Vital Signs Part 1

Vital Signs – Indications that a person is still alive, which include a heartbeat, a pulse, breathing, and body temperature.

God forbid that the definition might include any higher reasoning, moods, and mental capacity or activity, for you can seem alive and be dead to the world.

* * * The stigma of metal illness * * *

have bipolar disorder (bipolar II to be precise).

I will never say I am bipolar. Ok I have, but I don’t like doing so or hearing others describe me that way. It doesn’t define me. In this world we tend to label those with special needs or mental illnesses with an “is a” instead of the more appropriate “has a”.

For example, you would never refer to person x is a broken leg, person y is a concussion, or that so-and-so family have a cancer child (or have a child that is a cancer, but of course that has its own set of very rude connotations). Such descriptions are nonsense for physical aliments. It should be nonsense for mental disorders as well. Yet the language used to describe each is very different in our “enlightened” society.

Why discuss my disorder in such a public forum?

To share, educate, and make aware. After all, isn’t that what the caring bridge web site is all about? To write about one’s battle with cancer for all your friends and family to see, or to have loved ones participate in your online journal as you struggle to survive.

Where is a mental health caring bridge? There isn’t one, though bipolar disorder can be equally deadly.

Though only 10% the number of deaths from cancer, bipolar disorder kills about 5,000 people each year through suicide.

Some think of those with a mental illness as loons that go on rampages and kill, commit suicide, are weird or dangerous, or that shuffle about in institutions or push shopping carts around in alleyways.

Perhaps this is a bit of a melodramatic description, but it’s also a description that far too many believe. None of us would hesitate to say we have a hernia, a broken leg, or any other physical aliment. However many keep mental illnesses to themselves, worried about how people will perceive them or misunderstand what such a condition means.

There are HR web sites devoted to how to “deal with employees with mental illness”:

Whereas there are web sites entitled how to “accommodate employees with cancer”:

Language matters.

I think it’s necessary for a perception shift within the general public about the realm of mental disorders. To be open and honest and not to treat these conditions like some dirty little secret.

Here is a quote by Natasha Tracy I like very much (some of which I paraphrase):

“Emotional pain, like physical pain, is a matter of degree. Everyone experiences sadness – which is the problem. An average person who experiences sadness thinks they know what it is. And they do. They know sadness over a normal range, perhaps acutely when a loved one dies. But they don’t know the sadness that is so big that it destroys your world.

Similarly, people can get upset and get anxious before a test or a job interview and think they know anxiety. But that isn’t the grating, jagged, writhing beast that eats you from the inside of your flesh.

People seem to think they understand severity – thinking that their pain must be the worst pain, and if they got over it then so should everyone else. No one would compare a twisted ankle to a shattered femur and expect the shattered one to “walk it off” but with emotion, that’s exactly what we do.”

* * *

“People go mad in idiosyncratic ways.”

– Kay Jamison, An Unquiet mind

My first major hypo-manic episode occurred when I was 21, followed by another at 24. Both were mingled with depression in a witch’s brew that stirred my brain painfully. I was unaware at the time that it was a manifestation of bipolar disorder. I chalked it up to “I freaked out.”

I don’t experience euphoric mania, but a miasma of swirling anxiety, anger and irritation all at the same time with feelings of sadness and worthlessness. Last summer I wore a trough in the sidewalk outside the building where I work. I felt very much like a shark in a tank that has to be constantly moving in order to keep the water flowing through its gills.

I had a penchant for crying for no reason or becoming so agitated I had to move, move, move. Or, in a healthier vein, write, write, write and write some more – for writing is not only cathartic it’s also a productive form of kinetic energy.

The worst aspect of being bipolar, as I alluded to above, is my “mixed state” mood swings. I am now taking Lamictal, an anti-convulsant mood stabilizer, which has helped tremendously. So does psychotherapy.

Here is the formal definition of mix state mood swings from Wikipedia:

“In the context of mental disorder, a mixed state, also known as dysphoric mania, agitated depression, or a mixed episode, is a condition during which features of mania and depression, such as agitation, anxiety, fatigue, guilt, impulsiveness, irritability, morbid or suicidal ideation, panic, paranoia, pressured speech and rage, occur simultaneously.

Typical examples include tearfulness during a manic episode or racing thoughts during a depressive episode. One may also feel incredibly frustrated or be prone to fits of rage in this state, since one may feel like a failure and at the same time have a flight of ideas. Mixed states are often the most problematic period of mood disorders, during which susceptibility to substance abuse, panic disorder, commission of violence, suicide attempts, and other complications increase greatly.”

All that aside, Katniss and my family are my best medicine. I love her: she keeps my demons at bay as much as anything or anyone, as do my children. They are my whole world. I’d be lost without them.

For years, despite the incidents in my 20’s, I had been able to suppress my feelings. Graduate school at Iowa State University was my personal renaissance, despite the hypo-manic incident when I was 24. ISU was a wonderful place, filled with great friends and happy, carefree, fun days and memories. It’s also where I met Katniss. Getting married, having children, a false start in a career, and then switching to a new one, kept me sane and happy. And the demon at bay.

So what caused it to come back now, later in life, in such a visceral and forceful way?

In addition to having bipolar disorder, I have PTSD. Two years ago it all came tumbling out when someone I worked with was aggressive, petulant and angry with me. The PTSD, during these set of encounters with this person, triggered a brain short circuit, like a war vet who has seen too much battle and reacts to a car that backfires. The demon in my head stood before me – corporeal, wagging its finger back and forth at me. I couldn’t believe the intensity of my reaction.

I’m empathic.  I can read/pickup people’s emotions. I can read facial expressions, body language, eye contact, etc. Call it a sixth sense. Sometimes it’s unconscious and only later mulling over conversations do I realize what I’d picked up on. Not always, of course, and it’s not like I have crystal ball.

I also have a fairly common side affect of bipolar disorder: hypersensitivity. Being hypersensitive I can, and do, misinterpret the emotions I sense. I often believe that negative emotions are directed at me, or that I have done something wrong. It also means that I feel like I’m always saying or doing the wrong thing, which will anger or offend someone.

I have been likened to a sprinkler system, which normally goes off in the presence of a fire. I’m so sensitive to those around me, all someone has to do is enter the room, light a match and I’ll react.

So, stir together the PTSD, bipolar disorder and hypersensitivity in the cauldron of my brain, add that encounter 2 years ago, and you get:

Double, double toil and trouble;
Fire burn and cauldron bubble.

Fillet of a fenny snake,
In the cauldron boil and bake;
Eye of newt, and toe of frog,
Wool of bat, and tongue of dog,
Adder’s fork, and blind-worm’s sting,
Lizard’s leg, and howlet’s wing,
For a charm of powerful trouble,
Like a hell-broth boil and bubble.

Where’d the PTSD come from, you might wonder? That condition, after all, isn’t a manifestation of bipolar disorder. Read part 2 of Vital Signs, and I’ll try to explain.

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