title for a song by Poison—hasn't shown any significant growth in four years, so it's not causing much concern. But we still monitor it with an MRI every other year. And every other year happens in half an hour. Having an MRI on your brain is like being stuffed in a too-small casket that screams at you—like a song by Poison—for 45 minutes. Plus you can't obsessively play on Facebook while you're in your tiny, screamy casket. So it basically totally sucks. But at least it triggers any latent claustrophobia you may have hiding in you, so it totally gives you something to occupy your otherwise unproductive time. So there's that.

This is just a bucket of melty cheese encased in pointless single quotes ...

but I cannot overstate its inherent truth; I wouldn't be here today if it weren't for my family and friends. If you are a part of a mentally ill person's support team—even for a moment—you are a saint. And on behalf of everyone who ever needed a reminder to take his meds or a voice of reason before taking a wrong turn or just a random hug in person or via text, I thank you.

When you’re a total stupid dumbass

who absent-mindedly takes your Saturday PM meds when you wake up at 5:00 on a Monday and then a few hours later you take your Monday AM meds and quickly send yourself spiraling into a painful, disorienting, blinding, terrifying—but ultimately non-threatening—double-dose overdose situation last week so your mom devises a brilliant MomGyver fail-safe using nothing but rubber bands and a butter knife to save you from your stupid self in the future.

Also: While most of these pills are supplements to enhance the efficacy of my psych meds, the collective volume of psychotropic and supplemental pills has finally reached a critical mass that obligates me to take them in two shifts instead of in my usual badass single-fistful gulp.

The horrors of Depakote

Facebook is reminding me that seven years ago today was my first attempt at functioning in public (specifically at work) on the hardcore anticonvulsant Depakote:

Depakote either works wonders for you or it destroys you, and I was DEFINITELY on its no-fly list. The pharmacist who filled my first prescription actually pulled me into a consultation room, warned me about the horrible, terrifying things I might experience, and literally held onto my hand as she talked to me. I'll never forget the look in her eyes that was a mix of both kindness and visible concern.

[Don't get me started on the hack Chicago psychiatrist who'd prescribed it without saying any of this to me and who obviously made zero attempt to set up a line of communication should I have problems in my first terrifying, confusing days and weeks.]

Once I got home that night, I took my first dose with much trepidation, went to bed on the guestroom bed my parents slept in on their visits so I could maybe feel somehow close to them if I needed to ... and right on schedule I was immediately flooded with such graphic nightmares of being hunted and murdered over and over that they're seared in my brain and I can still replay them in my head with absolute clarity.

That was a Friday night, and all weekend I'd hallucinate intruders in black hiding in my apartment and wake up screaming when I tried to sleep. But psych drugs can have side effects like these as you ramp up, and I was at least self-aware enough to know (or be pretty sure I knew) that the hallucinations weren't real and the nightmares would eventually go away.

Which they never did. I was taking Depakote with the more established anticonvulsant Lamictal (which I'd been on for years) and at least one other drug (but probably two or three) that I can't remember, and in the weeks that followed it seemed to be the tipping point from barely managing my bipolar swings to living in terrifying hallucinations and falling into daylong blackouts where I'd come to riding the Red Line north to parts of Chicago I'd never been to or sitting on a bench in the Lincoln Park Zoo without my coat or my phone.

I seem to recall that seven years ago today I was able to hold myself together at work, but I do know that the abovementioned blackouts caused me to start missing entire days of work. I can't remember how long I gave Depakote to finally level out in my head and maybe start working, but I do remember it never did. And my hack psychiatrist eventually had me quit it cold-turkey as he threw some other random drug at me. And I was too meek and confused and overcome with self-doubt to challenge him on any of it.

And it was all awful. Just ... awful.

But it DID give me an opportunity to make a big-gay-musical pun (that wasn't half bad, imho) about it on Facebook seven years ago today. So there's that.

And it took another four years before I found my magic psych cocktail that's kept me stable and functioning and able to laugh at everything I went through. Especially that awesome big-gay-musical pun.

And if you're struggling through your own parade of trial-and-error psych meds (hopefully not with that hack psychiatrist at the helm), try to be be patient and diligent and even optimistic about your adventures. I made it. There's every chance you will too.

Not to make things alarmingly about me

but I accidentally took my meds twice this morning like a forgetful idiot and now I'm dizzy and unable to walk and really sensitive to light and barely able to see and slightly nauseated and talking a bit randomly so this post is taking forever to write.

My neurologist took forever to get back to us, but he said just to sleep it off—which is hard to do because I have to wedge my arms under my sides to hold myself in place because I have a weird sensation that I’m going to roll off the couch where I’m spending the day near my doting parents. 

If you’re on either of these meds, never take 600mg of Lamotrigine and/or 1,200mg of Gabapentin (we’re not sure which is/are making me fall into this bizarre hole). 

That’s enough typing.

Giving cigarettes the Axe

My seizure medication (Lamictal, which is being slowly titrated up from 400mg/day to an eventual 800mg/day) hasn’t killed my cigarette-smoke hallucinations, so I’ve resorted to attempting to mask the imaginary stink with one of these plug-in room-smell thingies (in the default—but debatable—Fresh Linen scent):

And even though it’s on the lowest setting and hidden halfway behind a huge piece of furniture, it makes my entire Basement Bachelor BunkerTM smell like a middle-school boys’ locker room the day after a massive sale on Axe Body Spray.

It does mask the cigarette-smoke hallucinations—which get especially strong (or at least acutely noticeable) as I work at my desk—but it’s giving me a low-grade headache.

Even worse, it’s giving me flashbacks to my boyish middle-school waistline, first fuzz of pubescent armpit hair and store-brand parachute pants. Can I borrow some hair mousse?

MRI/OLFACTORY HALLUCINATIONS UPDATE:

My MRI showed no evidence of seizures, but my cigarette-smoke hallucinations are so pervasive and choking that my neurologist had the levels of Lamotrigine—an anti-seizure medication I'm already on to control my bipolar disorder—tested, and since the numbers were so low he wants me to quadruple my dosage.

Quadruple. In one fell swoop. Which is crazy. And since I'm crazy, I KNOW crazy.

So I have a call in to my psychiatrist to get a second opinion. Because it took a decade to test and titrate the med cocktail I'm currently on that finally makes me (relatively—the jury is still out) functional. And I'd rather choke on imaginary cigarette smoke the rest of my life than spend another day in a psych ward with a roommate whose first words to me are that he just got out of prison. Because I've already crossed THAT off my bucket list.

BUTT UPDATE:
The super-handsome leather-clad supposed-to-be-for-a-dining-room chair I use for my work-at-home desk has started leaving crippling pain in my butt and tailbone—please keep your vulgar comments to yourselves—so I ordered an ergonomically designed butt pad to hopefully let me stand up after every hour of writing without shouting epithets at the no-butt-pain gods.

The pad I bought is literally called Everlasting Comfort(R)—which, I'm sorry, should have been snatched up by the funeral industry decades ago, so way to drop the ball, casket-makers—and it's velvety soft and everlasting-comforty cushy and it has a cavernous space for my poor beleaguered tailbone to hang in peace. I can't say the same for the little hill it expects me to rest my boys on, but if I can walk like a bipedal hominid after spending a day writing about pajamas and kitten hats, the boys and I will learn to adjust.

This is my first day riding the Everlasting Comfort Train, and I've been ergonomic-butting and tailbone-hanging and boys-resting on it for six hours of work now. So far it doesn't feel like anything's changed, but that could just be because my existing profound butt pain hasn't cleared itself up yet. So—like Nevada—the boys and I are still tallying votes and we'll announce the results sometime before the peaceful transfer of power.