I pull my boots off
throw my weapon on the floor
I cry my eyes out in my private little war
Well it seems I’ve been a soldier, heaven
knows I’ve been no saint
With my camouflage and armor, cold heart and
grease paint
To you this has no meaning, the Armistice
laid down
The armies all are quiet and the guns don’t
make a sound
Cause you
Melted the steel walls tore down the barbed
wire
Filled in the trenches, demanded a cease fire
And now you’re leaving; there’s nothing I can
do
I want you to know now, you’re gonna take me
with you
Well now three on a match is suicide in the
foxhole of my mind
And way off in the distance the air raid
sirens whine
And they sing your song of rescue to my
tattered worn out shell
You
drag me to your safety from this my front line hell.
The blood that was spilled in the heartache
before
Left remnants of scars that I never, never
could ignore
‘Til you…
(chorus)
(Take Me by Edwin McCain)
Finally, brothers, whatever is true, whatever is noble,
whatever is right, whatever is pure, whatever is lovely, whatever is
admirable—if anything is excellent or praiseworthy—think about such things.
(Philippians 4:8)
My doctor and I had finally
found a mood stabilizer I was not allergic to.
We settled on eskalith, a derivative of lithium. It was discovered in the 1950’s that lithium
helped balance those with bipolar disorder, or manic-depression as it was
termed then (Hymen, 2003). It has been
known to be most successful with bipolar I disorder and not as much with bipolar
II, but it worked better than anything we had tried previously, though I was to
discover medication is only one aspect of treatment for bipolar.
Years ago a doctor told me there
were three areas I needed to address before I could find harmony with bipolar
disorder. Those areas were biological,
sociological, and environmental. The
biological area addresses the organic aspects of bipolar; the genetics, the
brain, the mechanics of the illness, and the diagnostics involved in
discovering the illness in the human body.
The sociological part addresses the
internal behaviors of persons with the illness and their relationships with
others. This area focuses on discovering
one’s strengths and weaknesses, where the person ends and the illness begins,
and how to create healthy relationships or maintain the ones already in place.
The environmental area is concerned with the
external surroundings or the habitat of the person with bipolar. This aspect addresses the actions taken by
the person to maintain a high level of mental health by creating the most
optimizing environment for them as possible.
These three areas create a holistic approach to living life with
bipolar.
At the time I began to take eskalith, however, I
was not aware there were other areas I needed to address in order to gain
balance in my mind. I was still trying
to self-medicate by moving around. Jayme
was offered a job teaching music in Kansas City, MO, and I jumped at the
opportunity to try somewhere different.
I had been to KC for Jayme’s graduation.
I had spent time at the National Alliance for the Mentally Ill (NAMI) in
their extensive library, collecting information on bipolar. I was excited to be somewhere where such a
facility was accessible.
We were in Missouri for five years. Most of it I cannot remember with
clarity. I had thought I was leaving
behind the worst years of my illness only to find I hadn’t yet begun to
experience it. Looking back I realize
that my environment was the number one contributor. The number two contributor was my
personality.
I thought Jayme and I would kill each other
before it was all said and done. For the
first year we lived in a one-bedroom apartment because we could not afford
anything bigger. It was difficult to get
away from each other. I was volatile, to
say the least, and she was afraid to do anything on her own. She had been so used to me being the big
sister, often taking care of her, that she had a hard time handling my
resentment and flat out hostility at being forced to make the decisions in our
jointly shared existence. I was wanting
to take charge as I so often had in the past, but the strain of making all the
decisions in our relationship along with day to day decisions in my own life, would
trigger episodes of extreme mood, most often in the form of violent outbursts
of anger. I often broke things or would
go from a seemingly normal state of mind to very volatile. I remember slamming a cupboard door so hard I
broke it off its hinges.
I was continually over-stimulated by the
environment we lived in, noise from surrounding apartments, and then the noises
of the city. I felt lost without
mountains to go by in terms of navigation, and I resented never being able to
go somewhere, anywhere, without someone else having beat me to it.
These things may seem petty, but I grew up in
Wyoming where the entire population of the state is less than a fourth of
Kansas City’s population. I did not know
I would have a hard time with the geography.
The flatness of the surrounding vistas made me feel insecure as though I
might slide right off the globe without the mountains there to hold me in
place. I had lived in many places over
the years but none of them had been so big and they all had mountains.
That first year for Jayme and me was brutal. She reacted often like she did the day the
barking dog had driven me mad; she felt I was overreacting. She had little compassion for me, and I
needed someone to empathize with me on some level. I knew I was unbearable to live with, my
moods doing a continual pendulum swing between dark aggression and hyperactive
excitement, but I could not control any part of it.
I did manage to find a job I liked doing hair,
and within eight months I was the manager of the salon with eight girls under
me. I was a good manager, I think. I have an unwavering sense of fairness and I
tend to lead with logic as long as my mental faculties permit.
I was
going through a gambit of doctors, not finding anyone who seemed to fit my
criterion. I needed a doctor who cared
about his patients, who I felt a report with, and who was not condescending but
was willing to learn right along with me.
I settled for someone who could give me meds. I think I desperately needed therapy but
could not afford it. Hairstylists tend
to make lousy money with little benefits.
What I remember of the almost two years I did
hair was that the pressure from work got increasingly heavy. I had a hard time listening to the girls’
problems and then leaving them. I would
worry. My boss and his wife were young
and had never been in the hair business before.
I was constantly running interference between them and the girls I
managed. Mentally, I would pretend to be
normal for as long as I could and then collapse. That meant I would pretend at work to handle
all the crises with strength and endurance, then go home and completely fall
apart, my moods making mince meat out any evening solace. Most of the time that translated into me
releasing aggression by breaking things.
This worked for a while, but then I began to see that I was unable to go
a full day at work and then take out my aggressions at home. I could not wait that long. I became, what appeared on the outside, as
chronically irritated. But the truth was that I was like a volcano giving off
small puffs of steam all day long.
Eventually, though, I was going to blow sky high. I did not know exactly what that would look
like, but I did not want anyone else to witness it. I decided I needed to make a change. Somehow I needed to get out from some of the
stress I was under. So I began to look
for other work, something where I could just go, do my job, and leave.
My friend Angel, whom I met at the salon I
managed, was looking for other work as well.
We had become good friends, and she shared with me information on a
place where she had just gotten a job with good pay and benefits. It sounded ideal. I went and applied. The only drawback was that it was in downtown
Kansas City, which was almost 20 miles from Blue Springs where we lived. That doesn’t sound like a long way, but with
interstate traffic, the Royals’ stadium, and the Kansas City Chief’s stadium in
between, it would often take a couple of hours to drive 20 miles.
Nonetheless, the pros outweighed the cons. The deal was clinched when my boss informed
me he did not want regular customers to be rewarded for their loyalty by being
given occasional discounts. I just
looked at him and said, “I think we’re through here.”
He looked nonplussed, “What do you mean?”
“I mean you have no idea what you are
doing. I have been in this business for
a long time, and I’m here to tell you, you make money through the slow times by
hanging on to your regular customers. Anyone
in the business knows that. And
sometimes that means rewarding them,” I said, shaking my head as he began to
argue.
“Look, this isn’t open for discussion,” I said,
“We are at an impasse I’m afraid. I’m
not going to compromise my standards and it doesn’t look as though you’re going
to get any. I’m overworked and
underpaid. And frankly, working for you
has killed any desire I have for doing hair ever again. I’ve been offered another job and I’m taking
it.”
There was not much he could say. Our profits were up across the board, because
I encouraged the hairstylists to nurture relationships with their clients to
build clientele. When that happened
retail sales increased and we did better during the slow times. The stylists were much happier when they did
not have to treat the people in their chairs like cattle, and so were the
people. I had fewer complaints across
the board as well. But my boss was
greedy and unwilling to allow things to take their course. He kept pushing and pushing until I was
completely burned out and so were many of my stylists.
I was glad to be rid of the salon. I looked forward to a new job. The place I went to work for was a large
transfer agency for mutual funds. I
spent two months in training before being put on the floor in the broker dealer
department. My job was to take calls
from brokers from all over the country who had questions about funds that their
clients held or were thinking of investing.
It was a very stressful job. The
questions could come from anywhere, and I had to be able to find the
information they asked for. Brokers as a
whole are not polite people especially those from the east coast. I apologize for the stereotype, but that has
been my experience. They are in a hurry and would like the information before
they even ask.
Not only did I field calls but there was an abundant
amount of data entry and processing that my area was responsible for. Much of it was problem solving, and rarely
simple. My difficulty was that I was not
adequately trained on the processing side of things, and I was completely
intimidated by taking phone calls, mostly because I had a hard time
hearing. My auditory processing problems
made it difficult to hear what was being said through the phone. I would strain so hard, investing so much
energy into not hearing surrounding noise, that I would leave work irritated
and absolutely exhausted. It seemed I
had jumped from the frying pan into the fire in terms of the stress from my
previous job and stress from my new one.
I worked for the transfer agency for almost
three years. I became very good at my
job, but my mind paid a huge price. I
refused to quit because for the first time in my life I had insurance that
covered some of the mental health expenses I accrued monthly. What was bad other than the stress of the job
was the pressure placed on the employees by the employers. It truly was all about numbers. I was a number, not a name. What I processed
per month needed to be a certain number, and what we scored by the way we
talked to brokers on the phone had to be a certain score. It got to where someone was plugging into my
phone to listen to my calls on a regular basis.
I was being watched to see what I was doing at my desk every day, and I
could not leave my desk to even go to the bathroom without asking permission. I began to feel trapped. Being watched and the anxiety it caused
compounded with my mental condition to cause paranoia.
The first time I was called into a meeting it
was because I had chosen to call in sick with two other girls I carpooled
with. We had had an ice storm and I was
not going to drive in it. Drivers there
drive like idiots most days, not to mention when there’s something on the
ground making it slick. Apparently,
someone else from our area made it in to work.
I was reprimanded for not driving in and told they were giving me a
warning. The next time I would get
written up. I looked right at my boss
Stephanie and said, “Look you gotta do what you gotta do, but no one tells me
how to handle my life. If I decide it’s
too dangerous to drive somewhere, unless you’re going to volunteer to fly me to
work, I won’t be in.” They had prefaced
our meeting with, “Just so we’re clear,” so I finished by saying, “Just so
we’re clear.”
At my one year evaluation I was asked how I
liked the job, I gave my boss a slight smile, then said calmly, “I hate this
job. I hate it with a nuclear
capability. I’d rather be scrubbing
toilets with my toothbrush than working here.”
Of course the response was, “So why don’t you quit,” to which I replied,
“Toilet bowl cleaning doesn’t offer insurance.”
As time went on the demands made on those in my
department became heavier and heavier. I
began to have times when I would black out whole sections of the day. I would
not remember what I had done during certain times of the day. My behavior
became hostile. It is difficult to
describe what went on there except to say that when a human being is
continually watched and nit picked, it does something to them. The turnover rate was unbelievable. Within two years of my being there, I was the
only one left in my area and I was processing almost 100% of the work that came
through, while taking 30-40 calls a day.
I felt the weight of the demands placed on me at work pounding me down
to a nub. And the anger that was an
ever-living bonfire, was pushing me to the edge of my control. I would drive
home in the summer heat with no air-conditioning, 98% humidity, and pray all
the way home that God would give me the strength and control to get there
alive. I just did not know if He was listening any more. I figured He might listen since there were a
lot of innocent people I could take out with me on a crowded interstate.
I knew I
was headed for disaster, but I did not know what to do. I felt like I should be able to handle my
job. I placed very high demands on myself
because I needed the money and the insurance.
Jayme and I had a nice place to live.
I did not want to fail her and I did not want to have to tell my parents
I could not manage my life once again.
It was a Friday when I looked at my boss and
knew that I was capable of putting him in the hospital. That line I had drawn in the sands of my mind
that I would never cross was gone, and the animal was unleashed. It did not matter that I was medicated, the
bipolar had taken over, and my mind hurdled the medication like a fence. It was much worse than what had happened in
Minot. In Minot, I was only a danger to
myself. Now I was a potential danger to
any who posed a threat. I made it home
that day, utterly shattered. The strain
on my mind to control my moods was unbearable.
By Sunday, I was in knots, as was my ritual
every Sunday night. I can only describe
my state as one of sheer terror, and when I am afraid I take on the persona of
a junk yard dog, ready to attack anyone who messes with me. Jayme looked at me and said, “I don’t think
you need to go to work any more. I think
you need to stay home.” With her
permission, I collapsed into a heap on the floor, sobbing hysterically. Suddenly I was able to let go of the anger
that was propelling me from one day to the next. It did not go away, for it was every present,
but instead of a constant bonfire, it receded back to more of a campfire within
me. With it at low ebb, the world dimmed to fuzzy black and white. I could not form complete thoughts, and my
movements became slow and belabored. I
was a balloon someone had let the air out of, all stretched out and
flimsy.
Jayme was the Bionic Woman taking charge
of my life like it was her profession.
She called my mom first. They
conferred for some time, and then I think I made an attempt at coherent
conversation. Then Jayme called my
doctor who agreed absolutely with her that I should not go back to work. Then she called and left a message on my
boss’s phone, letting him know I would not be going to work the next day.
My sisters and my mom came up with a
plan that would get me help and yet keep me out of a hospital. I would go stay with my sister Kelly in Idaho
for three months while receiving therapy from a psychologist there. I spoke with him over the phone for a
while. I do not really recall what he
said or what I said. I just remember
that I felt like he could help me and that was enough. My doctor in Kansas City helped Jayme with my
work situation so that I could get leave.
They were not very happy that they could not fire me for taking leave,
but federal law overrode.
My time in Idaho was traumatic and
confused. I was very paranoid, and for
that reason I will not elaborate on any relationships I had during that time
for I still do not know if my thoughts and interactions were real or a
distortion. My overall mental picture of
my time in Idaho with my sister Kelly and her family is much like being at the
fair and going on a ride called House of Mirrors. Inside is a room full of mirrors, but
they are no ordinary mirrors. Each one
takes an individual’s real shape then distorts it, making it long and stretched
out, short and smashed, or squiggly.
That is how I remember my interactions with others during that time.
The psychologist’s name was
Larry. Larry was a Christian
psychologist who had worked with mental illness as well as sexual abuse. I met with him once a week for three months. Each session ranged in time depending on how
I was handling it. I do not remember how
far we had gone into our sessions before he asked me if I had been sexually
abused. I told him no. I wasn’t lying; I just didn’t remember what
had happened when I was in high school.
Larry left it alone and moved on.
But another day when we were discussing the way I did not register
emotion or grieve things that happened to me, Larry asked me again if I had
been sexually abused. He said, “The
reason I keep coming back to this is because you have no access to your
emotions when it comes to processing shocking or traumatic events. You also can sever an emotional commitment to
someone like cutting off an appendage, walking away from it without allowing
yourself to feel anything. This is not a
normal process for how one should experience these kinds of situations.”
I mentioned that something had
happened in high school. Larry did not
pressure me, but allowed me to explain at my own pace, asking me on occasion if
I needed to stop. I shook my head,
no. I needed to finally speak it out
loud. I suddenly, desperately needed to
say it. I had locked it up for so long,
that after I had given a monotone dry-eyed account of what happened, I just sat
there. Then he told me it was not my
fault. That is when the wall that seemed
to have closed off the pain and hurt of such a violation broke, and I was
finally able to connect my feelings with what happened, like connecting a plug
to an outlet.
The cool thing about Larry was that
he was always building me up, and not in silly flattering ways, but in ways
that mattered to me. He told me how
smart I was, how unique and special. He
told me God had an amazing plan for my life.
He said he knew I was capable of great things. The funny thing was that we really did not talk
that much about the bipolar. We mainly
cleaned up all the garbage around it. We
discussed my childhood traumas and called them out into the light. We talked about abusive relationships I had
been in and how I had begun to use my weight as a way to determine if men
really like me for me or for other less noble reasons. I determined that was not an effective
weapon, for it harmed me. Larry helped
me to see all these things. We took all
my garbage out of the closet and dumped it on the floor; every little
thing. We addressed my need to perform,
to be a care taker, to be what my friends called “the closer” who goes in and
cleans up everyone’s mess but cannot admit to having any of her own. Indeed the latter has been so ingrained into
me that often when I voice my problems, those close to me do not believe I should
have any.
At the end of my time with Larry we
made a list of every person who had ever wronged me. It was quite a list I must say. Then I prayed that I would be able to forgive
them. Then Larry said I must pray for
forgiveness for being angry with them.
It was no more right that I harbored anger toward others than what they
did to me. This was a bit harder, but I
did it. This was what I mark as the beginning point of the dissolution of my
anger.
Then he said, “You will not have closure on all this
for some time as you are so delayed in how you process and experience
things. Eventually that will get better
and the gaps in between will not be so large.
Do not be frustrated with yourself.
Give yourself time. You are a
magnificent person. It has truly been my
pleasure to know you. And now let me
leave you with Philippians 4:8 (see beginning of chapter). This verse is a blessing and reminder for
you.”
I went home feeling much better, but
as I mentioned before, there is more than one part to finding balance with
mental illness. Medication fits in with
the biological aspect but there is also the environmental and sociological
aspect. I had the environmental under
control. I got enough sleep, drank lots
of water, expressed myself creatively, and was careful about the things I put
into my mind. What I did not have under control yet was the sociological
aspect. Even though I had spent some
time in therapy, I was not equipped to sort through my present life. I had not learned how to manage day-to-day
aspects of having bipolar, because I so busy putting out fires from previous
traumas. But after I dealt with the past
I was able to focus on learning the daily maintenance of bipolar.
Because I have bipolar II, I do not have the
full range of manias that are present in those with bipolar I disorder. I have hypo-manias which are much less
severe. However, I have very extreme
depressions that are synonymous with a bipolar II diagnosis (DSM IV,
2002). Because of my penchant towards
time in the bell jar (very severe depression), I have had to learn ways
of managing my thought life. I was doing
cognitive therapy long before I knew what it was. It is the single most
valuable tool I have outside of medication.
I began practicing cognitive therapy in order to control the daily
aspects of bipolar that needed to be addressed in order to have balance.
Long ago I began to develop a part of my mind
that became an objective voice, detached and clarifying. It is what I call my watcher. This is the part of my mind that is
constantly reformatting what is taken in and what is distorted. For instance, because I deal with depression
at different levels for about eight months out of the year, most of what enters
into my head becomes negative. As long
as I am not in crisis, I am able to reframe what is entering into my mind and
make it more positive or just more feasible.
It may be that I am in a situation where there is a lot of noise. Noise is something that triggers very serious
stress on my mind because it over stimulates me. The over stimulation causes an overload in my
mind which in turn causes me to shut down and become depressed. If I listen to that objective voice, my
watcher, I can often talk myself out of the stress or at least alleviate
it. It may be something as simple as
telling my self that I may leave an environment if I need to. It may be that I can analyze the noise and
accept the intrusion, or it may be that I can simply remind myself that the
noise will not last forever. This
process is a part of cognitive therapy.
Cognitive therapy was developed by
Aaron T. Beck. The theory centers on the
concept that negative thoughts can cause depression (Segal, Williams,
&Teasdale, 2002, p. 21). The active
part of the theory is to do a thought record.
When a person experiences a shift in mood, they write down their
thoughts. If I am depressed and my
thoughts are those of feeling like no one understands me, that I am all alone,
those thoughts will perpetuate the depression to both linger and become even
worse (Segal, et al., 2002, p. 22).
I have become fairly proficient at
taking a continual check at the state of my moods, which even though a mood
stabilizer moderates them, are rapid cycling on a regular basis. They are much like a river flowing underground. Above ground are the thoughts that are
continually moving through my mind. If I
am not careful of what I do with those thoughts and how I perceive my
environment, they are capable of causing rough waters below ground. Likewise, if things are already turbulent
underground, I have to be very aware of that and know that the chaos underneath
has a way of coloring my thoughts, which if negative or paranoid, cause even
more problems underground. It can be a vicious
cycle.
It is important to say here that I
am referring to cognitive therapy in the context of mental illness. Many people do not have a mental illness but
suffer from depression due to death or any number of traumas that assail human
beings during life. These people may use
cognitive therapy instead of anti-depressant medication, which is used to treat
depression (Segal et al., 2002). This is
not what I am referring to. I am talking
about a person who has a mental illness and deals specifically with depression
in the context of that mental illness.
This type, like me, can use cognitive therapy as another tool in
conjunction with their medication. The
use of this tool has become as much of my daily routine as has taking my
medication.
My time with Larry helped me let go
of my baggage, and that enabled me time to format a game plan for how I would
survive my life. I knew that I needed to
know who I was without my illness, something I could only begin to work on
since it was time for me to go back to work.
The thought of going back to work terrified me, triggering the beginning
of another descent back down into the black hole of despair.
My therapist in Kansas City was a
genius in his field. Unfortunately, he
was greedy as well. He was indicted for
selling pharmaceuticals from his home.
But not before he had a great impact on my life. He was unusual for a psychiatrist because he
also did therapy with me. None of my
other psychiatrists had also been psychologists. He was a big strapping Italian, able to charm
his way through any situation…well, almost any situation. He once said to me, “I can’t figure out why a
woman like you is not married. You are
beautiful and truly extraordinary.” I
was of course flattered but replied sardonically, “Well when you figure that
out you let me know will you?”
Then one day he said, “I know why
you aren’t with a man, Lael. You scare
the living hell out of them.” I was
incredulous.
“Why is that,” I queried.
“Well it’s because you’re too damn
smart. I don’t know a man who can keep
up with that brain of yours. You can
flatten ‘em before they even get a chance to inhale.” I responded by rolling my eyes at him.
My Italian doctor was the one who
told me about the three levels needed to find balance. He also told me my sociological area was the
one that was out of whack. He said, “You
have to do something about that job.
It’s going to kill you.”
He was right.
I was not back at the job long when I was informed that I would be not
only doing the broker/dealer work, but they would be adding another area to my
workload. One of my friends said he
heard one of the managers saying I wasn’t going to go on work leave again. She’d get me fired before that happened.
On the day I learned about having more work
piled onto my load, I called my sister panicked, she called my doctor and he
told her to have me call him. He told me
to immediately leave the building. I
went to my boss and told him I didn’t know when I’d be back and then I
left.
My doctor saw me again and refused to release me
to go back to work. I became very ill,
both physically and mentally. Occurring
so quickly on the heels of the other episode, it was much worse, causing more
extended bouts of paranoia. For weeks I
felt as though my mind was wading through sludge just trying to form a complete
thought. I had huge black circles under
my eyes and they were blood shot.
I had a lot of guy friends from work. The irony of my life is that in spite of the
sexual issues with men, most of my friends have been men. They keep life simple. As long as I was not in a relationship with
them, I got along with them great. Tim,
James, and Jarvis all came to see me. I
especially remember James though, because he came the day after I had left work
for good. I remember he asked my friend
Angel what it was going to be like seeing me so sick. She laughed and told him my head wasn’t
spinning around or anything. She said,
“She’s sick, James. You’ll see it when
you see her, but it’s not scary. She’s
just not Lael. She’s very fragile and
the best thing for her would be a chat with you. You probably won’t find her joking around or
being sarcastic. That’s a bit beyond her
right now.”
I’ll never forget him knocking on my
door, all 6’5” of him standing there, holding a bag of Cadbury Eggs, my
favorite. He came to see me a lot and
often brought his wife and their new baby.
James was one good reason for that job.
Jarvis and Tim were good reasons as well. I feel privileged to have been a part of the
lives of such wonderful men.
I spent a year in my
home. I rarely left and if I did it was
in the middle of the
night.
When I did venture out, I would suffer extreme physical side
effects. What I was experiencing was
part of my anxiety disorder called agoraphobia. Agoraphobia is “derived
from two Greek words: agora, meaning
marketplace or place of assembly, and phobos,
meaning terror or flight” (Garfield, 1984, p. 128). It is the fear of being in
an open space where one might find it difficult to escape (Healthtouch, 2004).
Agoraphobia s is considered to be a result of environmental and physical
factors. There may be chemical problems
in the brain and certain social situations, such as grocery shopping standing
in line at the movie theater, may contribute (Smith, 2005). People with agoraphobia tend to have panic
attacks that can cause serious trauma in social situations. A panic attack happens when a person becomes
very anxious quite suddenly and for no apparent reason. A person who is having a panic attack may
experience worry over losing control and may develop a fear of having a heart
attack. It may become difficult to
breathe. An individual who suffers from
panic attacks will attempt to steer clear of places where they may feel they
may have one (Healthtouch, 2004), which for me was just about everywhere. When
I was somewhere that was overly crowded with a lot of noise and commotion, a
panic attack would most likely ensue.
The first panic attack I had was
when my sister and I went to an amusement park with the corporation I worked
for. We were having a good time and were
walking past the kid’s rides when we were stopped for a moment in a sea of
people. All of a sudden the world
started to spin and my vision became distorted.
I couldn’t breathe and all I could think of was getting out and away. I remember thinking that the people that were
pushing and crowding around me didn’t have the right to invade my space. I pushed my way through, as though driven,
heading for an open area nearby that had benches to sit on. I sat down and put my head between my knees
until my breathing became normal. That
was the first incident and I have had many more since that time.
People who have panic attacks may feel
depressed and become upset with themselves because they have fears of going to
places where they may have panic attacks.
They may feel like prisoners in their homes because they are too afraid
to leave. This is where agoraphobia
becomes an issue. Individuals who suffer
in this way may tend to self medicate with alcohol or may abuse medications in
order alleviate symptoms (Healthtouch, 2004).
I know
that I used to self medicate with cigarettes.
Going to the grocery store, which was a necessary evil, was
traumatic. I would use cigarettes to
help control my anxiety. Even if I were
at home, if I began to think about going somewhere I would begin to have a
panic attack and I would then use a cigarette to calm myself.
One of the most embarrassing things
about having a panic attack, at least for me, was the physical symptoms. My hair was very nearly to the middle of my
back and when I would have a panic attack I would sweat so much that my hair
would be soaking wet by the time the attacked abated.
Fear is the driving factor in both
agoraphobia and panic attacks. In
agoraphobics, there is a fear of crowds, of standing in line, of bridges, of
having panic symptoms such as dizziness and or diarrhea, of being on a train or
automobile (DSMV-I, 2003). Symptoms can
come and go but many times agoraphobics are housebound for years, and sometimes
for the entirety of their lives. First
attacks usually occur between the ages of 18 and 35, and they happen suddenly
(Garfield, 1984).
There are several theories on the
origins of agoraphobia (Garfield, 1984, p. 129). One theory comes from Weekes, Chambless, and
Alan J. Goldstein, Department of Psychiatry, Temple University Medical School,
Philadelphia (Garfield, 1984, p. 129).
They believe that stress is the precursor for panic attacks. Some of the events that could trigger such
attacks are traumatic in value and include, death, miscarriage, and divorce,
but do not exclude happy events such as marriage and birth (Garfield,
1984). For me, I believe, it was the
combination of already having a mental illness and then having tremendous
stress placed on me by my work situation that was the trigger. I also feel that being chained to my desk
with negative reinforcement—waiting in the wings if I produced errant
behaviors—compounded my disorder.
It has been determined that cognitive therapy is
more effective and less costly than pharmacotherapy. Treatment choices are contingent on the skill
of the therapist and what the patient prefers.
Cognitive therapy is often used in conjunction with medication (Andrews,
2003). For me, cognitive therapy was
something I was already practicing to keep my bipolar under control. I utilized my watcher in the area of my
anxiety disorder as well. I later found
out in the research I was doing on bipolar disorder that there is generally a
co-morbidity that goes along with bipolar.
It may be psychological or physical, sometimes both.
The top
three psychological ailments to accompany bipolar disorder are anxiety disorder
(93%), substance abuse (71%), and binge eating disorder (30%). I wasn’t surprised at the first two as I have
battled both in my long experience with bipolar, but I was surprised to find
binge eating to be next in line. And
finding that more men than women binge eat was even more surprising (Preston,
2006).
Next are the medical ailments. Migraine tops the list, followed by obesity,
and type II diabetes. I was not really
surprised by any of these, though I had thought heart disease might be one of
them (Preston, 2006).
The best way for me to handle the bipolar and
the anxiety disorder at the time was to simply shut myself off from over
stimulation and stress. I simply could
not be a part of the world for over a year.
At the beginning of the sojourn, my mind was so fractured; I couldn’t
even make decisions as to what to wear.
It was just too stressful for me. Jayme had power of attorney for me for
several weeks. She wrote out my checks
and paid my bills. Anything that had to
be done for work in terms of paperwork, she and Angel took care of. It seemed as though I lived in a bubble. But I needed that protection while waging a
war for sanity. My family did not want
me in a hospital. So the next best thing
was to insulate me away from the world. Jayme
didn’t want me to leave the house during the day, for she would be so worried
about me she would be unable to work. It
wasn’t as though I was on a mission to kill myself. My reflexes and judgment were impaired.
Any time Jayme had to leave school, she was able
to. The teachers rallied around
her. At first I was really happy about
that, but as time went on I became more aware of things outside the crumbled
workings of my mind. Many of the
teachers felt that Jayme was picked on, having to take care of her “psycho
sister”. And where were the
parents? Jayme got asked that a lot, and
many times it was mentioned that Jayme should not have to deal with me. Not in those exact words, but the meaning was
there. It stung that I was being
referred to like that. I, the big
sister, who had punched out bullies, given fashion tips, tolerated a tag along
when I really just wanted to be with my friends, and paved the way for an
easier life with my parents. Why should
it not be my turn to be taken care of?
Yet there was a part of me that was screaming how unfair this whole
situation was. I did not want to be
taken care of. I wanted to be
whole. I wanted to express all the
brilliant creativity and genius that I saw as I had floated through the
shattered pieces of my mind, where the boundaries of sanity had cracked and
fallen, when I had glimpsed another dimension of my mind where few are able to
go. If only I could bring something back
with me from that place in my mind, maybe it would be okay that I had had to
lean on my little sister. Maybe then
these people who had no idea what I was facing every day as I awoke and gathered
the bits and pieces of my mind together in the box of my brain just to cope
with the little bit of world that made it past my front door, would not see me
as a liability.
But I could not bring anything with me. I could only slowly regain a precarious
balance between what the world demanded of me and what I was capable of
doing. It was like I began life on a
three-legged stool. My mind was so
fragile; I never knew where to step.
Sometimes it was okay and other times I would get bucked off and would
have to go back to simple tasks, such as cleaning or organizing, things that
gave me some control and sense of accomplishment. It was a long slow journey but eventually I
was able to fly with Jayme up to see my parents in Barrow, Alaska. They had been living up on the Arctic for
several years teaching and working. They
wanted us to experience what it was like up there, and my mom wanted to get a
hold of me to see that I was going to mend for herself. The journey to Alaska changed my life forever.
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