Weird feelings – is this ‘relief’?

I am feeling weird, buzzing, a bit strange, somewhat difficult to explain.  This week was really busy, productive, with some significant developments. Also, I’ve had trouble sleeping and thoughts racing a little faster than usual.  Actually, although this strange feeling feels positive, it’s also a little unsettling and worried me slightly.  I spoke to a close friend who gave me some perspective. It could that since I’ve been highly stressed for some time, when the stress lessens, even slightly, there is natural tendency to feel pleasant, but possibly unfamiliar release of emotions.

As I tried to explain to Dyane in a reply to her comment, I guess the best way to describe it, is that the events of the last few days seem to be aligning in a very positive way. It’s by no means been easy, but there is a significant shift between my wife and me in dealing with our difficulties. Using a fishing analogy, it’s like I’ve been tugging on our fishing line with the hook snagged on a rock, then suddenly it breaks free and I can wind in the line again (feeling progress, growth, healing).

In the last few days I discovered a new blog by a woman with bipolar disorder, who offers life coaching services, I stumbled across standupformentalhealth (reminder for importance of laughter), my wife and me saw a musical with intense mental health themes, especially relating to stigma (will post more about this too soon) and I was referred to Vic’s blog, which has some excellent old posts by a guy dealing with usual challenges of life with a bipolar wife, which is exactly what I needed (a partner’s perspective).

All of this overwhelmed me somewhat, making it difficult to find the time to write.  But I finally did it.  Please comment or ask questions & stay tuned for more developments…

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Rollercoasters

Tags

Bipolar Disorder, Denial, Depression, Relationship, rollercoaster

I never enjoyed rollercoasters as a kid… and I still don’t.  That feeling of your stomach being in your throat is not pleasant for me.  I am starting to have a similar feeling at the moment, as I ride with my wife’s mood changes.  After a relatively short 2-3 weeks depression crash, with daily functioning virtually zero, my wife has gradually crawled back over 1-2 weeks, probably assisted by the lamictal / venlafaxine combination that she restarted.  I am very thankful for the improvement, but I am naturally monitoring that the she doesn’t fly too high, especially with the antidepressant effects.  I find this such a difficult situation – if I express concerns for potential hypomania signs, it seems like I’m complaining.  Last year, she expressed this frustration like this: “You’re worried when I’m depressed and you complain when I’m happy, you’re never satisfied!”

As I sat down to write this post, I noticed recent discussions on PsychCentral forums about ‘normal periods’ and ‘hypomania after depression’ – HOW APPROPRIATE!  As my wife comes out of the recent depression, she seems to be tending towards the creative, but irritable hypomanic mood that I noticed few a few weeks before this crash.  Daily functioning has improved significantly, but she tends to become highly focussed on one thing, while neglecting other important things in her life, such as kids, physical exercise or household chores.  This has been a long standing challenge for her, which she struggles with even more when the hypomanic mood creeps up.

Interestingly, when I thought about the question of whether it’s possible to find a ‘normal’ mood state, the idea of a rollercoaster came to mind.  Is a rollercoaster ever truly travelling on an even (normal) level, not going up or down?  Maybe at beginning of the ride and at the end of the ride. Similarly, I think, it could be the same with life: babies and extreme elderly at end of life don’t seem to have huge mood fluctuations, but every stage in between seems to involve fluctuating moods.  Obviously, in bipolar disorder, it’s usually the intensity (and occasionally the frequency), of these mood swings that cause such difficulty.

Praying things will stabilize and we will find balance in all areas of our life soon.

Blog triggering suggestions, please?

Over the weekend, my wife admitted that she briefed looked for this blog site last week, but gave up after not finding anything when searching for “Bittersweet”.  This was a suprising disclosure, since it showed that she was still thinking about the ‘condition’, despite the agreement to have a break from talking about it.  This led to an interesting discussion, in which I shared some of the insightful comments I have received from readers and some of the words of support that have been extremely helpful (Thank you everyone).  The chat was constructive, non-threatening and cozy, as I shared how this blog was an example of the work that I am doing to help myself and our family to navigate through this challenge.

My wife clarified that she doesn’t think she’s ready yet to read this blog – I fully agree.  After seeing warnings on other blogs, that content may possibly trigger strong reactions, even severe episodes, I think our situation needs to be a little more stable.  Also, I emphasized that it would be recommended to read the blog together with me and also have therapy session scheduled for same or next day, to help process any intense feelings.  Does anyone have any other suggestions to be better prepared, before my wife decides to read this blog?

For example, my wife inferred that it might upset her to see the word “bipolar” in my blog posts, so I jokingly said that I could change the word ‘bipolar’ to ‘PTSD’ everywhere that it appeared.  That might be a bit confusing if I did that, especially for the last sentence I just wrote!  But seriously, at this stage, I am not so fixed on my wife accepting that we are dealing with that specific ‘condition’, however closely it may explain the challenges we have been facing, but rather that we focus on general self awareness about mood changes, and its effect on our relationship, family dynamics and her general daily functioning.

My wife reluctance to accept that particular label, while somewhat understandable, has not been fully explained.  She has expressed ideas like “What if it’s not really bipolar”, which happened to be exactly the title of a recent post by one of my new blogasphere friends, BipolarFirst.  This blogger has her own unique way of expressing herself, sometimes her written posts errily sound like they’ve been recorded word-for-word from what my wife has said to me!

Blog going public

It’s been about a month since I started blogging consistently – it’s been a wild ride.  There are muliple motivations here: initially, the goal was simply to help clarify my thoughts and feeling in dealing with this difficult, unsettled period.  Secondly, I hope this outlet will assist my wife and me work together on the problems we are facing and receive support and guidance from others who have been through similar challenges.  Once our situation stabilizes, I am hopeful that we might be able to use our experiences to help others through this blog, but first “place the oxygen mask on yourself”, right??

The response to my attempts to publicize my blog have been incredible and very revealing.  I have been told I am too ‘scientific’, that I should do personal therapy, spirual obsessions and doubts are common in depression, ultimatums are sometimes required and mindfulness is something I may have been neglecting.  Actually, there were many, many more insights shared, by a number of readers, sometimes with comments that were longer than my blog posts!  I am really blown away by how relevant and helpful this feedback has been.  I look forward to receiving more feedback and suggestions, as the blog becomes known more widely.

So here’s where we holding at the moment. As self awareness of the likelihood of have a condition developed a couple weeks ago, my wife spent a few days intensely researching websites and videos explaining bipolar disorder II, as well as other related conditions.  We read some sections from a few books and talked, sometimes argued, but mostly it was a really positive step towards acceptance.  My wife took a bunch of questions to her last psychiatrist appointment, which unfortunately I couldn’t attend, but I heard that it was also quite helpful.  This period of discovery has been quite confronting and stressful, so last week my wife understandably asked that we have a break from discussing her ‘condition’, for a few weeks.  Also, since the intensity of the depression has reduced slightly, possibly due to medication starting to take effect, the motivation to understand the distress is naturally reduced.

Interesting, before the ‘ban’ from talking about bipolar disorder went into effect, I was able to clarify something interesting.  My wife’s resistance to accepting a psychiatric label, depends on which condition it is.  She acknowledged that she had accepted the diagnosis of ADHD in the past and is potentially comfortable accepting a Post Traumatic Stress Disorder (PTSD) label, having identified some significant stressful events in her childhood, such as a ‘rough’ divorce of her parents at aged 9. I have always tried to suggest that we don’t need to focus on what the condition is called, but that the pattern of difficulties, intense mood changes and frequent anxiety, need treatment.

This idea was repeated many times on a recent psychcentral forum discussion about psychiatric labels. I like the way ‘Jacky’ responded:

The best thing I did was say f#/! the label…. 50% of my brain was like…’you have it, deal! And the other half was like nope nope nope . It led me to a vicious cycle of going on meds deciding I was fine going off meds having an episode going on meds…..you get the point. So now I just tell myself it doesn’t matter WHAT it is. you do bad on your own, so accept the help

Overall, I’m extremely thankful for the progress that we’ve made, proceeding with medications and couple therapy, while the current episode stabilizes. I guess my hopes to work with my wife to develop a holistic treatment plan, including clarifying mood states and identifying triggers, has to be put on hold for now.  Alternatively, maybe she’ll agree to do this work for her unnamed ‘condition’ or PTSD…we’ll see…

To Tell or Not To Tell?

Posted version to a few blog comments/forums…

I am new at all this – partner to a wife recently diagnosed with bipolar disorder 2. I happen to be a family physician, which actually seems to complicate our relationship as ‘life partners’ during this scary time.  We both have many questions, doubts and worries.  I need help / support – we both do.  I also seek clarity to navigate this minefield of symptoms, emotions and treatments.  This is why I started this blog.  It’s already been helpful, just to get my thoughts and feelings clearer, but I want more. Like many bloggers have noted, public feedback and questions promote sharing ideas and support – so spread the word.  For now, my focus has been on the current severe depression (episode 2), and an awakening from the denial slumber.  Hopefully, as my wife’s insight strengthens, she may join me on the blog to provide her perspective as a newly diagnosed couple / family, dealing with bipolar disorder 2 / cyclothymia.

Here’s my current question – does anyone have any thoughts on the advantages with disclosing diagnosis with specific friends / family (incl kids)?  It’s obviously a personal decision and from what others have written, clearly dependant on ones own stage of acceptance and timing in the relationship.  I accept it requires working through issues of stigma, identity and even paranoia, which I have discovered is fairly common.  Since working through this stuff is so challenging, I wonder whether the benefits of ‘coming out’ justify the efforts and if so, then gaining a deeper understanding of the benefits of disclosure, can only help sufferers reach that point sooner, to receive those benefits sooner.

Looking forward to your responses…

Insight: like the sun or the moon

Tags

Denial, Relationship

The paranoia has settled. Sleep improved. Celebrate every positive moment.  I am excited, maybe too excited.  I was excited about the possibility of getting greater stability and starting to work with my wife on a holistic treatment plan.  But insight/acceptance fluctuate – intellectually I understand this to be normal and expected.  But emotionally, this is still draining and somewhat worrying.  Also, insight takes time and I have had over 1.5 years to develop it as I saw the first depression crisis evolve and resolve, but the ?rapid cycling hypomania which remained, blocked any chance of my wife to start the acceptance process.  In this way, the current depression episode is bittersweet – the bitterness is palpable, but opening of awareness and acceptance is definitely a sweetness.

I need to find my own outlet for these feelings, since my wife doesn’t need any extra pressure at this vunerable time.  I discovered this the hard way.  The last couple of days, my wife’s acceptance of having a condition called bipolar disorder II has risen and fallen like the sun; like her moods.  Me trying to stop the fall of the acceptance is like me try to stop the sun from setting.  Worse still, it seems like the more I react wrongly to her verbal or written (email) doubts, the faster I see it fade ‘into the night’.

If I take the analogy of the daily solar cycle further, then I guess I need to trust that although all seems dark now, I should be reassured that light will follow.  Obviously, I am hopeful that her insight that this is a serious, but treatable, condition will finally reach a paradigm shift, in which a baseline acceptance remains present constantly, with periods of more/less brightness being easier to manage… much like the moon.  The moon is a constant feature in earths sky, but its brightness fluctuates according to the cycle of the sun.  Let my wife’s acceptance become like the constant, but variable, appearance of the moon.

Recently I discovered objective validation for my experience, which also answered what I empirically knew to be true – “Why is insight so important?”

“…the importance of insight in bipolar disorder is obvious. It is relevant both during acute bipolar episodes and during remission. It may impact on acceptance of treatments during acute phases of the illness, as well as on compliance with prophylactic treatment and recognition of early warning signs of relapse”.

Insight in bipolar disorder: relationship to episode subtypes and symptom dimensions : Neuropsychiatr Dis Treat. 2010; 6: 627–631

I had planned to write about something else…but ‘insight’ was more pressing and a prerequisite to disclosure.  Next post… an introduction into the issue – ‘To Tell or Not To Tell’

Downers pass, for partners too

When I wrote about a low point in our struggle a few days ago, I realised it came after a number of apparent setbacks:

• my wife ‘rejected’ my phone calls, requesting that I write sms’s rather, felt like an emotional withdrawal
• worsening early morning insomnia, which was unfortunately affecting me too (shared bed)
• my wife cancelling couple-therapy session, which she has always resisted because of the inevitable tension it always seems to trigger

On a positive note, she answered a call from her psychiatrist and agreed to scheduling an appointment for today, which was long overdue.  I decided to respond with writing her the email below.  Her reply (not included here, till she’s ready for public blogging), was positive and further calmed the situation.  Then we spent my morning off yesterday, talking, crying, reading, walking, watching videos about bipolar disorder and experimented with some mindfulness meditations.  Sigh! much, much better than the couple days before, AND to top it off, she had made a home-cooked dinner (rice stirfry), which has been understandably rare the last few months.  Reminder: celebrate and feel gratitude for the positives.

It’s a confusing time for us both, but more for her.  I continue to reassure her of my commitment and confidence for getting through this, together. I try to encourage her to stick with her regular routine of prayer, exercise, learning, housework etc. I’m still pushing her to reach out to fellow depression sufferers for support.  She resists sharing anything with others because of worry about confidentiality – but I try reinforce that the potential help and support we could receive should outweigh the low risk of leaked personal information from a trusted friend.  Until the paranoia settles further, there’s not much more I can do…

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Dear Sweety,                                                                         12/10/15

The other day, I suggested that you write to me, but instead you wrote in your journal.  I feel you distancing me in the last couple days – you presented it as a need for ‘quiet’ and preference to write sms rather than speak on phone.  I respected that.

Maybe we’ve reach the point where writing is necessary.  Until today, I felt shared connection with your pain and suffering and I thought we had a mutual understanding that we’ll work through this together.  I have done nothing against your will – I support your process.  But I feel a real distancing between us and it worries me.

I love you.  I know I keep reminding you that I’m in a completely different ‘place’ from last year.  I am still confident that we can growth together through this challenge, as long as we keep our trust and connection strong.  If you push me away, even if you don’t mean to and it’s part of the condition, I don’t feel I can fight it. The tension that it causes is not good for either of us or our kids, and I don’t see any other options other that step away.  I’m not perfect – I am constantly trying to work on myself.  But if our relationship takes strain, I don’t how the damage and distance will affect our future.

I hope this makes sense – please clarify anything that isn’t clear.  I want desparately for us to continue to work together on accepting and treating this condition with the attention it requires.  Do not fear about being ‘dragged’ into appointments, as you describe it.  But consider seriously the effect of straining the trust we’ve worked so hard to rebuild recently.

I look forward to your reply,

Missing you…

Hubby

Ups and Downs

Today, I feel LOW.

You probably notice that despite the severe depression crisis last year and the current recurrence, I am generally focussed on doing what I can to support my wife and I’m generally hopeful that we’ll be able to grow together through the challenge.

But, gosh… it’s exhausting.  I can handle the low mood and irritability, I can provide reassurance for the general anxiety, but the paranoid delusional thinking, with anxious rumination is really wearing me down.  I feel completely trapped with no good options available   As she sinks deeper, even the fleeting insights she had seems to have weakened.  She has extreme fears of reaching out for support from friends, for fear that they’ll spread personal information about her. The inner anxiety is expressed through compulsively searching the internet and personal journal writing to understand her pain, or obsessively want to explain to me why the particular incident at the school is so significant. Validating her feelings does not relieve her pain, and attempts to change the subject always lead back to that issue.  I feel stuck.

As it happens, I noticed that Fast/Preston (Loving Someone with Bipolar Disorder) refer to this type of situation as “The Bipolar Conversation”.  I thought I was being sensative enough to my wife’s perspective, but it seems I have alot more work to do, to find the right words and support, to respond and not react.  This is definitely never easy.  Compounding the challenge is our reduced sleep from my wife’s early morning waking.  The last couple days, I feel the supportive, trusting connection between us is being strained.  I fear I won’t have the strength to hold our family together, if it gets much worse.  It’s certainly not at ‘panic’ levels like last year, but I think I need minimum committment to stick with a process of doctor appointments and therapy.

Despite my wife’s strong reluctance, I am certain we need more support.  She agreed that reaching out to a friend who has been through her own experience with depression seems worthwhile, but this clarity fluctuates with her mood.  I will encourage her to follow through with this – maybe she can provide enough reasurrance for my wife to stick with the treatment process.

Second Opinions

Last time round, over a year ago, I made alot of mistakes.  Despite my medical background, or maybe because of my medical background, I seemed completely unprepared as a partner, to support my wife through a severe emotional crisis.  I guess the biggest challenge was balancing the amount of influence through supportive gestures and care, versus taking a more controlling approach.  This is a common problem when a partner becomes so unwell that their daily functioning and physical safety are at risk.  Taking too much control prematurely, can lead to your partner resisting and tension ensuing.  I feel I am in a completely different place this time around, especially having more resources and learned more effective tools to support my wife’s current depression episode.

Despite this, I still don’t have all the answers and I am certainly not perfect – one book I read suggested that getting a reputable, second opinion may support acceptance of the diagnosis, thereby encouraging engagement in a treatment plan, especially with taking medication.  Although this specific goal wasn’t more clearly explained in advance, I didn’t expect differing opinions on medications would confuse my wife. The psychiatrist felt compelled to recommend a medication regimen (venlafaxine / lithium), which was different to the venlafaxine/lamotrogine combination my wife was stable on before she stopped meds 4 months ago.  My wife has never had a full manic episode, so I think that lithium may be less critical for her milder cyclothymia-type of bipolar disorder.  Despite this, the psychiatrist’s confidence reinforced the message that my wife was suffering from a medical illness, and that medications could help her.

Fortunately, I was able to remind her that it might take time to find the perfect combination of medications, but starting back on what she was taking before makes the most sense.  Add or changing to lithium in the future can always be another option, as recommended by her treating psychiatrist.  Phew!  The pain of her current depression / anxiety episode, combined with the mutipronged validation for the need for medications, seems to be working for now.  Her pattern of anxiety is really debilitating – paranoid ruminations about various social interactions, which keeps her thoughts in an anxious, unresolvable loop.  The pain compels her to need to constantly explain (and reexplain) why she made such a fool of herself, even considering to contact the people involved to explain to them too.

Her distorted thinking is creating an intense embarrassment feeling and shame over the possibility that she may have cursed (saying “shoot” only) accidently in front of a group of high school students. No amount of reasurrance is helping her get over this incident.  I have seen this pattern of anxious, delusional ruminations last year – it’s extremely debilitating, sucking all her energy and focus, with nothing left for anything else.  Daily function as a mother and wife spirals down with an anxious expression constantly on her face.  All I can do is make sure she takes the meds and pray for them to start working quickly.  I also planted the seed for her to considering writing down some of her current experiences, possibly to share online here.

Breakthrough, I hope…

It’s funny – often when we’ve been striving for something important, praying hard for a redemption from suffering or simply searching for the light to guide the path forward, when it finally arrives the feelings can be mixed.  I thought I would be ecstatic when my wife finally accepted a diagnosis for our pain, but I guess chronic worry takes time to dissipate.  Also, this is only really the beginning of a new stage, hopefully with a smooth transition for us to join forces against the bipolar ‘demon’.

After meeting the spiritual guide a couple days ago, my wife became slightly more open to accepting that her suffering could be a mental health issue, with biological basis.  This meeting, combined with her current low mood, has softened her denial, but it’s obviously not completely gone.  With her anxiety escalating, now significantly affecting her sleep, I felt compelled to deploy the next weapon I prepared for the battle against denial.  I shared with her the books on bipolar disorder that have given me the extra strength and clarity to recreate our relationship dynamics, accomodating for the new reality –  that my wife’s brain is ‘sick’.  We flicked through some pages, significant parts resonating with her own struggles over the years.

“Pow!”, as they say in the cartoons.  If ‘denial’ was bruised from the meeting with the spirtual guide, now it was limping, hopefully with some broken bones.  It was an emotional night – lots of tears, from both of us.  As you may have noticed from my posts, I am not a naturally ‘feeling-type’ person.  As men generally do, I lead with my intellect, with emotions being somewhat secondary.  This makes feeling my wife’s pain that much harder to bear, particularly because my intellect seems impotent and helpless against emotions, especially when ‘denial’ is in the picture.  I am hopeful that once my wife accepts treatment and her mood stabilizes, then my intellect and her emotions can finally reconnect, complementing each other, making us whole again.  (My wife might even decide to join me here, online, in the blogasphere, then this interlectual blog can be balanced with emotions, too!)

My wife is definitely going through a significant transition at the moment, with much confusion and ambivalence.  The battle is not over yet.  The next weapon planned is another psychiatric opinion by a religious psychiatrist – I hope this will be the knockout blow to the denial demon.  Stay tuned…