Tuesday, January 27, 2015

Who Cares for the Caregiver?

Below is my latest Huffington Post blog post. I thought the message was a good one (not to toot my own horn!), so I decided to share here too.

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Mark Lukach's article My Lovely Wife in the Psych Ward has been making the rounds on social media for the past few weeks. It is an honest and painful read. As the title implies, Lukach writes about his experiences with his wife's psychiatric problems. Her diagnosis: depression with psychotic features. Reading it, I was struck by the depths of his love and devotion to his wife. And I was also concerned for him and for all caregivers of the chronically ill.

Yes, psychiatric problems can be difficult for the mental health consumer, but the consumer does not experience their symptoms in a vacuum. Their loved ones, family (spouses, children, extended family) and friends, are also impacted. As a bipolar sufferer, I try to be cognizant of how my illness impacts my loved ones. I've also tried to think about what I would tell other consumers' loved ones as well as my own about self-care. 

So this article is for you, the caregiver.

Here are some tips to ensure that you effectively care for yourself while providing for your loved one:
  • Don't neglect your own needs: get adequate sleep, eat regularly, and keep up with your own health needs (such as doctor's appointments, taking any prescribed medicine, exercise, etc).
  • Invest in self-care. In other articles I've written about the importance of self-care for the consumer, but caregivers also need to make self-care a priority. Self-care is whatever you do that puts you first and soothes you: listen to music, make a spa appointment, go for a walk, read a book, eat your favorite meal, take a vacation. In short, do something you love.
  • Find your own therapist. I don't mean couple's therapy or family therapy. But a therapist all your own. Everyone can benefit from having an ear to vent to and problem solve with.
  • Spend time away from your loved one. Yes, you are entitled to take a break.
  • Learn your loved one's signals. They might not always know when they're headed for an episode, but if you've lived through a previous episode or hospitalization, you probably know what to look out for.
  • Be patient, understanding, and kind with your loved one. Everyone needs extra nurturing when not at their best. 
  • Be patient, understanding, and kind with yourself. You won't have all the answers. You won't always know what to say or do. You might get frustrated or overwhelmed. Don't beat yourself up.
  • Know your limits and enlist help when you need it. Help from family, friends, mental health doctors and providers. You don't have to think of yourself as a fixer.
  • Specifically for romantic partners: 
    • Depending on your loved one's diagnosis, he or she might have mood swings or easily get angry or irritable. Try not to take it personally. With your partner, create coping strategies to handle emotional outbursts.
    • Again, depending on the diagnosis or even as a side effect from certain medicines, your loved one's libido can be impacted. Both extremes are possible: too much of a sex drive (hypersexual) or too low of a sex drive. Be patient. If a low sex drive is a problem, find non-sexual ways to be intimate. 
    • Be sure to keep the lines of communication open and honest. Listen to your loved one's concerns about his or her care, but also make your concerns known too.
If your loved one hasn't told you lately: you are important, you are valued, you are making a difference. Being a caregiver is a tough role. So don't neglect your own needs and your own life in the process of providing love and care to others. I love the airplane analogy about responsibility and help: in emergencies, you are exhorted to put your oxygen mask on first before assisting those around you. Be sure to take care of you.

Saturday, December 27, 2014

Blogging Year-in-Review


This has  been quite the year!

When I was hospitalized in 2013 for mania I left the hospital wanting to write a memoir. The mania had me super excited to accomplish that feat. However, my mood had other plans. I became depressed shortly after the mania ended. And I spent the rest of 2013 and half of 2014 in a funk. The depression zapped my motivation and energy. And the memoir I was so excited about did not materialize.

Hospitalized yet again in 2014 for mania, I was re-determined to write a memoir. But this time I decided that starting a blog would be more manageable than a full-length book. Within days of being discharged I started Manic Monique's Meanderings. I was so manic in those early days that I managed to pump out 52 blog posts in the month of June!

However, the reach of my writing did not end with Manic Monique's Meanderings. Here's what else I've been up to:
  • I was published on The Root. Being published on a black publication was really important to me.
  • I was invited to blog for Huffington Post (sometimes I republish MMM posts, sometimes I write new material). My reading audience has grown exponentially. A UK mental health organization even referenced one of my Huff Post articles. I'm global, y'all!
  • I was interviewed by BP Magazine. The interview will be published spring 2015. I have a subscription to BP so I was really excited for this opportunity! 
  • I was interviewed by and featured on the Real Brown Girls blog.
  • For Mental Health Awareness Week, I guest blogged for Strut in Her Shoes.
  • I was interviewed by MyndTalk, an internet radio show.
  • I was interviewed by Black Women Empowerment, another internet radio show.
  • And social media has been such a godsend.
I have no idea what 2015 will have in store for me, but I'm looking forward to continuing to share my story.

Thank you for reading my blog. Make sure you come back :)

Monday, December 15, 2014

To Accept or Reject Mental Health Labels, That is the Question

What's in a mental health label? Schizophrenia. Bipolar. Anxiety. Depression. OCD. And so on.

Does a mental health label define you?

I've had numerous conversations with my therapist about the bipolar label. I've been diagnosed for seven years now. I went six years in between my first and second hospitalizations for mania. And in those six years I did not really claim the label. My therapist showed me the bipolar entry in the DSM (Diagnostic and Statistical Manual of Mental Disorders). There is an entry for single-episode mania. Mania is what determines a bipolar diagnosis; otherwise, one would just have unipolar depression. I thought I had that, the single-episode diagnosis, not the full-fledged diagnosis. I thought my one episode of depression and one episode of mania were one-time flukes. I didn't think I really had bipolar disorder. However, my psychiatrist disagreed. He told me "once a Heisman trophy winner, always a Heisman trophy winner." I hated this analogy.

The two medicines I was on for those six years in between hospitalizations kept me stable. Having a bipolar diagnosis didn't impact much for me except sleep. I had to be in bed by 11pm in order to avoid next-day grogginess. But that was the only inconvenience. I had a few side effects within the first few months of being hospitalized, but after I changed to a new medicine I was fine.

Until 2013.

Elevated liver enzymes were detected in my routine blood work. Elevated liver enzymes might mean liver damage. I was told to stop taking this medicine immediately. My psychiatrist didn't replace this medicine, leaving me only on one medicine to maintain my bipolar disorder. Within two months I was manic and hospitalized. This hospitalization removed all doubt that I was really bipolar. I was hospitalized for ten days as the doctors tried to find me a new medicine cocktail to control my mania. I had to also go on short-term disability for two months.

Needless to say my therapist and I renewed our conversations about my label. I could no longer act like I didn't have a mental health diagnosis. I didn't have any friends with mental health diagnoses, so I wanted to talk to other diagnosed folks. In search of a space to discuss my disorder, I sought out and attended a DBSA (Depression and Bipolar Support Alliance) meeting.

My therapist was concerned. He didn't want me to identify with a mental illness. He didn't want it to define me. But I disagreed with him. Just as I am black and a woman and an American, I too, also have bipolar disorder. It does have an impact on my life: my choices, my thoughts, my actions. To deny the label would be like denying a part of me. Now, I don't subscribe to the belief that to have a mental illness means I have to be consumed by instability. I am a highly-functioning professional.

For me, having a bipolar diagnosis does not signal dysfunction or disability.  I've learned to use the diagnosis to my advantage. I think it makes me special: I am creative, intelligent, and empathetic. When I look at my bipolar lineage (all the famous writers, artists, actors, and doctors), I feel proud.

And when I read the DSM entry for bipolar disorder, I see that I have had nearly every symptom of mania and depression. The diagnosis and label made my actions and thoughts make sense. I've actually found comfort in the label. But I do realize not everyone wants to be labelled.

What say you? If you are diagnosed, how do you interpret your label?

Sunday, November 23, 2014

Unlikely Sign of Depression

I was depressed last year from June/July 2013 until May 2014. The insomnia was perhaps the worst part. I couldn't fall asleep. When I did fall asleep, I couldn't stay asleep as I woke frequently throughout the night. And on top of that, I woke up early. Like 3am or 4am early. The other big problem was the empty feeling. I didn't feel sad. In fact, I didn't feel anything. I was really worried that I'd feel empty forever. I thought my newfound numbness was my new default emotion.

But beyond the insomnia and the empty feeling, I also noticed a change in my handwriting. I recently found this article, "Are You Depressed?", on a handwriting website. Just as you can tell a person's mood from their behavior (are they smiling? are they moping around? are they irritable?), handwriting also signals a person's mood.

When grading my students' essays last year, I could barely read the feedback I'd written on their papers. At the time, I noticed the change, but I did not attribute it to my depression. I tried to compensate. I started writing slower so I could concentrate more on writing out each word. I don't recall if this actually worked or not. But no student ever came to me to tell me that they couldn't make out my writing.

My depression ended in June 2014. Since then my handwriting has gone back to normal. I thought the above article was an interesting read. I would not have made the connection between my mood and my handwriting. It's interesting how our moods control so much of our thoughts and behaviors.



Tuesday, November 4, 2014

Manic Shopping Spree 2014

I sometimes think in terms of musical lyrics. When I think about my addiction to shopping, this Kanye West line comes to mind: "Single black female addicted to retail" ("All Falls Down").

There are a number of symptoms that come along with being manic. The following list comes from the WebMD website:
  • Excessive happiness, hopefulness, and excitement
  • Sudden changes from being joyful to being irritable, angry, and hostile
  • Restlessness, increased energy, and less need for sleep
  • Rapid talk, talkativeness
  • Distractibility
  • Racing thoughts
  • High sex drive
  • Tendency to make grand and unattainable plans
  • Tendency to show poor judgment, such as impulsively deciding to quit a job
  • Inflated self-esteem or grandiosity -- unrealistic beliefs in one's ability, intelligence, and powers; may be delusional
  • Increased reckless behaviors (such as lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs, or ill-advised business decisions)
When I'm manic, I experience nearly every symptom. Yes, the mania feels good. And the mania has saved me from depression twice (2007 and 2014). By that, I mean, I was depressed and there was no sign that the depression was going to end. The depression only ended because I swung into a manic episode. This is why I love the mania.

A clinician once told me that mania is worse than depression in terms of life consequences. Manic people quit their jobs, have affairs, use high amounts of drugs and alcohol, engage in risky sexual behaviors, and spend lots of money. All choices that can wreak havoc on your life, finances, and relationships.

My mania manifests in me shopping a lot. In 2007 I charged $10,000 in two or three months. In 2013 I didn't charge anything. But in 2014 I charged $20,000 in three and a half months. That figure is just ridiculous. (I have really high credit card balances; this is not necessarily a good thing for a person suffering from bipolar disorder.) Note: my $20,000 isn't an unreasonable amount of money to have spent during a manic spree. I met a bipolar man who charged $150,000 in a week; he bought three new cars. His number made me feel a whole lot better about my damage!

But the truth remains, I am in such credit card debt.

I am not worried though. I have a plan to pay off the debt. And I bounced back from the 2007 spree. I know I will bounce back from this one too. My credit score was excellent the last time I checked it a few months ago. I know now that that is definitely no longer the case; I checked today. But I won't be making any big purchases (like a house or a car) anytime soon, so I'm not concerned with my credit score.

I know medicine isn't for everyone. But I couldn't imagine me manic and unmedicated. I spent this much money while medicated. I'd be totally out of control without the medicine.

In the future, to protect my finances from my manic self, I'm going to lower my credit card balances once I get the debt paid off. I might even give my credit and debit cards to my mother the next time I feel the mania coming on. Lack of impulse control and credit cards don't mix. I have certainly learned my lesson. Only took two spending sprees.

Saturday, October 25, 2014

The Professional, High-Functioning Bipolar Patient

I came across this very interesting article by Laura Yeager on the "professional, high-functioning bipolar patient." The article discusses the author's experiences with her bipolar disorder and her ability to maintain normalcy in her life (career, family, mental stability). She details about a dozen questions that bipolar sufferers have struggled with: religion, the decision to bear offspring, medication, hospitalization, and relapse among other topics.

When I've gone to DBSA (Depression and Bipolar Support Alliance) meetings I've been one of (if not the only) highest functioning person in the room. The other people I met were either out of work on disability or between hospital stays or in the midst of a depressive episode. Don't get me wrong, bipolar disorder is a chronic illness. I've personally found that relapse is pretty common. I've been depressed three times and manic three times. I've also been hospitalized three times. I understand what it feels like to be in the midst of an episode. I understand how debilitating it is.

When I went to my first DBSA meeting last year I found the meeting to be simultaneously therapeutic and damning. I had never been to a meeting before so I didn't know what to expect. Prior to this support meeting, I hadn't thought much about my bipolar diagnosis. It had been six years since my first and only hospitalization. Yes, I took medicine nightly and I couldn't stay awake past 11pm (if I did I was groggy the next day; the meds I was on were highly sedating), but other than that I didn't think much of my disorder. All that changed in April 2013. I started to feel high. Like manic high. And I was worried. I spoke to my therapist about my concerns, but I felt like I needed to talk to people living and coping with the disorder. My therapist didn't think it was a good idea. He didn't want me associating with people he said wallowed in the dysfunction of their disorder, people who made their illness their whole life.

I went to the support group despite his concerns.

It was a small group of people. About 10-12 people of various ages and races/ethnicities. But about 75-85% of the people present were in the throes of an episode: either one had just ended or they were currently symptomatic. There was no professional clinician. So it was the blind leading the blind. There were lots of tears. I even cried myself. I shared my story. A story I had not discussed with anyone other than my therapist. I heard other people's stories. I felt understood.

But the next day I wound up in the hospital for 10 days. The support group was a trigger. It was very emotional and draining.

It is hard to be around lower functioning bipolar people. I've only been to two DBSA meetings. The second meeting was better than the first. But I still was one of the highest functioning people present. Maybe people who have a good handle on their disorder don't need a support group?

You know what else I've noticed? I haven't seen manic people in any of my three hospitalizations or at the support groups. I did meet one in IOP (Intensive Outpatient Therapy) this year. My thoughts on mania is that a manic person probably doesn't consider themselves sick. They feel on top of the world. They are bursting with productivity and energy and creativity. Why change that? Medicine would lessen or deaden these feelings.

In this instance, I'm kind of an oddity. I've never been hospitalized for depression; I only go to the hospital when I'm manic. For me, the mania is a lot more destructive than the depression. I managed to go to work everyday last year while depressed. But when the mania started, I needed to admit myself immediately. The mania gets out of control.

But to bring it all back to the start of this post, I would love to meet large numbers of highly-functioning bipolar people. I know they exist. Just look at all of the famous artists, poets, writers, and actors who have used their bipolar disorder and the ensuing creativity to their advantage.

Wednesday, October 8, 2014

MyNDTalk Internet Radio Interview

I have three ventures in the works for Mental Health Awareness Week: two interviews (a blog and an internet radio) and guest blogging at Strut in Her Shoes.

My second internet radio, MyNDTalk with Dr. Pamela Brewer, aired today.

You can listen here. If you feel so moved, please leave a comment, either on my blog or on the internet radio site.

Thanks so much for listening :)