Sunday, May 24, 2020

On the Merry-Go-Round Once More

It has been a truly emotional week - both good and bad. You would think I would be used to riding this mood roller coaster by now, living with bipolar as well as going through all kinds of crap throughout my life, but it's still hard to deal with.

First, the really good news... two months after I first filed for unemployment because of COVID-19 issues, I finally received it, including some (not all) of the weeks I filed in the past but didn't get anything. This has been an incredible stressor off of me, as even though I had a decent amount of money still out due to the way my clients pay me and I had a little bit saved up, I knew it wouldn't last forever. I tried not to worry, but I had a huge underlying stress every minute of every day during that time of uncertainty.

So, that's a big relief.

But medical issues... Ah, medical issues... Many years ago I wrote an article about the issue of not finding answers to my medical issues - or at least not ones that help. I updated it and posted it last year. If you go to https://www.spotlightonstigma.com/2019/09/on-merry-go-round-again.html and read it, you'll see more where I'm coming from.

The past couple of weeks I've been spinning again on that merry-go-round. I virtually saw my sleep specialist after the last failed attempt at using a BiPAP (similar to CPAP) machine for my truly horrible sleep apnea. I finally got to see a rheumatologist after suspecting I have fibromyalgia for many years. I also actually asked my primary doctor to prescribe something for the GERD (acid reflux) that she told me I have, but that taking an OTC acid reducer didn't help (hoping the prescription will help more). I also was finally able to reschedule my appointment for my cataract surgery after COVID-19 postponed the original one.

Second, the good news... I guess. My rheumatologist did confirm that I have fibro as well as an overarching syndrome called Joint Hypermobility Syndrome. Though hearing you have yet another lifelong, chronic condition isn't good news in and of itself, he does have a treatment that he uses that most rheumatologists don't.

In fact, that's why I decided to pursue a diagnosis - my daughter switched to him after already being diagnosed with really bad fibro but the doctor told her there was nothing she could do other than yoga or water aerobics to help the pain. Always before I had assumed that there was nothing that could be done about it, so why take the money and time to pursue that particular diagnosis?

The frustrating part about that good news is that there was a mix-up with calling in that wonderful prescription and I have no idea when I'll be able to get started on it. I'm hoping for one day later this week, but I just don't know.

At least the fibro diagnosis only had one frustrating part. The sleep apnea was an incredible debacle...

So, third - the pursing of an alternative to the BiPAP machine. I was originally diagnosed with both really bad Obstructive Sleep Apnea (OSA) and Restless Leg Syndrome (RLS) in 2007. RLS was able to be somewhat controlled through meds but I tried various types of CPAP machines and different masks and couldn't handle any of them. After trying and trying, I gave up. If I knew then what I know now, I would have saved myself a lot of time, trouble, and money.  But there's nothing I can do about that now.

(Note... CPAP and BiPAP are two versions of the same type of OSA therapy. Throughout this I might use them interchangeably but they mean the same type of thing.)

Then around 2014-15 I decided I'd try again. I thought maybe the technology was better with the machines or there was another new therapy that would help. The same thing happened. No matter what I did, I couldn't sleep with the BiPAP going.

This time I took it a step further... I went to an ENT. He told me I had several issues that made me a horrible candidate for CPAP/BiPAP therapy - a severe overbite that put my lower jaw too far back, a deviated septum, and a large tongue (gross to think about). Surgery could fix the first two but jaw surgery is a big surgery with a long recovery period, so that was out. Because fixing the deviated septum alone didn't seem like it would help that much, I gave up again on this therapy.

Something the ENT has stuck with me since that visit. He actually got mad... saying something like "These neurologists should never prescribe a CPAP without consulting an ENT who can sometimes automatically tell if the patient can use one or not." So all that time I fought with the machine was for nothing! I never would have been able to use it. But there's nothing I can do about that now.

After seeing the ENT and finding out about my jaw, my neurologist prescribed a custom-fitted mouthguard to bring my lower jaw forward. Getting that mouthguard was a huge mess in and of itself, which I won't go into. But I tried the mouthguard and even went back for another sleep study solely to see how much it helped. During the follow-up visit, my neurologist said that it wasn't a big improvement and since it was a pain to deal with, I also abandoned that treatment even though the mouth guard cost like $750 out of pocket. But there's nothing I can do about that now.

So... a few more years roll around and I had a routine visit with my cardiologist. He told me that there were was a brand new treatment for OSA that didn't have anything to do with tubes or mouthguards. It's a hypoglossal nerve stimulator (brand name "Inspire") which basically is similar to a pacemaker for your airway, keeping it open throughout the night.

I decided to look into this option. I got a new sleep specialist (who was the first one I really felt had my best interest at heart and didn't just want to push CPAP treatments). During our first visit, I explained my history and that I wanted to look into this new surgical option. She told me that because it was new, they were pretty strict on the criteria to qualify and at this time I wouldn't due to my high BMI (which, ironically, is probably at least partially so high BECAUSE of the apnea... sigh...)

She did, however, tell me that the technology once again had changed and would I again try the BiPAP? She also told me that the settings the last neurologist had used were way too high and it was no wonder that I couldn't stand it.

In addition, she asked why I was no longer using the mouthguard. I told her that the last doctor said it wasn't helping. She said that it was, just not enough to "cure" the apnea. This kind of ticked me off. I could have been using it that entire time and could have had a little better sleep. But there's nothing I can do about that now.

Against my better judgment, I gave in and decided to try the newest, latest BiPAP machine and ending up getting a mask that was hot off the press. I really thought this time it would work.

I was wrong.

Once again, I tried and tried. This time I also added in another mouthguard, but one I didn't have to see a dentist to get (you fit it yourself). I didn't really try the mouthguard much without the BiPAP, as I thought my jaw was part of the reason the BiPAP wasn't working. In hindsight, I should have at least kept using the mouthguard when the BiPAP therapy wasn't an option. But there's nothing I can do about that now.

I also had sinus surgery, as I knew my sinus issues were at least part of the reasons I couldn't use the BiPAP. The sinus surgery corrected one of the issues but didn't help enough for me to be able to use the machine.

Life got really busy and so I just put the machine in the closet and just prayed that I wouldn't have a heart attack due to the apnea (one of my biggest fears). I didn't want to follow-up because she acted like she had exhausted all of her options anyway, so why deal with one more doctor's appointment?

Then a couple of years passed. I thought that maybe by now they would have relaxed the qualifications on the nerve stimulator and I might qualify now. So I made an appointment with her to discuss it. It takes months to get in to see her and guess when my appointment hit?  Yes, right as the COVID-19 restrictions made most doctor's offices close. But there's nothing I can do about that now.

I had to wait a couple more months for the appointment, but thankfully I was able to get in to see her virtually relatively quickly. I suggested trying the nerve stimulator and said that maybe the standards were less now. She checked with the ENT who does this procedure. (See? An ENT consult IS needed for sleep apnea issues!)

This is where it really got messed up. She told me that they require a recent sleep study - within 3 years. My last one was too old. I haven't yet mentioned this but I HATE sleep studies. I can't sleep; I have horrible anxiety; and I am more than miserable the entire time. I had said I would never do another one. But if it was required, what could I do? I agreed to do the sleep study appointment.

She also told me that they would have to do an Upper GI to see how my airway opens and closes in order to see if I was a candidate for that treatment. An Upper GI isn't fun, by any means, but it's much easier than a sleep study.

After I got home, I realized that I might not qualify because of the way my airway opens and closes (I assumed that if my BMI was still a rule-out, I would find that out early on). So I called the ENT's office and asked if I could do the Upper GI first. If it showed I was still a candidate, then I would do the updated sleep study. After all, I had two sleep studies that showed I had it and it doesn't cure itself, so I definitely still had OSA. The scheduler supposedly asked the doctor and said that I had to have the sleep study first.

Well, the day came for the sleep study. My anxiety rose all day even though I tried really hard to keep myself calm. One thing I comforted myself with was that I didn't have to have the RLS leads, which I hate more than all the other leads combined (except the nasal cannula - it's #1).

I got to the clinic and when the tech came in to hook up the leads, she reached down to my legs. This wasn't my first rodeo so I knew what she was doing and I objected. I won't go into that whole story, but let's just say I lost and had to have them. If I had thought about it ahead of time and specifically asked my doctor to mention not to do that part of the test, I probably wouldn't have had to do it. But there's nothing I can do about that now.

I'm also not going to go into the details about the sleep study. It was just as bad as I remembered... no, it was worse. The ONLY thing that was good was that I was exhausted so I was able to sleep a little on the front end of the night. I knew from past experience that an hour or so of data is enough so I knew I had enough by the wee hours of the morning. I was able to leave at 3:00am, which was wonderful (though I was messed up from the anxiety and lack of decent sleep for a couple days afterward).

But I was glad it was done. Now I should be able to at least get to step two towards the nerve stimulator treatment, right? WRONG!

My follow-up with the ENT was two days after the sleep study. Once more, I won't go into all the ENT said, but the main point was that the nerve stimulator wasn't an option because of my BMI. WHAT?! So I went through that sleep study for nothing?!

He gave me some other options, none of which are really good options - soft palate surgery (which is mentioned twice is really painful), jaw surgery, which I already knew was major surgery with a long recovery time, and a tracheostomy, which "wouldn't be that bad because I could plug it up during the day." WHAT?! A trach?! Jaw surgery that takes literally months to heal? Soft palate surgery that is really painful (and doctors never admit that something is going to be painful so it must be really bad).

I got home and spent the day extremely depressed. That horrible sleep study (and the huge copay) may have been for nothing. As of right now, I did go on and make the appointment for the Upper GI test, just to know my options - exactly which of the procedures I would need to get done. However, I might cancel it. I already know I would need the jaw surgery and that's the one that has the longest recovery time. I just can't be off work that long. However, I might cancel the appointment and just keep praying that the apnea won't cause something like a heart attack. After all, there's nothing I can do about that now (or at least nothing I feel I'm willing to do about that now.)

And last, the cataract surgery. This blog is already way too long but I wanted to mention it. Right now the first one is four days away and the one on the other eye is two weeks after that. I'm again really nervous. Everyone I talk to says it's not a big deal but it seems like no medical procedure is simple for me. But hopefully both surgeries will go well and for the first time since I was a preschooler (or maybe earlier), I will be able to see clearly without glasses or contacts.




Tuesday, May 19, 2020

Exhaustion From COVID-19 - Not the Illness, But From Helping to Flatten the Curve

COVID-19 has affected society in so many ways. When the CDC first asked everyone to stay at home as much as possible, I didn't think too much of it. In fact, I kind of liked the idea... at first.

When I first heard it was going to be much longer than I had originally thought, the idea became a lot harder to deal with... but it was still doable. My initial impression had been how much I could get done with not as much paid work as before (though that worried me on another level) and so much time at home. As the time was extended, that was still my goal - to get a lot of projects done that I normally don't have time for.

But nothing in me realized how it would feel to be home so much - and its unanticipated effects. 

One of those has been exhaustion... bone-weary, fall-asleep-at-my-desk, can't-think exhaustion.

There are so many factors directly related to the pandemic that could be playing into this issue:

- Not getting enough sunlight...
     Lack of sunlight affects us physically in two main ways. First, being in direct sunlight for about 10-30 minutes a day helps your body produce vitamin D, which is essential in warding off fatigue. Second, the lack of sunlight causes your body to produce more melatonin, which helps make you sleepy. On top of these, there is a psychological boost to being outside and spending time in the sun.

- Anxiety...
     Excessive worry causes tiredness due to many factors. It's draining to try to figure out solutions constantly, especially if the cause of the worry doesn't have a solution (like COVID-19). Your adrenaline runs high with anxiety and when it finally runs out, there can be a physical crash. Wanting to get away from the worrisome thoughts may lead to naps which makes sleeping at night more difficult. Insomnia from this stress can also lead to being very tired during the day.

- Lack of exercise...
     We don't realize how much we are up and moving around in the course of a typical workday. Even short times of movement like walking to and from your home/office to the car add up. Kids activities, church events, social gatherings... these all lead to not sitting as much. I know that for some, being at home has caused increased exercise - maybe from chasing children who would normally be at school or cooking and cleaning more because of more bodies being in the house all day. But for many of us, the days are passed through more screentime than we are used to and thus, less being up and about.

- Too much or too little noise...
     Too much noise can cause what's called "listener fatigue." There are many who are used to having at least periods of quiet at home or work during the day. More people at home, as well as more screentime, often means more noise to deal with. On the other side, for those who may be home alone may have too little noise, which subconsciously promotes the feeling that it's time to sleep.

 - Boredom...
     Like anxiety, being bored can lead to activities and behaviors which interfere with good sleep. Not having a lot of plans can lead to staying in bed longer than typical in the morning, taking naps throughout the day, and going to bed early at night.

- Eye strain...
     Because of the screentime increases in most households, eye strain can be a problem. This can result from looking at something at one set distance for long periods. In the course of a regular day at school, work, or even leisure, there are a variety of things to look at - all different distances. For example - going to your child's ball game. Getting ready involves going back and forth from looking for what you may wear to what you are putting on to looking in a mirror to just looking around the room. The drive there includes looking out the window, looking at the speedometer, and looking at others in the car. Once you are at the ballpark, you are watching your child play ball, checking your phone, looking at the back of the ball field for the score, etc. During the stay-at-home order, there often are much longer periods of watching tv, gaming, or Zoom meetings where you look at one place. This eye strain can lead to feeling worn out when all you've done is sat in a chair all day.

- Grieving/Depression...
     Everyone has lost something during COVID-19. It could be having to cancel special plans, job/income loss, a relationship, or just the freedom of being able to run into a store without worrying about wearing a mask and abiding by social distancing measures. Grief is hard on both your physical and emotional state. It often leads to a period of depression. One of the main symptoms of depression is not being motivated to do tasks that were loved before. This lack of motivation, like several other factors mentioned, leads to less activity, more naps, and generally an interruption of regular sleep cycles, which contribute to fatigue.

- Too much caffeine or rich/sugary foods...
     Caffeine and sugar are often used as ways to wake up. But what many don't think about is how after that period of being artificially alert, there is a crash. The fatigue that some of the other issues listed have caused is only exacerbated by using stimulants such as sugar and caffeine to combat it due to this crash later. Plus, these can interrupt getting deep sleep at night due to the effects of caffeine lasting into bedtime and GI issues from too many rich foods.
     
- Not enough water...
     Dehydration is a sneaky thing. It's obvious when you have been outside in the hot sun and haven't been drinking water. But it's way too easy to miss when you are home all day and just forget to drink as much. Maybe you are used to having a water bottle at your desk at work but can't seem to remember to carry it around with you while you are at home. Maybe it's because you are used to bottled water but there is a shortage in your area. Maybe it's because since you are home you are drinking more soda or alcohol than you would normally drink in a typical day. But either way, even mild dehydration can lead to fatigue.

- And finally, actually having COVID-19...
   One of the top symptoms of COVID-19 is excessive fatigue because it's a byproduct of your body fighting the virus. Add to that, other COVID-19 symptoms can lead to not getting good sleep, like continuous coughing or a high fever. 

So when I am fighting exhaustion, there is a continuous battle playing out in my brain... Is it one, two, or a combination of many of the non-COVID-19 causes listed above or do I have one of those cases of COVID-19 where I don't really have the other symptoms? Without being able to get tested every time I feel really tired, I'll never really know. 

What I'm doing is trying to work on as many of the preventable non-COVID-19 exhaustion causes as I can. I'm taking extra vitamin D and trying to get outside every day for just a few minutes if I can't do more. I'm trying to be grateful for little things, which helps with both anxiety and grieving/depression. Exercising isn't happening but I'm working on a plan to do so. I try to control noise levels and eye strain (though not always successful). I finally got to the point where I carry water with me all day. 

All I can do is control what is possible to control. There's that Serenity Prayer again: God, give me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.


Thursday, May 7, 2020

Mania to Depression During COVID-19


I have bipolar disorder, Type 2, which some consider "mild"... but live in my shoes for a few weeks and you'll think it's anything but mild.

As with many mental illnesses, one can be high-functioning or lower-functioning, depending on the severity of the illness, support from others, etc. 

Maybe it's because performing well is a major part of my self-worth; maybe it's the work ethic I've been brought up with; maybe it's something else, but I have to be really, really depressed to keep me from working if I have a deadline for a task.

Lately, I’ve been that depressed.

Today I realized a couple of the reasons...

First, the obvious: I mentioned why I feel I am high functioning despite having a serious disorder. COVID-19 has robbed some of that from me and I hadn't even realized it.

My main job is as an event photographer. I supplement my income with rideshare (Uber/Lyft), mystery shopping, and some writing. So, three out of four of my main sources of income have been taken away, as I'm high risk so photography, rideshare, and mystery shopping are all out.

I thought my recent severe depression was due to the financial stress of losing my main three sources of income. But today I realized it's a lot deeper.

I get a lot of my self-worth by hearing how great a job I've done on a project. Since all this social isolation started, I've gotten very little of that positive feedback. There has been almost no photography work and my writing though "good enough" isn't award-winning.

This has affected me more than I like to admit. I had no idea how much I thrived on hearing those accolades or even just giving them to myself when I took a great photo. Both the photography and writing assignments I've gotten haven't lent themselves to getting those types of compliments. They are good... just not "great." Many mystery shops are scored... and I love getting those high "grades." Even with rideshare, you can tell when a customer has enjoyed the trip, and even when my riders don't mention it, I can tell when I've done a good.

Currently, I don't have that steady stream of compliments. With the work I've managed to get, I send the photos and/or articles to the newspaper and then hopefully later see them published. I don't get any, "Wow, that was a great photo!" or "I really enjoyed that article. You had some wonderful insights."

Then there is the mania/depression cycle that is inherent in Bipolar Disorder and its impact on all this.

At the beginning of the stay-at-home orders, I was mostly manic (I am a rapid cycler and can cycle between moods even within a day). I had so many hopes and plans about what I could get done since I had to be stuck at home - all the projects I've been putting off for a while, sometimes years.

The mania stuck with me long enough to get started on several projects. I pitched some great ideas to my editor (of course I thought they were great - I was manic). I was going to catch up on personal photo editing, go through and get rid of lots of stuff in my attic, finish updating a series of articles that never got published, clean out and organize all of my camera equipment, list most of this extra stuff on eBay, work on the book I started writing months back, etc. And then, in my spare time, I was going to take over the world.

It hasn't happened quite that way.

To my credit, I have had a lot of issues that got in the way. Major computer problems showed up that had to be resolved before I could do anything else. I re-did my photography website which took at least four times longer than it should have, due to issues with the new hosting site. My daughter broke her foot which caused some hassles. I started showing symptoms and, though I tested negative, haven't felt well more days than not. Basically, it seemed like everything I tried to do took at least two or three times longer than usual... or more!

So, my list of all of the things I planned to do during my COVID-19 isolation should be mostly done by now. 

It hasn't been. 

Not by a long shot. 

I have made progress and have gotten a lot done, but one thing about the mania, you think you can do so much more... and it's just not possible. Then you get down on yourself for not finishing all you started. Then that depression leads to doing even less. The only thing that breaks this cycle is a new manic period, but then though I do get more done, I add more to the list.

Sigh...

This has happened before but usually, steady work gets in the way. In other words, I make the plans but there's a part of me that knows I probably won't be able to finish many of them. In the COVID-19 isolation situation, my expectation of finishing that crazy amount of tasks was way too high - and the disappointment when there is still a lot more on my list even after almost two months of being home has driven me into a deep depression, which, ironically, has made it more difficult to get anything done.

My plan is to take some time and try to list everything I HAVE gotten done during this crisis. Maybe being positive and putting the emphasis on what I've finished instead of what I haven't will help list some of my depression and give me hope again.

With writing this, it occurred to me... maybe I'm not the only one who feels this way. Maybe others with high-functioning Bipolar or other mental illnesses are having similar problems coping with these kinds of issues. Maybe, just maybe, it's not just me.


Wednesday, May 6, 2020

My Heart is Breaking Once Again

I don't know how many of you have children with multiple physical and mental issues, but it's hard. I mean, HARD! As a parent, one thing you most want for your children is for them to be successful in whatever they want to do... whether it's to be a stay-at-home mom, a garbage collector, a doctor, or anything else.

She did so much to become all she could as she was growing up... All those years of trotting around to lessons and sporting events and after-school activities... All those years of Science fair projects and research papers and practicing math facts... All those years of teaching manners and work ethic and compassion for others... Sometimes I feel like all of that was for nothing because of the diseases and conditions and syndromes that my almost 21-year-old has to deal with.

Last semester her physical and mental health issues caused her to have to drop out of college and take incompletes for 3 of her classes (she was able to finish 2 through a lot of pushing through). She now has about a week to make up the work that she missed in those classes in order to change the incompletes to credits or they will turn into F's.

She worked so very hard last semester to try to get everything done but her own body and mind became her worst enemy. It just wasn't possible to push through and do everything needed in time.

So she took the incompletes, knowing that a couple of months to focus on her health and it would be no problem to finish these 3 classes when she was already so close... right???

Just as she was starting to recover from all of the trauma and stress of last semester and was again able to focus on getting into various specialists (which always takes a while), the world stopped. She had made several appointments but then she only got into one before doctors' offices closed for anything except for emergencies or COVID related cases.

Even without the doctors' appointments and treatments being done, at least she could go on and get in touch with her professors and start her work, right? NOPE! About the time she planned to do that, the college shut down. The professors were scrambling to switch to online learning for their current students so she felt bad about bothering them to help her get started on her classes.

At this point, she had plenty of time to finish so it wasn't a big deal. But as the deadline loomed closer and closer, stress about finishing set in and exacerbated her symptoms. This was heightened by stress about COVID-19, both because she is high risk and because she can't work.

As a parent of a child with an invisible illness, I often get "advice" on how I should be pulling back and letting her take care of her life on her own. "She's smart and she's 20 years old now," they would say, having no idea how hard it can be just for her to get out of bed each day or take a shower without almost passing out. They see her on good days and so, for them, she should be able to be doing these kinds of things on her own by now.

But what the advice-givers don't understand is that ongoing struggle. They haven't seen her cry because it hurt to get dressed. They haven't seen her try to study (and she really is smart) where she would read the same paragraph over and over and not be able to retain the information.

So this is my dilemma in all of this... How much do I push her to finish? How much do I let her do it on her own, knowing that the consequences could be failing those classes and ultimately not finishing school (because she's already struggling so much, any issue like having to make up these classes, could be too much)?

I've been walking this tightrope for a few weeks now and finally really talked to her about it last week. She said she did want to finish and I and some of her friends said they would help her in any way we could.

So I had hope that at least this chapter of her life would be okay... until she was in so much pain that she again missed a virtual voice lesson earlier this week. I was devastated... and so mad.

Your first thought might be that I was upset and mad at her. I'm not. I'm so f'n mad at these diseases that are robbing my beautiful, talented, smart daughter out of living the life she should be able to that sometimes I can't see straight.

I don't know what to do with these feelings. It's not going to change. She has been able to see a couple more doctors virtually the past couple of weeks, as offices are switching to that format, but there are still no answers. The more I learn about her conditions, the more I realize that she will probably have to deal with chronic pain and mental health issues her entire life. There are no cures. There isn't even an effective treatment for most of the issues she deals with.

The best we can hope for is a reduction in pain, a reduction in depression and anxiety, a reduction in the symptoms that keep her from living life.

Now she's at less than a week. I'm worried she won't finish, but I can't do it for her. Once again, it's time for the Serenity Prayer...
     "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

Wednesday, April 15, 2020

Another Week of Solitude

Another week... For the most part, my computer issues have stayed away (though I still haven't fixed those small other issues I found). However, the virus hasn't. My older brother was diagnosed on Monday after starting to show symptoms last Thursday night. His girlfriend started showing symptoms yesterday.

I'm still thankful... it looks like he's going to have a relatively mild case. He's had no breathing issues and his fever never got that high (it's been about like a seasonal flu in his case). He hasn't had to stay in bed all day, every day. He was able to "attend" our family's virtual Easter get-together and he seemed to be fine (even though we all knew he wasn't).

That said, it's still been difficult. He was over at our house to eat supper with us the same evening he started showing symptoms. My 82-year-old parents and I have now definitely been exposed. So it's the waiting game the whole world has been playing... waiting to see if we get it; waiting to see if we are the lucky ones that have it mildly; waiting to see if we may have infected someone else... but now the game's on hyperdrive.

My anxiety and depression have been constant companions during the quarantine but now they are also on hyperdrive. At least they've taken turns fighting for which one is in charge each day. Anxiety took the lead and pulled way ahead after we first realized my brother was symptomatic. Then Anxiety went into cruise mode and wasn't doing anything remarkable - just still there, holding his own by steadily whispering random thoughts and worries straight into my ear...

"What will we do if he gets sicker? He lives alone - are you guys going to just let him fight this out himself or will you go help him, though that would be risking your own lives? What will we do if one of us gets sick? What will you do if you've infected someone else you love? How are you going to be able to live with that guilt?" (I did see my boyfriend and daughter over the weekend because I thought I might lose it if I didn't see some friendly faces.)

Ironically, Anxiety wasn't worried about keeping the lead in the race, so Depression (which usually doesn't care about winning - it's all she can do to enter the race and just get started) zoomed ahead into first place. She caused me to feel numb and not care, after Anxiety had made me care too much. She kept that first-place pace for a while and her whispers were more like yelling...

"Why even try?! What good will it do?! If your brother can get sick when he was so careful and interacted with almost no-one, then what kind of chance do you and your parents have when you guys are high risk and he isn't?! You are never going to get the things done you wanted to do during this time, so why even work on them?! You might as well give up on addiction recovery, too, while we are at it! You'll never see any real progress there, especially with the food addiction! It's just too hard! You can't do it!"

Then there was the late entry from the twins... Insomnia and Exhaustion. They must be drinking major energy drinks, because they found the reserves somewhere to recently speed past Anxiety and even overtake Depression. Maybe it's because they work together and can take turns driving and also because they are focusing on driving instead of talking to me, but it doesn't matter why - they are definitely in the lead at this point.

When I am able to fight off the monologues by Anxiety and Depression and try to get something done, Insomnia and Exhausted make that work time much shorter than I'd like. Exhaustion makes me fall asleep at my desk; fall asleep in the tub; fall asleep when eating meals... then his twin, Insomnia, jumps in so that the only time I don't fall asleep and stay asleep is at night, in bed.

Somehow I've got to learn to withdraw from this particular race because I know that there's no way I - Tracy - can win when these opponents are so strong.

Maybe withdrawing isn't the answer, though. Maybe I need a yellow flag - and resign myself to last place for the duration of the race (pandemic quarantine). If Exhaustion is in the lead, I need to take a nap without guilt. If Insomnia, then a middle-of-the-night cleaning binge or other similar work is okay. If Anxiety is whispering constantly, instead of fighting the thoughts, I need to make a plan, knowing that I can change it if needed. If Depression is yelling, then to quiet her down, I can answer with things I am thankful for and that are going okay, if not "great."

If I recognize that they have superior cars, pit crews, and probably cheat a lot, and try not to win this particular race, just maybe it will be enough to keep going with life until life gets back to whatever normal is.






Thursday, April 9, 2020

About a Month into Quarantine...

From my best guess (I didn't write it down), I started trying to stay home around March 12. Today is April 9 so it's been almost a month since I've been at home.

I haven't been at home all day every day during that time. At first, I did go to a few places where I stayed away from crowds but still got out of my house. But the majority of the days I have stayed home. There were a few days that I thought I was coming down with COVID-19 and, to keep my family safe, I stayed in my suite (which thankfully has a bathroom.)

I am a freelancer/gig worker. I'll do just about anything legal to make money but my jobs boil down to basically 4 things - photographer, Uber/Lyft driver, mystery shopper, and writer with writing being the thing I did the least of... until this month.

Now writing has kept me going as it's not safe to do any of the other jobs since both I and my family are all high risk to catch COVID-19. The only problem with it is that I only have had a few articles that I have been able to write, as I'm just a new writer and don't have a lot of contacts at this point.

But it really hasn't mattered as I've had MAJOR computer issues that started not long before all this happened. I have spent 5-6 hours a day many days of the quarantine working on trying to fix these issues. I still haven't gotten them all fixed but I do have enough fixed that now I can generally work doing more than troubleshooting issues.

It's been frustrating, to say the least. When I first heard about staying home, there was a tiny part of me (NOT the financial part) that was excited that I "had" to stay home. I have so many projects that I had been putting off because I just haven't had the time that I hoped to get done.

Then the tech issues got worse and couldn't be ignored. So my focus had to shift to fixing them. Each day I would cross only one thing off my list, if that. The only thing that had been keeping up my morale was that I could get that original list accomplished before life got back to normal and that wasn't happening.

I went into a deep depression but the determination to win over these stupid computer issues kept me from staying in bed all day like I wanted to. I kept heading to the computer each morning, trying new things or trying old things again but hoping they would work this time.

This past Monday I finally got most of the issues fixed. I'm still dealing with some of them, but I'm taking them slowly because they aren't integral to day-to-day computer tasks.

My mood has been better because now I can actually see some progress on the things I wanted to get done. It's still not great, though, because I'm exhausted from all of that effort plus anxiety over what's going on in the world.

But, for today, I'm thankful I can use my computer without too many issues and no-one I love is sick. And that's good enough.

Saturday, March 28, 2020

Perfectionism and Anxiety

Write about anxiety over getting my eyes checked - wanting them to double check.

Being Socially Isolated with Mental Health Issues - A Perspective for Loved Ones

One of the mental health conditions I deal with is social anxiety. So you would probably think that I rejoiced when the CDC guidelines came down about social isolation. 

However, social anxiety doesn't mean I want to be a hermit. I still crave certain types of human interaction, just not all of them (like crowds, small talk, or making phone calls), and the amount of anxiety I feel about social situations varies depending on where I am with my other mental health issues. In fact, with everything going on, I need social contact more than ever.

In my case, I have bipolar disorder, type 2, which means my mania isn't as high as type 1 but my depression can go lower. I also have generalized anxiety disorder, major depressive disorder, social anxiety, agoraphobia, addiction issues, and I'm pretty sure I have ADD.

When I am manic... 
I get hyper-focused on multi-tasking several things. So in this case, when a friend reaches out to me, I often ignore the phone call or text until a later time "when I'm finished with what I'm doing." 

It's not that I'm ignoring that person as I often really want to touch base, especially now when there's so little regular human interaction taking place. It's just that once my brain is locked on to getting certain tasks accomplished right now, I can't switch out of that mode quickly. 

In my mind, I always think I'm almost finished and I can call or text that person right back. But then one of these possibilities usually occurs:
- I take much longer than I thought to complete the tasks and the person is no longer available; or
- I am absolutely worn out from my frantic focusing (seems like an oxymoron but it really isn't) and I just can't deal with communicating with anyone at that point; or
- I just plain forget that you called because the part of my brain that remembers those types of things was being used to keep up with all of the tasks I was trying to accomplish.

To my loved ones: 
Please understand that I'm not ever ignoring you because I don't want to hear from you or because I don't value our relationship. I know that if I did manage to stop what I was doing to take that call or reply to that text, I would be very distracted. My plan is always to wait until I have calmed down from all of the tasks to focus on you. The problem is that it rarely works out that way. If you haven't heard back from me soon, don't assume it's because I don't want to talk. Reach out again.

When I'm anxious... 
Another way I'm affected during social isolation is how hard it is for me to reach out. This is due to my social anxiety. Making a phone call can take a herculean effort. It sounds crazy and when I step back and look at it, it is. 

I will often put off making a phone call for hours or until it's too late, even when I really need or want to talk to the one I'm calling. I've always assumed it's because I don't want to disturb that person but I don't know if that's the actual reason or just one I can deal with. It also may be fear of rejection... if the phone isn't answered. It doesn't matter why I feel this way though because I've tried to overcome it and I haven't been able to.

Anyway, texting is easier to use for initial reaching out but it's hard to really have a good conversation. The way I often get around this is that I will text someone I want to talk to and ask if I can call. That's also awkward if it's someone I don't know well (and impossible if the person doesn't text or if it's a business call) so it doesn't work in all situations.

To my loved ones: 
Please understand that I want to reach out to you so much more than I actually do. I think about it many times during the day but if I'm having a hard time with anxiety, making that initial contact with you can take more effort than I have, especially with all of the anxiety that COVID-19 has brought. Don't forget about me and reach out to me, as when I'm in this state I can take calls and texts... I just can't make them myself.

When I'm depressed... 
Depression is a time that it's hard for me to communicate with others no matter what. However, when I'm really depressed (and sometimes when I'm really anxious), I need to know you are there for me more than ever. 

Clinical depression is a state where you often literally can't make yourself do what you want to do or enjoy. Concentration issues, crying, feeling hopeless, apathy, and irritability are other common symptoms. 

During a depressive phase, I need to know that someone cares while at the same time I don't want to burden others with how I feel. I don't want to snap at you because I'm so frustrated I can't stand it or spend an entire conversation on the phone crying.

To my loved ones... 
If we haven't communicated in a while, please make the effort to reach out to me. If you call, know that I might not be able to talk. Talk to me. Tell me about your day. Something as simple as listening to you breathe while you watch tv can help, even if neither of us says a word. It's a reminder that someone is out there and cares when I feel so alone. If I'm severely depressed, a phone call at the right time can literally save my life (and actually did for my daughter).

So what do you do when the one you love is like me and has multiple issues that each take different strategies to overcome? I have talked to my boyfriend, daughter, and friends when I am in a good mental health state about these issues so they know how to respond when I'm not. I also never mind being asked at the beginning of a conversation where I am with my mental health, so ask if that's an option in your situation.

Just don't give up on those you love with mental issues, ESPECIALLY during this fearful time in history. We need you now more than ever.

(At least I don't have to worry about my agoraphobia, as there are no crowds right now! 😅)

Sunday, March 22, 2020

Boredom x Depression + Anxiety = Misery

I am getting bored. Not the "I don't have anything to do" kind of bored, because as a freelancer, I ALWAYS have something to do.

However, I'm getting to the "there's nothing I want to do" stage of this COVID-19 social isolation quarantine. I pushed through this past week and even was able to do some of the things I didn't want to do. This was mixed in with things at least didn't mind doing or at least items I wanted to check off my list so badly that I got them done.

But you know how there are things on your to-do list that are overwhelming for one reason or another... those things you tend to procrastinate with much more than everything else? I'm at that stage of my "what to do during the quarantine" list.

The next points on my list are either difficult, for little reward, or just plain ol' not fun. My anxiety is at a level where I'm kind of shaky from nerves no matter what I do. My depression is at a level where my motivation is almost nonexistent.

One of the major characteristics of depression is that you don't want to do activities that you previously enjoyed doing. One characteristic of anxiety is having trouble concentrating due to the racing thoughts you just can't get rid of. This makes any task extra hard to do.

Take, for example, watching TV. There isn't a TV show, Youtube video, or Netflix movie on that will overcome the racing thoughts I'm dealing with as well as the nervous feeling that makes it hard to stay still. (It's hard enough sitting here at my desk to do this, but at least my mind and fingers are busy.) My go-to when I can't find anything else to watch is usually a comedian. Nothing is funny right now. I'm not crying at everything so that's a step in the right direction, but laughter feels very, very far away.

Another example is Candy Crush. I would almost consider myself a Candy Crush addict, as there are times I want to quit but I keep finding myself saying, "Just one more game," until I run out of lives, even if that means another hour has passed. I still play but purely because it's a habit. I don't find it enjoyable. Before all this happened, I only had a limited amount of time I could play, just because I was so busy. Now, however, I keep reaching for my phone to play when I know I have more lives, but it's just not fun. It's kinda stressful, in fact.

I love organization and I've been cleaning out stuff, trying to find things that I can sell to help pay bills while photography sessions, rideshare, and mystery shopping jobs are almost non-existent. That gets really old too, due to the depression symptom: "things I used to find enjoyable no longer being fun."

It's a task... something to do to be productive... something to do to be proactive and keep from going crazy worrying about finances. However, almost nothing I've listed is selling. I'm sure others are worried about finances too so I didn't expect lots of sales. Out of listing lots of stuff, I've only sold one item.

It makes it harder and harder to list each new thing because in the back of mind I hear a voice telling me I'm wasting my time. There's also a voice that seems to get louder the longer I do this that says, "You might need this one day so you shouldn't get rid of it." The voices are unrelenting and wear me down over time.

Decisions, even small ones, are always difficult for me. My anxiety tells me I'm making the wrong choice so I research and research to at least up the odds in the favor of making the "right decision." When I'm in this state, it's so much worse. Culling photos, which is something I could do 24/7 for a week and still not get through all of them, is hard; editing photos, of which includes a multitude of decisions for each image, is darn near impossible. Making a decision on something important, like which ideas I should try to pitch to the newspaper I work for, makes my head hurt to think about.

Then there is my go-to when I'm anxious or bored or depressed... food. I'm trying to use the principles of my eating disorder 12-Step group and I'm working on not compulsively grabbing food when I'm in this state. But food calms me down. Depending on the food and the moment, it can be a physical rush with an instant peace that comes over me. I haven't been working that program long enough to know how to deal with times when I feel like this. I think it's very similar to someone addicted to drugs or alcohol - there's literally nothing that gives you the same feeling - so it's very hard to come up with alternatives.

Add having mental health issues... in my case, major depressive disorder, bipolar disorder, and various anxiety disorders to the mix... I wonder sometimes if there is anyone else with my combo of mental health issues and addictions who successfully recovered. If so, how?

I haven't given up... yet. I am still trying to do my food plan and trying to not act out. (By the way, I'm successful at one but miserably failing at the other - from what I said above you can probably guess which is which.) I need something to cope with this stressful time. I know food isn't the answer... but what is?


Tuesday, March 17, 2020

Anxiety... By a Stuck at Home Freelancer with Mental Health Issues

It has been a while. I have been sick, then super busy making up for being sick, then just super busy. This blog has been pushed aside more than once when I really wanted to write... because, in this time of such uncertainty, I felt that blogging wasn't being "productive" (with my definition of the moment meaning somehow do something to make money). Well, I hit the breaking point just a few minutes ago and it doesn't matter if it's "productive" or not, I need to write.

The timing has been weird on this one. I'm about to have cataract surgery and due to a test I need to have before the surgery, I had to go without contacts for a week. Given the nature of my businesses, wearing my old glasses has made it very difficult to do some of my jobs and impossible to do others.

I have known this for a few weeks and have been preparing for the loss of income and work. I was very proactive by making a list of things that I've been putting off for a long time that needed to be done. I knew this would keep me busy and not feeling so bad about the loss of income. I actually wasn't anxious during the beginning of the news about COVID-19, maybe because I was already mentally prepared for downtime.

Then COVID-19 hit my immediate area, one of the last states in the country to really be impacted. When I was just missing work due to wearing my glasses and recovery from the surgery, I could still make money a few other ways, just not as much. However, because I live with my parents who are very high risk, it's safer for me to stay home. COVID-19 killed that potential for "not as much" work that I was still hoping for during this time.

Add to that, I hit a down cycle in my bipolar disorder and have been extremely depressed. Several other things have happened personally and with some of those I love that have been hard to deal with. The support groups I rely on have had to cancel (though we were able to pull off a phone conference for one last night).

The biggest issues I'm dealing with right now that are so hard are the lack of control and uncertainty. I'll talk about each of those separately.

Control... Everyone loves to be in control. World Wars have been fought over control. Marriages have been lost over control. Businesses have fallen apart because of control.

But control is a defining characteristic of an addict. Trying to control others and the environment and failing is one thing that leads to addictive behavior. Not being able to control the addictive behavior leads to shame and a feeling of worthlessness.

So I'm an addict who has major depression and anxiety issues and is a freelancer who can't work for who knows how long. In this environment, there is so little I can control. I'm not doing well.

Uncertainty... I think we are all programmed to know that we can deal with just about anything for a specified amount of time. When I was still in college, I remember thinking that I could deal with any subject or any professor for just a quarter. If I know that I'm going to have a medical procedure or if I'm sick, I have an idea of how long it will be until I can get back "to normal."

Not knowing how long this will last, what will happen before it's over, and what will be the aftermath is a huge problem for me. I have lived through some horrible times in my 50+ years and there was always an end. So intellectually I know there will be an end to COVID-19. But the biggest issue is what my life will be like when it's over.

For several years now I have been building a photography business - specializing in event photography. I was just starting to build up some momentum in my business. Big events have obviously been canceled left and right. It's scary to not know if the businesses will still remember me when it's over.

Of course, I'm also worried about my parents. I'm worried that they will get sick... and I'm worried that if I leave my house it'll be my fault. Both my boyfriend and my daughter are high risk so there's a little worry about them getting sick.

Surprisingly, I'm not worried at all about me getting sick. For myself, I'm worried about being inconvenienced... specifically with my cataract surgery. Wearing glasses for this week has been truly horrible. If the test is canceled at the last minute, then all that misery will have been for nothing. If the surgery is put off, then it's that much longer before I can get back to work full-time after recovery.

I know I'm whining... I know that I'm one of the many dealing with all of these issues... I know that there are many others who have it worse off than I do... In this case, though, knowing I'm not alone in how I feel doesn't matter one bit to help me feel better.

The only thing that has made me feel better in this time has been to help others. Setting up the phone support group last night was one of the better times I've had the last week. Knowing I was doing something for others kept me out of my head for just a few minutes. It didn't lift the overwhelming depression I'm feeling but did keep me going for a little longer while I'm in the midst of it.

There is no better time to recite the Serenity Prayer... and really try to live it. "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

Thursday, February 20, 2020

Choices... A Love Story

This blog is so serious and often very depressing. I tend to vent about all that is wrong in my life and sometimes forget that there's a lot good there too. So, though late because I've been very busy and somewhat sick, in honor of what Valentine's Day really means (not what Hallmark/the chocolate companies/the flower shops try to make it into), I present my personal love story...



They met online. Each had been involved in a long-term relationship that ended. They both realized, once distanced from these relationships, that they had been toxic. Each was an amazing person who had a lot to offer a partner but had been beaten down by the ones they chose.

Photography brought them together as it was highlighted on each of their dating site profiles. It also almost brought them apart after one asked the other… “Canon or Nikon?” and the answer was wrong. She was Nikon; he was Canon. It was so sad. They would never be able to share lenses or even speak the same language for settings.

This budding relationship was further hindered when a similar question was asked… “iPhone or Android?” Again, the answer was wrong. She was Android; he was iPhone. They also would never be able to Facetime or share all the same apps – and he was able to hear Siri’s angelic voice when he needed information where she had to almost yell, “Hey, Google!” to get the same response.

Thankfully, the last major question… “PC or Mac?” was answered the same by both parties. They were both PC! Though this wasn’t as big an issue as camera brands and cell phone platforms, it seemed there was hope after all. This led to their first face-to-face date which included barbeque and kissing by a lake in the moonlight. Neither wanted it to end.

By this point, they had learned enough about each other to want to try to overcome those two earlier almost insurmountable barriers. Maybe it was because each had known what it was to love someone who took advantage of that love. Maybe it was because they did have a lot in common after all, despite their oppositional preferences of cameras and phones. Maybe it was because there is such a thing as “soul-mates” and this powerful connection was felt by both.

Whatever the reason, they quickly became great friends. They found a spot by a river that was almost exactly equidistant between their homes where they would meet and hang out. Free time in between date nights was spent talking and texting each other. It quickly became routine to stay on the phone each evening until she, an early riser, was almost asleep.

Need it be stated in writing? It seemed that they were falling in love.

There was one other major barrier, though… She was also dating someone else. He worked in Information Technology. Actually, Mr. I.T. was the one who encouraged her to date others as his wife had passed away and he realized he wasn’t ready for a serious relationship. She hadn’t dated him long, but she thought she might love him.

Because she had never been the kind of person to date more than one person at a time and she couldn’t keep such an important secret to herself, she soon let each know about the other. Mr. I.T. was a little blue, as he kind of hoped that she wouldn’t find someone else and would be there for him when he was ready. Mr. Photographer was caught off guard but wasn’t upset because they had never discussed being exclusive.

For a couple of months, she pondered incessantly about what to do. Each one had characteristics that she loved. However, she knew she couldn’t go on indefinitely dating both as it was tearing her up inside.

Finally, she made the difficult decision.

She first went to talk to her soon-to-be former love interest, Mr. I.T. He was sad but wasn’t surprised. He knew her well enough to notice that she had been rapidly falling for the other. They both cried as they said their goodbyes and promised to stay friends.

Then she called the other. He had a difficult time comprehending her through all her tear-filled hiccups. All he could understand through the blubbering was that she wanted him to meet at “their spot.” Though it was late on a weeknight, he immediately said he would head that way. She did the same.

When he got there, he invited her into his car, wondering and worried about the outcome of this conversation. He then just held her, trying to calm her down so she could tell him what had brought on the waterworks.

She was finally calm enough to say three little words. No, they aren’t the words one might expect to be said in this situation, but it meant even more than the standard three little words...

She said, “I choose you."

She is still choosing him to this day.



Tuesday, February 4, 2020

Tired - So... Very... Tired...

I'm tired... Exhausted... Fatigued... Drained... Consumed... Spent... Empty... Wasted... Pooped... Worn out... Done for... Run-down... Finished... You get the idea.

Everyone close to me (including myself) has a chronic condition and/or illness:

- My mom has a laundry list of conditions but right now, she has been having fainting spells?/seizures?/something like that. She already has had several falls in the past few years, with many of them requiring at least an ER visit and sometimes a hospital stay. But the thing is, they can't find out what's wrong so they can't treat it.

- My dad has heart and blood pressure issues and is a diabetic. He has had a sore on his foot since last summer and it looks like there infection in the bone. Most likely he will need surgery but they are getting a second opinion. Until then he's supposed to try to stay off his foot but the lack of movement makes his diabetes worse. It's pretty much uncontrolled and he needs for his blood glucose to stay below 150 for his foot to heal. It's not even close and if he has surgery, then that will also have to heal.

- My boyfriend has an auto-immune disease and depression. The auto-immune disease has been flaring up a LOT recently and he's having a hard time making it through work each day. Though it's early in the evening, he's asleep right now and this is not the first evening he has had to do this recently. Everyday life wears him out and he used to be the epitome of healthy and athletic.

- I have many physical and mental issues, which I won't go into now. But I'm in a down cycle with my bipolar and I am having something go on with my stomach.

- But my daughter is the one who has torn me up tonight. She has fibromyalgia, POTS (dysautonomia), depression, anxiety and major back issues to name a few things. Today she is hurting so badly she couldn't even get in the car to meet me for supper. She's just 20 years old! It tears me up. She needs to get a job but she can't in her condition.

And I can't fix it - Any of it.

GREAT! My mom just came in here (I live with my parents) and my dad is sick and she says he's burning up with a fever. It won't ever end...

And I don't know how I'm going to make it. I very much want to just be the last synonym in the first sentence: Finished.

Awareness About Those Who Are Really Overweight

Weight problems are a huge issue in the US and even worldwide. We have access to food too easily and we often don't have to walk to commute in many areas of the country or work a physical job all day. Add to this, medications we take can add weight and it has nothing to do with overeating.

This also applies to anyone who has issues with not being a typical size - too tall, too short, too thin, physical differences... The world is made for the average person, as it should be. But when someone who is different has to live in a world built for the average, it can be an issue.

So this letter is:

To everyone who is of a typical size:

It is somewhat of a compliment when you treat me like everyone else. I appreciate it when you look at someone my size and not automatically think that I need every accommodation in the book.

But on the flip side, there is so much I wish you knew.

1 - If you are a hostess and there's someone really large in the party, even if they don't ask for it, know that a booth can be at the least, uncomfortable and at the worst, really embarrassing when you try to slide in and just can't fit. If a group has someone pretty large included, save everyone some heartache and offer them a table instead (and not a high top.)

2 - If you are a tour guide and there's someone with mobility issues (that could be either from a handicapping condition or just being big), please slow down. It's again really embarrassing when most of the group takes off and gets way ahead and the person with issues is behind and alone.

3 - If you have some kind of meeting or event, anything from a Sunday School meeting to a wedding, please be considerate of the seating. It's difficult to admit out loud (or literally in writing) but I don't fit into some chairs with arms (or they really, really hurt) and I am terrified I'm going to break a flimsy chair like a plastic chair or a non-sturdy folding chair.

I know sometimes there's just not an option and I can't speak for every big person, but I would much rather have the person leading the meeting/event come up to me privately before it happens, explain the options, and let us talk about it before I get there. Those options can include: bringing in another chair just for that person and also ask that person where he/she would like to sit and somehow reserve that seat and the ones around it for those who come with him/her; making sure the chairs are all big enough; or just asking the person in question what he/she would prefer to do. Some would rather take a chance or be in pain so don't assume that the person necessarily wants something different, either.

4 - If you are catering an event, don't assume a particular need for a type of food to either include or exclude. Some who are obese aren't on diets or might be on a diet where he/she can only eat at certain times but the types of foods don't really matter. Some need specific foods. Just think how you would handle a friend who has a food allergy/intolerance and give the big person the same consideration.

5 - If a larger person is riding in a car with you, let him/her choose the seat. Personally, sometimes I choose the back even if it's a tighter squeeze because it's embarrassing to get into a car and not have the seat belt fit. I know some states have laws about those in the back seat having to have a seat belt on too, but if neither will fit, I feel much more comfortable taking that chance in a back seat than up front.

6 - If you go to an amusement park with a group of friends and/or family, remember that the one who is very overweight won't fit into a lot of rides. As safety standards have gotten much stricter, the number of restraints on rides, especially roller coasters, have increased. If the person in question doesn't want to wait in line only to then find out that they don't fit, the embarrassment has increased exponentially. Don't try to coerce them to try, even if you would have ended up being right. It's not worth it many times to take the chance.

On a similar note, I applaud parks like Dollywood who have seats at the entrance to the line for you to test yourself and see if you can make the restraints "click".  I do wish they would be in a more discrete place than out in the open (because it's still embarrassing to have it not click even if you haven't waited in line, just not as much) but I don't know if there's a way around that.

I also applaud those ride workers who are very discrete in the way they hand me a seatbelt extender on rides that take seatbelts without my having to ask. It's no fun to have to ask for one, especially if the ride is loud and you practically have to yell it or the ride is stalled from starting because you didn't realize it would be an issue until you sat down and it didn't fit.

7 - For concerts, plays, and similar events, I know lots of people like to sit in an aisle seat but if there is limited seating left in a general admission situation, please move to the middle and allow the big person to sit on an end. I have sat through performances with my arms crossed across my chest the entire time because I didn't want to bother the people sitting on either side of me. If I'm in an aisle seat, then I only have to worry about one person to not bother because I'm too big for the area.

8 - This leads to air travel. I love to travel and sometimes I have to. I can't afford to buy a 2nd seat and I technically fit into one - it's just really tight. I know it's uncomfortable if you end up sitting beside a big person but you could also sit by someone extremely annoying, or talkative, or who doesn't understand personal space. Please don't embarrass us (or yourself) by automatically assuming that we are the worst seat-mate you could have and begging to be moved.

From an atypically sized person who has to live in a typically sized world

PS - Some hints I've learned for others of atypical size like me:
- Find an airline where you can choose your own seat. I personally love Delta for that feature but I'm sure there are more. Get a seat as near to the bathroom as you can. Going up and down those tiny aisles with people trying to sleep or eat or read and somewhat spilling out into said aisle is difficult. If you are traveling with a companion, find a row with only 3 seats and choose the ones on either end for you and your companion. If the flight doesn't sell out, you have an extra seat between you. If it does, you can always ask the one stuck in the middle if he/she would please switch.
- Get in the habit of just asking for a table instead of a booth (and after a recent bad experience, if the restaurant has high-tops, specifically ask for a low-top table).
- If you are going to an amusement park, do some research ahead of time to find out which rides are, as one atypically sized comic says, "fluffy-friendly". Sometimes you can find out that information on the website but I've found calling works even better.
- I have found handicapped seating to be my friend. Some places are very strict on someone being in a wheelchair, but again, if you call and describe the situation, I have found that most are accommodating. Theatre seats, especially those from years ago, are really small and uncomfortable.
- When I book a hotel, I request a handicapped room because it's often on the ground floor and the tub/shower is easier to deal with. I tell them that I'm not in a wheelchair and it's just a request, because I don't want to take it from someone who needs it more, but again, I have found that more often than not, it's available.
- About the seatbelt issue, I usually offer to drive. I like driving and then I don't have to worry about the seatbelt not fitting with another car. Also, because my car has difficult to fasten seatbelts for everyone, I bought a seatbelt extender. You can find them on ebay or Amazon and it makes life so much easier (it's also great for those who wear big coats). If I am going to ride in another car, I can always take the extender with me.


Monday, January 27, 2020

Fooled Again

I hate... hate... hate having bipolar disorder. It's so sneaky and even though you know you have it and know what it does, it still can fool you.

Last week I had some really bad things happen. However, I used what I've learned in the 12-step program, support groups, and counseling, and dealt with them all. Unlike my norm, I didn't stress too much over it or worry constantly on how I could change each thing that happened. I worked very hard at letting go and surrendering.

This time was the most peaceful time I've had in a while - a long while. I was on cloud 7 (cloud 9 is still just a little too much right now). I got together with a friend for lunch early in the week (my social anxiety usually doesn't let that happen - I might make plans but often can't carry them out). I got a lot done at my desk and even though nothing I did was for pay, I didn't stress. To top it off, on Saturday I went out with some friends for lunch and I realized I was participating in the conversation and even found myself laughing. Not fake laughing because I'm tired of being sad, but honest-to-goodness find-something-funny-and-laugh kind of laughing.

The mood stayed through Sunday. I signed a song for the deaf church I attend and even though I messed up some, I didn't beat myself up. I did rideshare for a little bit in the afternoon but when I wasn't getting rides, I didn't worry about it. When a ride took me close to home, I didn't analyze to death whether I should quit earlier than planned or not - I just went on home.

But the real kicker was this morning. In my journal, there's a prompt that asks what I am excited about. When I first got the journal about 3 weeks ago, I wrote things that I was looking forward to, but never could say I was "excited" about them. Later I couldn't even name anything I was looking forward to, as my depression got worse. However, this morning, I actually said I was excited over some possible upcoming opportunities. I wasn't lying one bit about it - I actually FELT excitement over those things.

So when I started a nose-dive into a depressive cycle later this same morning of finally feeling excitement for the first time in a while, I was truly caught off guard. I know that my bipolar won't just go away. But I thought that the things I was doing - finally committing to an eating addiction 12-step program and an eating plan; drinking more water and much less soda; hanging out with friends; making a major effort to not stress about things I couldn't control (think Serenity Prayer) - would keep it away a little longer. I thought that as long as I kept doing all of these things that I assumed had made the depressive cycle lift in the first place, it would stay gone.

 I was wrong.

I've never thought about it this way, but maybe my bipolar is also one of those things I can't control. Maybe the mania and depression will come no matter what I do. Maybe I'll never get consistently  "well".

I already wrote about a very similar experience last September in "Realization About Progress Not Perfection." I'm trying to remind myself now what I realized then - I may never get "well" but I can keep trying to make each day the best it can be, no matter whether I'm depressed, manic, or one of those rare times I'm stable.


Friday, January 24, 2020

A New/Old? Mental Health Issue... Really?!

So... I'm working on a document and in it, I'm describing some of the mental health issues I had when I was in my early 20s. I thought one condition I had was called agoraphobia but I get all of the phobias' names mixed up so I decided to research it to make sure.

Some background... My panic disorder started at that age (or my late teens, I can't remember exactly). It got so bad that I developed a mild version of agoraphobia. I would leave my house only to go to work and to church but wouldn't go anywhere else. Even work and church were difficult but my sense of responsibility somehow prevailed during those times.

As many of us with mental or physical health issues do, I was a good actress and acted like I was okay when I was away from home, but I was a basket-case otherwise. Looking back, I was already displaying signs of both my addictive-prone personality as well as bipolar disorder, but then I had no clue mental health was really the issue.

You probably think, "How could she NOT think that mental health was the issue with panic disorder and agoraphobia?" The times were very different then. Most people didn't believe you if you had major depressive or anxiety disorders (which I also had) - they thought you just needed to think more positively or "just let go and let God."

Actually, I guess times haven't changed that much, as many people still believe those things about mental illness. But there are many who are learning about it and there are so many more systems to help now than there were then (mid- to late-80s) - from counselors, to medical professionals, to support groups, to online publications and communities.

During that time, I was diagnosed with Mitral Valve Prolapse (MVP) which is greatly associated with two conditions - a form of dysautonomia and panic attacks. It was treated much more from a medical (physical health) viewpoint than a mental health perspective. I took meds to help regulate my heartbeat. I drank lots of water with electrolytes to raise my blood volume (another issue with these conditions). I also tried to find patterns on when I usually had panic attacks - which for me were too little sleep and/or too much caffeine.

Once I did those things, the panic attacks didn't go away, but they lessened in frequency and severity. No one told me that I needed to get to the root of the problem, which was my anxiety disorder. But the agoraphobia got better as the panic attacks lessened and I assumed that I no longer had agoraphobia because I was again able to leave my house without too many issues.

Jump to this week and my realization... When I looked up what agoraphobia was, just to confirm it was the phobia that deals with not leaving the house, I found it was so much more.

Mayo Clinic's website defines it as "a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless, or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd." (https://www.mayoclinic.org/diseases-conditions/agoraphobia/symptoms-causes/syc-20355987) That alone answered my question about it being the correct term, but that last line nudged me to look more into it.

What I discovered blew my mind... My go-to medical site, WebMD has lists of causes and symptoms.  (https://www.webmd.com/anxiety-panic/agoraphobia#1)
Their site states:
               "With agoraphobia, you might worry when you are in:
                        - Public transportation (buses, trains, ships or planes)
                        - Large, open spaces (parking lots, bridges)
                        - Closed-in spaces (stores, movie theaters)
                        - Crowds or being in line
                        - Being outside of your home alone
              Symptoms may include:
                        - Fast, pounding heart
                        - Sweating, trembling, shaking
                        - Breathing problems
                        - Feeling hot or cold
                        - Nausea or diarrhea
                        - Chest pain
                        - Problems swallowing
                        - Dizziness or feeling faint
                        - Fear of dying"

I still have this! I can't stand crowds and avoid them at all costs. I have to sit on the end of the aisle or the front row when in an audience, and I need space between me and the next person (not always possible, which freaks me out). Online shopping was a God-send for me because I can't stand going into stores. I always try to sit where I can see the door and/or most of the room at a restaurant or event where we sit at tables. I will wait if there is a line (I try to be either first or last) and don't go to areas like amusement parks on days they will be crowded, both because of the crowds and because of the lines.

I have attributed all of these things to other issues, such as social anxiety disorder, generalized anxiety disorder, panic disorder, major depressive disorder, and bipolar disorder. Where one starts and another stops is a mystery. I'm not even sure if a person can technically have all of these disorders or if everything would actually fit into one - like my bipolar disorder.

In my research, I found out that agoraphobia is one type of anxiety disorder, with some of the others being social anxiety disorder and panic disorder (https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders) I did also find out that a person can be diagnosed with more than one anxiety disorder (https://www.rand.org/pubs/research_briefs/RB9525.html) but I'm still not sure how that fits with the bipolar.

It really doesn't matter in practical terms, though. Anxiety disorders all have very similar symptoms and treatment options. The reason I'm glad I came to this realization, though, is that it explains more of the behavior that has become so much a part of me that I didn't even realize it needed to be addressed. Now that I know that it didn't "just go away" when I was young and I'm still dealing with it at times, I can bring it up in counseling and maybe one day the fears I have that are associated with this disorder will be much more manageable and I can live a better life, with a few less fears.

Tuesday, January 21, 2020

It Sounded So Simple...

I went to a dietitian yesterday. That in itself, is somewhat of a small miracle. I can't afford a dietitian, though I've needed one for a very long time. But in December my numbers finally got bad enough to technically become a type 2 diabetic. Though that's not a good thing, something else happened at the same time.

My insurance company started including dietitian services for those who are diabetic. I think that started in January of this year, though I may be wrong about that. But anyway, because of this change, I could afford to go to this dietitian and get some help.

Since my very first meeting with a food addiction 12-step group, I knew it was the answer I was looking for. I have known and seen success in my other 12-step group and knew that it was possible. But from the way everyone was defining abstinence (though I knew in this program you come up with your own definition), I wondered if I could ever deal with being so strict.

We are talking MAJOR food issues with me. I've never had a normal relationship with food, not even when I was very young. My older brother wrote an essay for school about his "red-headed little sissy" who would "burn the soles off her shoes if she heard someone in the kitchen because they might be getting out something to eat," talking about when I was a toddler.

And there are so many barriers to not being able to make this work now. My bipolar isn't under control; I live with my parents which brings major stress; I'm trying to start a business and I'm always in major stress from that; my mom is a food hoarder and there's literally no room in the pantry, the kitchen refrigerator, the refrigerator in the garage, and the very large deep freezer for me to keep some foods that I like or want to cook; cooking is difficult because I have to keep the kitchen clean and my mom wants to be involved (which translates as "wants me to prepare stuff her way"); there is always junk food laying around; my schedule is constantly changing; I'm extremely picky on what I like to eat and don't; I am nauseated most days... I could keep going but I'm sure your eyes are glassed over by now.

Needless to say, it's not the time to start something that will be an added stressor on top of an already incredibly stressful life. But I can't wait.

So I got what I called a pre-sponsor until I was entirely ready to tackle this. During that time, my pre-sponsor would give me some encouragement when I told her I didn't know how to do this. She was there to support me before I was ready to take any real steps towards abstinence. This gave me time to try to think through some of the above issues and see if I could figure anything out.

Then after the holidays were over, I told my pre-sponsor I was ready to get to work, even though I was terrified of doing so. We planned to meet tonight but ended up having to cancel. So this past week I was trying to get ready for this first meeting.

Like I said before, within this program, you define your own abstinence. Most choose foods that they tend to eat compulsively and avoid them. Many have a meal plan where they weigh and portion their food and even might email it to their sponsors each week. Some avoid entire categories of food - like no sugar or non-whole-wheat breads.

I knew none of those wouldn't work for me. For me, it's not a particular food that causes me to eat compulsively. I have had times where I had a half-eaten candy bar in my desk for weeks and other times I thought I would die if I didn't eat peanut butter every night before bed. So I do have foods that I want to eat compulsively but they constantly change.

I finally figured out that it was situational. I will compulsively grab a doughnut off the counter if there's a package of them sitting out. I will grab something to munch on to keep me from falling asleep at my desk or will run through a drive-through for the same reason if I'm out late at night. It could also be if I'm bored, or stressed, or depressed, or on the flip-side, manic.

Because of this realization, I had already planned to go into the meeting with my sponsor wanting to discuss having times when I could eat and when I can't. This would mean that if I'm extremely exhausted but it's not during a planned time to eat, I would have to figure out a way to get through it without food... and the same with the other scenarios. I didn't know how that would go over but it just felt right to me.

Back to my dietitian (you probably wondered if I had forgotten about her). She was amazing. She listened to me and I didn't feel at all condemned by my weight. After listening to all of what could be taken as excuses, but are just my reality, she said that we needed to start simple. She wanted me to focus on two things.  1 - drinking water instead of diet sodas through the day (which she blew my mind about, telling me that your brain thinks diet soda is the same as regular and even though there are no calories and no direct weight gain, your brain tells your pancreas to shoot out insulin, which messes up everything). And 2 - eat every 4 hours, and don't eat between those times.

WHAT?! She basically told me, as far as food goes, to do exactly what I had already come up with for my abstinence plan. I was riding high. I was hyped. I had thought I could do this and now I had a professional to back me up. How hard could this be?

Turns out, very. It's my first day trying this out. I drank only one soda this morning, though I did have tea with supper (very, very watered down). I woke up super early and had forgotten to eat supper last night so I was so hungry I could barely stand it. I ended up eating breakfast about 5:00am. Four hours after that would just be 9:00am, which is way too early for lunch. So I compromised and ate a snack around then and ate lunch about 1:30pm. Supper was a little late for the four hour rule - 6:00pm - but my stomach has been torn up all day and it was hard to think of something I could get down. My plan is to eat a small snack before I go to sleep.

So far I've been able to do it. I got super stressed and depressed earlier today and it was during an in-between time. I wanted to grab something to eat so badly I could hardly stand it. But I made it through. The water has been a bigger issue than I thought. I go through phases where all I want to drink is water and other times I can't stand it. I'm much more towards the latter at this point. But other than the watered-down tea, I've been faithful to drink my water through the day.

It's not going to be easy, but I know it's possible. I do plan to add more parameters as time passes - probably drastically stopping or eliminating sugar for example. I also want to build up to almost never eating in the car, which is a huge problem for me. But this is where I can start and with the help of my  a food addiction 12-step group friends and the 12-steps, I'm hoping I'll learn how to deal with life without food being my go-to. Maybe one day I'll be at least mostly free of this horrible disease.

Friday, January 17, 2020

Exhausted and Overwhelmed

So many "shoulds"... I should be resting. Or I should be out making money with Uber and Lyft. Or I should be doing one of the myriads of other items on my current To-Do list...

But I'm not doing any of those things. I need to process this day and this week even more than those things. I'll get them done eventually.

It's been a rough week. My depression has been at one of the lowest places it's been in a while. I often don't cry much when I'm depressed (though it happens sometimes), but this time I've felt like crying almost constantly for several days.

After thinking about it a lot, I've realized there are several reasons that may not be the cause but are at least likely to be contributors. One of my best friends has been mostly MIA for various reasons, none having to do with me. I understand why he hasn't been available but I've missed him terribly anyway. It also made me feel so helpless because there was nothing I could do about the situation.

Another best friend has also been missing but it's a very different context - my 20-year-old daughter. She in her first serious relationship and is spending any free time she has with this person. I knew in my head that this empty nest thing would be coming up soon, but I honestly thought it was when she moved out. I never realized it could happen while she technically still lived in the same house I do.

Every time I talk about her being one of my best friends, I can hear the chorus saying that you need to be a parent to your child and not a friend. I see the wisdom in that. But she and I have been through some major hell the past few years together and it's bonded us in ways that aren't just a very close mother and daughter relationship. We have a lot in common and have had a lot of both fun times and really, really bad times together. So I'm no ashamed to call her one of my best friends... and one with whom my relationship is drastically changing and there's once again nothing I can do about it.

So many other issues like finances or my health keep my anxiety at a moderate level under the surface constantly, even if life is going great otherwise. So this doesn't help.

If you've read my blog much at all, you know that my bipolar disorder, anxiety, and addictions affect every aspect of my life. The paragraph before this one isn't new information. Even the way I'm handling missing my friends isn't unusual.

But combine it with yet another week of dealing with my parents' health issues and it's just been too much. Again, if you have read my blog at all, you know that doctor and even ER visits are not uncommon in this house. There is never a week that goes by without at least 2 doctor visits (usually many more), and I'm not counting ongoing therapy or support groups in with that.

So when my mom falls again or my dad has another health issue pop up, I know the drill. The majority of the time I'm calm and collected. I know what needs to be done and I get it done. I gather up needed supplies or information; I inform my family; I take care of what needs to be taken care of.

Today when my mom had another issue (not quite a full fall, but she was so weak she might as well have), I felt like a basket case. I don't think I really let it show but I had a hard time figuring out what to do. I felt very scattered as I gathered up the things she, my dad, and I would need for an ER visit and possibly a hospital admission. I was mentally and physically able to drive to the hospital but if I had been just a little more upset, I wouldn't have been.

I'm at a loss about what to do now. I feel like I've been through a wringer. I had planned to do rideshare but I'm not sure if that's the best idea, given my physical and emotional state (my financial state is yelling at me to go and get to work though). The longer I sit here doing this, the more I realize the way I feel right now, it's just not safe for me to do rideshare. Maybe I could do it a little later tonight. But for now, I need to just be and let God take care of that particular worry.