When Mental Illness Stigma Is Self-Imposed

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I have been stable for the past four years, but now my bipolar disorder has resurfaced. It could have been triggered by stress, meds or the weather change — or equal parts of all of these things — but the reality is that I’m unwell.

It was when I said this that my husband asked if I was hypomanic. Calmly, he described my behavior. I trust his judgement enough to know it must be true. Saturday highlighted this, as I was in a full hypomanic episode. Upon reflection, it had been building all week but I didn’t realize it. I had been having extreme anxiety all week and had been very agitated. I wasn’t sleeping and I was extremely volatile. By Saturday, this agitation and anxiety had turned into excessive, delirious energy and despite working out for two hours, taking anti-anxiety meds and trying to take a calming bath, it wouldn’t go away. My speech was rapid and bouncing from one thought to the next. I couldn’t sit still. I was moving like I was on speed. I had great ideas. (I saw a girl with half of her head shaved and thought that would be an awesome look for me, too. And while it might be an awesome look for me, it’s not a decision to be made while hypomanic.)

I’m equal parts frustrated, disappointed and defeated. It has been so long since my mood swings have been so volatile and explosive. It has been a long time since I felt manic. It has been a long time since I have felt so completely out of control.

Under the suggestion of my doctor and psychiatrist, I’ve taken a leave of absence from work. To be honest, this has been the hardest thing I’ve had to do in my life. I feel like I have admitted defeat to my illness. I feel like my leave of absence is showing the world my illness makes me weak and that I can’t hack it in the real world.

Rationally, I know this is totally unsubstantiated. I have a supportive partner, family and friends. I have previously disclosed my illness to my boss in preparation of writing this blog and she had demonstrated my illness didn’t taint her view of me. But there’s nothing I love more than feeling guilty, so I still beat myself up.

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We often speak of stigma in terms of external judgement — how others perceive those with mental illness. But a form of stigma we don’t often talk about is the self-imposed stigma. Will I get fired for taking a leave of absence? Will I be given less interesting projects because they’re less stressful? Will they think I’m less capable because of my illness? Do my colleagues think I’m lazy and just don’t want to work? Are people whispering about the crazy girl who had a breakdown? I am so consumed by thoughts about what other people might be thinking about me, I neglect what’s most important — what I think and need. 

I try to situate my mental illness like someone who has cancer. If a colleague took a leave to get chemotherapy, would I judge them? Of course not. I would probably send them an email wishing them well or send flowers to their hospital room. But we don’t think of mental illness in this way because its symptoms are not visible. My moods are visible — I’m agitated, I’m teary, I don’t sleep — but the “proof” that the actual illness exists isn’t visible. It’s my word and a doctor’s signature on some paperwork.

Last week, these self-imposed judgments were spinning in my head increasing my agitation and anxiety. In an attempt to help, my husband and I set out on a walk of undetermined length. As we walked, I explained all of these thoughts to him.

“I’m regretting taking this leave of absence. Maybe I could take back the paperwork that had been submitted. I could go to work and have my medication readjusted — I could handle that. I didn’t really need this leave of absence at all. But on the other hand I’m so tired and angry — what if I blow up at work? I already snapped at one co-worker when I normally wouldn’t. I could lose my job. Also, I was sobbing at my desk on Tuesday. That’s not right. No, I do need this leave. It’s good for me. But on the other hand…”

After listening patiently to my rambling and often contradictory thoughts for the better part of an hour, he finally said something: 

“I know deep down you know this is the right decision. In the 10 years we have been together, this is the first time I’ve seen you choose yourself over other people. I’m proud of you.”

This stopped the self-stigma in its tracks. He reminded me this leave is only a minor setback. I haven’t surrendered to my illness, I’ve just retreated. No general would continue when the battle is surely lost. A general would regroup, tend to the wounded, gather reinforcements and re-strategize. And that’s all I’m doing. I may have lost this battle, but there’s still a war to win.

Follow this journey on Mad Girl’s Lament

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There Is Hope After a Bipolar Disorder Diagnosis

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I feel like there’s been a lot of attention lately on people with mental illness. There has especially been a focus on overcoming stigma in the world, to help people who are struggling feel safe talking about it. We all know the statistics. We know that because of stigma, people are less likely to seek treatment. We know serious mental illnesses can be lifelong. And we know that despite sensational media reports, people with mental illness are far more likely to be victims of crimes than perpetrators. These are sobering facts. Even with these sobering facts, I feel like there is still a disproportionate shortage of hope being spread about serious mental illness, and that’s why I’m writing today.

I have a serious mental illness. I’ve lived with it for most of my life. I’ve been diagnosed with bipolar disorder type I. I go through extreme mood swings, varying from periods of mania, where I’m euphoric and make really poor choices because I feel indestructible and on top of the world, to periods of severe depression, where I feel utterly worthless and think life is meaningless, and that my family would be better off without me. I manage to stave the worst of these highs and lows off with medication management and therapy.

What do I know about hope and mental illness? I was once a train wreck of a typical case. I was untreated, court committed, in and out of hospitals and well on my way to being another statistic. I hit rock bottom in my life about 10 years ago, right when I was first diagnosed, actually. It was about this time when I lost everything of value to me. I lost my car, I lost my apartment, I lost my job, my family shunned me and I lost custody of the one thing that meant the most to me, my daughter. I literally lost my will to live at this point. I earned myself a six-week stay at the local psych ward during this time, and I had a lot of time to reflect on just how much I’d ruined my life. I finally got out close to New Year’s, and as that year drew to a close, I knew without a doubt I was closing a chapter that had been the worst of my life, and I was never going to repeat it again.

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I woke up to a new year, and I was a new woman. I was determined to get my life back together somehow. So I did. Very slowly. My family unwillingly had let me come home, and I had determined that the first thing I needed to do was find a job. I immediately stated putting out applications. Once I got my job, I got a phone. Then, a car. I also made sure my daughter was back in my life, too. After I got into the groove of working, I decided to go back to school. Now, I’m not saying this all happened smoothly, but it happened. I still continued to struggle with my bipolar episodes, but I had a lot of support from my friends and family to help me through them when they happened.

A few years after I had my epic breakdown, I met a really wonderful guy, who treated me amazingly, and we got married. He’s been a great support to me as I’ve had ups and downs with bipolar disorder moments. We have three kids together, in addition to my oldest. I may have bipolar disorder, but I’m doing something right by these kids. I send my kids off to school every morning, and not one of them will leave until they get a hug and kiss.

Now, here’s the important part — I still struggle. I’ve been hospitalized more times than I care to admit. I’m not perfect. I still have moments where I don’t know if carrying on is worth it. But I know I’m in a good place. I’m doing good things. I have a part-time job that I’ve had for over a year. I work at a place where I actually feel like I make a difference. I write articles I feel are helping people and have the potential to help a life. I’m constantly improving myself. I know myself, I watch myself constantly for fluctuations in my mood and I’m am on top of seeing my doctor if I sense a disturbance in the force. I regularly see my therapist, and I’m dealing with issues that have been holding me back all my life.

I may have bipolar disorder, but it doesn’t have me. I’m not defined by it. I have value and I see that. I may need medications for the rest of my life, but that doesn’t make me “less than.” Considering the weight gain it causes, it actually makes me “more than.” I jest, I jest. I like me. I’ve been told I’m an innately likable person. Being bipolar doesn’t take away from that. It doesn’t take away the fact that I’m a very authentic and real person, or that I love serving others or that I love writing and being creative.

There is hope after a mental illness diagnosis. I lost hope after I got my diagnosis, I think. I felt like I would just be a waste of space, and why try because I was just going to be a label no one would ever see past. I’m happy to say people all around me see past that label all the time. My boss sees past it. My coworkers see past it. My husband sees past it. My friends see past it. People who know me just see Tricia, not bipolar.

If you’re struggling to find yourself in the midst of an mental illness identity crisis, I promise you, you’re in there. There’s nothing wrong with needing help from a support person to find yourself, or perhaps needing help from medication to find your best self. Just keep reaffirming to yourself who you are, and keep hanging on.

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'Functional' Is a 24/7 Job When You Live With Bipolar Disorder

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In the dark of morning, I struggle the most. Every day, I wake up and try to convince my rapid cycling bipolar brain to function. There is a debate. Every day. I stand at my bed and argue silently as to whether or not I should crawl back into it. It is in this moment I struggle with being functional the most. This exact moment.

Realistically, I don’t actually get to claim the title “functional” until I am up for about two hours. Technically, I claim it as soon as I hit the shower.

For a moment, let’s back track to the night before. At 10 p.m., which should be my bedtime, my brain suddenly decides that it’s time to take over the world. Fractions of ideas, half concocted story lines, bits and pieces of thoughts and images project into my consciousness. They’re just semi-completed annoyances trying to self-actualize into my brain without actually being a whole self. Nothing is accomplished, as I allow them to stream through without attaching any value statements to them.

But they certainly keep the lights on while they party, while I lie in my bed, awake.

As anyone who takes psych meds may know, well, sometimes they can destroy us with side effects. It’s like stopping that party by literally burning the house down, party-goers inside. (On a side note, one med is trying to ruin my cholesterol, but that’s a different story.) In this instance, another med makes me drink ridiculous amounts of fluids to combat the vicious, unending thirst that accompanies the ridiculous and incessant urination. I wake up every two hours to take care of business. I am in the process of getting blood analyzed and all that jazz to determine if this is, indeed, the problem.

So, I go to bed every night with the synapse remix blasting in my head, preventing me from going to sleep, and the brutal side effects of the sacred medication cause me to continually wake up. Often less than five hours total, no more than two hours at a time. 

Yes, I am tired. In the dark of morning, I struggle to reason that going to work is the most logical conclusion at that particular point in time and space. But I am here to rise, period. Sucking it up one day at a time just seems like the right thing to do. It’s a fight, right? We don’t get paid, and we can’t win, if we just sit in the corner.

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In the dark of morning, with little to no faculties available, I can’t give in. I just can’t. So I don’t.

The Mighty is asking the following: For someone who doesn’t understand what it’s like to have your mental illness, describe what it’s like to be in your head for a day. If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

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6 Tips for When Your Mental Health Is Going Downhill

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Living with bipolar disorder isn’t easy. Recently, I had an epic relapse, a rather serious near miss with a suicide attempt and scared the numerous people who care about me. I realized what I normally do to take care of myself is great, but things are different when I find myself in a crisis situation. So, I’ve discovered I have a totally different set of rules for crisis management, and I think they can also be a great tool for preventing crises as well.

1. Don’t change your treatment without consulting your doctor.  

Honestly, this could probably be the only rule and the end of this article. If I hadn’t quit my meds, the rest of these rules probably wouldn’t be necessary. Sometimes when you’re experiencing side effects or feel “better,” you think you don’t need to take your medication anymore. I stopped taking my best line of defense because I was feeling insecure about my weight, even though I was doing phenomenally mood-wise. I know not to quit my meds usually, but I was just so tired of feeling hopeless about my size. If you’re unhappy with your medication, talk to your doctor. That way if you do decide to go off medication, you can have a game plan in place if you become unstable.

2. Utilize your support system!

I did not utilize my support system at all during the last six weeks leading up to my attempt. I talked to my therapist about quitting my meds, so she knew, but my husband didn’t know I’d quit them until the week I started to really go downhill. I think if he’d known earlier, he could have pointed out the warning signs of my instability to me sooner. My husband is the one who encouraged me to go back on them ASAP, thankfully, but by then it was just too late for much to be done. I didn’t call my doctor when I started spiraling downhill to see what he could suggest as emergency options. I didn’t reach out to my friends for support. I just isolated myself more and more and got worse and worse.

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3. Don’t shut your therapist out. 

I shut down and stopped working with my therapist for a couple weeks before my attempt. I knew something was getting to me, and I was feeling more and more down, but I couldn’t express what it was exactly. Instead of telling her that, I just put on a show and pretended everything was fine. I did try reaching out a couple of times in the days leading up to my attempt, but I denied feeling suicidal right up until I sent her my final text saying goodbye. Not such a smart idea.

4. Accept you might have to go to the hospital, and embrace it for what it is — an opportunity to get help. 

There’s no shame in getting treatment. Repeat that mantra over and over to yourself, especially if you’re having a hard time coming to terms with possibly being “labeled.” Labels aren’t always a bad thing. I’m lots of labels. Mom, Wife. Teacher. Advocate. Writer. Storyteller. Bipolar. When I first got admitted, I was angry at the world. It took a lot of patience from the nurses’ and therapists’  for me to come out of that bitter shell and start working on feeling better.

5. Recognize that treatment doesn’t end after the crisis has passed and you’re relatively stable again. 

You’re going to need aftercare. A good doctor and a therapist is going to be crucial to keeping you stable. You might even need more than just a good therapist and doctor (preferably a psychiatrist if you’ve got a serious mental illness, in my humble opinion). Using me as an example, this has been my fourth hospital stay in the last two years. I’ve made lots of progress, but I’ve finally realized that I’m not progressing enough with what I’m doing when I get out of the hospital. Now, I’ve decided to do intensive outpatient treatment, meaning I’ll be doing group therapy as well as a education group three times a week for three hours a day for six weeks, in addition to meeting with my individual counselor once a week.

6. Practice self-compassion, yet again. 

This is so important. I made a lot of mistakes. I burned some bridges with this last crisis. Thankfully those bridges were built with something stronger than wood, and I was able to extinguish the fires rather quickly, but I hate letting people down. That all being said, I’m still trying really hard to tell myself I’m good enough. Eleanor Roosevelt once said “No one can make you feel inferior without your consent,” and that includes yourself. I’m not giving myself permission to beat myself up.

I wish I had a silver bullet for dealing with bipolar disorder. I wish I could say that doing all of this is cake, and “since I can do it, you can too!” But even if one of these rules I have for myself can help one person, then I’ll have not suffered all this for naught. I’ll consider my time spent learning these rules the hard way time well spent.

If you or someone you know needs help, please visit the National Suicide Prevention Lifeline. You can also reach the Crisis Text Line by texting “START” to 741-741. Head here for a list of crisis centers around the world.

The Crisis Text Line is looking for volunteers! If you’re interesting in becoming a Crisis Counselor, you can learn more information here.

Follow this journey on Ramblings of a Bipolar Mess

The Mighty is asking the following: Create a list-style story of your choice in regards to disability, disease or illness. It can be lighthearted and funny or more serious — whatever inspires you. Be sure to include at least one intro paragraph for your list. If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

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To the Well-Meaning Friend Who Said I 'Didn't Really Need' All My Medications

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Dear Friend,

I know we’ve known each other for many years. During those years we have laughed and cried together and grew up and got married and had kids. During the early
years of my marriage you and I lost touch and a lot changed for me. I was diagnosed with bipolar disorder.

Through many trials and errors and many trips to the doctor and a suicide attempt, I have gotten on the road to recovery. I have worked years on getting the right medicines and behaviors down so I stay in recovery.

During a recent episode in my life you came to me to give me support, and it meant so much to me to have you by my side. You were such a good friend to me most of my life, and I was so glad you were there for me. However, during a conversation one day you said something that hurt my feelings, and I have never said anything to you about it, but now I feel it important that I do say something so you don’t make the mistake with another friend.

You said to me that I “didn’t really need all the medications” I was on. Your
intentions were good, but what you don’t know is the struggle I went through during the years we weren’t close. You don’t know how bad my depression got, or how severe my manic episodes were. There were days I would do nothing but scream and throw plates against the wall. I broke doors off hinges, and I wouldn’t have been able to stay married without getting those angry moments under control.

Each one of my medications takes care of a symptom you may have never seen. My medications took years of trial and error, and when the right combination was found it was like the world was lifted off my shoulders.

My medications saved my marriage and let me be a mother, but most of all they
saved my life. I know since you don’t have mental illness this may be strange to you, but please understand I have to do what is best for me and my family, and know that saying I “don’t really need all my medications” is actually hurtful to hear.

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I know we are good friends and that we always will be. Please just love me for who I am, mental illness and all.

The Mighty is asking the following: What do you want your past, current or future partner to know about being with someone with your disability, disease or mental illness? If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

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When the Nearest Psychiatric Hospital Has No Beds for 8-Year-Olds

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My daughter’s been blessed with pretty good physical health. She’s rarely sick and hasn’t had to miss much school due to illnesses.

Her mental health has been almost the opposite.

Even though she’s been stable over two years now, she’s missed a lot of school due to behavioral health challenges. She was diagnosed in August of 2011 with bipolar disorder, but it wasn’t until over a year later that she had her first hospitalization.

In October of 2012, my husband and I were attempting to get our daughter ready for school. She was having a hard time transitioning back to a school routine after summer, and it was difficult getting her ready for school every day. We saw a lot of aggression and self-injurious behaviors during this time. Finally, one morning, I made the dreaded phone call to our local police to ask for assistance. I truly was hoping we could eventually make it to school that day. The officers who came out didn’t really know how to help us, but they were able to diffuse the situation. My child calmed down enough so we were able to transport her in our vehicle to an emergency room in a neighboring city.

As is typical of any visit to the ER, my daughter was seen by the triage department before being taken back to the ER’s psych ward. It was a scary place for sure. At the time we had insurance through my work that was pretty amazing. We only needed the doctor on call to approve hospitalization for my girl. For all of her future hospitalizations, she was on government insurance. We had to jump through many hoops to get approval on each of those occasions.

The problem we had this time was not with getting someone to agree that my daughter needed hospitalization — it was finding a bed. The hospital we went to didn’t have a place for an 8-year-old with mental health issues. We had arrived at the ER around 10 a.m. that morning. By 6 o’clock that evening the nurses still hadn’t found a bed close by. I finally spoke up and asked what the hold up was. It was then that I discovered they had only been looking in the county we live in. I implored them to look into other counties.

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Finally at 9 p.m., a bed was found in different county over 100 miles away. I didn’t care, I was elated one had been found. My husband and I called our therapist who then called the facility to make sure it was a quality hospital. Once the decision was made, we signed tons of paperwork to pre-admit her. I think it was almost midnight before we were told the ambulance that would be transporting our daughter had arrived. At this point my child was calm and almost angelic. The ambulance workers buckled her onto the gurney just to make sure. This was a new and terrifying experience for all of us, so I rode in the back while my husband followed behind in his car. I recall it was about 4 a.m. when we arrived at our destination. It was eerily quiet and dark in the hospital corridors. When we reached the youth unit, we signed more paperwork while the nursing staff took our daughter’s vitals.

Sometimes, when a child is admitted to a hospital, the parents are allowed to see where their child will be staying and in most cases, will be offered a bed to sleep on. In behavioral health hospitals, this is not the case. We were ushered out while our precious baby was whisked off behind a set of locked double doors.

As we stumbled out into the pitch black darkness of the early morning hours, numb and in shock, I looked down at my watch. It was 5 a.m. I still hadn’t slept a wink and was suddenly overcome with exhaustion. My husband and I had no clue where the nearest hotel was. We both looked up at the same time and noticed one right across the street from the hospital. It was a godsend, an expensive godsend, but a godsend nonetheless.

I don’t know why I thought it would be easy to see my daughter that first morning. It was one of the roughest days I had ever experienced up until that point. As the double doors closed at the end of our visit and we left, our beloved child cried gut-wrenching sobs. I knew she was where she needed to be. I knew she was safe. Still, it was hard. The hospital staff encouraged us not to visit every day so we went back home. Over the course of the next 10 days we saw our daughter as often as we could. I talked with her social worker every day.

When she was discharged, we couldn’t find an outpatient program close to our home, so my daughter and I stayed at a nearby motel at the facility she had been inpatient in. As it turned out, my girl was still unstable and required more hospitalization. She was accepted back at this wonderful hospital since she was in their outpatient program. She stayed for another 10 days inpatient before resuming their day treatment program.

While at this facility, the social worker acted as a liaison between myself and the school, and myself and the doctor. I later learned this is the exception, not the norm at most behavioral health hospitals. In fact we never experienced this level of care and concern again. The entire nursing staff worked with our family and our child in a loving, but firm manner. It was rough leaving my pride and joy in the hands of strangers, but at the end of my girl’s stay there, they were almost family. For that I am truly grateful.

As I reflect back on this first hospital stay, I learned a few things about myself and our mental health system.

I learned I’m stronger than I think I am. It was incredibly difficult to leave my child crying behind the double doors with strangers I had just met in a strange city.

I learned about the shortage of beds in our psychiatric hospitals. It’s unfortunate there aren’t enough beds for children my daughter’s age in all of our county.

I also learned how important it was to ask for help. Unlike most families in our situation, we had some incredibly supportive friends. Members of our church family gathered donations that significantly helped us. These funds provided us with gas money for traveling to and from the hospital and money for eating out. These same friends also helped provide us dinners when our daughter returned home again. Many parents are ashamed to admit their child needs this kind of hospitalization, so they stay quiet. We spoke up and stated what we needed.

Should you ever find yourself in a similar situation where your child needs to go to a behavioral health hospital, I encourage you to reach out to friends and family. They may not be able to visit your child, but they can offer practical things like gas cards, gift cards to your favorite fast food restaurants or even taking your other children for play dates. Together we can end the stigma surrounding mental health by speaking up and supporting each other.

Follow this journey on Raising a Drama Queen.

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