The Midwife of Mental Health

In a very surreal moment, the kind you only see in movies or on TV, I was sitting cross-legged on the floor of my across-the-alley neighbor’s apartment telling her boyfriend to shut his mouth as I tried to soothe her during a panic attack. I had just hung up her phone from calling her mom and realized I should probably call her best friend back, I had got off the phone with her just a few moments ago and left her likely quite confused.

I have not yet once talked to this neighbor in the last 9 months that I have lived in my apartment. I’ve said maybe 12 words to her boyfriend on two separate occasions – he smokes out on their stairwell so I see him in passing. I was leaving to meet up with a friend at a set time and as I was dragging my stuff out of my place I noticed that my neighbors were arguing – very loudly – I just figured it was the 20-30 something typical couple’s fight of whatever and yeah, yelling’s ok to some people. It didn’t seem to be abusive and I couldn’t make out anything. As I came back out for a second round of my stuff to take to my car it had escalated, I could tell she was sobbing and he was shouting orders about standing up and breathing. He stormed out and I heard him on his phone talking about how she was having a panic attack and he couldn’t handle it. Then she was screaming after him to help her – then she screamed “somebody help me!”

So. . . fuck. . . I gotta do something. The boyfriend was being a dick. I can understand both sides of it because I’ve been on both sides. I’ve had bipolar breakdowns and flipped my shit on a partner before – something which at the time I could not control and was an absolutely horrendous mess. I suppose as a test of if I had learned the lesson life was trying to teach me, I have had the same out-lash inflicted on me. I’ve also had a panic attack and witnessed others try to help me with logic then watched their frustration escalate as their logic or “solution suggesting” failed to improve my condition – which can sometimes even further escalate their reaction to anger.

I believe this boyfriend reverted to the “suggest solutions” then “use logic” and once those two things didn’t work and he didn’t understand why – he flipped and started yelling.

Let’s get something clear. You DO NOT YELL OR ESCALATE when someone is having a panic attack.

If you know someone who has a history of panic attacks, it would be very kind of you to ask them what works FOR THEM when they are having an attack. If they prefer to be left alone – then you leave them alone. If they say they prefer to be left alone when they’re not in a panicked state then once the attack hits and they decide they want you by their side – you go be by their side.

I’ve learned these things (through research and experience) and as a completely unrelated bystander I was much better suited to help.

I knocked on their door – kind of terrified actually – and the boyfriend automatically started talking about whatever whatever at me but I went straight over to her, she was slumped over on the floor, leaning against the couch. I shushed him as he kept trying to explain her panic attack – I DID NOT need him to mansplain HER panic attack – I also didn’t need to escalate or assume anything so I just shushed him and focused on her.

I don’t really do touchy-feely stuff unless I’m in a relationship with someone. Even my BFF gets hugs but like, not all the time. This poor girl though, I just instinctively started rubbing the back shoulder blade area and I might have called her sweetie? I never use names like that. She was hyperventilating and asking to call her mom – she was on the phone with her best friend but hung up. I called her best friend back and explained who I was, and decided to call her mom. I assured her best friend that I wasn’t leaving until her mom arrived. Meanwhile the boyfriend was still talking at us – I don’t know their situation and I’m sure he meant to be helpful but no! I did ask her if she wanted water and when she said yes he went and got her ice water, so that was very nice.

I called her mom and explained who I was (this was so incredibly surreal – “Hi, I’m Jessie, your daughter’s neighbor. She’s having a panic attack. Can you come over? She’s asking for you. How far away do you live? Ok, I’ll wait here with her until you get here.”

It took her mom about 15 minutes to get there. In that time I called my neighbor’s best friend back and told her what was happening, I met the neighbors’ cats and learned that they all (the neighbors and the girl’s best friend) think my cat is very pretty (I’m assuming they see her in the window all the time), the boyfriend is bipolar (it was his excuse for not handling the attack well, I said NOPE! I’m bipolar too and that’s no excuse not to put your own shit on hold to help your partner), and I was remarkably composed for such a weird situation.

When I was rubbing her back I was gently saying that panic attacks, and mental health, are not things we can control and are not our fault. I might have given the boyfriend the stink eye some. But he chimed in with his excuses for not handling it well and how he’s had a panic attack once but then he researched it so he would never have one again. I calmly explained that – there is no logic in a panic attack, you as the partner are there to support the person and get them through it. Talk about solutions for the NEXT TIME when this one has passed.

A very very sweet moment where I felt oddly, proudly helpful – I asked her if she had a blanket or a pillow or some stuffed animal that really comforted her that she’d like to have. She didn’t really respond but her boyfriend hopped to and asked if she wanted her squishy pillow to which she perked up and he quickly went to their bedroom and got it for her. He poofed it up and helped put it under her head. It felt like he was finally calming down, listening, and maybe picking up on how this whole deescalation thing works.

As I recounted this story to my mom I blurted out that I felt like a “mental health midwife” and that’s exactly what it was. I filled a temporary need, pulling resources together, sharing information that will hopefully stick, and then left when the real players came in to really do the healing work.

I have not yet been back to my apartment today. I’m hopeful that they won’t be embarrassed or weirded out or anything when we run into each other next. This morning was not the time to tell them that it’s my own personal mission to end the stigma of mental health, but I did try to make them feel like I was a judgement-free zone.

And there you have it. A very bizarre Saturday indeed.

 

w-w-w-j-e-s-s-i-e-d-o-e-s-l-i-f-e-c-o-m

Also, just now researching it I feel like “psych doula” should be a thing – so I totally just registered that as a web domain and shall determine the feasibility of inventing it. I imagine it may be much like a life coach. A supplement to legitimate LMHC or psychiatric counseling. #bam

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Cocktail Hour – Mental Health and Medications

Treating Neurodiversity

When your brain chemicals work differently than most peoples’ and it’s enough to become a hindrance to your life, you may choose to address the issue with medication.

Bipolar II was a diagnosis I received something like 11 years ago.  I didn’t take it seriously until something like 4 years ago.  I didn’t find the perfect “cocktail” of medications until a little over a year ago.  And now, I’ll be entering new territory all over again as I change my cocktail in an effort to make my body chemistry the least destructive to reproducing.

 

My Personal Current Bipolar Medication Cocktail

I’m currently on three medications in three varying doses taken in the AM and PM.  I have one of those weekly pill divider things that I have to be sure to remember any time I go somewhere overnight.  I have to “reload” the weekly divider/dispenser every Sunday because if I left it up to “in the moment Jessie” to remember opening each of the three bottles every morning and every evening to take them, the odds are very slim that there would be any regularity.  I’ve tried a lot of the medications out there, including Lithium, and this past year has been a wonderful reprieve from the daily uncertainty of how my neurodiversity would allow me to feel.

***It is INCREDIBLY IMPORTANT that anyone reading this realize that what works for one person (or even the majority of participants referenced in a study) may not work for you.  Your psychiatrist is your most knowledgeable ally.

Currently I’m prescribed the below medications:

Lamotrigine, 100mg, 1 in AM and 1 in PM (brand name Lamictal, anticonvulsant and mood stabilizer)

Bupropion HCL XL, 150mg, 3 in AM (brand name Wellbutrin, antidepressant and smoking cessation aid)

Trokendi XR, 100mg, 1 in PM (anticonvulsant, nerve pain medication (migraines), and a whole lot of things that haven’t been tested enough to prove (mood disorders, alcoholism, binge eating)

 

Excuse me, bartender

I had an appointment with my OBGYN last week and we talked about these medications and their effect on pregnancy.  I started out by saying “Ok, so I don’t actually have a partner right now and this is years out, but I want to ask now, what medications can I continue for my mental health that won’t harm a potential baby?  Is that weird?  Too soon?”  She responded with a no and thanked me because apparently most women that she sees on medications for mental health just kind of stop taking their meds when they find out they’re pregnant.  Sometimes it goes just fine, but sometimes it makes things way more difficult.  So ok, I didn’t feel like some super duper A-type personality planning my life out way before I needed to.  She looked at her super official database and explained that there are categories for drugs relating to safety during pregnancy now which you can learn about here, and check out this handy table below!

medcategories

She said that the lamotrigine was fine and could be continued.  She said that she’s actually prescribed the bupropion to pregnant women who smoke in order to help them quit while pregnant – neat bit of info!  But. . . the trokendi is a big fat D.   Back to the drawing boards we go!  I’ll be doing some research these next couple of weeks to see what potential meds might work for me in order to replace the trokendi (or change the dosage of my other two), then bring that to my psychiatrist and see what her suggestions are.  My last appointment with her I got what I consider to be the gold star of proving that you’re properly caring for your own mental health – she said she didn’t need to see me for SIX months!  Usually it’s every 3 months but I’ve been solid on the current cocktail so unless I had issues come up, she was fine seeing me in 6 months.  I actually felt a weird sense of pride.

 

What Might Work for You?

I won’t say that taking care of your mental health is easy.  Nothing is easy about this.  You have to be vigilant and do the hard work.  The thing is, YOU ARE WORTH EVERY BIT OF THAT HARD WORK.  Your stability, should you enjoy that kind of thing, is worth every annoying minute you spend on hold with the new receptionist at your psychiatrist’s office.  Your happiness is worth those $60 copays with your therapist (I’m fortunate enough to have health insurance, but I also know a lot of therapists who offer sliding scale rates for self-pay clients).  Your success in life is worth you taking your mental health just as seriously as you take your physical health.  Whatever is nagging at you, don’t let it build – something like a “mental” cavity which can be taken care of with a small fix like a filling, is way easier to work with than a rotted tooth that requires a root canal.

Aside from a psychiatrist or therapist, YOU can also be your most knowledgeable ally by keeping a short but sweet daily log of your happenings and feelings.  This simple practice has helped me immensely in figuring out triggers so that I can better avoid them.  Once you start trying new medications it’s also a huge help to go into your next psychiatrist’s appointment prepared to answer the questions of how the new med made you feel and when did it start making you feel that way.  I know I’m super forgetful with that stuff, then add on the fact that a few of the meds I’ve tried have “brain fog” as a side effect and you’re self-reporting from memory may just as well be told by your cat.  Even if you don’t go the route of seeing a professional for any mood disorder, keep this daily log/journal for your own personal emotional processing and potential pattern-finding.

Be kind to yourself.  I can write this post after several years of counseling and medication management under psychiatric supervision.  I promise you I was not, and am still not, the shining example of “Little Miss You Can Do It!” all the time.  Reality is a lot harder than words on a blog.  But try.  Just try.  Every day try to be kind to yourself and allow yourself the room to figure this all out.  If I can realize, at 32, that I might just want to have “the thing” I’ve been saying I don’t want aallllll along, then all is fair game in the name of personal growth.

Sadness vs Depression

I know we live in a “politically correct” world and sometimes that can be debilitating when we’re looking for ways to say things but apparently no “PC” way of saying them exists. I get that. With that said, however, I have a personal pet peeve of people saying “depressed” when they really just mean “sad” or “super bummed” or “upset about some trivial thing” (think sports team losing).

Depression

Depression, to me, is a medical condition that I have struggled with for 20ish years now. Depression is an all-encompassing cloud over my world that I cannot escape for some undetermined amount of time, sometimes weeks, sometimes months. Depression has caused me to lose one job, fail at least one college course, gain weight, lose weight, miss important events, strain almost every relationship I’ve had, and overall decreased my quality of life up until a few years ago (thank you health insurance, good psychiatrist, and actually giving a damn about my mental health!). Depression is not caused by trivial things and often does not just come and go on a whim. Depression can be triggered by life events – death, big changes, trauma – or it can show up and stick around for absolutely no environmentally solicited reason. Depression is not something one simply “gets over.” Depression can show up at any time and have no visible expiration date in site. Depression affects each person differently, for me it’s wanting nothing to do with anyone or anything because I feel empty – then realizing that there’s no logical reason for this so I feel even worse because I’m just being “selfish.” Depression is me not wanting to leave my bed, ever, for the foreseeable future.

Once I became regularly medicated a few years ago I could see my depression from a sort of “outside of body” experience. My medications made me higher functioning but they didn’t erase the feeling entirely. I could see what was happening in how I was acting and I was able to pinpoint WHY I felt a cloud over me for no reason, but that didn’t mean I could just magically stop feeling that way. Once I was able to identify the depression I was able to acknowledge it and either allow myself to embrace it (I called this “being a blob”) or try to say “eff that jazz, I’m just going to force myself to do XYZ anyway.” Since I’ve settled into a successful “cocktail” of medications in the last year, this depression has been at bay – it’s been so, so lovely.

PSA on Drinking and Depression

Side note on drinking and depression because I feel a lot of people ignore this (myself included). . . When you’ve got less than stellar mental health it’s ill-advised to be drinking alcohol, when you’re on medications to stabilize your mental health it’s even more ill-advised. I experienced first-hand the effects of too much drinking on my mental health sometime over a year ago when it actually sent me into a depressive state, negating all the hard work I had done getting to a happy norm. I realize now that I had allowed a temporary sadness to actually cause a depression. I strongly advise against that!

Sadness

I actually love the Sadness character from Inside Out because it’s true, sadness is in fact an emotion we need to experience sometimes. Sadness is a reactionary emotion. Sadness can be gotten over with distractions, time, counseling, hugs, whatever works for you. Sadness is that pain you feel in your chest (heart) when you know something is just not right and it’s made even worse when there’s nothing you can do about it. Sadness is something that, even though it really truly sucks, you know there’s an end in sight – somewhere. Sadness is crying it out, cursing whatever upset you, taking a few days of solitude, calling up your friend, going into nature, meditating, writing, reflecting, or just escaping in whatever non-destructive way you prefer until you can come back, having processed it and are ready to start moving on.

I hope this helps clarify why I’m “PC” on the depressed vs sad statements. I do not want to be that person saying “Oh really, Your Sports Team losing made you “not want to leave your bed for three weeks because you felt completely worthless” depressed? Or did their losing just make you “sad”?” Though I did that when people thought it was ok to call things “gay” in a derogatory way “Oh really, that shirt likes other shirts of the same sex?” if someone made the mistake of calling a shirt “gay” around me.

Let’s just try to be more aware, shall we? And perhaps share our own stories so these concepts are more human than simple words.