Manic Season

We had a great Labor Day weekend, with a four-day camping trip to the Uinta Mountains. We camped at a beautiful, serene mountain lake (interrupted on occasion with people on ATVs), hiked to several mountains lakes, David fished, and I read and knitted. I enjoyed the beautiful weather, and noticed leaves slowly changing to mark the beginning of a new season.



Unfortunately, on the way home I noticed David slipping into mania. A few days later he told me that he had been slipping out of the house to go on his midnight walks when he couldn't sleep several times for the last few weeks, and asked me to call his dr. for help. By the time I came home with a report of the concerns the dr. shared with me, David had forgotten all about what had happened, and accused me of over-reacting. It was not a pretty conversation because I felt incredibly upset, worried, and angry over his behavior, and I forgot the first rule about staying calm.

I try not to go into gory details here of all that was said until after a crisis has passed because I want to be as fair as possible to David. I also want to focus on what I have learned, instead of the crisis itself. (I have also been really busy with work and family issues lately, as well.) We managed to have a truce for several days because our Soldier Brian and his family came for a visit. It was fun to have them here, and to get better acquainted with and enjoy the grandchildren.

His mood, though, kept getting more and more manic, complete with listening to the voices in his head, no sleep, and irrational ideas. He started realizing that he was out of control and asked me again to call the dr. for help. We went to a therapist for the first time this week, and David has another appointment to see him in two weeks to work on his temper.

It was helpful to spend a few minutes talking to the therapist about my view of David's behavior, and some of the challenges that I have in dealing with his moods. He and my brother both told me that I cannot "make" David to do what is healthiest for him; it ultimately is his choice. I've been thinking about that, and I do see their point. However, I also do not have to protect him from the consequences of his actions. On the occasion when he succumbs to a desire for some alcohol I refuse to give him sympathy for the hangover that accompanies it.

Fortunately, David finally worked through the mania, and is relatively stable again. We've been able to talk about what happened and some more on what we need to do to work through these difficult cycles that come every few months. For example, my birthday is this coming weekend. At first he wanted to go on another camping trip, but I frankly am really tired of being away from home on the weekend. We were going to compromise for a one-day camp, but we both decided that we would rather just go for a drive in the mountains to see some fall color. Now that I can live with; I'm looking forward to the day.

More on Managing Emotion

David has been doing better by degrees for the last two weeks. He went to his dr. last week for some blood tests and we are waiting to hear the results. In the meantime, he is working hard at controlling his emotions. I appreciate that about him. Every time he goes through a bad cycle, when he comes out of it he becomes introspective and redoubles his effort to control his illness. He's learning to use his character trait of being strong-willed and stubborn to fight this illness. David commented the other day that just as he thinks he has it under control, it escapes him again. It's a never-ending battle that sometimes wears him out, but he keeps fighting it.

Even though things have calmed down, I've been thinking more about how to manage my emotional reaction to his moods. Most of the time I can stay calm and fairly detached emotionally because I know it's the illness talking and not him. But every once in a while it gets to me, and I react.

Fortunately for us, after he's had a fit of bipolar rage, he becomes quiet and that allows me the time I need to gather my thoughts and feelings and get back to my emotional center. Only then are we able to talk over what happened.

One of the challenges of mental illness is that it affects people in so many different ways. Because of that, there is no one-size-fits-all method of treatment or coping for mental illness. I have been looking at different sources for advice about handling the emotional roller coaster, and have found some helpful hints. I hope to fully explore the subject in another post.

One piece of advice that I've read in several places is that it is important to acknowledge my feelings so that I can work through them and move on. I appreciate that, because I find it too easy to bury my feelings. That doesn't do either of us any good because my resentments build up and it eventually boils over and poisons my desire to work with him.

Several sources mention the need to take time for myself to de-stress. I have learned the importance of taking several mental health days a year. I know I need one when I start to feel resentful, overly tired, and pre-occupied. I'm planning on taking another one soon.

One of the best ways for me to cope is to turn to prayer for help. When his moods get to be too much for me to handle I rely heavily on prayer to get me through the tough times, and for David to get the help he needs. And without fail, that help comes.

Learning what triggers his mood is also important. Holidays are stressful for him because of expectations that come with them. We decided to stay home and relax this year. We are hoping that this Fourth of July will be a lot better than last year.

Working with Mood Swings

I recently saw a list at "The Bipolar Spouse" about how not to interact with loved ones who have the disorder. Since I can't seem to link to the page, I thought I'd share them in a condensed form. After looking around the internet, this is the best list I could find on the subject. I have also had to learn the hard way about all of these issues, and I wholeheartedly agree with what he says:
"1. Ignore Suicidal Behavior or Tendencies"2. Fight Back Over Irrational Arguments"When the bipolar cycle shifts into a manic/hypomanic or depressive state, the mood and mindset of our loved on may slip into a very irrational state and the basic sense of reality may also deteriorate. Such arguments may arise that include topics or concerns that are normally not a concern or a threat and there may be no indication as to why the topic has been brought up at all. Choosing to fight back on such topics can be damaging to both parties and can enable our bipolar spouse to view such topics as a true threat and may inhibit some intense reactions and dangerous results if not resolved as soon as possible.
"3. Blame Your Loved One for the Disorder
"Bipolar disorder is developed over time and may generally be handed down genetically from the family tree. Those afflicted with the disorder never ask to be affected, nor have they chosen to host the disorder so it is not fair to simply place blame for the disorder on our loved one and how it affects the relationship. Given the progressive appearance of the relationship, younger individuals may witness the slow appearance of the disorder over time and make false assumptions that the changes are planned out by the afflicted individual. This is not the case and blaming our loved one for allowing the disorder to hurt the relationship is simply not fair to the individual.
"4. Enable Abusive Behavior and Disrespect
"There is a fine line between “acceptance” and “abuse” and unfortunately, even our bipolar loved ones can learn to cross this line during an episode if supporters are not willing to place an appropriate amount of accountability into the relationship. There are indeed occasions where our loved ones may make some irrational decisions and lash out without merit, but if we do not make it known that there is a line that must not be crossed, we as supporters can quickly being to advertise that we are willing to take any amount of such factors without much consequence. Although the disorder can push our loved ones over the edge, we must still maintain respect and love in the relationship.
"5. Digging Up Old Bones
"Bringing up the past can trigger off some intensive anxiety which may induce an expected episode and introduce either old arguments, or previously resolved tensions. Rehashing past mistakes or events can repaint an image that was once forgotten, and during an full-blown episode, that past may become the present again.
"6. Pass Judgment on Irrational Behavior
"Along the lines of placing accountability, we must keep in mind that bipolar disorder’s most common symptom involves driving the afflicted individual to act out on irrational decisions and present very ordinary behavior. Although some of these decisions can be managed, mistakes can be made and if we are willing to forgive and/or forget, this must be an all-or-nothing agreement. Mistakes are just that, mistakes…and they must be become an identifying factor of our loved ones.
"7. Support or Offer Self-Medication
"8. Use Physical Restraint or Violence
"During some manic/hypomanic episodes, frustrations and outright anger may ensue during an outburst or argument. Unless there is a threat to human life, it is imperative that physical restraint or violence is not introduced into the situation (unless performed by a paramedic or other trained professional requiring restraint). Confining or restraining one during an episode may result in firing a trigger which may make the episode ever worse.
"9. Leave Loved One Alone During Episode
"The worst time for our loved ones to be alone is during the high or low end of an episode. In some cases, when left alone due to a walk-out after a fight, abandonment anxiety may set in and spur feelings of worthlessness and a feeling of being unloved. It is during these times that irrationality may take over and dangerous decisions and actions may be made that could potentially be life-threatening.
"10. Making Condescending Statements
"Such remarks that may appear insulting or condescending in nature can only add to the challenges of a bipolar relationship. "Some examples of these remarks are:
“Snap out of it.”
“Stop feeling sorry for yourself.”
“So you’re depressed. Aren’t you always?”
“It’s your own fault.”
“You do this on purpose.”
Worst of all, do not say, “I know how you feel…”

True confession time: I used to raise my voice (OK, yell) at David or slam doors when I was frustrated with his irrational behavior and arguments. Unfortunately, all that accomplished was adding more contention and frustration for both of us, as well as for the children. I eventually learned better ways to react, but it was a long, slow learning process. Now when he's in one of his bad cycles (they do happen even though he tries so hard to control them), I listen to what he means, not necessarily to the words he's saying, watch his body language for clues to his mood, ignore insulting comments and irrational arguments and/or change the subject. When he tells me I'm yelling at him (and I'm not!) I calmly remind him that I am not yelling, I am explaining how I feel. It works MUCH better for both of us. The key is to remain as calm as possible to help him work through his mood swing, especially the dark ones when he says he's feeling "angry and hateful."

I also found some good suggestions on how to deal with biplar disorder at ehow.com. I especially agree with the counsel to NOT take anything he says when in one of his moods personally. He doesn't mean it, and most of the time doesn't even remember what he said.

Even though this illness is hard to deal with on occasion, there are also many happy moments and a strong bond developing between us that makes it worth all the hard work.

Payday Weekend

We had one of those great weekends that cause us to stop and count our blessings.

We had a family halloween party on Saturday with most of the kids and grandkids in the area (the family with the new baby was excused). It was so much fun to watch 6 of our grandchildren, ages 2 to 8, play together and do some arts and crafts projects, while we visited with our children. Two of them spent Saturday night and most of Sunday with us. We had a good time playing together, and reading a pop-up book of the "Wizard of Oz." They went to church with us, and 7-year-old Gabby sang in the Primary music program. She said, "And I wasn't even scared because I was in a school program." We were proud.

Then, on Sunday, our Soldier Brian came into town for a short visit before heading to Ft. Lewis, and his family. We haven't been able to see him in a year, and he looks wonderful. He just finished five months of officer training on the east coast. Every time I see him I'm impressed by how much he's grown in confidence. I am so very proud of my brand-new Army officer. Sailor Jeff's wife is in town for some schooling, and they talked about military life and argued over which branch of service is better. (Jeff is doing fine on his deployment, but we miss him badly.)

I couldn't help but look back and think of where we were 15 years ago. It wasn't pretty. At the time, we had 5 teenage children, ages 13 to 17, struggling with broken- and blended-family issues, 2 young children at home, and 2 daughters living with their mother. David was undiagnosed, and reacting badly to family stress. Of course, it didn't help when the kids pushed his buttons, as most will do when frustrated. They were a close-knit group, and frequently egged each other on. (Oh, the stories I could tell!)

I knew David had some emotional problems, but I couldn't convince him of that. One time when he had an emotional break I was able to get him into a psychiatrist. Unfortunately, the dr. was more interested in overmedicating David and pushing us out the door. It took another 10 years to get him back to a doctor. I went to a family counselor for several years who helped me through some of the worst times, but he never talked to me about the possibility of David having a mental illness. His counsel helped, but it would have been much more helpful if he had given me some coping skills for David's obvious mental health issues.

Time passed (quickly, it now seems, although at the time I wondered if it would ever end) and our house emptied out within just a few years. Jon left for the Marines and married; Brian served a mission to the Yucatan peninsula of Mexico and later joined the Army; Ben worked and then served a mission to Perth Australia; Lara, Brittany, and Shannon each married and became young mothers. The younger children, Jeff, Katie, and Krista, also eventually grew up, married, and left home.

We wonder sometimes how we made it through those tough years. Mainly with prayer and patience, coupled with good friends and family who helped out. Weekends like this seem even sweeter after all the storms we went through to get to this point.

Update: David went to the p-doc today. The dr. increased his lithium to 300 mg. and put him on risperdone to help control the voices and paranoia. Here's hoping it will help! He also counseled with him to not doing his "walks" anymore. That means I will feel more comfortable about calling next time I see those symptoms start to develop. I just haven't been sure about what to do when David gets in that frame of mind. It makes me feel better to know that more help is available.

Learning Coping Skills

David struggled this last month with increasing bouts of paranoia and mixed episodes. For him, it seems to run in three-month intervals. The pressure and noise in his head, which he calls "buzzing and voices" builds up until the need to run away by himself becomes overwhelming. "Don't take this personally," he says when his illness starts to get the better of him.

Last weekend I was busy with a work-related project, and he went to help our daughter Shannon with her car. He came home and said all he could do was get her the parts she needed, but he couldn't focus enough to repair it. They did, however, have a long talk about his illness to help her understand what's going on with him. And early Sunday morning he left before I got up to take one of his "walks." The weather had turned cool and overcast with rain showers. He came home several hours later, and said, "I'm cold, hungry, tired, and I couldn't find a 'safe place,' so I came home." Welcome words!

When David comes home, I have to fight the urge to smother him with attention and affection until he feels ready to talk. I have learned to make home a comfortable place for him so that he wants to be here. Sometimes that means giving him lots of space. Then, when he's ready, we have a good conversation about his feelings and experiences (not very specific, but enough to help me understand where he's been). I have learned to stay very calm while he's talking, and spend most of the time listening to him. But he also is understanding of my feelings and encourages me to write down what has happened and how I feel about it.

I know he's feeling better when he jokes about "that other guy," and makes fun of the voices (he calls it "THEM") in his head and what they encourage him to do or not do.

We had a similar episode in July. After skimming through Julia Fast's book, "Loving Someone with Bipolar Disorder" and browsing through helpful sites on the Internet, I (finally) figured out what I needed to do during these so very difficult episodes:

1. Remember that I cannot "fix" David. This is a hard one for me. I have a caretaker-type personality, and my instinct is to hover over him, and try to make everything better. There are times when he tells me to leave him alone. I have to respect his wishes, and leave him alone. He use to pick fights with me as an excuse to leave. Now he tells me what's going on with him, and is apologetic.

2. When the urge to leave hits him, there is absolutely nothing I can do or say that will help. The only thing I can do is pray for him and his well-being and safety. I feel comforted and reassured that all will be well. Though, human nature being what it is, I still worry, and as the hours tick by, find myself mentally and emotionally planning for the worst.

3. While he's gone, I keep myself busy instead of pacing, and waiting by the phone for a call. Last July, it coincided with one of my rare days off, so I took myself out for some retail therapy, and had a great time. This time, it fell on general conference weekend, so I listened to the sermons and crocheted baby blankets for 3 more expected grandbabies that are due in the next several months. I can handle the stress better when I do something for myself. For me, I need/want to be left alone when David is gone. I guess it's my way of coping. Our children have been wonderfully supportive of us. Shannon called to see how he was doing, and we had a good conversation about her father. Then, later, when David was home and feeling better, Jon and his family came by with a plate of cookies that their 8-year-old daughter made especially for "Grandpa David." We feel blessed by the care of our children.

I thoroughly enjoyed the shopping trip in July, but there were several messages that I needed to hear this weekend that helped me keep things in perspective.

"We are important to God not because of our résumé but because we are His children. He loves us because He is filled with an infinite measure of holy, pure, and indescribable love. He loves all His children, even those who are flawed, rejected, awkward, sorrowful, or broken. God's love is so great that He loves even the proud, the selfish, the arrogant, and the wicked.
"What this means is that, regardless of our current state, there is hope for us. No matter our distress, no matter our sorrow, no matter our mistakes, our infinitely compassionate Father desires that we draw near to Him so that He can draw near to us.
"We increase our love for God and demonstrate that love by aligning our thoughts and actions with God's word. The pure love of our Heavenly Father ever directs and encourages us to become more pure and holy. It inspires us to walk in righteousness—not out of fear or obligation but out of an earnest desire to be like Him." President Dieter Uchtdorf, Second Counselor in the First Presidency

"Sometimes in our repentance, in our daily effort to become more Christ-like, we find ourselves repeatedly struggling with the same difficulties. Like climbing a tree-covered mountain, at times we don't see our progress until we get closer to the top and look back from the high ridges. Don't be discouraged. If you are striving and working to repent, you are in the process of repenting." Elder Neil L. Andersen, Quorum of the Twelve Apostles

I appreciate these words of counsel and support to help me through the hard times.

Deployments

I talked to Sailor Jeff last night, and he said they aren't leaving for another two weeks. I was happy; that means two weeks of not worrying about him. He felt a little let down, but OK about it. He says he just wants to get it over with, but I'm sure he'll find a way to enjoy this extra time at home. We had a good visit with him and his wife, Nikki, when they were here on leave. I didn't want to let go of him.

Even though this will be deployment number 7 for our family, I am still anxious when our boys are deployed. We have a former Marine, 1 active duty Army, 1 active duty Army Reserve, and a Sailor. All have been deployed at least once.

I have found some things that help me cope while they're gone:

1. The most important thing is to rely on faith and prayer.

2. I spend more time on military parent forums visiting with other parents who are also experiencing the same waves of emotion that I am: deep pride mixed with fear.

3. Keep busy with other things.

4. Send e-mails and care packages regularly. Though, to be honest, I could do better with this.

5. Keep as informed as possible about what's going on in the area of the world where they are. I depend on blogs that deal with trouble spots to give me a better picture of events taking place.

6. Jeff's captain is really good about leaving recorded messages, and I often visit the ship's website to read and look at pictures about it.

The Internet is a great thing. Our Marine was deployed to the Gulf in 1998 when the African embassies were bombed. I didn't have Internet access, and had no idea of where to look for information on what was happening. I was a basket case. Brian was deployed to Iraq in March 2003, and then it was a case of too much information all of the time. That was also unnerving.

When I have asked my sons to tell me about what they're doing, I get the standard response: "Oh, just the same old thing." But I don't know what "the same old thing" is. It helped me understand Navy deployments last year when PBS aired the series "Carrier" that coincided with Jeff's deployment to the Pacific.

Surprisingly enough, David does better with deployments than I do. He has to remind me that a) they are well trained, and b) in Jeff's case, he is on an aircraft carrier that is well protected. I know that, but I never completely relax until I know they're safely back on US soil.

Setting Boundaries

David's mood is still very much up and down: he becomes a little hypomanic for a short time, then it's right back to depression.

The other day he really hit bottom. When that happens, the schizoaffective part kicks in, he puts on his "traveling clothes" and becomes obsessed with wandering away. He says something like: "I need to quit taking my meds and see what's out there for me. I have to know what's at the end of the road. I have to go away by myself." Every time he gets like this I mentally start to plan his funeral because there's no way of knowing where he'll end up.

The only thing I can do is put my arms around him so he can't leave and let him talk through it. It's such a relief when he finally says that he'll take his meds, changes back into his regular clothes, and becomes more rational. We also talk about what would happen if he did leave or if something happens to him. This last time he told me he wants his funeral to take place early in the morning because it's his favorite time of day. Sunsets really bother him. Fortunately, after it's all over with, he doesn't remember much of what happened. He says when he's like this he has a hard time distinguishing reality from hallucinations. He is, however, becoming more aware of when this mood is coming upon him. And when he says something hurtful, he apologizes to me. The whole thing is so emotionally draining!

We've been talking a lot lately about boundaries to behavior. One of the best things about David is that years ago he decided what his personal boundaries are (no drinking, drugs, cheating, etc.), and has stayed true to them, even when he has the urge to do all of those things and more. My job is to help him remember and keep his boundaries intact. One of the ways he does that is to go to church and pray frequently. Another is to go to a gym to work through his frustrations and temptations and to visit with his friends who understand where he's coming from.

I admire him for his strength. I know it's ten times harder for him to make and keep healthy choices than for those who don't have this disorder. As he frequently says: "I wake up every day and have to fight to be normal."

On a happier note: I took a test this morning, and I feel pretty good about it. Only one more test and a paper to go! Hooray!

Post Vacation Depression

David is having a bad spell with post-vacation depression.
I'm not really surprised, given all the stress that we've experienced in the past month: Our youngest getting married, my graduation, becoming empty-nesters, and our favorite dog getting killed.
I can see the signs when it starts getting harder for him to control, and I feel frustrated and sad that I can't do much more than give quiet sympathy when it overtakes him.
In the bad old days I took it personally when he distanced himself from me emotionally. That's when we argued the most. Now I realize it's one of the symptoms of his illness.
Here are some hard-won lessons that I've learned over the past 20 years on how to work with him. It's not that I'm perfect at it, but this is what works the best for us:
When he says he wants to be left alone, I've learned to give him space and continue on with my own projects and life.
He tends to say unkind and inappropriate remarks; I either ignore them and leave the room, or tell him as calmly as possible that he's out of control.
Most of the time when I ask him how he's doing he gives me full sentences about how he feels. When he's in this frame of mind, he gives me one word answers or a cold look. I've learned to accept the answer and not press for more.
David has very little energy and motivation right now. I accept what he does, and don't demand more than what he can give.
We usually have a nightly prayer together, and that always helps. Now is the time when I also need to put his name on the prayer roll at the temple.
I try to remember that a loving Father in Heaven knows him, his needs, and how best to help him. I've learned to "let go, and let God" take charge.

Beacon of Hope

I don't know the story behind the site Beacon of Hope, or why it hasn't been updated for a long time, but I'm truly grateful the information posted there is still accessible.
I went wandering around the site again recently while trying to figure out how better to cope with David's moods. Several items in the coping section were welcome reminders that I'm not alone in dealing with a mentally ill spouse.
I especially relate right now to the section on "burnout." It's easy to get so involved with the drama surrounding him and his moods/needs/demands that I forget to take care of myself. Last week I made a stab at spending some quality time by myself, and it does help. For me, time by myself is as important as eating and breathing. I don't function very well when I don't have enough time alone to think and dream.
David's moods are still dark, but he finally went to his doctor. He's working with the doctor to adjust his medicine, and he needs to take some more blood tests. We were very lucky to have landed with caring, competent doctors when we most needed one. Last fall we had a Dr.'s appointment that coincided with David having a severe anxiety attack. Our regular Dr. was concerned, talked to the psychiatrist on the staff at the same clinic, and got David in to see him within just a few days. We're grateful for their good care and compassion.