That Horrible Feeling of Being Abnormal

August 2, 2009 at 5:04 am | Posted in Sociability | Leave a comment

One of my favorite blogs right now is Mentally Interesting: The Secret Life of a Manic Depressive. In her most recent post, the author talks about two phenomena that are quite common for bipolar people: isolation, the sense of “tapping on the window” of life, and degeneration from fearless to fearful over the course of one’s life.

Unless you are very high functioning indeed, being bipolar entails a certain sense of isolation, a feeling that your thoughts and emotions are taboo and terrible, and must remain unspoken. Time after time, if you reveal how you truly think or feel, if you strip back the layer of charisma or seeming bohemian that the author discusses, others will find you both dull and repulsive. Depressive thoughts are both horrid and grindingly repetitive, and one’s past is, as she points out, hardly a comfortable topic when discussing it means admitting to long hospital stays and suicide attempts. In addition, she lives on the British equivalent of SSI, and feels deeply ashamed of that fact. I wish I could say that I would handle that with equanimity, but, in fact, when I was dependent on state benefits for my mental health care and my family for financial support, I felt that it would be downright dishonest to date or make friends — I would have had to conceal so much just to get others to accept me.

She also alludes to the sensation of going from fearless to fearful, a progression common to many bipolar people. In the early stages of the disease it can seem glamorous and interesting, particularly if you’re young upon onset. To be wildly moody and “adventurous” in one’s teens and 20’s is not just acceptable, but downright liberating to one’s more normal peers. When those qualities persist into one’s 30’s, though, they become less fascinating. An “artistic” temperament does not suit one for family life, and it is sad to see one’s once-charmed friends disappear one by one into marriage and parenthood, which can seem so painfully far off. I think of this quote from Van Gogh, a fellow sufferer: “At the height of artistic life there is, and remains, and returns time and again, a hankering after real life — ideal and unattainable” (The Letters of Van Gogh 354). As the lucky age and normalcy overtakes them, the bipolar tend, I think, to retreat behind a desperately maintained mask, and ultimately into isolation.

I want very much to keep this blog positive, so I will include some steps that might help to mitigate this condition, which is nothing short of tragic:

1. Take your meds and strive for stability. Put aside your pride and do whatever it takes to get decent health care. I’ll warn you all now: I am a huge advocate for meds. Combined with family support, they’ve saved me and given me what I have; I can’t imagine life without them. It’s taken me a long time to find an effective combination, and I still need to tweak them occasionally. I’ve put up with awful meds that made me much more miserable than I needed to be, and I’ve been over-medicated, but having found remarkable and long-lasting balance, I do believe that most manic depressives belong on medication and will need to take it all of their lives. It can take years of experimentation to find the right mix, but for me it’s a moral imperative to find that mix and cling to it. The people around you need you to find stability, and for most manic depressives, that means medication.

2. Seek out people who are both accepting and sane. These folks are rare and priceless. It’s easy to make friends with people who are as troubled as you are or have been, and much more difficult to meet people who will tolerate your oddness without sharing it. When you find a friend or family member like this, be willing to go to extraordinary lengths to cultivate the relationship — which is admittedly difficult, given our tendency to disappear during depressive episodes.

3. Likewise, avoid people who need help as badly or worse than you do. Also try to stay away from individuals who thrive on helping you at the cost of ignoring their own depression, anxiety, or mere neurosis. You need to be around people who are actively working to solve their own problems — we all have them — and who are willing to support you without needing to shove you back into the patient role when you show signs of wellness.

4. Find a therapist experienced in treating serious mental illness and pour your odd thoughts all over her. This will help you to avoid dumping on friends. If your therapist is experienced in either acceptance and commitment therapy or cognitive therapy, she should be able to teach you how to relieve some of your more persistent odd thoughts, and to live with your emotions until they pass. If not, find a different therapist.

5. Employ every wellness strategy backed by scientific evidence. Zen Habits is an excellent blog that gives very specific advice on how to make slow but real progress in changing your habits. I suggest that you read it and begin to make incremental changes in your eating, exercise, and sleep habits as needed. I will discuss strategies for change here, too, but Zen Habits is an entire blog devoted to personal development, and as such it covers specific techniques in more detail than I plan to.

6. Help your friends and family out in any way that you can so that you will discover your competence and gain balance in your relationships. Your first-degree relatives are more likely than average to suffer from depression, and you are uniquely qualified to offer support. Give it where you can without being intrusive. If you’re an artist, give them art; if you’re a poet, write them poetry. If you’re good with your hands, offer to fix things. You don’t need to be servile, but do make an active effort to help out.

7. Likewise, don’t be ashamed to ask for help when you need it. You don’t need to detail the exact contents of your head; if you simply can’t make a phone call or navigate the shameful medical system here in the U.S., don’t be afraid to delegate these tasks to people who will find them easier than you do.

8. No matter how worthless and alone you may feel, remember that your death or severe illness will impact others. When you’re deep in depression, it may seem that your actions — refusing treatment, drinking or using street drugs, attempting suicide — won’t affect an uncaring and remote world. No matter how distant you feel from others, you are closer than you know, and they will feel your actions even if you are estranged. Take responsibility for the effect that you have on others, and strive to become well for their sake, if not for your own.

In other words, stay as healthy as you can and choose your associates carefully; both will help to alleviate the isolation you feel.

It is very, very hard, but so worth the effort. Study after study shows that close relationships are necessary to mental health. They are a source of great pleasure and solace. No matter how difficult it proves, keep trying to achieve them.

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