What Happens When Things Fall Apart

Pin Down That Mummy Hand

In my outpatient crazy classes we talked about self-care–a lot, actually. The first thing I did that helped to lift me out of my wretched little hole was to clean and organize my space. I know very well that my external surroundings are a projection of my inner state. Peaceful and zen like? Every thing is in its place. The bed is made. The laundry is put away. As I sink further and further into the chaos my space gets less and less organized. It’s one of my warning signs that things are out of whack. When I stop meditating, that is a definite flashing red light.

Somehow I managed to make it to work today, unraveled and with flashing red lights, my insides all squishy, my cognitive function deteriorating. Let’s not mention the crying fits. I work in a place that is inhabited almost exclusively by men. I need to sneak out of my office, into the bathroom and push the tears out. Like a tiny birth. Today I accidentally double dosed on Wellbutrin. It didn’t really take effect until halfway through my work day when I was on the phone and all of the sudden things became unreal like they do with LSD. My jaw started grinding, my heart started pounding and I started pacing. I think I managed to pull the phone call off without obvious signs of insanity. But did I pull the day off? I don’t know.

I’m at a familiar crossroads here. Many times in the past I have reached this point in a job and have just dissolved into depression, anxiety or mania. I make too many mistakes thanks to my holey brain and my inability to focus. At first the boss is somewhat understanding, then a little testy then pissed. So I apply the over-compensation–working extra hours that I don’t clock on for. The ensuing anxiety and down right terror wakes me up at night because I have all of this work-related anxiety.

Now that this has happened so many times I’m starting to think that maybe it is a choose your own adventure. Or better yet, maybe it’s like the Buffy the Vampire Slayer mummy hand episode where our saintly heroine was magicked into reliving the same torturous hour of retail service over and over again until she succeeded in satisfying her customer.

This was tricky because the Mummy hand was a devious trickster and the customer was a bitch. Bewitching aside, I think it’s an apt metaphor. Buffy realized that using the same tactics yet again would land her in the basement wrastling a mummy hand to the ground. She tried a new approach. It’s time for my new approach but I haven’t quite pinned it down. Much like Buffy did the mummy hand with a knife.

So I’m going to be sans husband for the next ten days. His band is touring and I can’t go with because of work and money, yadda yadda. I think that taking this time for some spring cleaning would be a good move. Maybe I’ll actually get some stuff done.

The Mind and the Muscle

I feel the connection between mind and body deeply when my mental pathologies are in high gear. When I am depressed, my bones hurt, I feel burnt from the inside, my metabolism slows down. When I am in the throes of a mixed episode with heightened anxiety I have a flight or flight reflex that is catlike. My adrenals dump into my bloodstream and my nervous system zaps away. I have horrible agitation and all of the wonderful self-care tools like meditation, Reiki, breathing and even exercise are futile. It’s obvious to me that these illnesses aren’t just in my head, they’re in my body too.

I’ve recently developed an ongoing left lower lumbar spasm. It just won’t heal. It causes radiating pain and weakness and is in general a pain my ass. I’ve had unpleasant dealings with doctors who don’t want to treat patients who are in pain. They prescribed a short course of a muscle relaxer and recommended ice and heat. It wasn’t cutting it. They had no further answers for me and no concept of how all of my symptoms connected.

So I went to the chiropractor who I visited when my lumbar went into spasm last year before the ACA kicked in and before I had insurance. I needed to talk to someone who would listen to me, someone who actually understands the body. Doctors are good for the prevention and curing of diseases but when it comes to anatomy, many seem to have skipped that class. My chiropractor, after doing a series of strength and range of motion tests directed my attention to the psoas, the muscle at the root of a lot of lower back and hip pain (some people think it’s the root to almost all chronic pain).

When I first learned about the psoas muscle in massage therapy school, something about it stood out to me. It is the deepest muscle in both the back and the abdomen, it holds you up, it creates a shelf for all of your organs as well as massaging them and the spinal fluid. It is the core that supports health and longevity–not the abs or obliques but the psoas. But it seems nobody really talks about it that way. People talk about core strengthening in terms of abs but nobody mentions the humble psoas that takes the biggest beating from not only physical activities but mental and emotional stressors.

Since it is also deeply linked to the sympathetic nervous system holding up and massaging the body’s organs its job, among other things, is to protect them from the hailstorm of stress. When trapped in a state of flight or fright–when a person is pathologically scared, filled with anxiety, panic, terror and is hypervigalent–the psoas constricts to protect the precious organs and spinal fluid but it can cause crippling conditions wearing away joints and harming spinal disks. This wearing away doesn’t kill us but it can make us a lot weaker.

So, according to the philosophy of the body set forth in Yoga, as well as the understanding of human anatomy and psychology, it turns out this relationship works both ways. The releasing of my psoas, encouraging it to work correctly will theoretically help reduce my nervous symptoms as well as the physical ones. My new favorite body blogger Brook over at Fascia Freedom Fighters shared this. It’s called constructive rest. I love the idea of intentionally incorporating rest into the day. Apparently some people fight it wanting to multi-task but I say no way, my body needs a break from the perpetuality of doing.

We’ll see how that works. Anybody have any experience working with the psoas? This is a part of the body that I am definitely going to explore further because as I mentioned, when I am in a state of flight/fright and my adrenals are pumping for no good reason, the mind-oriented self-care techniques I’ve accumulated do not work.

Body of Evidence

In many ways our bodies are physical records of our lives both inner and lived. Areas of knotted fascia (the webbed connective tissue that keeps everything in place) may be the result of the time I fell off my bike as a kid. You would have thought it would have healed by now but no. The body keeps a ledger of missteps.

We all know the commercial with the pathetic looking puppy and neglected family–depression hurts…everybody. It’s facile but not wrong. Depression amplifies pain and distorts it (and perhaps adds some reverb and a little delay). Depression lives in the body as much as the mind. Pain, the accumulation of extra pounds and lethargy are all the real deal for a depressed person.

For me, this is the baseline level of pain I feel (when I’m not hypomanic). Add PTSD and anxiety and it’s a wonder I function at all. Depression, anxiety and hypervigilence tax the body’s autonomic nervous system–the system that regulates the body’s functions (like blood pressure, digestion and heart rate) in order to bring it into homeostasis.

When that system is clogged up with constant triggers to its fight/flight response it remains engaged–meaning the body cannot rest and repair itself. Adrenaline is dumped straight into the bloodstream and when that runs out, it’s cortisol, a hormone that among other things makes us hold on to fat. Gross

It was this what brought me to the ER this summer. I had so much anxiety, I was constantly in a state of hypervigalence AND I was depressed. It was like being tied to a chair while being tickle-tortured but without the fun. Right now I’m feeling the restlessness again, along with the heft of depression. It’s not yet a mixed-state but it’s about one state over.

For anybody else who has or is experiencing this special brand of torture here are some things I have come across that can be helpful if I catch it in time.

1. Creative therapy. Automatic writing, fast drawing, sculpting clay or putty, beading, singing, playing a musical instrument and whatever else is kicking around in there can draw the attention away from self and onto something tactile or sense-oriented in other ways. It only works if you can manage to divorce yourself from the outcome. It isn’t about making art, it’s about the act of creating and it doesn’t matter if it’s good.

2. Tense/Relax Meditation. This is the kind of meditation I can do in the midst of a mixed state, when mindfulness meditation is a no-go because of pain or restlessness.  First, center yourself within your surroundings. Make note of sensory data–what do you see, hear, smell, feel and taste? If associations pop them up, notice them but don’t hop on the train of thought. Let them fall away. Keep your breath grounded in your senses. Then tense your muscle groups individually, hold for a few breaths and relax. Notice the difference?

3. Move It. Honestly it doesn’t matter if you’re prepping for a marathon or cleaning the attic. Moving uses the extra adrenaline as fuel. It can be fun too–I like Wii Fit Plus Rythm-Fu, or putting on a record and dancing like a fool. Other ideas: jumping jacks? Shooting hoops? Walking around town? Yoga? This is where I often fail. The pain and stuckness become so unbearable I feel I can’t move. I suffer for it. I get mad at my doctor for suggesting it. But I have found that it works.

The point of these activities is to get out of the brain and into the body, even if it’s just for a few minutes (though longer l, definitely better). It’s about reconnecting with the body and feeling it in the moment, trying to let negative associations go.

That’s enough proselytizing. I’d love to hear input from others.

Work Shy – Working While Bipolar

One of the very first jobs I held was as a barista at a coffee shop that was like a bar for underage goths to drink black coffee and pretend to read Sartre. It had vegan food before vegan was really a thing. And it was in Florida. Amusingly, Florida is pretty much the goth capital of the country. Marilyn Manson (the band, not the guy) hailed from Fort Lauderdale and, you know, parents and people who liked banning things in general, pretty much thought they were the devil. You would think that with the sun scorching down people wouldn’t really want to wear black from head to toe but you would be wrong.

I lived in Tallahassee.I moved there while in a manic state and was still pretty ‘up’ when I got my job. I was what all the Craigslist ads refer to as a ‘rockstar barista.’ I was fast, funny, thought five steps ahead and was pretty much always on. The hypersexuality of my mood state helped. It fueled my game with the customers. That continued for awhile. I had a lot of ‘firsts.’ It was probably the longest hypomanic episode I’ve had.

When I crashed, my work suffered. This is not uncommon for bipolar people. The excitement of a new job itself can be a trigger for hypomania. Eventually that train runs its course and the boss thinks you’ve lost your passion, that you’re losing your touch, that you can’t handle the workload or that you’re on drugs.

With depression those things can be very true–but it’s a transient state, much like the hypomanic one the boss loved so much to begin with. I loved that job. But my touch was no longer golden. My manager called me to the back office and I went, heavy-hearted, terrified about what was about to happen.
“I’ve noticed you haven’t been yourself lately,” he said, both feet on the floor and his hands clasped in front of him. It was a power position. He did it a lot.
I was quiet…I didn’t know what to say. “Did I do something wrong?”
“It’s not one thing,” he said, a little hesitantly, “it’s a bunch of things.”

I knew what he said was true. Being depressed, I probably felt worse about my performance than he did. I felt like the sun fried the energy out of me, boiled my life blood. That’s what depression always feels like to me. Like being burnt. I started crying. Fuck, I thought. I hated crying in front of people and it happened more often than I would like.

He dropped from power-boss stance to compassionate-guy position, obviously rattled by the waterworks. Most men don’t like making women cry, and Alex was a decent guy in a kind of old-fashioned way, even though he was probably 23 at the time. “What is it?” he asked. He was reaching out a branch, I could tell. There was no anger in the confrontation, just a kind of sadness. A bunch of years later, having been on the other end of this scenario–a manager firing an employee who was clearly depressed–I can say with some certainty that he was looking for a reason not to fire me.

“I have to tell you something and I don’t want the others to know.”
“Ok…” He now looked truly nervous. Alex was not a dude who liked being in the company of bare emotions. I don’t think he wanted to be the only one in on my big secret, particularly after a traumatic event happened to me earlier–one that everyone knew about to some degree.

“I’m bipolar. I’m having a depressive episode. I really don’t want to lose this job. I love it here…I promise I’ll try harder.”

His whole demeanor changed. Was it self-preservation? (As I later found out, Bipolar Disorder is protected by the Persons with Disabilities Act.) Did he have a relative with Bipolar Disorder? It didn’t really matter to me what mattered was his reaction. He told me not to worry about my job, that he was sorry I had to live with this disorder and that if I ever needed chunks of time off, he would happily accommodate me. I was relieved. I was somewhat ecstatic. I thanked him profusely.

That was then. I am now scared to death to tell my employer about my mood disorder. He’s going to notice. Even though I religiously take my pharmacopia like a good Catholic takes Communion, the disorder seeps through. Some days I am drained of energy, feeling burnt. Sometimes it last weeks. Sometimes I talk like I have no off-switch. I am good at my job. I have ideas above my pay grade but I live in constant fear that my disorder will show itself, that the depression will make a fraud out of what I believe to be the real me. This fear leads to paranoia and anxiety which in no way help the situation.

All of this shit has made it difficult to find employment. I have talked myself out of jobs I’d be suited for. I spent the better part of a year sick, eeking out freelance work and finding myself hospitalized. But I thrive while I’m working. The structure gives me room for creativity. Like many other things about me and other Bipolar people I know, it is perverse. Work is the thing that makes me function creatively, it gives me energy. At the same time it makes me feel my disorder more than anything else.

At a loss for words

Sykkogirl’s post about losing words spurred me to write my own. For me lithium is the little word thief. It isn’t so much that the drug directly yanks the words out of my brain or impairs my cognitive abilities, it just slows the speed of my neural activity. That is, it does its job. The unfortunate thing is that job is to make me slower on the uptake. There I am having a conversation with my boss, with someone on the phone or my mother-in-law and all of the sudden — I blank. It could be a word like pajamas or snorkel — obviously in my vocabulary but rattling around. I am unable to make the connection.

When I’m writing, it isn’t as much of a problem. I still falter. I was having trouble with spurred in the previous paragraph–enticed? No that’s too…sexy… Encouraged? Well sort of but not really. But I’m not on the spot when I’m writing. I can go back and edit the missing words back into the sentences. They eventually come back. Most of them anyway. Now typing includes more hunting and pecking than my pre-lithium days. My fingers are more like someone learning to play chopsticks than Bach fingering a new concerto on the harpsichord.

Sometimes I feel as if psychopharms are a choke chain on my intellect, trying to keep it within confines, walking a straight line. But that way, I miss the trees. It’s a trade-off though. There have been studies that actually suggest lithium improves cognitive function–or more accurately that it protects it from degeneration. Maybe my word loss can be chalked up to depression and not a side effect of lithium? I don’t know…the jury’s still out. There is evidence that all states of bipolar impair cognitive function so I suppose I best preserve what I’ve got.