The Real Possibilities – Reaching Beyond a Diagnosis

I’d like to preface this with one thing.  I don’t usually post to Sunny about things in my life that are just developing or things that I would consider to be “in limbo”.  This is me, Lulu, reaching out into the community in search of some informed opinions and suggestions.  I want to hear from you to learn about your personal experiences and gain from the reader’s pool of knowledge.  Not every answer is clear cut, and most of the best answers can’t be found in a book somewhere.

The New Doc on the Block

I went into my psychiatrist’s office for my regular med check last Friday.  Except, there was nothing about this that was regular.  My psychiatrist Dr. K. wasn’t in, and another doctor I was meeting for the first time was filling in.  I figured it would be more of the same, you know, “How’s it going?”  “Fine, except a couple of things.”  “Okay, well go off into the world, be good, and take your medication.”

I was dead wrong.

He asked me a few typical questions, like “What’s your diagnosis?”  and “What medications have you been on?”  and things of that sort.  He asked me how I’ve been feeling recently, and I answered honestly.  Mostly, I’m alright.  My moods are pretty stable, and I’m in a pretty good place most days.  I’m still pretty irritable and the anxiety I’m experiencing is just unmanageable anymore.  But, those are the constants.

I’m not fighting depression or mania at the moment, or living inside the confusing anguishing hell that is a mixed episode.  I’m alright.  Just alright.  Probably the best I could expect to be doing being someone with this condition.

This part shocked the hell out of me.

The doctor goes into a long explanation of why I’m still experiencing symptoms, being that I’m apparently not on medications that actually treat the disorder.  He tells me that Lamictal is not a mood stabilizer. Since I’m not on a mood stabilizer or and an antipsychotic, and since I have a lot of options, I should be on both.  In his medical opinion, I should not be on Wellbutrin or even really any antidepressant at all.  And Xanax and Halcion are not supposed to be for long term use to manage anxiety.

I fought him on the antipsychotic, explaining that those types of medications and I don’t get along well.  He insisted it was because I’ve never been on an actual mood stabilizer.  He kindly smiles and promised that as soon as my meds were fixed, then my bipolar would be fixed, and I’d be right on track.

He advised me to take a look on the internet at my treatment option throughout the next month, and then discuss with Dr. K. when I came back.

It was like getting slapped by someone in a moving vehicle.

As quickly as I went in, I was back out again.  I was disoriented and confused.  For a minute, I actually considered his words might be the truth to the whole thing.  Then I remembered what being on antipsychotics was like.  That created a whole host of problems that were unlike any I had ever experienced before.  And I don’t care to EVER go there again.

So, Xan and I got in the car, and I laid the whole thing out for him.  He was completely on my side.  He said, “I don’t see why they are trying to fix something that isn’t broken?   Why are they trying to dope you up like this?  What did you tell him?”

I replied, “Nothing out of the ordinary!  I told him that I’m having difficulty keeping a job, but I have no idea what that’s all about.  I’m struggling socially and have been, well, pretty much my entire life.  And that irritability, insomnia, and anxiety have been a constant for me.  I mean, for my ENTIRE life, before all the mood stuff started.”

And we both agreed.  Whatever throws down, that cocktail is not happening.

To Be Bipolar, Or Maybe Not Bipolar?

I’ve been thinking about this for quite awhile now.  My moods have been pretty stable for about a year now.  I mean, that is cause for celebration here.  I’ve had some minor snags here and there, but all in all, I’ve been pretty level.  The episodes I do have are not nearly as deep as they once were, even if the duration might be seemingly longer.  So, why am I still seeing significant dysfunction in certain respects?

Is it possible that I might not even have Bipolar Disorder in the first place?  Could it be something else?  Borderline Personality Disorder and Bipolar share some diagnostic traits.  Could there have been a mixup?

Or, perhaps, the mood episodes were actually solved, as I suspected, and we’re now uncovering something underneath the mood shifts?  I have long suspected that the anxiety that I’m reporting hasn’t had anything to do with my mood shifts, although I did describe them as having the ability to spark depression or mania, depending on the context.

Xan and I sat down later, and I said, “You know, if Dr. K. is going to cause trouble and shift medications around, I’m going to request that we do a complete reevaluation.  I’m talking about starting from scratch, covering it all from A – Z.”

He answered, “I think that’s a good plan.”

My Homework Assignment

So, I’m doing my homework assignment right now.  I’m doing my research on the internet.

BUT!

I’m going beyond all of the articles, medical websites, and online assessments.  Sure, I’ll have those tucked under my belt, but I’m not a person who half-asses anything.

I’m taking it to the people.

Tell me about your experiences.  I’m open to all suggestions, ideas, theories, and everything and anything all open minds would like to add.

Thanks ahead of time readers.  I’m counting on you!

Nails – A Tribute : 30 Days of Truth

Day 13 : A band or artist that has gotten you through some tough days. (write a letter.)

Trent Reznor receiving an award for truly remarkable music.

Preface: In the liner notes of “Pretty Hate Machine“, the first studio album by Nine Inch Nails, there is a statement that says, “Nine Inch Nails is Trent Reznor.” Indeed, it is. This is why I address this letter as such, though I would like to include every person that ever had a hand in his projects. They were also important in making his music happen.

Dear Trent Reznor,

Yes, I am indeed very young to be following your career. I ask you to dismiss any immediate notions of some kid fan looking to “find a voice” or “find an image to latch on to”. Fifteen years ago, that may have appeared to be the case. However, I advised any who made the accusation that it wasn’t a phase, and in my age group, it certainly wasn’t a fad. The music spoke to me, and I took a lot of shit to pride myself as a fan in my peer group. It wasn’t about a popular song, attraction, lifestyle, or any of that bullshit nonsense. It was the lyrics and the music, not the man or the movement.

I sincerely doubt that you will ever personally read this letter. It’s not a matter of dismissal, or anything of the like. I realize the intense focus, schedule, and deadlines that must accompany such incredible success. However, I’d like to assure you this isn’t one of those stalker letters, but only a fan tribute. And, of course, an exercise of prompt response to a blog project. If it wasn’t for this prompt, I may have never written this at all. That is, despite the fact that there is much in my personal life that I can attribute to the music.

Today, I am a part-time music teacher at a local inner city youth program here in Pittsburgh, PA. I am aware that you are local to the area, which is another reason the music is personal to me. You grew up in the area, therefore you were aware of the lifestyle and culture of the region and how it affects a person. But, that wasn’t the only personal connection. In the seventh grade, though music had been a lifelong passion, I became symptomatic with a mood disorder. A deep depression was ravaging through my life, taking each passion away from me. It took one man, my band instructor Warren Sullivan, to convince me otherwise.

One day, he took the class to the Piano Graveyard, a hallway behind the auditorium where old, detuned and broken pianos went to die. He wanted us to experiment with sound, though most of us had never touched a piano in our lives. I sat at a piano bench, disinterested in just about everything, including that exercise. Others plucked at sour keys, and some just pounded the pianos in the effort to make as much noise as possible. Mr. Sullivan sat down beside me, clearly as downtrodden as I was. I looked up at him and noticed this awful look of defeat and resignation.

We didn’t speak for a few moments, just poked at keys together. And this was the first time a teacher had addressed me personally, as an equal. He said, “Have you ever had anything really bad happen to you?” I nodded. He asked, “So bad that it changed your entire life?” Again, I nodded. He told me a story, a secret as to why he would be unlikely to return the following year. I liked the guy, and it was difficult to swallow.

And he said to me, “Did you know that I knew Trent?”

It took me aback. “Really?”

“Yeah, we were in a college band together,” he replied.

“So, what happened?” I eagerly inquired.

Mr. Sullivan look uncomfortable for a moment, but continued timidly, “We had creative differences.”

I noted, “I could see that.”

We were quiet again for a moment, and he admitted, “Do you know what the last thing I ever said to Trent was?”

“What?”

“Trent Reznor, you will never amount to anything!” He paused, then continued, “I guess I was mistaken. And that’s something I live with every time I hit a bad spot in my career.”

“Wow,” I breathed. It was really powerful. But, it taught me a valuable lesson. Go with what feels right and where my heart takes me. Never try to take anyone else down to get a leg up. And, it kept me in band, even with the terror of a director that took over. I withstood her for five years and five more instruments, just so I could get as much music under my belt as possible. I was inspired to move to tenor sax, which opened up the door to all woodwinds. Today, I have an alto on my wall, only because I can’t find a reasonably priced tenor sax. Imagine me, all of 4’11″ with a tenor sax strapped to my neck. The thing went down to my knees! It was worth it.

Anyhow, returning to the music itself. I started off with the album “The Downward Spiral”, which could not have been more appropriate for the life changes I was going through.  To this day, I have owned four physical copies, because I would wear them out so badly, and one digital copy, all legal.  It was at that point in my life that I became symptomatic with Bipolar Disorder.  “The Downward Spiral” was my mainstay.  I knew in my bones that I was different somehow, and that the deep depressions were abnormal for a young adolescent.  But, the album in it’s entirety showed that what I was going through, particularly the self-loathing, suicidal ideation, self-injury, questions of faith and religion, disdain and disillusionment with the world, and dysfunctional relationships were not uncommon events.  I had figured that if these things were inspiration for an adult, why couldn’t they be my inspiration, with the music being my solace.

As I grew into adulthood, the music came with me.  “Pretty Hate Machine” and “Broken” lent me music that resonated with me.  In a way, these albums aided me in support of developing my identity apart from parental and societal expectations.  I realized that I wasn’t like the others, and I could never be.  Instead of fretting about it, and making futile attempts to conform, I fought for the freedom of expression.

The music and lyrics tapped at something deep inside myself.  It found the part of me that conflicted and the dissonance touched.  It found the fundamental contradictions that created so much confusion and made it flow.  I identify with the complex and unique chord structures.  They are beautiful, yet eerie, and have so much tension in them.  My ear can identify them in music I wasn’t aware that you had a hand in, not because of the musical familiarity, but because of the way it touches me.

I could go on identifying each album, with various songs that have colored my life.  But, I find it unnecessary.  The message is this.  Each album contained a number of songs that had personal meaning.  Most were very fitting for the time period of my life, whether it was touching upon symptoms of my progressing disorder, dysfunctional and abusive relationships, general discord with life, or absolute disgust with society and the people that run it.  And in those songs, I found the music and lyrics to tell me the most important thing I needed to know in my life.  I am not alone.

So, today, I share my passion for music with kids, and help them find their sound.  I do that as part of my passion, and as my day job.  As a person who suffers from mood disorder, you could probably appreciate the following.  I spend most of my time putting the same message out there through creative mediums.  If you are suffering, you are not doing it alone.  I know how you feel.  I was granted the gift of music and writing to share my story and give a certain gift of companionship to those in need.  And, I feel as if you had a hand in aiding that.

I am still a fan and a listener.  I am greatly enjoying the long rumored, “How to Destroy Angels” project.  I appreciate how the music was able to evolve with me.  Or, it’s possible that I was just able to put it into a different context.  Either way, I am grateful to have had such an inspiration and support in my life.  Many thanks for following your passion, and not letting Warren take you down.

All the Best,

Lulu Stark

The Scorpion and the Frog

In one of my previous posts, The Family Furnace, I described a situation happening with my family, and came to some conclusions about the situation.

What I failed to mention is the circumstance of the situation.

Prior to the last month, I had lived in one of my family’s properties for six years.  I went to live there in the summer of ’06 after I was facing certain eviction from my apartment.  When my parents heard about that predicament, they offered to help me fix up the property, so we (my ex and I) could live there.  In preparation for our arrival, the bathroom was completely gutted.  The only bedroom with a remaining ceiling was plastered, and an extension cord was run from their house to mine.

Temporary patches to a desperate situation.  Which became more critical as time passed.

The house was fatally flawed.  Winter started to approach, and I started to inquire as to how I was going to get heat.  I was told that I faced thousands of dollars of work, replacing the furnace, hiring professionals to install a furnace, water heater, and rewire the entire house in order for it to be up to code with the electricity company.  It took me by surprise.  The only other option was to improvise.

I lived in one room with a futon mattress in the corner, and a kerosene heater in the middle of the room.  The floors were bare, and the house was not insulated.  My ex had the place covered in garbage, wrappers, used glasses, empty bottles, etc.  Essentially, we were squatting in a hobo house.  The only luxury we had was running water, but it wasn’t hot.  The rest of the house was so cold that the water in the toilet would occasionally freeze.

When I was not thinking about the misery of the weather, I brainstormed ideas on how to improve my life. That’s when I discovered that constantly wearing a hat increases body temperature, but has the unfortunate side effect of making me dirtier with sweat.  I learned how to warm a bowl of water over a kerosene heater so I could sponge bathe.  I also came to the conclusion that this was rock bottom.

The obsessions started.  When those thoughts were not enough to occupy my mind, I considered all of the ways that I could die.  Exposure.  The constantly recurring infections I picked up from unsanitary living conditions, chronic health problems, and a weak immune system from inadequate housing.  I could die in my sleep from asphyxiation due to the kerosene heater.  Even better, I could be consumed by smoke and fire.

After living without heat through a Pennsylvania winter, I learned to appreciate the basics of life that others often forget about.  The essentials of life are not guaranteed, and sometimes, we are forced to fight for them.  I count my blessings each day to not be cold, hungry, and dirty.

However, I still have a problem counting my other blessings.  Particularly with people in my life.  I often find that I have difficulty letting go of wrongs and seeing clearly in the present without the past forming a cloud over it.  I despite being left to fend for myself, getting kicked out of the house that I poured thousands of dollars of time, manpower, and money into that pit, and all of the rest of things in the past, I was set on putting the past in the past, and working toward a better future with my parents.

I came to the realization that my parents were never parents when I was a child.  What would possibly make them such now that I’m an adult?  True, I have a Mommy and Daddy complex, so badly that I accidentally married a man under false pretenses of not being like my father, when it turns out that he is.  Worse, I spend time daily obsessing about the similarities between my mother and me.  And the worst, I attempt to find family in other people.

But, all of that is fine.  One day, I will be able to resolve that.  But, I knew that if I dropped the inexplicable unreachable expectations, maybe it would possible to move forward as friends.  Seeing as how we have had some time and space, literal and figurative.

I made an effort to drop my suspicions and stop reading into things my mother says to me.  We actually had a good conversation, and I was happy with her offer to clean out my refrigerator.  I was ready to resign my key to her when she asked.  She was excited to hear that we were stopping by in the evening, and she couldn’t wait to see Beast (my son).

We did stop by in the evening.  When I asked if she would mind watching him for twenty minutes so we could go to the store, she attempted to make up some lame excuses.  Her voice was noticeably displeased, although she was completely enthusiastic less than twelve hours ago.

I noticed that I accidentally left my keys at home, and requested Zen’s (hubby).  He put up a fight, and I became extremely frustrated, feeling as if this was going to become a serious battle.  Yes, my mother brought up the refrigerator, but never requested the key exactly.  My parents were pleasant enough.

Until we were going to cross the street to leave.  We were about to climb into the car when my father called after me.  “Hey, when are you going to have the rest of your stuff out?”  I carefully explained that we’ve been taking serious and unexpected financial hits, and we’ve had to take it weekly in our PT Cruiser.  That’s when he dropped the bomb of complete betrayal.  “Well, I need to get in there so I can fix the place up and have it rented out by winter.”

My mother had lied to me.  She told me that it would be impossible to have it rented due to the numerous code violations that stood between them and a renters permit.  My family was passively-aggressively bounced so they could turn a profit.  And, I was stung by the memories of living in abject poverty while they stood by.  The memory of spending my last two months of pregnancy alone, because my husband was fixing the house.  And all of the money siphoned out of our account by $700 electricity bills in the winter and repairs to every emergency situation that happened to that place.

Betrayal could never be enough of a word to cover all of the emotion coursing through every nerve and vein.  I was stung, and the venom made me lightheaded and nearly paralyzed.  I climbed in the car and assured him that we would do so swiftly.

I was quiet for a few minutes.  Zen asked, “What’s wrong?”

I replied, “It’s unbelievable.”

Zen said everything under the sun to try to make me feel better.  He attested how it would be impossible for them to get it rented, because nobody in their right mind would take it.  Even so, they would never be able to do it legally.  We could vindictively turn them in to the township, or repossess the furnace in the middle of the night.

“I’d rather draw up that contract for the furnace that they will inevitably default on, and have to drag them into magisterial court.  There would be nothing more embarrassing, and it would cost them more money,” I insisted.  Still, it was nice that he would go out of his way to settle my vendetta.

I asked, “Wait, why aren’t you upset?”

“Are you surprised?”

When I made certain promises to the man upstairs (my higher power), I asked him to give me a sign as to what I should aim for.  He responded, “Put others before yourself.” The problem is the inability to accurately anticipate wants and needs outside of the basics.  I assumed that my higher power would want me to forgive and start over with my parents.  But, after some thinking, I came to a realization.

There is a parable about a scorpion and a frog.  At the end, the scorpion betrays the frog’s trust.  When asked why, he could only reply, “Because it’s in my nature.”  Sometimes, we have to be reminded that there are ugly truths in the world.  And sometimes, things are exactly as they seem.  My gut reaction when my mother asked for the key was that she was intending on pilfering belongings she did not expect that I would miss.  Zen admitted that was the reason he withheld his key.  He knew better than I did, because my mind was clouded with optimism.

Optimism can be just as dangerously perilous as pessimism.  We can be misled into believing in the best in people, when it just simply nonexistent.  I realized that I am not a scorpion, and I didn’t have to be the frog either.  Instead, I know better than to play the game.  It is the exact reason why I am put off by gambling.  There is too much risk to be manipulated into losing it all.

I resign myself of that life.  And just because I can’t have the relationship that I want with certain people doesn’t mean I am unable to have a relationship at all.  I don’t have to hang onto the past to remind me to not let it repeat.  I only have to keep one piece of it, the least poisonous as a reminder.

A Spectrum of Depression

Blank.

Each time I go to write, I get a blank.  Is it a blank, because I feel as if I don’t have anything important to say.  Or is it a blank, because if I make a certain statement, then it is real.  It becomes something tangible in this world, not only for me, but for others, and I will eventually have to come nose to nose with it.

I’ve grappled with this before.  Making certain admissions.  I do not lie as much as I turn a blind eye.  I rationalize.  I attempt to will it out of existence.  But, it is just not that easy.

Simply – I am in the midst of a depressive episode.

Why was that so hard?

There is a certain hesitation for me to use the word depression.  It is not a word that I use loosely; others use it as a part of their regular vernacular to describe sadness.  Depression is not sadness.  Depression has a depth beyond that of sadness, loneliness, isolation, self-loathing, or any other word.  No amount of words arranged in any way can accurately depict depression, and do it any kind of justice.

The hesitation to term it as depression stems from the idea that, if it doesn’t feel like the worst I’ve ever felt, then it’s not depression.  I have faced more gruesome depressions than this one.  With the admission comes a certain fear.  If I am to term it as a depressive episode, then it really will be such, in the worst sense of that word.  It could worsen the episode itself by acknowledging it.

Blank.  Again.

I have found it so interesting that Bipolar Disorder has this grandiose spectrum to encompass so many different types and symptoms.  However, they are exclusive to mania.  Depression is just depression, and it by itself is MDD, or unipolar depression.  Except, now psychologists are starting to recognize symptoms that are related to atypical depression.  However, by reading through these symptoms, it seems as if it may be exclusive to unipolar depression.

How much research has been done to distinguish unipolar depression from bipolar depression?  So far, the only thing that separates the two is the existence of hypomania / mania.  In theory, there wouldn’t be a difference.  I get the feeling that there is, and it is significant enough to have a separation between the two.

So far, the mood spectrum looks like this:

But, I really think that’s being too broad about it.  I fall smack dab in the middle of Bipolar II, no full on psychosis equals no full on mania, even if I have delusions.  I wouldn’t even suspect that I have full on mania, anyway.  Even with delusional thinking, I can honestly say that there has never been a time where I have been hypomanic where I lost touch with reality.

People with mood disorders are familiar with the depressive symptoms.  But, I’ll sum them up:

Sadness, anxiety, irritability,  Loss of energy,  Feelings of guilt, hopelessness, or worthlessness,  Loss of interest or enjoyment from things that were once pleasurable,  Difficulty concentrating,  Uncontrollable crying,  Difficulty making decisions,  Increased need for sleep,  Insomnia, Change in appetite causing weight loss or gain, Suicidal ideation, and / or Attempting suicide.

Symptoms of atypical depression:

Increased appetite, Unintentional weight gain. Increased desire to sleep. Heavy, leaden feeling in the arms and legs, Sensitivity to rejection or criticism that interferes with your social life or job, Relationship conflicts. Trouble maintaining long-lasting relationships, Fear of rejection that leads to avoiding relationships, Having depression that temporarily lifts with good news or positive events but returns later

These are all familiar.  I’ve bolded the ones that I’m experiencing at the moment.  It seems that I’m bordering on the more atypical part of depression.  This is the kind of depression that no one really tells you about.

I had mentioned my diagnosis of Bipolar II, resulting from non-psychotic “manias” clinically termed “hypomania”.  Fair enough.  Let me put a question out there.  Has anyone ever experienced a psychotic depressive episode?

I have.  And I have mentioned this to doctors on several occasions.  I will have breaks with reality when I am depressed.  I have severe delusions, almost completely the opposite of delusions of grandeur.  I will have severe paranoid episodes – in fact, I just had one.  I can have myself convinced that everyone hates me and is out to destroy my life.  It makes me combative.  I will sometimes invent conversations that never happened, just because my brain contorts a criticism.

Mayo Clinic appended this in fine print below their list of classical depressive symptoms:

When a person with psychosis is depressed, there may be delusions of guilt or worthlessness — perhaps there is an inaccurate belief of being ruined and penniless, or having committed a terrible crime.

Perhaps?  I’m nearly positive that exists because not enough research on bipolar depression versus unipolar depression exists to accurately differentiate between the two.

There are a few questions that remain.  Again, not to just the bipolar population but the unipolar population as well, have you ever experienced a psychotic depressive episode?  Is this more commonly found in MDD, BP II, or BP I?

Because if this is common amongst all populations, then the mood spectrum should look more like this:

Perhaps a more accurate model