Friday, November 30, 2007

Because they can

This is a continuation of the previous two posts. Start with the first one and work your way back up.

It occurs to me that this story is long. Very long. I wish it weren't, and what's really hard is I've shortened the story considerably in this telling. A lot of detail is left out, and I'm reporting only what you need to make sense of the story.

Just a few minutes into Jeopardy!, the doorbell rang. I put down my cheese and got up to see who it was. I opened the door and saw three police officers outside. I looked at them with eyebrows raised in a tentative gesture.


A forty-something cop said, “Are you May?”

“Uhh, yes. Is something wrong?”

The cop put his hand on the storm door knob and as he opened it said, “Can we come in?” His foot was already across the threshold before he finished the question. I know this because I was looking down at black cop shoes as the door swung open. That’s the only thing I remember seeing at that moment—the brass knob and cop shoes.

The three officers came into my house. The lead (I assume) officer told me, politely, to sit down. I sat on the couch. He told me, politely, to turn off the television. I sensed I was in trouble, but I hadn’t made the exact connection yet. I scanned the faces of the three musketeers and asked, politely, “So, what can I do for you?”

Cop #1 asked, “May, do you know why we’re here?” I had to admit that I did not. The cop said, “We got a call from the bank. Did you call the bank today?”

Ah. The bank. CitiBank. Diner’s Club. The asshole gets his revenge. I remember thinking, “Stay calm, May. Watch your mouth. For the love of god, watch your mouth. Be friendly. Be pleasant. You can do this.”

Pleasant. “Oh, my gosh. They called you? This is a huge misunderstanding. They shouldn’t have called you. This is really embarrassing. You can leave—everything is fine here.”

Oh, that it should have been so easy. Cop #1 said, “May, do you suffer from depression or mental illness?” Fuck. Branded, stereotyped, labeled, screwed.

I replied, "Well, as a matter of fact, I do. I was diagnosed with bipolar disorder about two years ago, but I’m stable. It had nothing to do with my angry outburst on the phone—really.”

They just kept looking at me. I was starting to feel heat creep up into my face. My heart rate kicked itself up a notch.

Cop #1: “Now, May, did you take your medication today?” Don’t freak, May, just don’t go off. I know that question pisses you off, but just let it go.

I smiled, and in my best friendly, perky voice said, “Of course! I am diligently medication compliant. Would you like to speak with my doctor? I’m happy to call him for you.”

The cops just looked at each other. At that moment, I realized things might not be going my way. Why were they still here? How could I make them leave? Be honest. Be polite. Be friendly. Be articulate. I debated whether or not to call my husband, but ultimately decided it wasn’t worth cutting short the dog’s walk. With any luck, I could convince these guys to get out of my house and leave me alone.

Cop #1 said, “May, tell me, do you ever have thoughts of suicide?”

Thoughts of suicide. “Well, yeah. Do you guys know anything about bipolar disorder? I mean, really, do they cover it in your peace officer crisis intervention training?” They just looked at me. “Here’s the thing. Thinking about suicide and committing suicide are totally not the same thing. You know that, right? One of the hallmark symptoms of bipolar disorder is suicide ideation, but only about 25% of people diagnosed with the illness actually commit suicide. I’m fine. You should really go now. There are probably crimes going on out there, or car accidents. You don’t need to be here.”

I looked around, starting to panic that they weren’t leaving. At that exact moment, I realized that the three of them had me blocked in. They had formed a human wall around my living room, blocking any possible exit on my part. They had me cornered in my own home. It was a flash of anger that I didn’t dare show. They were all standing in the same posture: legs slightly apart, hands together in front. Coats on, radios turned down, no hats. Black shoes. Plain, black shoes with laces.

Cop #1 said, “I need to talk to my colleague outside. We’ll be right back.” #1 and #2 went outside, and I started desperately wishing my husband would get home soon. Cop #3 stayed in my living room, strategically placed between the two possible exits from the room. This seemed unfair. They were in my home. I was being friendly, polite, and most definitely lucid. Why wouldn’t they leave?

When #1 and 2 came back in, #3 went outside. I had to say it. “Did it really require three of you to come here and have this conversation with a mild-mannered, middle-aged woman? I have to say, considering I’m no threat to myself or anyone, this seems like overkill.”

Before they could answer, I heard my husband and the dog coming up the driveway. Muffled voices. Side gate opens, closes. Muffled voices. I hear my husband’s voice outside. Thank god. He’s home. Then I realized he wasn’t coming in. He wasn’t allowed in. I immediately looked up and said, “I would feel a lot better if my husband were here.”

Cop #1 ignored my comment and said, “May, tell me about what happened with the bank.”

“The bank? Oh, the credit card thing. The guy I talked to at Diner’s Club, Citi Bank, whatever, was an asshole. I got frustrated and had an outburst. Why, what did he tell you? I think he called you because I made him mad.”

They looked at each other again. #1 and #2 went out again, and #3 came in. Still no husband. I took the opportunity to tell #3, “You guys are kind of stressing me out. I’d feel a lot better if you’d let my husband come in the house. It is his house, after all. Why is he being punished and kept outside?”

Cop #3 said, “He can come in soon.” He can come in? Dude, it’s his fucking house. Smile, nod, say OK. Pleasant. Friendly. I was already doing a great job at being perky and engaged. Why wasn’t it working? Slow crime night?

At this point, #1 and #2 came in and they finally let my husband come in. He looked at me and said, “Are you OK?” I assured him that I was, and yet my living room was still full o’ cops.

Numbers one and two stood in front of me, and with the most patent display of feigned concern ever, #1 said, “Tell me, May, if you were to kill yourself, what would you do?”

Suddenly, I felt like I was on Jeopardy! I knew there was a right answer, but I wasn’t sure exactly what I was supposed to say. I just knew I had a lot to lose if I didn’t say the right thing. Obviously, I hadn’t been saying the right thing up to this point, or there would not still be three armed men in my living room speaking to me in the voice you use to coax out a frightened dog you think might bite you.

Answer the question. They’re staring at you and #1 and #2 are a little closer than we’d like. “Well, I can’t say I have a definitive answer to that question. Let’s see. I would never shoot myself since I think guns are evil and the Second Amendment should be repealed. I won’t allow firearms in my house (takes a moment to deliberately glance, eyebrow raised, at each holster). It’s really much harder to die from an overdose than is popularly believed, so I wouldn’t try that. The thing is, I figure that for me, this isn’t something on my mind right now. I’ll admit that my illness makes me feel bad—really bad—sometimes, but now is not one of those times. I’m fine. That being said, I believe I have the right to choose the path of my own life and only I should control it. Maybe a year from now I’ll be ready to remove myself from pain, but for the time being I’m just fine. I have a good doctor and I see a therapist every week. I told you that I take my medication and that’s the truth. I’ll go and get the bottles and you can count the pills from the dispense date.”

Cop #1 was still prodding me to give him an answer. I wondered for a moment what the point of the question was. Did manner of self-demise matter? Were some ideations considered more indicative of danger and imbalance than others? What was I supposed to say? What was I not supposed to say? I felt like I was being pressured to say something, so I said, “Aw, geez, I don’t know. Probably self-asphyxiation. I hear that’s painless.”

#1 and #2 looked at each other and went outside to confer once again. I was getting really irritated by the blatant being talked about me behind my back. When they came back, #1 (his name was Martinez; I just don’t feel inclined to type that repeatedly) said, “May, we would feel better if we knew you talked to someone. We want you to talk to someone tonight.”

I shrugged my shoulders and said, “Fine. I have a great therapist. I saw her a few days ago, and I’ll see her again Friday, but if it will get you out of my living room, I’ll call her after you leave. I‘ll call her now if you want me to. Heck, you can talk to her if you want to. I can also call my doctor if that’s helpful for you. Here’s his card. You can take it and call him now or later. I have more cards. I don’t need this one.”

I was now in full-blown internal panic. My heart was beating hard in my chest and I was so thirsty I felt like I had taffy sticking to the walls of my throat. Outwardly, I looked calm, but the bigger problem was my mounting frustration and anger. I couldn’t stop obsessing over what the neighbors must be thinking about two cop cars in front my house all this time. I resented the hell out of these people who seemed to believe it was appropriate for them to take up a lot of my time, imply I was unstable and a danger to myself, and speak to me in a tone that I can only describe as condescending. Maybe dumbed down.

I hoped that since they were to the point of recommending that I talk to someone (About what? Ending my life a year or two or ten in the future? I already paid two people to have those conversations with me), we were finally wrapping up our conversation. They had already been in my house for over an hour.

As it turned out, my night was just getting started.

More tomorrow. I need to take a break from this now.

Thursday, November 29, 2007

Not invisible yet

This is a continuation of the story I started to tell in the previous post. Start there.

I opened the mail. Bills, bills, bills. The words of the counselor at Consumer Credit Counseling Services ran through my mind. Just pick out the card with the highest interest rate and ask the company to work with you. If they won’t lower the interest rate, ask for a lower monthly payment. You’ll pay more interest in the long run, but you’ll free up cash to take care of your medical expenses. That’s the best we can do for you, Ms. Voirrey, since you’re not late, in arrears, or over limit on your accounts.

I had already run out of cash and had no way to pay for my medication. Lithium is cheap, but it only works on one part of the problem. EMSAM and Lamictal were the most important elements in the mix at that point, but there was just no way. I skipped the Lamictal, stopped taking Ambien for the time being and substituted Alprazolam to help me sleep. At well over $200, EMSAM was out of the question.

I was completely unprepared for how quickly my body responded to this change. I felt like my head had been smashed through a wall of depression and with such force that it had permeated my skull. I was dizzy, sad, foggy, and slow. Very, very slow. It was like trying to focus on a slow-moving object yet being unable to hold onto it for more than a few seconds, except the sensation went on relentlessly. I felt as though I had lost all the ground I had gained in the previous five months, and it slipped away so fast, it seemed surreal.

Work out the money, May, get the medication. I put down the mail, and then pulled out the Diner’s Club bill. What the hell. It was the card I’d had the longest—about 15 years. It seemed like a safe place to start. I called customer service and started into my spiel. The customer service telephone clerk had an attitude. It was a man, African-American, not very friendly, and he appeared to be incapable of actually answering my questions, finding a supervisor, or even comprehending what I was asking. As the conversation continued to go in circles, I could feel my temper rising and my ability to be polite slipping away.

Eventually, I said, “So, what you’re telling me is that it doesn’t matter what I say or do, you not only refuse to help me or work with me, you are going to deny me access to a supervisor or another department where I can speak with someone who has the authority to provide some actual customer service. Is this correct? Yes or no?”

“Ma’am, Ms. Voirrey, I am not going to change your payment.”

“Yeah, I get that. Please transfer me to a supervisor.”

“I can’t do that. Nobody is available to talk to you. I can process your payment now, over the phone.” The arrogance in his tone smacked of condescension and mockery. To this day, I can’t identify what motivated his attitude toward me.

The anger inside of me slammed into the front of my head and came out of my mouth. “Look. I plan to be dead six months from now. I want to get my bills taken care of so I don’t leave a mess for anyone else to sort out. I’m doing the responsible thing. If you will just listen and work with me, your company will actually get paid faster and in full. Do you get it?"

By this time, I was sobbing, and I admit it probably proved detrimental to my credibility. The dickhead on the phone backed off and said, “Whoa, whoa, you’re OK with Diner’s Club. You’re good with us. Are you home alone?”

“Yes, I’m home alone. How the hell is that any of your goddamn business? Are you coming over to pick on me in person? My husband will be home in a couple of minutes. He knows what’s going on.” I took a breath and tried to take back my outburst. “I shouldn’t have said what I did. I’m very, very sorry. I apologize. I didn’t mean to say something bad that has nothing to do with anyone but me. Forget I said that. Please have a supervisor call me about my account.”

My apology sounded insincere, and it was. It came out like the apology a kid makes when forced to do so when there’s no remorse. Yes, a little snide.

I got off the phone and turned on the TV. I went into the kitchen and fixed a small plate of cheese and crackers. Time for Jeopardy! I kick ass at Jeopardy!

How I became invisible

In late 2006, after two years of struggling to get my medication-resistant bipolar disorder under control, rapid cycling and all, I thought I had been through every humiliating aspect of the illness. It is a humiliating illness, and anyone who tells you otherwise either has no connection to the real world or lives in such isolation and insulation that they haven’t really had the opportunity to be exposed to Life as We Know It.

There’s a shitload of stigma attached to Bipolar Disorder. There’s a lot of misinformation floating around out there, and a lot of misunderstanding about what the disorder is and is not, as well as flat-out disdain from those who believe it’s somehow willful or a matter of self-control. I watch my mouth, I lie abundantly, and I do everything possible to never, ever let on what my diagnosis is or to reveal when I’m having symptoms. It is exhausting, this living two lives in a simultaneous overlay.

When the fall of 1996 rolled around, I was depleted. Depleted of courage, depleted of fight, depleted of energy, depleted of dignity, and above all, depleted financially. Everything was a fight—the medication regimen, the day-to-day management of symptoms that just wouldn’t go away, the inability to sleep, the lithium-induced brain fog, the loneliness, the money.

The good news was that I had been put on EMSAM and it was working. The bad news was that I couldn’t afford it, and insurance wasn’t yet ready to pony up. In the first 18 months of my illness, I paid close to $10,000 in out-of-pocket medical expenses (not all BP-related). I had no money, no cushion. I paid for bills using credit cards, and although I was trying incredibly hard to dig myself out of a very deep hole, it seemed like I just kept getting slammed again and again with something new.

But I tried. “Try” was my signature, although most attempts at doing anything seemed to backfire. I just wanted to fix it—all of it—but I couldn’t seem to catch a break. I went to see Consumer Credit Counseling, but they told me they only work with three of my creditors, and I would do better just calling the companies myself and trying to negotiate a more manageable payment schedule. Yeah, that really works. Ha! Credit card companies take an evil glee in fucking over people who are genuinely trying to get out of debt. It’s sick and frankly, I think it should be illegal. It’s predatory and steeped in greed.

It breeds resentment and frustration. These are not feelings I manage well when I am cycling through the Bipolar Wheel. Although I can be calm, controlled and level-headed in crisis, when I am tired, sad, and depleted, there is no mechanism in my brain that can properly process resentment and frustration. There is no coping skill big enough to corral these emotions, and they are the very ones—along with anger—that get me in trouble again and again. I can see it happening, like an out-of-body experience. It is painful to watch and worse to experience. I become powerless in the face of my own irrational behavior and that makes me feel even worse.

At Thanksgiving last year, my mother came to stay for the week. She lives far away, so visits are never short. My mother is difficult even under the best of circumstances. Pile on not feeling well, being stressed out and broke, and running interference between my mother and my husband, and the whole holiday left me feeling drained and short-tempered.

On the Monday after Thanksgiving, November 27, I came home from a very bad day at work. I had a huge presentation to do the next day, but I felt overwhelmed by the prospect. If I could just tweak the PowerPoint. If I could just focus and feel more comfortable in front of people. I just needed to work out the slide order and the timing.

My husband came home and before taking the dog out for a walk, asked if I was going to try and call any of the credit card companies. I told him I didn’t want to—I wasn’t in the mood. In retrospect, I should have followed my feelings on that one.

I’ll stop here for now and continue in a later post. I need to catch my breath.

Saturday, November 24, 2007

The Pilates Monster

Black Friday. It sounds so ominous until you find out it's a geeky accounting word.

I started off my Black Friday at the private gym where I go for my Pilates sessions. I'm not there for my health so much as for the free Pilates machine that I can sell and parlay into months of pharmaceuticals. The research study I'm in is a bit more rigorous than I planned. Bob is killing me. Well, maybe not. It's just that on the Home Shopping Network, the models make the whole thing look so effortless. Reality check: It is not effortless.

I've come to think of my sessions with Bob as a form of self-inflicted punishment. What the hell was I thinking? I was thinking about those leggy ballerinas gliding through their Pilates routines and going on and on about what a gentle exercise it is. Doh! I am not a ballerina!

The gym is deep in the basement of the Jazzercise building, in a dark corner away from all other human interaction. The floor is black. The ceiling is black. It is obviously a dungeon. Bob always asks what the weather is doing when I arrive. It is a windowless, disorienting place. The Pilates machine even has a name befitting its role in this drama: The Reformer. It looks like a frightening device from the 17th Century, all wood and metal with straps and bars. Eeeeeee!

Bob is determined to reform me. Today he decided it was time to tackle my posture and abs--disasters all around. He said we needed to get to my core. My core! I am a pear, but it hadn't occured to me there would be a core involved.

The Reformer loomed large. I endured. For one hour, I endured. Now I feel like I had an appendectomy just before embarking on my Black Friday shopping. How is this going to improve my posture if I'm permanently doubled over? Glaaaaa.

My very own Reformer is in the garage, still crated. Tomorrow we assemble it and set it up in the home dungeon. Basement. Gym. That place that's not my Happy Place.

Exercise=tedium + pain. And people actually thrive on this?

Friday, November 23, 2007

When the brainucopia runneth over

Having spent yesterday feeling grateful for many, many things, I was still left with the nagging feeling that I had forgotten something. I made a mental checklist: The iron was off and unplugged. No candles burning, no doors or windows left open, the stove is off, bills were mailed, no appointments missed...

Ah! Yes. Today I went rooting through the mountains of paper clutter that teeter in every corner of my home office (and the coffee table), looking for the birthday card I knew I bought for my husband about a month ago. I never buy cards in advance for just this reason--they get pulled into the paper clutter vortex, not to be seen again until the next time we have company. Maybe. If I actually sort the paper clutter and don't just throw it into a shopping bag for its next stage of storage.

I found the bag with the birthday card, along with three other cards. Ohhh, Thanksgiving cards for my mom and a friend. Crap! How could I forget to mail three cards? Forget the mail part. How did I forget I bought three cards in the first place?

I am senile. I am a flake. My brain is full.

Thursday, November 22, 2007

Playing doctor

My psychiatrist is so comfortable with my knowledge of pharmaceuticals and my diligent pursuit of knowledge in that regard, he doesn't have any reservations about me tweaking my own meds. It helps that I'm responsible and I don't abuse, well, anything except my own self-esteem.

Toward this end, I'm making an adjustment to my EMSAM. In case you missed it in earlier posts, this is the $472-per-month miracle that gave me my life back. And massacred my bank account. EMSAM is a transdermal form of an old drug--selegiline--an MAOI. It is prescribed for major depressive syndrome, and works especially well for those of us who have hellacious reactions to SSRIs. When you have a condition as complex as bipolar disorder, having an entire class of drugs taken off the treatment table is reason for serious dismay.

EMSAM has two major drawbacks, and they are so significant as to classify this medication as an "after everything else has failed, try this" kind of medication. The first issue is that EMSAM is contraindicated with almost every other drug on the planet and quite a few foods, as well. In other words, if you can't self-monitor and pay attention to what you're putting into your body, this is not the drug for you (unless the threat of hypertensive crisis doesn't make you flinch). The medication itself causes an astounding change in blood pressure all by itself, so the contraindications need to be taken seriously. I've had freakishly low blood pressure my whole life, but in the 17 months I've been using EMSAM, I have developed high blood pressure.

The first and most significant side effect of this medications is...drum roll please...insomnia. At the time of year when so many people north of the equator are fighting off the urge to hibernate, I am hopelessly sleepless. I'm not like Martha Stewart, who sleeps four hours a night and goes about her day without any ill effects (other than being a supreme bitch, which may just be a character flaw). No, I need sleep or I risk going into a tailspin of mood and functionality.

So, in an attempt to alleviate my chronic, severe insomnia, I'm knocking down my EMSAM to the beginner dose of 6mg--a 30% decrease. A bold move at my most vulnerable time of year, I know, but if I start backsliding, I can always bump up the dose. I love playing pharmacist. Bwahahaha!

This reminds me: I want to write a letter to Bristol Myers Squibb. You know, if you look at other transdermal medications like nicotine patches or motion sickness patches or even hormone patches, the medication identification is on the part of the patch you peel off and throw away. EMSAM, on the other hand, has the name printed all over the patch itself. Anyone standing within a couple of feet of me can clearly read the word "EMSAM" printed again and again on the face of the patch. All they have to do is Google the name and my most personal secrets start to be revealed. It's not a big problem in the winter, but my patch placement has to be a lot more creative in the summer months if I am to maintain any privacy and discretion.

What the hell were they thinking over there in Somerville? I might as well be wearing a shirt that says, "Ask Me About My EMSAM." I am currently working on some kind of totally outrageous lie of a story. Hmmmmm. Creative lying to avoid embarassment. Hmmmm. Bwahahahaha!

Wednesday, November 21, 2007

Exactly as it appears

Sometimes a bad mood is just a bad mood. Sometimes fatigue is just fatigue and sleeplessness is nothing more than a hormonal hiccup.

This is one of the many pitfalls of Bipolar Disorder. Once people know, they tend to assume that any anomaly of emotion or behavior must be the disorder talking. Experiencing normal mood fluctuations, frustration, bad days, or even a fit of the giggles no longer goes unobserved without judgment and analysis. Somehow, having this disorder means "normal" just stops being taken into consideration.

Knowing this, realizing it will always be this way, makes me very sad. But not, you know, sad. No, really, I'm not being argumentative. Stop looking at me that way. Can't I just feel sad once in awhile? Oh, leave me alone. No, I'm not self-isolating. Yes, I toook my meds, you ass. Pass the Xanax.

It's like that.

Tuesday, November 20, 2007

Calendar reality

I have a headache. I get headaches a lot. Tonight's headache had me reclining on the couch, a position I usually avoid because it invites a face full of stinky dog breath and the uncomfortable abdominal pressure that results from having a 15-pound cat atop what it believes is squishy, heated furniture (that sometimes dispenses food).

My right temple was pulsing to the point that I worried my eyeball would pop out of the socket. I tried to distract myself with thinking. Thinking. Thinking. I'm so good at it, yet it rarely turns out well.

I opened my eyes in a burst of panic. My husband's birthday is Saturday. When did that creep up on me? I have no idea what gift to give him. You would think that when you're married to someone, knowing what to do for his birthday would be intuitive, but it's not.

This thought led me to the anxiety-ridden realization that Christmas is like a month away. Again? Already? There are just so many people I'm not really interested in shopping for, and yet I struggle under the burden of expectation. I would bake cookies or pumpkin bread, but that would require, well, cooking. In a kitchen.

Ah, the holidays loom. The festive spending and sprinkling of credit card debt, the manufactured charm of winter scenes (who, exactly, has these charming winter moments?), the anxiety, the pressure, the complete lack of imagination that makes itself so obvious in gifts randomly chosen. I continue to be bombarded with catalogs from Omaha Steaks and Honeybaked Ham. No vegetarian can really articulate the special joy of leafing through page after page of glossy, full-color photos of meat. The Wolferman's English Muffin catalog, on the other hand, is nothing short of carbohydrate porn.

I don't want anything for Christmas. Every year I tell my family and boss this explicit request. Give me nothing, please. The greatest gift would be to stop the madness of feigned holiday generosity. Donate money to charity instead. Still, they cannot overcome the sense of obligation that forces them to buy Christmas presents. Lots of them. It is so unnecessary and so insincere.

I feel forced to reciprocate. That means a whole lot of shopping in the next 25 days (I have to ship it all, too).

In the meantime, though, I need to figure out what the hell I'm going to do for my husband's birthday on Saturday. He deserves better, no matter what I come up with. That I know for sure.

Sunday, November 18, 2007

I just want to sleep

Sleep. I just want to sleep. I realize it's my lot in life as an American to be sleep deprived, but this is beyond reasonable. I suppose.

Here's the thing. When I don't sleep, I get cranky. When I get cranky, I say whatever pops into my head because I'm too tired to put in the effort to filter the appropriate from the offensive, but especially the gray areas in between that really require self-monitoring.

Sleep. It's a good thing.

At least I'm not psychotic.

Friday, November 16, 2007

Random thoughts

If I don't get some sleep soon, I am going to crack and have some sort of mental break. Most likely, I will achieve previously unwitnessed levels of extreme bitchiness.

I would rather be anorexic than fat. Anorexic people get sympathy and are approached with concern. Fat people get ridiculed. And anorexics get to be thin. As a society, we value discipline and self-control, and aren't those really the core issues of body image?

The Spaghetti Monster is getting serious discussion in theological circles. If that doesn't rock, I don't know what does.

I have to go to the worst public housing center in the city today. I can only believe that with my extreme bitch face on, nobody is going to fuck with me.

I've been faithful to my exercise research study workout schedule and dietary guidelines. My reward? I gained a pound. I hate my body.

A study released today reveals that one in six U.S. drivers would fail their driver's test if they took it today. Only one in six? I think GMAC needs to check its math.

Tuesday, November 13, 2007


I dreamed of my death and it was murder. It wasn’t a dream while sleeping, but a vision, striking in its clarity, that appeared in my field of sight, external and internal simultaneously. My eyes were filled with the scene.

I was there on the east side of the city, early evening, when the night is dark but not so dense as to feel as though it had depth. My body was face up on the sidewalk, just to the edge of the streetlight’s focus. Right arm above my head, left arm slightly twisted back, resting against the dirty sidewalk. Knees bent, pointing to the right, one shoe on, one slipped off as if it had been left behind when I fell, leaving five of my toes exposed to the cold night coming in.

My purse was still slung over my shoulder and across my chest, now standing up against my side. By my upper wrist, a thin trickle of blood branched off from the large pool of glossy deep darkness spreading out from the back of my head.

Shot. I had been shot while walking to my car in this gritty neighborhood where I came to do in-home visits with women from some of the most violent places on earth. They feel safe here. Everything is relative.

The shooter was long gone, having missed his intended target, who also had fled the street.

I saw my body in the black cotton T-shirt dress and silk tiger-print scarf I wore to work. Where was my book bag? I couldn’t see it, even though I saw the whole scene from directly above—a bird’s-eye view in reverse, a spiral going slowly up instead of spinning down into a clearer focus. I saw myself from 20 feet up, and then farther, and then looked away for just the tiniest fraction of a second and the scene was gone.

It was so real, but I was not unnerved by the scene that had billowed and spread out to take over my field of vision. I was dead by someone else’s hand, but I felt no pain, no fear. I was gone.

Sunday, November 11, 2007

It's happening again

It's showtime. It's time to call on those coping resources, May. You need to sort out the real and the fictional reactions in your brain, the rational and the chemically sparked. Take a deep breath, stay aware. Don't get pulled into the dark side of bipolar management. You aren't doing anything wrong, you can only control so much of what is coming, can be aware, bite your tongue, and above all else, you must rely on the data. Are you reacting to what is really happening? Are threats real or perceived? Look at the data, May. Don't let yourself react before you have monitored your own status.

Lisa said this would happen. She's been popping red flag warnings around my psyche for weeks, mostly because I am more than willing to overlook the obvious in situations like this--especially if it means slowing down. Slowing down means I'm sick. Slowing down means I can't keep up. Slowing down means I'm losing and nobody else is going to lag behind to nudge me along. I can't cut back, slow down, nurture myself blah, blah, blah. It only reminds me that I am so terribly defective and afflicted with something that is incomprehensible to anyone who doesn't have it.

Anxiety. I need to analyze the anxiety. The anxiety is coming from inside. Why am I anxious? Biological: Not enough down time, perceived inability to excel (I have to excel so that if I slip back, I'm still where most people are at "normal"), lack of sleep, time change, daylight slipping off to spend the winter south of the Equator, absorbing the anxiety of others, feeling totally overwhelmed by work with no end in sight and no option to delegate. Fear of failure. Fear of making a mistake. Fear of my mood tanking or of misinterpreting the words, actions, or even demeanor of those around me. I'm a little bit paranoid, and that's often the start of melting down and not keeping my misfiring neurons together. Crap. Paranoia. It's a big red flag flapping right in my face.

I hate it when I can't keep up. I feel like I can't keep up because it's hard to think straight when you don't sleep very much. I am not allowed to fail or fall behind at work. I'm just not, and no matter what my boss says, she lies. She says one thing and demands another. She cuts me no slack. Her definition of being accommodating is that I have a job in spite of having times when I can't be super dooper over-achieving May. I should have come in as a far more mediocre performer and then I wouldn't be held to such a high standard. I am not allowed to fall behind. I'm being judged all the time, not just by those I work with, but by the larger community that works with my program. Back off, people. It's stressing me out.

How the brain goes awry: A coworker says of our shared space, "I need more storage. Can we work together to figure out a way to make more room so both of us have a place for things?" What I heard: "You're an inconsiderate space hog who has taken all of the storage, leaving no place for my things. I work in this space, but you've claimed every corner for yourself. Something of mine got stolen because it was left out in plain view and that's your fault because I had no place to put my things away." Deeper issue: I hate sharing my work space and I do so with resentment, but I am still capable of playing nice. Nagging thought: I was there first. By a lot.

I know I'm falling behind rapidly at work. This is not BP-related, it's just work volume and my occasional incompetence. I am one person doing far more work than the position requires as it is outlined on paper. I don't live on paper and neither does my job. When my brain gets full, it...just...stops...working. "Where is that report, May? Laura needed it yesterday." Heard: "You screw-up slacker. How dare you take a sick day when you had work due? Laura is freaking out and it's all your fault, you irresponsible fuck up. You only care about yourself, and this is one more example of that. I come in when I have a fever. What makes you so special that staying home sick is appropriate?? It's only appropriate for other people, and maybe for me when I need it. Take a sick day when your work is finished." That, ladies and gentlemen, is the bipolar brain in its finest moment, rerouting input and letting the amygdala direct the neuronal traffic into all of the wrong transmitters. Can I stop it from happening? Is it just that I should take a long, deep breath of "rational?"If I could, would I down $600 worth of pharmaceuticals every month? The most I can do is step back, analyze, and compare my reactions to the data before me. Where paranoia surfaces, big, big trouble is usually coming.

The smallest mention of my shortcomings or tiniest misstep resonates in my brain like a frontal attack. It is a horrible, frightening feeling because although I can analyze the data, I can't avoid the initial reaction. These interpretations spark an inner dialogue that grows and swells and becomes a deafening crush of rapid thoughts that won't quiet themselves, leaving my brain unavailable to tend to the other tasks of living and functioning in the real world. How the FUCK do people like my boss conclude that this nonsense is even remotely voluntary, a conscious choice? No. The conscious part lays in trying to mitigate whatever behavior surfaces in an inappropriate way. Nobody sees this. They only see the inappropriate reaction without consideration for why it's there in the first place. They know if they don't like my mood or what I say or do, well, it is obviously meant as an insult directed toward them. They don't realize that they are so insignificant to me when I'm cycling, I couldn't work up the intellectual effort to consciously insult anyone. People are so self-centered. I am struggling to keep my brain straight, but they only feel indignance when I don't fit the parameters of their expectations.

I feel short of breath. Is it my asthma? Is it my anxiety? Is it that I'm subconsciously trying to stop myself from breathing in another thought, another piece of data that I have process before I can feel safe in producing a reaction?

I will rely on the data. I will compare my thoughts and reactions to the external events that trigger them. I will step carefully. I will pray to the cosmic forces to help me keep my thoughts to myslef, those snakes and lizards that slide so easily past my lips to shock those around me. I will watch my mouth. Better yet, I think I'll just keep my mouth shut for awhile while I try to convince myself that nobody is plotting against me.

Let it pass. Let it pass. Let is pass. Please, let it just pass.

Life should not require this much thought. Self-monitoring is perhaps the most exhausting mental exercise of all.

Saturday, November 10, 2007

Talk to me

It's 1:30 in the morning, and I have nothing else to do, so I changed the comments setting on this blog. You no longer need a gmail account to post comments, so it's much easier to use this Blogger feature. Wahoo. How exciting is that?

Tuesday, November 6, 2007

Little secrets

Every time I have a medication change, if I still have refills on the discontinued medication, I keep getting them filled until they run out. I've been doing this for several years. I have a huge collection of cyclics, benzos, sleeping pills, lithium, and painkillers, among others.

I take comfort in having this copious stash in my home, available to me at any time.

You never know.

Monday, November 5, 2007

Imagining the Perfect Life

Last year, probably in December, I was hunkered down for what turned out to be the most horrendous winter I can recall. A friend of mine helped provide mental stimulation by exchanging some very interesting emails with challenging questions for me to ponder. Cleaning out the hard drive of my computer is providing me the opportunity to revisit a lot of critical moments from the past few years. I re-read this conversation with great interest--mostly because I sounded so lucid when I absolutely wasn't.

For some reason I'm slightly dizzy this morning.
I’ve been like that for days. It’s getting old.

Nothing coffee won't fix - I'm sitting in my office drinking my one cup a day!
Hey, that’s my daily dose, too. I drink Folgers Simply Smooth. For years I’ve wanted someone to sell a low-acid coffee, and Folgers finally did. Hallelujah. Before that I drank something called Rocamojo with coffee added in.

The BP dependence on regular sleep patterns - it sucks.
Ah, insomnia. How I wish it would leave me and take those goddam migraines with it. How BP am I?

OK - so I was thinking of the game 20 questions. For the sake of efficiency, I narrowed it down to 5!
You’re so efficient (or is it really that I’m not that interesting that you need 20 questions? Kidding.)

1.) If you could design 'the perfect life' what would it look like? Where would you live, how would you feel, look, act, who would you be with, what would you be doing, etc. (You can summarize - don't want to force you to write an essay when your fingertips are frozen from the cold).

Using my fingertips keeps them warm.

I need to live closer to water. I would like to live someplace warm but not hot, and not too far from the ocean. No winter. I’m not sure where that is. I prefer medium-sized towns to very small ones or to large cities.

The perfect life. Hmmm. Well, first of all, I would be taller. Even a few inches would suffice. I would be a hell of a lot thinner, preferably with a toned body representative of the sporty woman I used to be. Even when I was really active, I was still squishy. I would have better skin and no need for glasses. I’ve never been particularly pretty. I don’t need to be gorgeous, but pretty would be a welcome change.

In my perfect life, I would never feel awkward around people, and I would immediately put people at ease. My energy level would always be great. I’d be less cynical. I would not have big mood swings, but more than that, I would never be paranoid, irritable, agitated to the point of distraction, or chronically anxious. How can I ever achieve inner calm when inside I’m always squirming? I would never offend anyone (tact filter issue when things are bad). I would do as much for my husband as he does for me. I wouldn’t loathe myself.

I would be as funny as I am when I’m freshly hypomanic (and that’s pretty damn funny); I would be charming and a very good listener. I would not feel inferior all the time. I would have sex a lot more.

I would still choose to be with my husband. I would choose my friends much more carefully and surround myself with compassionate, intelligent, down-to-earth people who are open-minded, intuitive, and understanding, but who have enough time to spend being friends. Smokers need not apply. Nobody arrogant, grandiose, or negative would be in my group of friends.

I would feel well enough to ride my bike every day, and I would have the time to do it. I wouldn’t have to ride in an urban setting. I would be a much better skier. I wouldn’t have to work, but I would still work anyway, but without the financial pressure. In my perfect life, I would have no debt and no moronic behaviors that would get me into financial misery. I don’t need to be rich, but I detest struggling. In a perfect life, I would have a lot of time to do the things that make me happy, including gardening, playing with my dog, taking pictures, reading books, and of course, writing. In a perfect life we would have a housekeeper.

I would be able to travel, I would have the means to do it, and I would travel often. I want to see all of the good places, but I would still like to spend time working for an international aid organization. Maybe I could work for the UN helping refugees somewhere. Of course in a perfect world, there would be no refugees.

I would have a tattoo, a very intriguing tattoo.

2.) What scares you most about life as you know it or experience it in the present? What is the most unsatisfactory thing about life as you know it or experience it in the present? What is the best thing about life as you know it or experience it in the present?

What scares me most is the thought of losing my husband, my job, my house, and the few real friends I still have (including you). Life as I know it is complicated and sometimes very hard for me to navigate. I’m afraid my BP will cause my moods and behavior to deteriorate to a point where I can’t really be helped or where I’m left totally alone. I’m scared every day that I won’t live up to the world’s expectations of me and I will feel too ashamed to live. I worry that the way I feel now is as good as it’s going to get no matter how much effort I put into my health.

The things I like least about life as I know it are my financial obligations and limitations. This colors every other aspect of my life, and I hate being so preoccupied with money. I really, really hate being broke. I’m not good at it, and it makes me live with an unrelenting undercurrent of fear and anxiety. I would have more leeway if I hadn’t cut up my credit cards, but I felt I was doing the responsible thing. Maybe I was, but it made my life a lot harder, instantly.

The best thing about life at this time is that I get to make a difference in people’s lives. I know that if I were to quit today, someone else would do this work and every bit as well, but I like knowing that the fact that I cared may have made someone else’s life easier. The other good things are that I have you to converse with and spend time with, and that has made a huge difference in improving my outlook and in mitigating my sense of anonymity in this world. Being with my husband and talking with you are the highlights of my day, every day.

3.) Are you sometimes afraid that if we ever meet in person I might not like you as much as I do in the 'virtual' realm?

You have no idea. At least you have pictures so you’ll never say, “I pictured you as a tall brunette.” I’ve actually heard that a half-dozen times, from people who only “knew me” by phone. Seriously, though, I worry about that a lot. I’ve always believed I was much better on paper than in real life. I worry you’ll think I’m just a total dork.

4.) What preoccupies your thinking? I know currently it is probably the weather, but in general, what preoccupies your thoughts?

Money, money, money. The weather bothers me a lot, but I don’t brood about it. Money, on the other hand, is, as I said before, a source of unrelenting anxiety. The other things that preoccupy me are self-monitoring for saying stupid things, self-monitoring for signs of BP flare ups, and the constant, running dialogue I have going on about all things work-related.

5.) Do you ever think you will feel 'right,' whatever that means? What does that mean anyway?
I’m not sure what right is. I hope that feeling right means I’ll have more self-confidence, more optimism, a more peaceful feeling inside, and freedom from anxiety and self-doubt. It would mean having almost total control over where my moods go, and my emotions would never sneak up on me and smack me in the head. I’d remain calm in the face of criticism, and I would never think irrationally.

No, I don’t think achieving any of that is ever going to happen, but I keep taking meds and going to therapy in a total leap of faith that may or may not leave me sprawled out and battered anyway when and if I fall.

Sunday, November 4, 2007

Daylight Savings

I wish I could have saved up some daylight. I just couldn't figure out how. I'm so tired. I want to sleep. My body wants restorative sleep.

Daylight Savings Time is finished, but without having managed to save any daylight, I have to get used to the dark. The dreaded, non-10,000 luxe dark.

Here I am, needing to go to bed, but I'm writing, easing up some space in my full brain, instead of lying in bed waiting for sleep to come. All in all, this scenario would be called poor sleep hygiene. Even with the "extra" hour, I'm not able to go to bed at a reasonable hour. 2:30 last night. Awake at 5:30 this morning.

I could use a massage or something, but I hate to be touched. That's another story for another day.

Saturday, November 3, 2007

Stop saying that

This has been bothering me for awhile now, but I could never quite articulate why. I think I can finally put it into words. Ever since it first became obvious that I was sick and getting sicker, I expressed deep dismay and frustration about it.

I get absolutely despondent because I want to be normal--I want to function among people without having to watch every word coming out of my mouth, or every blip in my mood, or any potential misinterpretation of the things happening around me. I hate it when I try to think but can't latch onto one thought, or when I feel so anxious I can barely stand to be outside of my house. More than anything, I hate it when my brain just stops processing everyday information and I can't work, write, speak, or read without tremendous, not-always-successful effort. Most people do not live with these issues, nor do they have to self-monitor so closely. They do not take six expensive medications every day. This is a very real and exhausting part of my daily life.

I have tried many times to explain to the people who know me just how frustrated and sad I can get because of the things my brain does or doesn't do on a regular basis. I always think that if they could understand how the disorder feels from my internal perspective, perhaps they'll see why I feel so overwhelmed with sadness and frustration. They'll see why I say I want a new brain. They'll see that I need support and empathy.

Instead, the answer I usually get is: "There's nothing wrong with you. You're fine. You do better than most people who don't even have a disorder. This doesn't affect you as much as you think it does."

And they have this insight based on...what? I suppose that part of the perception disconnect lays in the fact that I am, for lack of a better term, high functioning. I go to work, I accomplish a lot, I'm usually articulate, and I do a good job of masking my own reality. But it is still my reality. So...what? People don't believe me? I cringe every time I hear it. "There's nothing wrong with you. You're fine." Great. Have they forgotten so quickly what it was like before medication and therapy? Are they trying to make me feel my desperation and frustration are unjustified?

It doesn't make me feel better. Whenever someone says there's nothing wrong with me, I actually feel...
  • they are being dismissive and insensitive;
  • I have no credibility
  • this is meant to avoid any further discussion of my woes
  • they don't consider my disorder to be a legitimate health problem or even a problem at all
It's just so goddam condescending. I don't find this "reassurance" comforting at all and I wish everyone would stop saying it.

Perhaps I want something like this..."I'm really sorry you feel that way, May. It must be frustrating to feel those deficits. For what it's worth, you do such a good job of persevering and working past it, that really, nobody except you can even tell something's going on."

Dream on.

1:20 a.m.

I am awake. Drowsy, but not enough to sleep. I am avoiding going to bed, but I'm not sure why. Intensely strange and disquieting dreams. I'm so sad when I wake up. Two cats, a dog, and a husband. Exercise in futility.

I have a very busy day tomorrow, so I'll just take a deep breath and try. I desperately need sleep. Why can't I sleep? My brain fights me on everything. Can't it cooperate for just this one thing?

Friday, November 2, 2007

Ow! Ow Ow!

Have I mentioned the exercise-for-slothful-fat-people study I'm enrolled in? Yesterday was my first full session working with the trainer and getting acquainted with the apparatus. It was so easy, so ridiculously effortless, I refused to believe this was doing any good. Exercise? How could it be possible if I was doing it and yet I wasn't miserable?

Ow. I can't be adamant. It hurts. My gut hurts, my abs hurt, my quads are not pleased. The only thing I dislike more than the tedious nature of exercise is...the pain. It's the main reason I stopped exercising. Boredom is one thing, but discomfort, well, I just can't stand it. Discomfort with sweat--no. No. No. No.

The trainer said I might feel this way today, but I was optimistic. That'll teach me. This reminds me of something that happened in 1994. I belonged to a gym but hated working out in the cardio and weight rooms. I thought, "surely, water aerobics is the way to go. Lots of old ladies and fragile people with blown out knees. How hard can it be?"

I got to the pool and put on the chunky, blue floatation belt. I took off my glasses and jumped in the water. And...floated like one of those red and white bobbers that go on a fishing line. My ass is big enough to be its own rather effective flotation device, so the flotation belt just threw me into some new anti-gravity state that made me have to fight tipping face-first into the water.

It took me a minute to realize the instructor wouldn't actually be in the water. This was distressing because without my glasses, she was nothing more than a chirpy blur on the pool deck. The indoor pool area was a sonic nightmare of echoes and swallowed voices that bounced around the walls but never regathered into coagulated words. In short, I couldn't see anything and I couldn't hear worth shit.

I did my best and paddled, kicked, arm circled, and underwater walked my way through the class. I thought it was a ridiculous excuse for a workout. Until the next day. The alarm went off, and I threw back the covers to get out of bed. My legs wouldn't move. Well, they would, but only with great effort that sent excrutiating pain through my limbs. Every part of my body hurt. I eventually sucked up the ab pain and made my way to the shower.

I moved like a robot. I moved stiffly as if I had no joints, like a Barbie, but short and without good boobs. The old people, with the help of perky-the-instructor, had kicked my ass.

You'd think I would have learned that it's the seemingly innocuous exercise that bares its torturing teeth the next day.

OK, then.Only another eight weeks of using the wood and steel torture device. Joseph Pilates was obviously a sadist with a sense of humor.

Thursday, November 1, 2007

Let's revisit something painful!

I've still been straightening up my computer files and in the process, revisiting the recent past. Everything I've written since 2003 becomes a litmus test to gauge my current state. I wrote this list in February of this year. I can honestly say that although I feel and cope better in many ways, the ideas outlined here really are core beliefs. In my heart, I still believe 90% of this; I just deal with it better, hide it more convincingly, and don't focus much on the debate about living or dying anymore.

Core beliefs * February 13, 2007

· The people who know me just cannot, will not, are incapable of understanding my problem or making the critical distinction between a willful, controllable emotional issue and a physical, organic illness that happens to manifest through behavior, speech, and perception.

· I will always be judged—and harshly—for things I cannot control.

· I will always be held accountable for things I said but didn’t actually think or believe.

· My health problem/disorder will always be met with skepticism and disdain.

· I try and try to educate, but nobody gets it. Except Joanna, but she’s a doctor and she’s deeply compassionate and tolerant. She knows to put the behavior into its correct context instead of being insulted by it.

· I feel so bad, I am toxic to myself.

· I believe—know—it’s not my fault. I try to fix myself, I do everything I’m supposed to, but I am just really beyond sad.

· No matter what I do, I just make people mad and probably always will since my condition is permanent. I am held responsible for feelings and behavior that control me. I believe it is easier for others to be mad at me rather than acknowledge that none of us can control or fix my problem. Fuck ‘em.

· I am held to an impossible standard of behavior and wellness.

· Sonja does not judge PeggyJo the way she does me. I do not believe she scolds or berates PeggyJo when her behavior and words are irresponsible, erratic or unkind. Same dx, different tolerance.

· Everyone expects me to overcome what very few people ever do; this standard is unfair.

· People only like a winner. Performing as expected is good. Having a serious, complex problem is just plain unacceptable. OK, I get it.

· There is no value in a life lived with so much pain, especially when compassion and understanding are so egregiously absent.

· Nobody cares about me, only that I get back to meeting their expectations.

· I am unlovable.

· I cannot live this way. I will not survive it. I know this unequivocally.

· This world and the people in it just absolutely suck, especially the people I always thought would comfort me if I needed it. Fuck ‘em all.

· I believe I will always feel abandoned and alone; the wound is raw and unhealable.

· If I can just act normal and meet expectations, I will not be judged. It’s so hard. Too hard.

· I do not want to live this way.

· I no longer want to live.

· Suicide is a civil right. It is a human right. It is inalienable. Period.

· Only death can free me from the pain, embarrassment, and disappointment I endure every goddam day. There is not enough therapy in the world.

· I am not capable of happiness. Not anymore.

· I am worthless.

· I can’t do anything right. I just can’t do anything right. Somebody is always mad at me for something--usually for being myself and not the self they're comfortable with. I wish they wouldn't get so mad.

· Everything is hard.

· I’m useless if I’m sick. Useless. I see it in the faces and attitudes of everyone around me.

· My brain is defective. I am defective.

· My future is hopeless. All I can do is pay my debts and manage the BP for the duration. It’s responsible, but is it actually worth living for?

· Nobody cares about me; they only care about what I can do for them. In the absence of achievement and service, I become irrelevant to those who would otherwise praise me. If I can’t “do,” then I do not matter. Worthless.

· No one’s life will change if I’m not here—not beyond the most superficial consequences. Whose life will be altered if I’m not here? Nobody’s.

· I can’t feel any connection to people anymore, and frankly, I don’t want to. People are unreliable and disappointing.

· My life has no value, not even to me. Especially not to me.

· I am physically repulsive. Homely, fat, and clumsy.

· I’m a big, fat blob of “Why Bother?”