Wednesday, May 31, 2023

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 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.

Sunday, May 21, 2023

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.

Tuesday, May 16, 2023

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. 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 dyskinesia 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 recently 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.

Thursday, May 11, 2023

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.

Saturday, May 6, 2023

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 four 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!

Monday, May 1, 2023

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.

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 ...