Hypomania, Wherefore Art Thou?

alone-in-fogI’ve talked a lot about the depression, the ceaseless days and nights spent in overwhelming darkness and despair.  That’s because, for me, depression has been a near constant companion over the past 13 years.  I’ve broken out from time to time, but generally speaking, depression has literally shadowed me.  Episodes of “normality” (whatever that is) and occasional periods of hypomania have let me know, fortunately, that I can go into a period of remission.  And, I believe that’s where I am now.  Thank goodness!

But what of this hypomania of which I speak?  What is it?  Well, for people with bipolar II, hypomania is…generally…a period of elevated mood.  It’s not as extreme as it is for those with bipolar l, but it is usually a happy, energized time.  A period where the world is charming, we’re charming, and life is grand and wonderful.  Generally.  I’ll get to the conditions in a bit.

amusement park ridesI’ve mentioned before how I had these periods of being down, usually just physically, followed by periods of euphoria.  That euphoria is something to be craved.  It’s like the best kiss ever, the most exciting carnival ride, the most fun time even during mundane tasks.  It’s the energy to work all day, put together a decent meal, play games with the family after dinner, and follow it up with an amazing romantic episode with your significant other.  All that and more.  Smiling the whole time.  Conversation comes more easily, witty remarks flow from your lips, creativity is at its max, we love more deeply, and the desire to do something…anything, really…is strong.

lots-of-money

All of this comes at a price.  Sometimes that price is literal.  Mania and hypomania are noted for spending sprees, often with money that’s borrowed.  Credit card debt is not uncommon, at all.  Later, during periods of relative sanity, someone with bipolar disorder will look at the purchases and wonder, “Why?”  I know I have.  Anxiety can be enhanced during mania and hypomania, as well.  During hypomanic spells, angry outbursts may be common.

However, we don’t remember this.  Or at least some of us don’t.  We remember how good we felt, perhaps because of how nice it was to not be depressed!  And the hell of mood stabilizers is that while they are intended to prevent those deep, dark periods, they also tend to prevent the up side.  I mean, what’s the fun of having bipolar disorder if you can’t have a little hypomanic spell once in a while?  (wink, wink)

This is a very brief, very generic outline of hypomania.  Ask two people how they experience it and you’ll get some similarities, but there will also be differences.

Then there are mixed episodes.  Oh, boy.  What fun (she says in her most sarcastic voice).  I’ll get to that in another post, along with discussing a plethora of other mood disorders.  Did you know it’s estimated that 25% of the population have or will experience a mood disorder at some point in his/her life?  Hopefully I’m passing along some information you see as valuable.  And, as always, if you have any questions, please pass them along.

The Quiet Room (First Published 12/12/2013)

So, where was I?  Back a couple of posts or so ago…?  Oh, that’s right!  I crashed and burned.  Yep.  First, a correction.  This occurred at the end of Block III in the teacher ed program, not Block II.  The next semester would have been the final Block then student teaching before hopefully passing the Praxis test and entering the classroom as a teacher.

College classroom

Now here I was, three weeks left to spare in Block III, and I was crashing.  I managed to complete the semester.  I had to!  I’d invested too much, and had watched the investment my family had also put into my education, to quit at that point.  And I believed I just needed a little break before hitting the books again in the fall.  I had a whole summer.

That’s not the way it went, though.  A month later I was sleeping almost non stop.  When I wasn’t sleeping I was crying.  Or that’s the way it seemed to me at the time.  Looking back I recall so very little.  Just that things were very dark.

John had been attending some of my counseling sessions with me in an effort to better understand my illness.  We made an emergency appointment with *Flo (can you see being in therapy with Flo as the therapist?  J ) and had to make a decision.  Was I able to cope?  Was I in danger of harming myself? Was I able to care for myself and/or my family? Was a more intense effort needed to become stable?

I know John wanted only what was best for me, as did Flo.  I’m also sure he must have been terrified at that point.  We decided that the best course of action would be for me to be briefly hospitalized in order to be stabilized, a decision I’d make again today if necessary.

Doctor and patient in hospitalI was fortunate in that my then-doctor was affiliated with an amazing hospital in St. Louis.  Fortunate because the psychiatric ward (now THAT’s a shocking term, isn’t it?) there was for those like me…not for those waiting to dry out between drunks or drug highs or those who were criminals.  Just for those of us whose neurotransmitters were taking a hiatus. And I hafta say, except for the whole crying and sleeping thing, and being horribly depressed, it wasn’t half bad.  Staff was amazing, I had no responsibilities except to get better, the food was great (Hey, that’s important!), and there were plenty of snacks on hand.  We were well cared for.  If called to give it a rating, I’d say five stars.

I have to add I was a little antisocial.  Okay, make that a LOT antisocial.  I didn’t want to attend group therapy, or activities, or anything else that involved other people.  I wanted to be left alone with my book and be allowed to read or sleep.  I was there because I was depressed, not to make friends over arts and crafts.

Then came the first night and the discovery that my roommate snored.  Like a truck.  I absolutely could not sleep through that.  I made my way to the nurses’ station and begged to be allowed to sleep in another room.  All the rooms were full, though.  I then begged to be allowed to sleep on the sofa in the common room, or even in a chair!  Against regulations.  The despair I felt made my earlier despair look like joy, and apparently it showed, ‘cause I was informed that there was the “quiet room” and it was unoccupied!

Girl says shhhhWhat??!!  A quiet room??  Why wasn’t I told about this room before?  Quiet!  That was exactly what I wanted! I almost-happily gathered up my blankets and pillow and tip-toed my way to the room. I wanted that room and didn’t want anyone else to claim it!  My precious!  It was adjacent to the nurses’ station with a window between them.  I noticed the mattress was on the ground but, hey, I didn’t care.  There was no one in the room but me!  Quiet time, here I come!

As I snuggled down, I noticed something on the floor at each corner of the bed.  They were kind of like bent over, u-shaped bolts but each side was bolted into the floor.

The bed wasn’t bolted down. It was just a mattress.  So what could it be?  Then it dawned on me and I actually laughed out loud.

The room could more appropriately be called a “time out” room and was usually for those who needed to be quieted, not for those needing quiet.  I’m still laughing about this, though my husband and doctor were not too thrilled with it (read: horrified) when they found out.  The u-shaped bolt thingies were in case a patient needed to be restrained.  Oh, my.  I’m so un-violent.  The irony is just too much.  But, hey, I’m just grateful the room was empty while I was there because it meant I got to sleep at night.

I was placed on lithium, which is generally a drug of choice for depression, assuming the patient doesn’t develop a toxicity.  I did, but not for several weeks.  It works quickly and had me pretty much stable by the time my three day stint was over. Actually, I felt pretty darn good at that point.

Blood work conducted at the hospital indicated my iron level was dangerously low and that my thyroid had taken early retirement.  Two more potential causes behind my exhaustion and contributing factors to the depression.

So, I did gain some answers.  But better yet?  I got to sleep in the quiet room!

The Darkness Comes (Originally published December 31, 2013)

getting darkThe darkness threatened to close around me.  I felt the tentacles stretching towards me, reaching, snaking their way through to my body and soul.  I could see them, slowly moving in, becoming stronger, increasingly darker as they approached.  The fogginess in my head deepened, making me feel ever more lethargic, fatigued…any effort to do anything was almost too much.  My spirit began to sink, interest in anything I enjoyed was slowly diminishing.  I wish I could say my feelings towards those I love was unaffected, but that would be a lie.  I knew that love was there, but it was becoming separated from me by the darkness.  That’s the way depression works.  It’s a wall between all that you love and enjoy and yourself.  In the end, when it’s at its worse, nothing exists but the darkness.

Sometimes that’s a relief.  Does that sound strange?  I know some of you understand.  Just to let the darkness have its way…to sink, curl up, sleep, and close out the world.  It hurts less. That twilight, in between state prevents enjoyment, but you’re still very much aware of all you cannot do, don’t want to do.  You don’t care about much, but somehow care that…you don’t care.  You’re supposed to care, and you know that. But the energy, the strength it takes to accomplish even the minutest task simply isn’t there.  And it’s frustrating, aggravating, demoralizing…here it is again.  At least with the full darkness everything is shut out.  That’s not to say full depression is a good thing.  It definitely isn’t.  I’ve spent more than my share of time curled up in a fetal position, blanket over my head, too tired to even cry, and just wanting it to stop.  In that in between, twilight state, though, is the belief that you should be able to carry on as if nothing was wrong.  As if you were walking in the light.  As if all was well in your world when there may only be enough energy present to take a shower, get dressed, and watch TV.  And sometimes there’s only energy to choose one from that list, like choosing dinner in a Chinese restaurant.

The tentacles have been stretching towards me since early October.  I woke up one morning and all my interests were simply no longer interesting.  I felt flat, emotionless, yet not depressed.  Slowly, little by little, I could feel the cold, misty-gray tentacles moving towards me, grasping me lightly, just enough to be aware.  The tentacles were getting stronger, darker, squeezing harder.  I managed to fake my way through Christmas and prepared a separate, second dinner on New Year’s Eve to celebrate with a son and daughter-in-law who had been out of town at Christmas.  I managed to get through, and was aware enough of having met the challenge to even give myself a little pat on the back.  “Good work. Success.”  The fact that I was in bed by 6:30 New Year’s Eve wasn’t important…I had accomplished what I had set out to do.

despair or hope signpostThen on New Year’s Day, somehow, for some reason I don’t want to even question, the tentacles’ strength lessened, they became a bit thinner, less dark.  I’m not yet back in the light, but I have managed to vacuum and mop my living room, dining room, and entryway, shop, run a couple of other errands, and still feel like writing this blog post.  That’s pretty good and I’ll take it as a sign that perhaps I’m moving towards the light instead of away from it. I feel I’m beginning to care again, and I take that as a good sign, too.  I had hoped I wasn’t experiencing a long, slow, spiraling decline into that dark place from which it is so very difficult to escape.

I feel blessed to be able to say I appear to be climbing out of that hole.

My Appreciation for Robin Williams

This was initially published in a different blog.  As we’ve just passed the second anniversary of Williams’ death, I felt it was timely to republish it here.

Williams-2

One look in his eyes and the suffering was there for all the world to see.  Despite being one of the world’s premiere funny men, Robin Williams was tortured by demons many of us, myself included, have battled.  Shocked is a good way to describe much of the reaction to his death.  Shock first of all that he’s dead, but that shock is compounded by the manner in which he died.  And as the details are revealed, the mourning deepens.

How can one be so funny while (my own term) dangling over the Jaws of Hell?  And not dangling just out of the reach of demons, but dangling and having flesh shredded by those demons?  Look at video of Williams performing.  The humor is there.  The genius is evident.  But look at his eyes.  Really look.  Do they look happy?  Does the smile reach them?  Generally, no.  His well-documented struggle with alcoholism was a dual-edged sword.  It was an attempt self-medicate the demons into submission but since alcohol is itself a depressant, it just made matters worse.  While drunk, though, at least the demons can be ignored.  Their collective voices, the taunting, the jeers, can be ignored.

Humor is frequently used as a mask.  Think of Chris Farley and his own brand of fat jokes, making funny at his own expense.  Make people laugh “at” him while making them believe they’re laughing “with” him.  Does that make sense?  Beat them to the punch.  No doubt he honed this humor while growing up.  The weight was the gorilla in the middle of the room.  Bring it up first, make people laugh, put them at ease about it, and gain acceptance.  Otherwise, become the butt of jokes and ostracized.  Everyone likes to hang out with the funny guy.  Forget that each joke carves another wound.  The wounds are invisible.

Williams’ humor wasn’t directed at himself, but might be considered a wall.  I know people who suffer from profound depression yet are extremely funny.  I recently read a great article (sorry I can’t cite it as I can’t find it now) that describes the process very well. Depression and the resulting pain (both emotional and physical) are uncomfortable for others to be around.  What does one say?  How does one react?  How does one treat and talk to someone suffering from deep depression…or even mild depression?  Easier to ignore it.  So, create a mask.  People like those who are funny.  Most of us like to laugh and someone who can make us laugh on a regular basis is a treasure.

But if that mask is dropped, what then?  If the emotional despair is allowed to peek out, discomfort sets in in those around the demon-haunted.  “Wait.  This person is funny.  How come he/she seems so down?  And how am I supposed to act?”  The situation is uncomfortable and the humor is pulled back out of the hat to dispel the discomfort.  A sigh goes up among the “friends”.  (Insert name here) is back to normal!  Let the good times continue. Do they see the pain in the eyes?  Do they realize or even care that the humor hides a damaged soul?

I’m not going to write about what should or should not be said to someone who lets down his/her guard and drops the mask, even temporarily.  You have to decide for yourself how comfortable you are with hearing the unvarnished truth.  You see, the problem isn’t when someone is being serious.  It’s when the chronically depressed is being funny.  That’s when he/she feels there’s no option, no one around who can take the truth.

No.  I’m not going to write about that.  The situation is as individual as, well, an individual.  Instead, this is about the demons faced by Williams, myself, and others like us. You see, I’ve said it before but I’ll say it again, the demons steal.  They lie.  They steal joy, family time, appreciating the waves breaking on shore, and a beautiful sunset.  They steal enjoying a rare family gathering as children grow up and go their separate ways in life.  They steal enjoying a quiet moment with a spouse.  They steal hope.  They steal peace and comfort.  They also lie.  They say there’s no chance of anything becoming better.  They tell you it’s hopeless, nothing will change.  They speak unmentionable things to the depressed.  Mainly, they say the only way out of the pain is to just check out of life.

Oh, I could go on and on about the demons.  And that’s why Williams’ suicide has affected me so much.  Unlike many of us, he had everything, including the means to obtain the best medical care money can buy, yet he could not run away from his demons.  Those demons.  I know them.  I’ve battled them.  Right now my arsenal is keeping them at bay.  They’ve helped me win the battle, and hopefully they’ll help me win the war.  Williams lost his war.  It’s the knowledge of what he was facing, how far down in the hole he was, how hopeless it all seemed that hurts me.  I would hurt just as much for anyone in such a position, it’s just that Williams was a public figure with a very public death.  But knowing what he faced, how utterly alone he felt, how hopeless the situation appeared to be, that’s what’s affected me.  I’ve been there.  And I sincerely hope and pray I’m never there again.

 

Since this time, I have faced the demons again.  Fortunately, even though I live in a small town, I have a fabulous psychiatrist.  A very early morning quasi emergency appointment led to a prescription for an old-school med with great properties.  I’m not going to mention this medication as I don’t want anyone to feel I’m advocating for it.  I’m not a doctor and I don’t play one on TV.  For me, though, a small dose of this medication as adjunct therapy was just what was needed.  Another more recent change is helping me face the “blahs” that can accompany milder depression.

Do you face demons?  Do you battle against what they tell you, knowing they lie?  Do you have a favorite memory of Robin Williams?  I would love to hear about it.