A Letter to The New York Times about Life with a Disability

July 30, 2009 at 4:45 am | Posted in Fighting Prejudice | Leave a comment

I sent this letter to The New York Times this morning:

I agreed for the most part with your article, “Why We Must Ration Health Care.” People are horrified by the notion of rationing when it’s done on the basis of facts and conscious choice, but accept it at the hands of profit-driven insurance companies. However, I found one aspect of the article disturbing. As a person with a disability (bipolar disorder), I was revolted to see that the author would place a lower value on the lives of disabled people based on polls of people without disabilities. Contrary to the prejudices and irrational fears of their non-disabled peers, disabled people lead full, rich lives. When considering this issue, it’s important to remember the consequences of this shameful attitude in Nazi Germany, where disabled people, including the mentally ill, were among the first victims of genocide. Any decisions about the value of life with a disability should be made by the disabled, not by people with no knowledge of the reality of how we live and thrive. I support single-payer with all my heart, but I do fear this potential consequence of mere utilitarianism.

I think we need to correct these prejudices wherever we see them. Leave a comment if you have anything to add.

The Business Case for Hiring Bipolar Workers

July 30, 2009 at 4:42 am | Posted in Work Life | Leave a comment

The company I work for — a large, publicly-held engineering and manufacturing firm — places a huge emphasis on diversity. I can’t begin to tell you how many times I’ve attended a “diversity event” where speakers informed me that hiring people of diverse backgrounds “isn’t just the right thing to do — it makes good business sense.” They then try to nail the argument shut by claiming that workers of different backgrounds bring different perspectives that result in more creative problem-solving, and thus a competitive advantage.

Perhaps not surprisingly, my coworkers and I aren’t totally convinced. After all, when it comes to solving an engineering problem, does it really matter if you’re black, or female, or a Southerner, or disabled? In fact, in my own diversity talk — a 15-minute primer on how to communicate about disabilities — I don’t even try to make a business case.

Recently, though, the head of my program posed a question for me to answer in a 15-minute speech: “Why should we care about diversity? Why hire disabled people when you can hire someone who won’t require accommodations?”

Good question. Naturally I feel like I’m good at my job and deserve to keep it, but it’s a real problem for a manager. Setting aside the fact that it’s illegal to discriminate on the basis of ability, why hire a disabled (or, in my case, bipolar) candidate?

Below, find my draft of an answer.

I do believe that disabled people bring, not just a fresh perspective, but skills that their non-disabled counterparts may not have developed as fully.

1. Determination. Disabled people are tough and disciplined. They have to be. They’ve suffered the loss of a major life function — that’s the definition of disability — and gone on to lead rich, rewarding lives. This is an incredible accomplishment, one that takes, among other things, the ability to set goals and achieve them. Clearly this quality is transferable to their working lives.

2. Empathy. This may sound a little too warm and fuzzy, but we all know intuitively that high morale is crucial to the functioning of any business. Because they tend to be fair and humane, people with empathy make better bosses and coworkers. Disabled people often go through a profound grieving process when they become disabled, and this helps them to be more gentle and compassionate when others suffer a loss — the death of a parent, for example, or the slow loss of a parent to Alzheimer’s. This compassion can make all the difference when life gets in the way and people struggle at work.

3. Creativity and problem-solving skills. Some disabilities, like bipolar disorder, are thought to confer some benefits in the form of increased creativity. When you think about it, though, if you’re disabled, you face problems that require solving. My disabled friends at work have had to figure out everything from how to use a wheelchair to negotiate a world designed for people who walk, to contriving ways to ride a bicycle after having had a disabling stroke. It can take remarkable ingenuity to solve these very practical problems. Again, this skill comes in handy in the working world.

4. Needed technical talents. Twenty percent of the population will become disabled before age 65. Meanwhile, high-tech companies are scrambling to find and retain talented, experienced workers with specialty technical skills. They don’t have the luxury of rejecting any portion of that 20% just because they might require accommodations to perform essential job functions. After all, if your company doesn’t hire a gifted and disabled person, then the competition will. This necessity will only accelerate in the future, since once the stock market comes back, millions of skilled baby boomers will retire.

5. People with disabilities are still quite able. People who are not disabled tend to think that a disability such as blindness or being confined to a wheelchair condemns the sufferer to a life of relentless misery, loneliness, and complete incapacity. Secretly or openly, they believe that such a life is worth less, and is ultimately not worth living. In this article from The New York Times, the writer openly argues just that, based on a poll of people without disabilities. In fact, once you’re forced to cope serious limitations, you often begin to value your life and your many remaining abilities more than ever. You cultivate new skills; you savor what you can do rather than pining for what you can’t. And what we still can do often surprises others. People in wheelchairs and with other disabilities marry and have children, and I earned an advanced degree while in the throes of untreated bipolar disorder.

So that’s my initial stab at answering my program manager’s question. Please feel free to leave your own suggestions in the comments, or (if you’ve reached this site from my company) to email me.

Goal Progress

July 28, 2009 at 10:34 am | Posted in Goal Progress | Leave a comment

I’ve done my yoga every morning since posting my goal, by the way, and I found out from using a loan calculator that if I follow my financial plan, I will be debt-free in a mere nine months. Pretty spiffy, and a big motivation to stick with it.

How to Control (and Learn from) Compulsive Thoughts

July 28, 2009 at 10:32 am | Posted in Cognitive Problems | Leave a comment

I recently discovered — created, really — a technique for dealing with compulsive thoughts. In my experience most people with a mood disorder experience distressing, intrusive thoughts and images pretty regularly. An obvious example, and one that most people have experienced, is the impulse to jump when standing on a precipice. You don’t actually want to jump — you’re not suicidal or even depressed — but you can’t help but entertain this odd and self-destructive urge.

For bipolar or depressed people, the urges can be far stronger and more disturbing. You may have a persistent thought like, “I wish I were dead,” or, like the bipolar character in a story by Donald Antrim, you may be tormented by images of smashing your hands through a window, complete with crashing and tinkling, glass rammed into soft flesh, and blood streaming down your forearms.

Here’s the trick: any time you have one of your most persistent self-destructive thoughts, stop and ask yourself, “What am I feeling right now?” Pinpoint whether you feel anxious, humiliated, frightened, angry, or whatever. Once you’ve done this often enough, you’ll realize which emotions tend to trigger intrusive thoughts. Before I started this exercise, I believed that these thoughts reflected how I truly felt — that I really wanted to die or hurt myself. Naturally, that was upsetting. I often felt ashamed of my thoughts and afraid of them. Once I pinpointed the feelings behind each them, though, I realized that they are merely a reflex that follows from particular feelings.

It can also help to take the next step and ask yourself why you feel anxious, for example. You may have made an embarrassing error, or you may be interpreting something your partner said to mean that he doesn’t love you. Once you’ve isolated the cause, ask yourself if you can do anything concrete to take control of the situation. For instance, can you analyze why you made the mistake and come up with a plan to avoid it in the future? If you can take action, do.

If you can’t, take one final step. This one comes from David Burns’ classic of cognitive therapy, The Feeling Good Handbook. Ask yourself, How long do I intend to do penance for this event, to feel guilty or angry or frustrated? Five minutes? All day? A month? A year? If you can forgive yourself and move on tomorrow, why not just do it now? No matter how horrible the event, this can help you to realize that you needn’t suffer for it eternally.

I’ve been following this process for about a month now, and it’s really helped me to gain perspective on compulsive thoughts. In fact, it seems to be slowly rooting them out and replacing them with constructive action. I don’t do this exercise in writing, since I find that I often have bad thoughts when I’m nowhere near paper — in the bathroom, for example, or while I’m driving. It helps to write down the steps, though, and carry them with you in case you forget them in the distress of the moment.

If you try this technique, please leave a comment describing whether or not it worked. If you have your own successful system for dealing with compulsive thoughts, please share it.

Confiding in Others: How to Come Out as Bipolar

July 26, 2009 at 1:50 pm | Posted in Sociability | 1 Comment

At times, I find it tremendously difficult to tell people that I’m bipolar.

It depends on the context, of course — I actually announce it at the beginning of a work presentation that I give on communicating about disabilities. That’s always hard, and has gotten me some odd but deeply honest reactions. One gentleman told me during the Q&A that he was very surprised to find out that a functional, dynamic fellow employee was bipolar. He said that he always thought of bipolar people as “going postal.” Oh my. One supervisor said, “Oh, yes, my first husband was bipolar. He shot himself to death.” It’s hard to come up with a witty comeback to that one.

Many people share personal stories with me about spouses, friends and family members who are bipolar. They often ask how to get them to take their medication, a question for which I have no answer. (I take my medication eagerly, and can hardly remember the year or so when I refused treatment because I was afraid it would change my personality or rob me of my creativity.)

Perhaps the most common reaction, though, goes a little something like this, “You’re one of the most normal people I know,” or, “You seem normal to me.” This is a tough one. It’s hard to convey the seriousness of the disease without painting a bleak picture indeed. And when people see me acting “normally,” it’s hard for them to understand how devastating and life-changing an illness it is, and, indeed, how much I suffer daily, partly because of my efforts to seem normal.

I do have a couple of tips to share about how to come out, though Lord knows I still haven’t discovered the perfect formula.

1. Let people get to know you first. Don’t tell people on the first date, or even within the first couple of months of dating. Don’t spill it all out to new friends, or people you hope to befriend. Be extremely cautious in the workplace, because despite the Americans with Disabilities Act, you will almost certainly face discrimination. There’s a great temptation to be “totally honest,” to let people see the “real you” immediately. However, I’ve found that people are most likely to shy away from you instinctively if they haven’t had a chance to see how you function on a day-to-day basis. So give it a little time.

2. Do tell your family, lovers, and direct supervisor. Time it carefully and think it through in advance, but do come out. With people who may end up caring for you or accommodating you in the legal sense, it’s only fair to let them know.

3. Two excellent books on how to have relationship-rattling conversations are Crucial Conversations and The Dance of Intimacy. Both will help you to prepare the ground before blurting out anything you’ll regret. The first, in particular, give step-by-step instructions, and also includes this striking bit of wisdom: There is no gentle way to throw a hand grenade, and lots of things that you need to say are hand grenades to the recipient.

4. Don’t come out hoping to get a particular reaction. If you’re hankering after love and acceptance, wisdom and comfort, you probably need to step back and get a little distance. Yes, it would be nice if a potential lover, for example, responded in an informed and sympathetic manner, but chances are that they’ll say something awkward or even offensive. Their first reaction isn’t all that important; it’s the ongoing conversation that matters. And, of course, some people will simply reject you once they find out. You need to be prepared for that possibility, and not to invest too heavily in getting the “right” response.

5. Once you’ve told someone, it can be a tremendous relief to stop hiding simple acts like taking medication and visiting your shrink. Talking in a matter-of-fact way about these activities can help the other person to see the day-to-day reality rather than focusing on the possibility of the operatic drama.

6. Take responsibility for educating the other person if they are an important part of your life. Recommend books that you’ve found helpful, point them to Wikipedia, explain how your meds work and what sort of symptoms you show during and between episodes. It would be nice if everyone were enlightened and educated about the major mental illnesses, but most people aren’t. If you want someone to understand what it means to be bipolar, you will have to tell them.

7. Unless they’re offensive or invasive, answer any questions. For example, a friend recently asked me what would happen if I didn’t take my meds. I explained that, except for Klonopin, they’re all long-acting, so it would actually be several days before I began to sprout horns and a tail. I explained about withdrawal from SSRIs and antianxiolytics. It was a reasonable question, and a good conversation resulted.

Let me end with a bit of a subject change. I’ve been told that some gay and lesbian people are offended by any comparison between coming out as bipolar and coming out as gay. The reasoning goes like this: you’re comparing us to someone with a disability, therefore you’re saying that homosexuality is a disability, and unnatural and undesirable.

Hm. Well, merely by drawing an analogy, I’m not suggesting that the two are the same thing. That’s the nature of an analogy; you’re comparing two different things, not claiming that two things are identical. An analogy implies differences as well as likenesses.

Also, is it so horrible to be disabled that it’s an insult to even draw a comparison? I would argue not. In fact, there are thriving mad pride and pro-disability communities that seek acceptance in a culture that places a much lower value on our very lives. Yes, homophobia is terrible an people have been killed for for being gay. The Nazis practiced genocide on homosexuals. But the first systematic mass-killings in Nazi Germany were of disabled people, including the mentally ill. As a result, I would argue that “coming out” is not the exclusive property of the gay community.

That’s all for now. I will try to write an introductory post and an “About” page sometime today.

My Biggest Goals, and Progress Towards Them

July 25, 2009 at 9:11 pm | Posted in Goal Progress | Leave a comment

I’m pursuing two major goals right now, aside from keeping this blog. I want to pay off all of my non-mortgage debt, and I want to train to be a yoga instructor. The second goal depends on the first; if I’m debt-free, I’ll quickly be able to save up enough money to take basic yoga teacher training at the Providence Institute. Once I’ve done that, I’ll start looking for small teaching gigs. I’m leaning towards beginning with volunteer work, since many of the things I’d like to do — hold classes in psych wards and for workers who suffer from repetitive stress injuries — would probably pay little or nothing.

What do I need to do to accomplish these goals? Right now, four things:

1. I’m putting $200 per paycheck towards debt payments in addition to what I already have withheld. For the record, here’s the total of my debts: $415.92 at 12.5% on my Visa card, which I cut up in accordance with my own advice; $3,859.42 at 5.75% on my car — I got a title loan a year and a half ago to pay an enormous and unexpected tax bill. The first I should be able to knock out in a month; one of my assignments over the next week will be to run a loan calculator on the second to see how long it will take at my current rate. Then I’ll decide whether to adjust the amount I’m putting towards debt. Eventually, once I’ve paid off the debt, I’ll start shoveling all of my debt payments into saving towards tuition.

2. Tracking my spending and setting up a budget. I hate doing this, but if I don’t I suspect that I won’t find the motivation to change my spending habits enough to meet my goals.

3. Practicing yoga daily and going to a class once a week, ideally at a yoga studio where I’ve never practiced before. This has been hard. For whatever reason, I’ve been deeply reluctant to practice for months now. Once I do it, of course, I love it. But my whole reason for going public with my goals is to get a little bit of accountability started on the yoga thing.

4. Research different courses of teacher training and decide where I’d like to go. I’m leaning towards Providence, but I haven’t really explored other options thoroughly. If there’s a cheaper, quicker alternative, I might try that first, just to get started. For instance, Pima Community College might offer something that would help me to get teaching right away.

So those are my goals. Look for updates at least weekly. I think the public accountability thing will really give me the extra boost that I need to take these crucial steps.

Steps You Can Take to Improve Your Finances

July 25, 2009 at 1:20 pm | Posted in Finances, stress | Leave a comment
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It’s no secret that bipolar people often have trouble with their finances. Both depression and mania can lead to overspending. When I’m depressed, I tend to spend money in an attempt to lift my spirits; when I’m hypomanic, I do the manic-spending thing, playing ducks and drakes with any money I can lay my hands on. Even so, I’ve done a lot to keep my finances in reasonably good shape. Here are a few tips on how to structure your finances to preserve as much as possible for emergencies and retirement.

1. Educate yourself. My favorite way to learn about personal finance is to read the excellent blogs that abound on the subject. Three of the best are Get Rich Slowly, The Simple Dollar, and Queercents. I like the latter even though I’m not a lesbian; it’s great for any single person, and if I had to guess, I’d say that bipolar people have greater-than-average difficulty forming stable romantic partnerships. The first two blogs can be annoying because they assume, not only that you’re married with kids, but that your life is kind of empty and pointless if you’re single. Nonetheless, all three are great resources on everything from frugality to Roth IRAs.

Both GRS and TSD have lists of recommended books on personal finance; I suggest that you look these up and do some reading. My favorite book is Your Money or Your Life, which includes a rigorous — perhaps too rigorous — program for gaining financial independence. And the phrases “gazingus pin” and “left-handed veeblefitzer” have practically replaced “thnead” (from Dr. Seuss’ The Lorax in my vocabulary as words for consumer objects that I don’t need but desperately desire.

2. Structure your finances so that it’s difficult to get at your money. I use ING Direct for savings for two reasons: they pay a relatively high interest rate, and it takes two business days to transfer money from savings to my credit union checking account. Often just knowing that I don’t have instant access to my money keeps me from spending it on some passing whimsy. It also forces me to exercise thrift during the waiting period if I do decide to transfer money. When it comes to thrift, I need all the practice I can get.

Along these lines, I also suggest that if you have an emergency fund, keep it divided between a money market account, which is fairly liquid, and short-term CDs. If you do run into a true emergency — like being laid off — you’ll be able to scrape by while you wait for the CD to mature. If you don’t have an emergency fund, start saving immediately using automatic withdrawal (see below).

Also, take a hard look at cutting up your credit cards and closing extra credit card accounts, especially if you’ve maxed them out. Credit cards represent deadly temptation for many bipolar people who experience full-blown mania. Screw freezing them in a coffee can — just get them out of your life entirely. Closing accounts that you’ve had for a long time can ding your credit score temporarily, but that beats the damage the accounts themselves can do if you fall behind in your payments.

Finally, take advantage of automatic withdrawal. For some people, it’s an excellent way to whisk away money before you can see it, feel rich, and spend it. It’s how I saved for the down payment on my house. Just be sure that your money goes to an account at an institution like ING Direct that will make it difficult to suck that money back into checking.

3. Contribute to your 401K — it’s a nearly painless way to save money for retirement, and it will reduce your tax burden. If your employer matches it, then you’re crazy not to. Shoot for a contribution totaling 10-20% of your income. Saving for retirement is crucial when your illness might force you to stop working at any time.

4. Make every effort to purchase short- and long-term disability insurance. Given that you do have a potentially crippling illness, it will be nearly impossible to buy this on your own. If your employer offers disability insurance, then definitely opt in. Chances are, you will be unable to work at least part of the time. Plan for that.

5. If your financial situation is particularly desperate, consult 31 Days to Fix Your Finances, an excellent program offered by The Simple Dollar. If you’re carrying a lot of debt, consider buying Dave Ramsey’s Total Money Makeover, which is devoted to that topic. Be warned, though, that the techniques he describes will be very difficult to follow without carefully structuring your finances to separate you from your money. Also, the book contains religious overtones that some people find difficult to swallow. That said, it’s an excellent program that has benefited many, many people.

6. If you’ve been fired or laid off, collect unemployment. My dad, who spent much of his career working for the Arizona state unemployment office says that it’s stunning and sad how many people refuse to collect unemployment out of pride — they mistakenly believe that it’s some sort of welfare. In fact, it’s called unemployment insurance for a reason: you and your employer pay for it with every paycheck you receive. So take advantage of this crucial benefit.

7. Keep good financial, medical, and employment records. This is crucial in case you should ever be ill enough to apply for medicaid or Social Security (SSI). I will discuss the process of getting SSI in a future post. For now, know that the Social Security Administration will tax your abilities to work the system to the limit if you should ever need it. Prepare yourself in advance for that ordeal.

8. If you work for a company with more than 50 employees, find out the process for getting intermittent leave via the Family and Medical Leave Act. This is worth its weight in gold. Rather than disappear suddenly when you get sick, you can call in intermittently without having to give an excuse. FMLA is unpaid, but it beats getting fired.

I’ll try to write a general introduction later. For now, think about setting aside a weekend day to prioritize these steps and implement at least one or two.

Actions You Can Take to Relieve Stress and Avoid an Unpleasant Episode

July 24, 2009 at 11:18 am | Posted in stress | Leave a comment
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It’s hard enough being bipolar.  If you’re like me, you have a demented drill instructor howling in your head most of your waking hours, and you feel like you must resist at all costs — even if resisting means lying very still and staring at the wall.

So what do you do when extra stress comes blasting at you?  Say you’ve broken off a long relationship (or been dumped), you’re under grinding deadline pressure at work, or God forbid and God help you, you’ve lost your job entirely.  What can you do to keep yourself from spiraling out of control when life gets really rough?

Here’s what’s worked for me in the past.  I don’t take these steps as often as I should, but when I do they help every time.

1.  Exercise.  It’s best if you can do something rigorous that’s both mentally and physically absorbing.  For me, bushwhacking and rock climbing can really help.  With the former, there’s the loveliness of nature; with the latter, if I don’t pay attention, I’ll fall (do rope in, unless you’re really determined to die with your boots on).  If you haven’t got the time (and who does when you’re working 12-hour days over some damn work crisis), then make time for small, mild bursts.  When I’m getting schizy at work, I often take a 15 minute break just to walk around briskly.

If you doubt my advice, read John J. Ratey’s book Spark — it will persuade you that moving your body really can change you intellectually, spiritually and emotionally.

2.  Take a yoga class.  I have a daily yoga practice at home, but there’s nothing like showing up in a lovely, lavender-scented studio with hardwood floors and just dong what the nice instructor tells you.  In my experience, there’s no high to equal it.  Yoga will remove you from your problems long enough for you to rejuvenate yourself and get some perspective on that lost relationship or job.  It will put you in touch with a higher self that transcends even great losses.

Again, what if there’s no time, or no yoga studio nearby?  Then get a book or video and practice on your own.  I swear by three books: Cyndi Lee’s Om Yoga will benefit both beginning and intermediate yogis, and is portable enough to take with you anywhere. Her excellent Yoga Body, Buddha Mind will take you up to advanced practice. The Yoga Bible includes everything from restorative postures to exotic balances. This book works better if you have a regular practice and are looking to shake things up by trying something like Scorpion that you never thought they could do.

As with other forms of exercise, some is better than nothing.  I like to do cowhead pose and reverse anjali mudra at my desk, which may be part of the reason why my office mate is on to my madness.

3. Orient yourself to the present. Notice five things you can see, five things you can hear, and five things you can feel. These things don’t have to be beautiful or exotic. Just focus on an icon on your computer screen or your pencil holder and really see it. Then tune into the tiny noises around you: the humming of the air conditioning, or the friction between your pant legs if you’re walking. Then become conscious of the air against your skin — is it warm or cool? Or notice the sensation of your watch around your wrist. The point is not to judge — I’m miserably hot, or God, that chattering bitch in the next cube bugs me, or even, what a grand saguaro cactus — instead, you’re just trying to jar yourself loose from your worries about the future and regrets about the past, and to exist in the present, even just for a moment.

4. Do something absorbing. Get engaged in work or play that has the potential to bring about a flow state. This is not busy work or any activity that you can do while brooding. No, this is something that will give you a sense of mastery while stretching your abilities. Only you know which activities work for you. Many people find flow in simple activities like driving and sex, or more complex activities like practicing a musical instrument or creating art. The point is to get outside of your miserable self and shift your attention to something external that you love.

5. Take a nap. Sometimes, when all else fails, I just take a 30-60 minute nap, and about 50 percent of the time, that just seems to push my reset button and improve my mood. Set a timer to make sure that you don’t just spend half an hour staring at the wall thinking of your own inadequacies. If you haven’t slept after 20 minutes, then it’s probably time to get up and try something else.

6. Purge stuff. For whatever reason, it really lifts my spirits to just sort through a desk drawer and toss old files, broken office equipment, and grungy sticky notes covered with old reminders. Like many bipolar people, I tend to accumulate things a bit compulsively, and it’s a great exercise to go through and get rid of anything that you’ll never use, or that holds negative associations. It’s a sign of the times that there are probably hundreds of books on how to shed your stuff, but I like Clear Your Clutter with Feng Shui. It appeals to my hokey, new age side.

7. Stick to a regular sleep schedule and get a minimum of eight hours. This is critical if you’re bipolar. For Christ’s sake, don’t make my constant mistake and try to trigger hypomania by shorting yourself on sleep.

A note of caution: many of these activities will seem impossible if you’re depressed. If you are, you’ll need to take much smaller baby steps towards positive mental states. Any of these can help if you’re willing to start very, very small — say, a single yoga pose, or a five-minute walk up and down the office hallway. For times when you’re truly down, I highly recommend Get It Done When You’re Depressed, a brilliant little book written by a woman who’s been there.

That’s all for now. I’ll save the formal introductions for later.

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