Category Archives: Nurses with mental illness

Bipolar Disorder, My Biggest Competitor

For those of you out there who have mental illness, like I do, this article will interest you. My greatest lament since I have been disabled is, “I used to be an ICU nurse, and I was good at it!” As if that means that now I am nothing. I know I am not “nothing,” and if I would quit lingering in the past I might get somewhere! Former Olympian Amy Gamble (photo, above) talks about a similar issue.

Shedding Light on Mental Illness

It’s no secret that I have struggled with bipolar disorder for several years. What may be less known is that I have also fought hard to overcome numerous setbacks and personal losses as a result of my illness. I don’t like that I have had to deal with an illness as cruel as bipolar disorder can be, but the more I focus on how unfair it is the less time I have to live a full life.

I know for sure I am not the only person who has suffered because of bipolar disorder. There are many kindred spirits out there who can relate. So I dedicate this post to all of you reading, looking for some words that may bring peace to your heart.

You see, I know a great deal about believing in the American Dream and living that dream to some extent. I also know first hand…

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Who am I? Blogging 101

I’m taking an online “course” on blogging and the first assignment is:  “write and publish a ‘who I am and why I’m here’ post.” If you’re going to read this, you will want to pour a cup of coffee and maybe get something to eat, because it is long.

All my life I have written this post (book) in my head and found it fascinating. I always thought I’d write an autobiography and sell it for millions. Who wouldn’t want to read it?

But now, I don’t even want to write it. What I once found fascinating about myself is either untrue or unremarkable. But, I’ll start it the way I always started it:  “I was born in New York …”

First fascinating fact. But really, it wasn’t “New York, New York,” it was upstate New York, and I only lived there til I was 6. 7. 8. I don’t know. First grade?

Then there is the what. For a time I was in therapy and had come to the conclusion that I’d been severely sexually abused, and in a Satanic cult.

Now I am not so convinced of that. I know some inappropriate touching went on, but pretty sure the rest of what I thought was the result of an overeager therapist who had her own agenda.

So where does that leave me?

Decidedly ordinary, is what.

But.

Well, let’s go back. I was very ordinary in grade school/ high school. Pretty much invisible. I almost wonder, if I’d been bullied, if it would have hurt less.

I did have some friends, fairly ordinary like me, and I know I would not have survived without them. My parents’ divorce. My inability to fit in. I did find a way to fit in. Alcohol fit the bill nicely.

So then! Post high school, I needed a job. Mom told me about a nurses’ aide training course. I really didn’t want to do it; I’d already done some candy striping (volunteering in the hospital), and wound up in the cafeteria and the laundry room. GLAMM-orous. I did not like the smells in the hospital, for sure. That smell of starch is still embedded in my brain. I suppose that is a better smell than the ones I smelled later.

But anyway, back to the training course. I’d already had two jobs in food service: one at McDonald’s, one at Howard Johnson’s as a counter girl. Both thankless – how could people be so rude? It was like they took everything out on you, and it wasn’t like you were getting paid enough to have to put up with that …

So I decided to take the course. It was very thorough and came with a guaranteed job at the end. They promised me I’d be on nights for only a little while, to cover someone else who was on leave. But I’d definitely go on day shift soon!

Well “soon” happened and I didn’t get changed to the day shift, so I took another job at a nursing home down the street.

I was never very efficient. I struggled as an aide to do the job. The time frame we had to work under was just about impossible. Some of the aides had time to set their patients’ hair and put jewelry on them. Not me! I was lucky just to keep them clean.

But at the same time, I took note of the nurses passing pills, in their starched (there’s that word again) white uniforms. I thought, I want to know why they do what they do? What are all those pills for? I decided to apply for nursing school, and got in to my second choice. In the end I was glad I didn’t get the first choice, which was a university program which did not offer much in the way of actual clinical patient care. My diploma program was more hands-on, and I was thankful for that.

But scared to death at the same time. I found out while in school that I had a familial tremor (think Katharine Hepburn) and hypoglycemia (think insulin shock, minus the insulin). You should have seen me trying to pull up medications into a syringe – let’s just say I didn’t have to shake the vial. I was terrified of the instructors, terrified of making a mistake. Somehow I made it through and did really well. Hardly even had to study, which I think was part of my confidence problem later on. I could cram for an exam and forget what I’d studied immediately after it.

I’d already had lots of practice with alcohol toward the end of my high school years, but perfected those skills while in nursing school. The skill of chasing boys, as well, since alcohol loosened my inhibitions. It was nice not to be invisible. That liquid courage …

But after nursing school, it became problematic. I was date-raped twice while under the influence. I was having blackouts. My “familial” tremors worsened after a night of drinking (hmm). Meanwhile I was really succeeding as a nurse, training to work in intensive care. What happened to the girl who was so afraid of failure? Still terrified, but alcohol helped me bury my fears.

After the second rape, I became more aware of my depression. I remember one night sitting on the porch steps thinking about how to take my life. Got up, drank some beers, and stifled that urge.

Soon after that I started going to Al-anon meetings, some of them especially for children of alcoholics. I don’t need to go into my family history, just, that’s what I needed to do. Out of principle I quit drinking. I had righteous indignation (“I’m not like them!”) to power my sobriety.

I also had gone on the Atkins diet and it was then I experienced my first hypomanic episode. I had no idea what was going on but I liked that feeling of power! More confidence, better recall of nursing knowledge, a superiority complex. And a feeling of being so sexy and irresistible! Did I tell you I liked it?

And then the depression came back, and worsened, and because I had stopped drinking I no longer had the liquid courage to get me through. I had started counseling, but when she’d asked me about suicidal thoughts, I’d said no. I made a plan to kill myself with razor blades and carried it out. At the last moment, when I know would have crossed over into death, I told God, “I want to die, but I don’t want to go to Hell!” Somehow I woke up in the bathtub 6 hours later, covered in blood and feces. I knew my attempt had failed, and I knew it was because of that prayer. I crawled to the phone and asked for help.

I wound up in a psychiatric unit where they started me on antidepressants. Very soon after that I began to experience the euphoria I’d had before, only bigger! I felt like I could leap tall buildings in a single bound, like I could read minds (I was sure!) and like I could personally talk to God in the sky. The sun was His all-powerful eye. I was Mary the mother of Jesus who had been raped by God and thus conceived her Son. The smoke alarms went off one day and I was sure that was because I had started a fire somewhere with my rage.

I remember my mother coming in to help me pay bills, and I had to have my Walkman playing in my ears in order to shut my brain off to concentrate. The doctors started quizzing me about my visitors, whether they had brought drugs in. When I told them about the ex-boyfriend and how we had smoked pot, they nodded their heads. It had to have been the pot, then, that made me go kablooey. It never occurred to them that their drugs and my dysfunctional brain had caused the mania and the delusions.

Eventually the mania simmered down, the antidepressant having been replaced with some other medication. I was still having brief episodes but had a prn (“as often as necessary”) medication which helped a lot.

I remember my father coming in to visit and that I started crying on purpose, just to make him feel bad. I was all about “it’s everyone’s fault,” and nowhere near to looking at myself. I was discharged with a diagnosis of depression.

I continued going to Al-anon, but I was also going to AA now because I had figured out the role alcohol had played in my life. I met my son’s father and we won’t go into that. Suffice it to say that between my inability to say no, and my lack of self-esteem, it did not take much for him to bowl me over.

After I gave birth to our son by C-section, the doctor ordered Tylenol #3 (regular Tylenol, plus codeine). I felt that euphoria beginning, and I got scared, and took myself off it. I was scared that I could hurt my son if I was under that kind of influence.

I was not a great mother. For one thing, I was with a man who seemed to thrive on rage (and later I found out was drinking). I stayed with him a lot longer than I should have. For another thing, I struggled a lot with depression, and my son’s days with me should have been filled with a lot more joy than I could muster. My work history was sketchy. At one point we lived in a transitional housing program which helped tremendously, but it was no match for my depressions and my continuing to choose, shall we say, men with problems.

I kept trying to get back to church, having been raised Catholic, but it just did not fit, nor did it fix anything, and that’s what I was looking for: a fix. I was hospitalized in a psychiatric hospital several times, both inpatient and outpatient.

I did eventually find a Christian church (non-denominational) and “got saved,” and by that I mean I raised my hand when the preacher asked who wanted to get saved. My understanding was that I was a sinner, and of that I had no doubt. I knew that Jesus died for sinners, to take our sin upon Himself, He who knew no sin!

For when we were yet without strength, in due time Christ died for the ungodly.  For scarcely for a righteous man will one die : yet peradventure for a good man some would even dare to die.  But God commendeth his love toward us, in that, while we were yet sinners, Christ died for us.  Much more then, being now justified by his blood, we shall be saved from wrath through him. — Romans 5:6-9

And so I knew I was a sinner, I knew I needed a Saviour from the wrath of God. I asked Jesus to “come into my heart” and save me.

I had another major manic episode, can’t remember any specific triggers, but again I was hospitalized. It became clear to me almost immediately that though I had accepted Christ as my Saviour, I’d never “deigned” to have Him as my Lord. And that meant following the Bible. I surrendered at that time, telling God that if He wanted to use me in that psychiatric hospital for the rest of my life, that was fine with me. But I wanted him to use me, wherever He might want me to be. I was rather surprised to find that I was discharged and I have never been hospitalized since. I started going to a church in ’06 that teaches from the Bible. It’s a lot more fundamentalist than the other church, and I believe it’s where God wants me to be right now.

That doesn’t mean I’ve been well this whole time. I have still struggled with depression and hypomania, still struggled to maintain my ability to work. In fact, presently I am “retired” from even doing a cashier job. It was too overwhelming to me. It’s very sad that as time has gone on I have become less and less able to function as a “normal” human being. I have been on disability for several years, but I have a hard time accepting that. I am very involved with my church, and it seems that doing volunteer work for God does not stress me in the same way. I do have to be careful not to overdo. Sometimes it is my guilt that makes me take on too much. Guilt for being mentally ill, guilt for not earning my keep. My counselor has said more than once that if I didn’t feel so guilty,  if I wasn’t so much in denial of having a mental illness, I could probably have a happy life and function better. I think he is right, but it is hard to just erase that voice in my head that says I am bad, and wrong, and lazy, etc.

My dream? If I had no shame for who I am, if I truly celebrated those gifts that God has given me, and used them only as much as He desired, I’d be a working novelist. I wouldn’t just dabble and play at it. I’m good at it, really. I also do have Spiritual gifts of mercy and hospitality, gifts He has given me to use for Him, but not for my ego, and not to be used under my own power. I used to dream of having a big foster home, with horses, and a long haired husband (lol). Now I just dream of being able to function, without feeling like I’m not enough.

 

And so I come to the real answer to the question:”Who Am I?” I leave you with this song by Casting Crowns:

A lot to be said for courage …

I’d say that, as people with bipolar, one of the most difficult things we have to face is fear. We fear ramping up, we fear getting down, after a little experience with this thing we’re afraid to even feel happy, in case it’s a symptom! What’s wrong with having a little joy, for Pete’s sake! Well, because it’s gotten us into trouble sometimes.

But we also do develop a lot of strength after a while. We have to! We have to have a thick skin to tolerate all the extra lengths we have to go to to stay healthy! In my case, to deal with some of the strange looks I get, how about you? Lol…

I love words, you’ll get to know that about me if you follow me for very long. And there is something about the word courage that is really interesting to me. The online etymology (word root) website says regarding the word:
:courage (n.) Look up courage at Dictionary.comc.1300, from Old French corage (12c., Modern French courage) “heart, innermost feelings; temper,” from Vulgar Latin *coraticum (source of Italian coraggio, Spanishcoraje), from Latin cor “heart” (see heart) which remains a common metaphor for inner strength.

In Middle English, used broadly for “what is in one’s mind or thoughts,” hence “bravery,” but also “wrath, pride, confidence, lustiness,” or any sort of inclination. Replaced Old English ellen, which also meant “zeal, strength.”

The French word for “heart” is “le coeur.”

So basically, when someone tells us to “take heart,” they’re telling us, “be courageous!” Like the cowardly lion:

Cowardly Lion: Courage! What makes a king out of a slave? Courage! What makes the flag on the mast to wave? Courage! What makes the elephant charge his tusk in the misty mist, or the dusky dusk? What makes the muskrat guard his musk? Courage! What makes the sphinx the seventh wonder? Courage! What makes the dawn come up like thunder? Courage! What makes the Hottentot so hot? What puts the “ape” in apricot? What have they got that I ain’t got?
Dorothy, Scarecrow, Tin Woodsman: Courage!
Cowardly Lion: You can say that again! Huh?

I always did have a “heart” for that lion. That little song of his:

If I were King of the Forest, Not queen, not duke, not prince.
My regal robes of the forest, would be satin, not cotton, not chintz.
I’d command each thing, be it fish or fowl.
With a woof and a woof and a royal growl – woof.
As I’d click my heel, all the trees would kneel.
And the mountains bow and the bulls kowtow.
And the sparrow would take wing – If I – If I – were King!
Each rabbit would show respect to me.
The chipmunks genuflect to me.
Though my tail would lash, I would show compash
For every underling!
If I – If I – were King!
Just King!
http://www.metrolyrics.com/if-i-were-king-of-the-forest-lyrics-wizard-of-oz.html

But we don’t need to be King – we have a King! Do you know there are 365 different references to “Fear not” in the Bible? I read that somewhere. I believe it’s true (I’ll back it up later lol). This one here is one of my favorites, and helps me to “Fear Not”:

Psalm 31:24 KJV

Be of good courage , and he shall strengthen your heart, all ye that hope in the LORD.
What I love about that is it reminds me that God strengthens my heart! Not me all by my own bitty lonesome. He will help me and make my heart strong! Because that’s what’s wrong with me, when I fear. And that’s what gets broken and torn apart – my heart! So, take heart! Do you realize what all we have survived already? And we don’t have to do it alone, oh thank God! I thank God for those of you who’ve been there, who share with me!
And of course, I thank God for God. I don’t think I’d be here if it weren’t for Him…

Land of Confusion Part Deux

Maya God is not the author of confusion

 

This picture was the first thing I saw on my facebook this morning, so perhaps I am doing something right. The last line of my first blog was:

1 Corinthians 14:33 KJV, “For God is not the author of confusion, but of peace, as in all churches of the saints.”

So I kind of wonder if this is God’s way of confirming that I’m doing something right.

 

(Continuing from the description in part one)
This time the car veers sharply to the right, into a ditch, and halfway into a field. The car stalls out and will not start up again. Dust is flying around in front of the headlights, a la “Back to the Future,” like a mysterious fog. Or is that the engine smoking? I throw open the car door and leap out,.thinking the car might explode. Then, forgetting about the danger, I panic at the next thought. Wasn’t my son in the car? Did I just hit him? I throw myself to the ground, trying to see under the car. Where is he? Then I remember. He’s at work and his father is picking him up.

Relieved, and catching my breath, I notice there are lights on at the house across the street. It looks like there may be a party going on. I cross the road, hearing multiple voices, some of which are familiar to me. They’re waiting for me behind the house! It’s the marriage supper of the Lamb! I begin to run toward them, nearly falling on my face. I hear Todd, a man from the church I’d attended before. I hear the pastor of the church I now attend. I run behind the house, excited beyond belief. I am stunned when I reach the back patio and find that no one is there.

I go around to the front of the house and knock on the door. A man answers the door, and I beg to use the phone to call my son, a friend, anyone. While I am using his cell phone, he appears to be doing something. He seems rather nervous. I notice a strong smell of pot. It overwhelms me and I am afraid. I had never considered that I could be in danger by knocking on a stranger’s door. I thank the man for his help and leave quickly, thinking he could have a knife or something behind his back. I start back to the car and see that there is a police car and an ambulance parked behind it. I wonder why they are there. I begin to cry, relieved that once again I am safe from harm. As I ride to the hospital, the ambulance attendant’s voice alternates between Todd’s voice and the pastor’s. The attendant prays with me at my request, and I start crying afresh.

Hallucinations (experiencing things that are not real through the five senses) and delusions (holding beliefs that are not true) are often experienced in the manic phases of bipolar. You can see in the example above that I was hearing, seeing, and thinking things that seemed real to me at the time. During another episode, I believed that I was Mary, Jesus’ mother. God was speaking to me personally from out of the clouds. The clouds undulated and had colors, shapes, and very realistic human features. No one could have convinced me these things were not real.

After the car incident, I was in a psychiatric hospital for the better part of a month. The psychiatric hospital, to me, is a safe place that I know will bring me back to health. Whenever I’ve landed there, I’ve always known it was for my good. I don’t know why I have never fought it. I suppose it’s because by that point what’s going on with me is not fun. Besides, the staff is nice, the food is good, my needs are met, my medications are managed, and in short order I’m usually able to return home and care for myself. The hardest part, I think, is the long wait in the emergency room before one is transferred to the facility.

One area of patient care that can be neglected is spirituality. In the emergency room one time, I was (I think) acting in a safe manner, but really needing spiritual help. A chaplain was called, and I asked him to pray with me for a little while as I was waiting to be seen. The best he could come up with was a pat on the shoulder every few minutes and a “there, there.” I kept telling him, “No, I need you to pray with me, say a prayer.” I grew desperate and frustrated that he wouldn’t listen to me. How could a person wearing a priest’s collar in a religious facility not pray with someone who obviously needed it? I had the impression that he was afraid of me. He could not make eye contact at all. And I’m pretty sure I was not doing anything inappropriate that would give him pause.

There are different modalities of treatment used in the hospital once a person is admitted. Besides the locked door, medication, and adequately trained staff, there is an individualized treatment plan to meet the patient’s needs. I have a social worker who coordinates my therapies: group meetings, a psychiatrist who sees and evaluates me daily, different kinds of recreation, and occupational therapy. There is very little free time. Inevitably there is a patient or two with whom I can relate. There is nothing like a friend who knows what you are going through who can commiserate. Again, I have found that spiritual needs are not addressed. Other than that, the treatment provided helps me to develop skills I can use on the “outside.”

Funny, that term “on the outside” is reminiscent of prison vocabulary! And I suppose that is one reason some patients object to being put in the hospital. Some are admitted against their will, once it’s determined that they are a danger to themselves or others. Once there, a patient has few choices. They cannot leave the building unsupervised and without being approved to do so. The doors are locked, and if a person becomes violent, they are restrained and placed in a padded room. But all of the above is for their safety. They may react to these interventions with anger, yelling and even throwing things. That is the one thing that’s difficult for me when I’m in the hospital. I react very strongly to loud noises and anger, and some patients who are ill do act out angrily and I feel threatened. But the staff is trained to deal with that and can usually keep everyone safe.

There are patient advocates in most communities who actively work on passing legislation to protect patients’ rights. These rights must be respected whether a person is in the hospital, and/or when law enforcement becomes involved on the outside. I agree that patients should not be restrained or medicated unnecessarily, but there are times when this is necessary. This will protect them, other patients, and the staff, who have a right to be safe as well. In fact, I briefly worked as a nurse in a combination psychiatric and chemical dependency unit. I enjoyed it tremendously, but there were times that I felt very threatened. I also had to take care of people who were on the wrong side of the law, including pedophiles, and it really traumatized me sometimes. The final straw was the time I was standing between two patients who were about to come to blows. I tried to intervene by talking them out of it, and one punched the other in the nose, right above my head (yes, I am vertically challenged, lol).

There are times, I know, when law enforcement or staff overreacts to a person having symptoms of mental illness when they are a threat to themselves or others. Advanced training is continually enabling them to work with the mentally ill, to be more sensitive to our issues, and to better know how to help us. Certainly there is a lot more to learn, and the care of those with mental illness can be improved all the time.

 

In the next blog I will be talking a bit about the effect of psychiatric disorders on family and friends, and also about the importance of having support when you have a mental illness.

 

PS: This image was on my Facebook after I finished this blog entry. Doo doo doo doo …

 God is the author

Land of Confusion

     The lights of the city are mere streaks of color. At the moment, I have no idea I’m in trouble. Every thought I’m having is brilliant. Every word, succinct. My mind is well-oiled, superior, efficient. Part of me is irritated at having to pay attention to the road, as I chase squirrels in my mind, enchanted with myself. Why can’t I feel this way all the time? If only I could write all of this down, I mutter, my fingers itching for a pen. Must remember. Remember what? I’ve forgotten already.

     On the car radio, Carrie Underwood is singing “Jesus Take The Wheel.” I sing along for a while, then cock my head. “You mean it, Lord? You want me to let go?” Of course! Why didn’t I see it before! What freedom to trust God! I slowly let go of the steering wheel, my hands hovering an inch above it, not quite daring to put them in my lap. I smile knowingly, honored by this test. Whatever happens is fine by me. God knows best. 

     Gradually, the car drifts to the right. The dirt crunches beneath the tires and the car rolls slowly to a stop. I smile. See? Nothing happened. I knew I could trust God. He kept me safe. I beam, humbled by His love. But I must not underestimate myself! Oh, the things that I can do!

     I pull the car back onto the road. The sky is blacker than ink. I don’t know where I am. But it doesn’t matter. God will take me where He wants me to go. Humming, I proceed down the winding road, oblivious to the speed limit, and let go of the wheel …

     What’s described above happened to me in 2006, one of several manic episodes I’ve had. About 2.6 percent of American adults suffer from bipolar disorder, characterized by periods of mania and depression. 1 in 4 adults have a mental illness of some sort. That means that if you’re in a room with 3 other people, and they’re ok, you’re the one.

      Ok, so that’s not funny, but you get the idea.

     Most people know that Robin Williams died by hanging on August 11, 2014. I suspect that he had bipolar illness; the highs and lows of his life seemed only to confirm my suspicions. It was interesting, over the next few days, to hear the various comments people made about why he did it. What he was thinking. And how selfish of him to do it. How people could know such intimate details I have no idea, but they were saying it. And then going on with their lives,  unaffected.

      But a number of my friends and I found ourselves comforting each other. It was as if one of our own had lost the battle. I have lost dear ones to mental illness, and said nothing, out of shame, or wanting to protect them. There are lots of euphemisms that can be used on a death certificate. But those close to them probably know the true cause of death. And yet, I said nothing about the disease, about my own struggle. I protected myself, but I also protected the illness. In a way, I contributed to its power, by saying nothing.

 

     I’ve had it better than some, I know. At one point I thought I’d live out the rest of my days in an institution. At other times I’ve been “this close” to being homeless.  But I’ve also been able to work as a nurse, raise a great kid, enjoy many aspects of life.

 

     In the past I have admitted freely, to anyone who will listen, that I’m alcoholic, that I have depression, that I suffer from anxiety. But to tell them I have bipolar is to risk rejection, misunderstanding, even mistrust. And I like being able to function in society without prejudice.

 

     However, I wonder if some of my anxiety is because I’ve hidden this part of me.

 

     So, again, my fingers are itching for a pen, a keyboard, a way to explain. And maybe, to help someone.

 

   And I’ll definitely be talking about God. Because God is not a delusion, nor the author of confusion …  He is my Rock, and the only reason, I believe, that I’m still here. He’s given me work to do, and one of these jobs is to help others who may be limping along. We may be doing a 3-legged race sometimes, but we’re still moving forward. Just keep breathing, and don’t quit.

 1 Corinthians 14:33, “For God is not the author of confusion, but of peace, as in all churches of the saints.”
 
 

You wait in darkness
For answers that you can’t see
You know what you deserve and
You’re wondering why your life is
Not what you thought it should be
When the night breaks, your heart still aches
How can you face the day, you just

Keep breathing, you’ll make it
Don’t give in, you’re not done yet
Sometimes all that you can do is
Keep breathing and believing
Don’t let go, just hang on tighter, a little longer
When you feel like you’re dying
Keep breathing

When every moment
Is almost more than you can take
You’ve got to know some tomorrow
Will bring you a breakthrough
That’s the reason why
You’ve got to get through today
When the night’s gone, you will be strong

Keep breathing, you’ll make it
Don’t give in, you’re not done yet
Sometimes all that you can do is
Keep breathing and believing
Don’t let go, just hang on tighter, a little longer
When you feel like you’re dying.
With every breath you bring in hope
You’re letting go of all your doubt
When nothing is easy, you’ve got to keep going
Even when you don’t know how
You don’t have to know how, no

Keep breathing, you’ll make it
And don’t give in, you’re not done yet
Sometimes all that you can do is
Keep breathing and believing
And don’t let go, just hang on tighter, a little longer
When you feel like you’re dying
And keep breathing.

Don’t give up,
Cause you are not done yet

And keep breathing

From “Keep Breathing” by Kerri Roberts