Encouragement

Folks, I’m in need of some encouragement.  I’m feeling like I’m slipping into  a depression, and I’m having major problems with obsessive thinking.  I keep thinking that Bob’s going to die in a car accident going to and from work.  I can’t get the thoughts out of my head, even though I know it’s simply bipolar disorder barking up a tree again.  I’ve let him know and he’s promised to be extra careful (they are doing major construction on the road where he works, which is where I think some of this is coming  from).  But it’s torturing me all the same.

Obsessions are hard to describe.  It’s like your mind gets into a groove like a broken record player and keeps playing the same song over and over and over inside your head.  It’s like an earworm where you get a song stuck in your head and can’t get it out.  But instead of a song it’s a disturbing thought or worry of some kind that just will not go away.  I try and stay busy so they don’t have time to set up housekeeping in my mind, but it doesn’t always work.  Just think about me and pray for me through these next few months that this is not the onset of something even more interesting later on.  Thanks for any prayers you can send my way.

Designer Purses

Other symptoms I’m more or less able to control on a daily basis.  I sometimes get the urge to spend money.  However, since I grew up in a stone-broke household, I know the value of a dollar and know that saving is a much better proposition than spending.  So I resist it, unless it is for Christmas and birthdays.  And even then I am so cheap that I don’t buy anything that isn’t discounted or that I don’t have a coupon for.  My current weakness is purses—designer ones when I can find a good sale.  I only have three so far, so I have kept that impulse in check very well.

I can obsess over small details.  I am by nature a neat freak.  I like to organize closets, cabinets, bookshelves, files, and collections.  However, I was so tortured over neatness by my mom when I was a young child that I swore I would never inflict my obsessions on my kids.  So I haven’t.  My house is generally neat but has pockets of chaos in it, and I refuse to stress over it.   I let the kids manage their own rooms and refuse to freak out over their messes.

I have a cleaning service come once a week to do the cleaning so I am free to spend my time doing the organizing that I enjoy and am capable of.  I have taught my girls how to clean but know they have to make the decision to use that training when they get out into the world.    My middle daughter loves neatness, while the other two like more clutter in their lives.  But that is who they are, and I will not make my condition worse worrying over it.

When I get anxious, I often pace around the house.  It’s aimless, directionless, and uncomfortable.  I try to do it after I’ve spent a long time sitting at the computer so that I am getting at least some motion into my otherwise sedentary life.  But sometimes I do it simply to fill the time.  When I feel the anxiety spinning out of control, I do have a medication I can take on an as-needed basis to calm me down.

I very rarely have crying spells.  One thing that makes discussing depression so confusing is that people use the word depression as a synonym for sadness.  When I’m sad, I cry.  When I’m depressed, I can’t muster up enough energy to cry.  I have very little to be actually sad about.  That is why I was diagnosed with clinical depression; depression that has a reason is called situational depression—it is in response to life circumstances.  Situational depression can turn into clinical depression if it lasts long enough with the variety of symptoms listed earlier.

I hope I’ve been able to describe the symptoms I experience well enough.  As I said, it’s very hard to describe them when not actually experiencing them, and it’s hard to remember in the middle of them that they will pass if you continue taking your medication, doing your therapy, and, most importantly, praying for relief and walking with the Lord.

Self-Injury

The first time I ever scratched myself was when I was attending college one summer under a special program for rising high school seniors.  It was my first real experience away from home, and I would get homesick at times. I was having trouble fitting in with the other students in the program with me because I claimed to be a Christian, while many of them seemed to either have no religious beliefs, have other belief systems, or simply live in a way that belied a Christian walk.  I felt my own faith weakening as I was exposed to new philosophies in classes and challenged in my beliefs by professors and other students.

One afternoon it all came to a head.  I was walking back to our residence hall from class by myself and was overwhelmed with a sudden fear and an immense amount of self-loathing.  I knew I would never fit in back in Ackerman where I grew up, but now I was faced with not fitting in where I had planned to go to college.  I started rubbing my upper arms with my palms and quickly moved to scratching them with my fingernails.  I did this over and over until the skin on my arms was raw while crying some of the most intense tears of my life.  I had always bitten my nails short out of anxiety, so I did not leave bloody scratches.  I feel like that would have been noticed by the people supervising the program, so I was glad.

The episode was over as quickly as it came.  I went back to my room and sat down on my bed and started rocking back and forth.  I was four hours away from home, and I didn’t know or understand what had just happened to me.  However, the fear and anxiety and loathing were gone.  All I wanted to do was go to sleep.  And I did, fully clothed without even unmaking the bed.

I’ve only done the scratching a few times in my life since then, and my last impulse to do so was two years ago after the funeral of my husband’s grandmother, who was dearly loved by our entire family, including my girls.  I was trying to hold myself together, to be strong for Bob and for the girls, and after it was all over, the roof seemed to cave in on my emotions.  I did not cry or scratch myself; I made my hands into fists and held them out from my sides as I walked out to leave the church.  But I desperately wanted to hurt myself to make the inner pain and anxiety go away.  Something about causing myself physical pain made the psychic pain more bearable.

My Experience

Many of my episodes have been what are called mixed episodes, where I had both manic and depressed symptoms going on.  I would have the irritation, grandiosity, and pressured speech of mania with the sleepiness, suicidality, weight gain, anhedonia, and feelings of worthlessness of depression.  Often my episodes featured psychosis, which is a loss of touch with reality in some area of your life.  Most of my psychotic episodes were rooted in fear delusions (false beliefs)—fear that my husband was going to leave me, fear of some unspecified danger, or fear that something was going to happen to my children because God was angry with me for not taking care of them like I thought I should.

Thankfully, I have never had hallucinations, where I was seeing, hearing, or feeling sensations that were not real.  I don’t hear voices, I don’t see dead people, and I don’t feel insects crawling on my skin.

Another one of my symptoms falls outside the definitions and involves self-harm that does not rise to the level of suicidality.  When I am extremely stressed, I have the urge to scratch my nails into the skin of my arms.  A more extreme form of this impulse is known as “cutting”, where people cut on their arms with scissors or razor blades.

The DSM

Bipolar symptoms are hard to describe.  The medical establishment has lists of symptoms they use to diagnose this disorder; they are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).  Mania is characterized by a period of mood disturbance where the person experiences an abnormally and persistently elevated, expansive, or irritable mood for at least a week.  Three or more symptoms from the following list should be present before the mood disturbance can be called manic:  elevated self-esteem (grandiosity), less need for sleep, more talkative than usual (pressured speech), the feeling that thoughts are racing (flight of ideas), abnormally low attention span (distractability), increase in goal-oriented activity (psychomotor agitation), and risk-taking behavior (such as buying sprees, sexual experimentation, or poor business decisions.).

Depression is characterized by loss of interest or pleasure in life activities for at least two weeks.  Five or more symptoms from the following list should be present and cause severe disruptions of a person’s life before the mood disturbance can be called depressed:  low mood (depressed mood), low interest or pleasure in all or most activities (anhedonia), significant unintentional weight loss or gain, sleeping too much (hypersomnia) or too little (insomnia), slowing of activity (psychomotor retardation), loss of energy (fatigue), feelings of worthlessness or excessive guilt, unable to think, concentrate, or be decisive, and recurrent thoughts of death (suicidality).

The bipolar person can switch from one pole to another very quickly or very slowly and can have periods of normal functioning in between them. Mania can be fun.  Depression is never fun.  In my personal experience, mania is scary.  I have had periods of high functioning that you could call hypomanic, which is when the symptoms are less severe than in full-blown mania.  I think most of my time between the birth of my middle child and my youngest child was spent in hypomania, in that I had the goal-oriented behavior and the drive to accomplish my goals without the excesses of true mania.  But my truly manic episodes feature a high level of irritation, a low need for sleep, pressured speech, and grandiosity, where I have big dreams and plans that had no basis in reality.