Monday, November 26, 2012

A day in the life of bipolar

Today was a very rough day. I don't think you would have known it to look at me, or talk to me. But I was struggling all day to maintain the mask of normalcy, so I thought I would describe my trek through my own private Gulag.

Monday, 5:45am: After having difficulty falling asleep despite a very long stint on the acupressure torture mat, I wake up from a dream in which Bina and her husband were running a yeshiva for rabbinical students, many of whom were using marijuana.

I was also approached, earlier in the dream, by a former co-worker (two jobs ago, before I became a social worker) who wanted me to come back to the agency. I didn't want to, but I made an appointment to meet with him, which ended up being at his home and not the office, and then his kids were running around so we couldn't really talk.

I don't know why Bina and Asher didn't know their students were using marijuana. I was debating whether to tell them when the alarm went off.

5:55am: I don't want to go to work. I feel sad. I have gone through another bad bout of crushing on Dr. Dashing.

[Side note: Two appointments ago, I went in very angry about my crush on him and the fact that went I first went to the hospital, they couldn't treat me because they were out of supplies, post-hurricane. I was mad that they didn't call me to reschedule. I was also mad that I sat for fifteen minutes in the reception area before the receptionist from the urology practice (pain management receptionist couldn't make it in due to the transit closure) called to let him know I was there. So he could tell me that they had no supplies.

[The next day, when I finally went in for treatment, I was furious, but I didn't want to show it. So I didn't talk to him. Didn't look at him either. I didn't want to see any judgement about my uncontrolled anger in his eyes. Usually I chat to him about this and that, and I don't shy away from eye contact. My avoidance made him very uncomfortable; he asked if I was "out of it." I told him I was fine, just very angry. Emphasizing that I wasn't angry at him -- although technically that wasn't true -- and didn't want to take it out on him. (Which was true.)

[Last appointment, Dr. Dashing was very friendly, telling me about his Thanksgiving plans with his family and trying to engage me throughout the treatment. Totally let his shields down, which have been up since the week he called me twice. I thought he was being friendly because he was romantically interested, which led to a wonderfully rich fantasy life on Saturday, but a psychoanalytic friend pointed out on Sunday that maybe Dr. Dashing just didn't want me to be as angry and avoidant as I'd been at the previous appointment. This of course made perfect sense, so on Sunday, I became sad, and I woke up sad on Monday.]

6:00am: How am I going to manage at work all day when I feel so forlorn? Well, I don't have to do a group. I just need to review some treatment plan problems with counselors. That's my primary function at work: "developing" the counselors' documentation skills. Progress notes and treatment plans. I also consult with them on complicated cases, involving psychiatric problems, domestic violence, child welfare entanglements, and the like. Clinical supervision.

6:10am: I don't have a lot of sick days, and I've already used two on my defective knees since August. I can't call in sick. I have to go in.

6:42am: I sign in. Where am I going to sit today? I don't have an office. I can usually sit in the chart room of one of the clinics, which has a computer and telephone, but I can't see patients there. Often a counselor is out, so I can use his or her office. But every morning it's a scramble. Most mornings this doesn't phase me. Today I just want to sit down and check my email and not talk to anyone.

6:45am: I have to say hi to everyone whose office I pass or they will wonder. One counselor calls out to me. What does he want? Is there a problem? I'm not up for complicated problem-solving. Mindless paperwork might take my mind off my anxiety. Fortunately, he says I can work with him tomorrow on his MSW application. Which I promised to do. Which I'm happy to do -- just not right now.

7:00am: I'm in the chart room. Counselors pass in and out. I smile and say hello. Inside I'm crying, inside I'm dying, but I pretend to feel normal. I start looking through my folders, seeing which counselors I need to meet with to discuss treatment plans. There are more plans in the bin for me to review and sign. Meaningless paperwork, take me away!

8:30am: Reviewed seven treatment plans with one of the counselors. Reviewed two treatment plans with another.

What do the counselors really think of me? Some of them act so nice, I am suspicious they are trying to manipulate me. They can't possibly like me as much as they seem to; they must be pretending, but I don't know what they think they're going to get out of it. This makes me paranoid as well as sad.

9:45am: Ouch. I went to see one of the more volatile counselors. She did not want to talk to me. Not my fault; she's been having a rough few days, I know that. But she turned on me like a wounded grizzly bear when I suggested she make a minor change to some screening paperwork. Which the clinic manager had flagged as defective.

Even thinking about the conversation we had, almost 12 hours later, is kicking up the anxiety again. Right after the exchange, I was shaking. For hours. Even after she apologized and hugged me and told me it wasn't my fault and she'd do anything I asked her to do. I couldn't recover.

11:20am: Time for lunch. I went outside and did some comparison shopping, trying to calm myself down. Bought a new pillow and a tuna sandwich and a bottle of juice. Maybe this will soothe me.

1:30pm: Nope. Still stressed and anxious. A counselor calls me to ask if I can meet with her and a patient tomorrow. I agree; the patient has an open child welfare case and wants my help. Five minutes later, another counselor pages me. Can I meet with her and a patient tomorrow concerning domestic violence issues? Sure.  It mystifies me that all these people think I'm a competent professional, when inside I'm screaming and clawing at the air, like I'm suspended by a single thread over the Grand Canyon.

2:00pm: Hanging on by my fingernails. Just one more hour. Another counselor comes into the chart room, and we talk about one of his patients. Who has bipolar disorder. Ironic.

3:00pm: On my way home. Still wound up too tight. I'm going to make myself a nice green smoothie, which I try to do every day. I bought apples and greens at the farmers market yesterday.

4:00pm: I can't finish the smoothie. I'm not hungry. Yes, I'm that anxious. I post a tweet:

2 kinds of anxiety: 1) makes you eat, 2) makes you unable to eat. No idea why or how each strikes at any given time.

5:50pm: Watching last night's episode of "Dexter" doesn't exactly soothe the anxiety. What was I thinking? I will take a Vitamin K tonight. I have to run a group tomorrow; I can't be impaired.

Yesterday a friend said he didn't think I'm disabled, because I live independently and I work. He doesn't understand how much energy it takes to maintain both. More the job than the apartment; I'm a terrible housekeeper. But I've been fired from almost every job I've ever had, and I blame the bipolar.

I look normal, most of the time. Except when I won't make eye contact or can't get out of bed. But I'm not normal. And I'm sick of always pretending to be.
Copyright (c) "Ayelet Survivor"


  1. You wrote:
    It mystifies me that all these people think I'm a competent professional, when inside I'm screaming and clawing at the air...

    I think your ability to maintain competence even while suspended over the Grand Canyon by a thread makes you even more so. How much more? Triply? Quadruply? Hard to say. But there's no questioning your talent, abilities, and competence.

    Is it possible, though, that your meds could be tweaked to bring you a drop closer to some form of equilibrium?

  2. I can't get over how clear it is that your "depression" symptoms are completely linked to your "fantasy" that your physician liked you. Those are not symptoms of depression. Those symptoms are caused by very poor interpersonal connection skills and on obsession with not being single. You are offensive to people who truly do experience biological depression. You could work hard at meeting people (and being friendly. And not becoming repeatedly enraged at things people say that are not directed at you.) you choose not to do so, rather complaining about your age and "disorder." I call your bluff, as have dozens of people over the last few years. I have no doubt you will ignore if not became enraged (again. sigh.) at what I have to say...maybe it's time to start listening and working on yourself.