The Bipolar II Conundrum, per PT

Psychology Today has an article that relates to the guilt I've expressed in several of my recent blog posts. It asks where the line of personal responsibility is and suggests that it's harder to discern with bipolar type II. This is addressed solely in the context of hypomania though, and I'd be interested to hear it discussed in terms of depression and/or mixed states.

Acceptably Flawed

It was encouraging in a way when my therapist recently referred to me as disabled. It legitimizes my struggle to work, to be productive, and relieved some of my crazy anxiety about all that. On the other hand, it reinforces the idea that I am not normal, that I am fundamentally flawed as I have always feared.

I guess the task here is to reassess what flawed means and to reassess what success means; what acceptable, what worth is. So the hope is not in me meeting a certain notion of worthiness, of success, of productivity, of acceptability—but to reconfigure what I mean deep-seated worth to be. A reconfiguring where I fit completely inside. It is not a shift of convenience, you know, redefining laziness or apathy as success, but somehow finding a different currency of worth all together.

Motivation

I am not self disciplined or self motivated. I act best under pressure (not too much pressure mind you). Why when I'm doing well can I not start to build, start to create a life, move towards that something I feel cheated of in depression?

Why can't I sit down and do job research. Brainstorm answers to potential interview questions. Buy an interview suit. Prepare a resume.

Why can't I stand up and wash the dishes. And go to the grocery store. And cook. And wash the dishes again.

Why can't I organize my closet. And then the spare bedroom. And the garage.

Why can't I play the guitar every day, and not merely on rare whim as distraction from routine or guilt?

Because, if I start to do one of these things, I am afraid I will get depressed.

Yup, I think that's it. I'm afraid it will depress me. Doing something routine, like chores, just because I "have to"; or skilled, like learning guitar, but only because it's the scheduled time to do it; or scary but life changing, like job searching, which needs a systematic approach--doing these things edges me towards depression. It makes me feel

Lonely,

Unalive

Bored, and

Empty.

Is that strange?

Atrophy

The funk is sudden death repeated
Good days are atrophy
Where can I invigorate?

I haven't posted in a while. That's because I'm feeling pretty good. Not too much to say. Something positive happened this weekend. I was in a social situation that usually provokes an enormous amount of jealousy which, to date, always lapses into depression within a few days. But this time it didn't. I allowed myself to actual feel during the situation, to hurt, and to cry, in front of others, and it was a release.

On the downside, I can't get over this damn fatigue. I get so little done. I just don't have the energy.

Guilt and Indulgence

Andrew Solomon in The Noonday Demon (which I have only just begun reading) says "Neither blame nor indulge yourself." I do both of those very well. I sometimes wonder if it's easier in a way for non-cycling depression in that you have time to fully recover and build a life, rather than crash, recover, crash, recover with little opportunity to build anything.

I ran across the following quote on the Internet. I do not know the context but the quote seems very relevant: "To dwell in this desert and make it bloom requires that we indulge in neither guilt nor vainglorious fantasizing, but struggle to know ourselves as we are."

And I suppose that type of true knowledge, one that fully embraces all that one is capable of and contentedly leaves behind everything else, leads neither to frenetic activity nor guilt-clad passivity, but instead to fully engaged activity born out of identity and dwelling in the instance of this moment, and this, and this, and this.

crawling productivity

It seems that I can only focus on one thing at a time; only have one main goal for the day, or one main focus for a week. It seems like a "normal" person could work on all of the following within a week:

research career options
work on blog
house hunt
make gift for a friend
exercise and eat healthy
clean house, pay bills, etc.

But for me, it seems usually I can only focus on one of those things at a time. If I try to take small bites of each, I just can't focus, I can't switch gears fast enough. I end up focusing on just one thing for 1 or 2 or 3 weeks instead of slowly building each one up. The problem is everything else falls by the wayside while I focus on the one thing. Not to mention, the amount I actually get accomplished in 2 weeks seems to me just 2 days' worth. This is not in my depressed state, per say. It's my normal, which I don't think is normal.
Part of it is because I do hit depressive funks every few weeks, and it always takes time to climb out of those, so my concentration and interests shift a lot.

I . . . feel . . . so . . . slow

mental illness and cholestorol windows

There is a degree of influence we bp2s have over our moods, but we don’t have control. That’s the hard part. We're responsible for that influence portion, but have no say on where on the continuum of mental health that small window of influence lies.

For example, some people seem to have a genetic propensity for high cholesterol, so naturally their numbers will be on the upper end of the spectrum. My dad is one of these people. He eats right, he exercises, he has always been thin--this is where he is exerting his influence. But despite all the appropriate behavior modifications, he can't get his numbers down to normal. He can engage all he wants within his window of influence, but he won't effect much change. It turns out that for some people that window is just very small, and it lies on the upper end of the continuum, so change can only be effected within this small range of upper numbers.

And so it is with my illness. The window of influence over mood can seem so insignificant compared to the range along the continuum. I want to have full range of control over my moods, but instead I have only a small window within which I have any influence. So all the behavior modification in the world can only help me so much. 

My dad and I both take pills for our illnesses. His cholesterol numbers are now normal; pills offer a control that his body on its own just can't. My medications have lengthened my window of influence, and thank God for that, but it is still not sufficient, still not a full range, still not a normal life.

I think this is why it's so easy for bp2s, or any mental illness sufferer for that matter, to keep on keeping on. It seems futile when your efforts produce only a tiny change while "normal" person over here has exerted less effort to produce greater change.

But this apparently is our calling. Or lot in life. Or curse. Our challenge is to find meaning within a smaller space.

Tired

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OK, no metaphors today. I'm just IRRITATED. I've been feeling pretty good (I managed not to slip into that funk after all) and trying to get some order back in my life, Sisyphean task though it is, but the fatigue and sleepiness, ugh! I have had sleep issues for years, I have little white sleep "aids" that I use which help, but feeling rested and energetic is so rare, even when I feel good mentally. I had some physical health issues last year and the treatment left me tired. Between any residual fatigue from that and a healthy regimen of medication, along with the fact that, based on a recent sleep study, I get zero stage 3 sleep, I struggle with tiredness a lot. And that's before you even put depression into the equation.

So today I was set, I headed to the doctor for a (mildly painful) shot, then was going to head off to a coffee shop to create a plan for job hunting. But I just had to come home and crash. I was out for over two hours, till a neighbor called to invite me for afternoon coffee. So crap, day wasted. I was too tired to do much of anything else today.

I did talk myself into getting on my exercise bike for 20 paltry, limp minutes, because I know I've slacked a ton on my exercise regimen. Earlier this year when my sole main focus was exercise and weight loss, I believe it really did help my fatigue level. (And by focus, I do not mean I was an exercise addict--I've never come anywhere near thinking about considering being close to that line--it was just the one thing I HAD to do every day--everything else could wait.)

So I'm frustrated that I am too tired or sleepy much of the time even when I'm feeling well to get anything done. And I'm also frustrated that it seems I can only focus on one project at a time, to the exclusion of most everything else, and it seems that this one thing is always something that others do in their spare time. It's as if the maintenance tasks that a "normal" person would tend to in a corner of their mind, for a small portion of their time, using only a pinch of their energies, for me takes the whole of my mental focus, virtually all my productive time, and almost the whole of my energies.

structure in an open field

I try repeatedly to impose a schedule on myself. I am not currently working outside the home so there is no externally imposed structure. Which is both freeing and constricting. I shrivel under rigidity and yet find myself slipping into depression even when the field is wide open.

Because, sure, the green grass is soft beneath my feet and the sun is warm and pleasant and the flowers smell lovely and smile up at me with their multicolored lips and the breeze is like a thousand kisses on my skin.

But my feet are getting muddy and the sun is a wee bit too hot and the flowers' fragrances are cloying and kisses soon grow numb and besides that I don't know which way to run.

With aimlessness, the joy of feeling normal is subject to a creeping anxiety or a dissociation or both. Structure helps ward off either, helps me have focus and discern individual flowers to tend to, without feeling the urgency to tend to the whole sea of flowers all at once. It protects me from the freneticism that heightens my sensitivities to unbearable levels. It protects me as well against the aimlessness that simply fades the entire scene to gray and blocks out all the movement and colors and breaths.

But it's so hard to embrace it. I just want to lean back in the grass and savor.

black and white

Partly it's my Myers-Briggs personality profile (textbook ENFP for the most part) that drives me to break the world down into categories of black and white, good and bad, right and wrong. I live in the grey most of the time and that ambiguity creates a sense of eternal unfinishedness, a feeling of all-is-not-quite-right, with head cocked sideways as I introspect to sift through the grey, to parse it into black and white.

I think that's also the bipolar funk. Relationships become all good or all bad. People are either admired completely or thought of disparagingly, but no one is percieved by my depressive brain as a complex intermingling of goodness and selfishness. Which of course is the grey that is far closer to reality.

Depression Descending

I think I feel it coming on. Sometimes I don’t know until it’s there. But the flattening of the affect, the disinterest in initiating conversation, that hollow heaviness settling in my chest, pushing up against my throat, making me almost feel like crying, except I don’t feel sad. Only weighted down. 

I’m kind of glad. I’ve started seeing a therapist again, and the three times I’ve gone over the past month, I’ve been in a good mood, so I haven’t been able to articulate the depression. Because when I’m feeling good, the depressed me is so very much a stranger, one for whom I have no right to speak.