What to expect when reading bi-polar wife

Thoughts and feelings of living with bi-polar as a wife, mother, and person in the world.

Friday, 12 February 2010

Did I mention I'd been discharged?

After a year of support, my lovely CPN feels I am well enough to be let off the leash. I am well enough mentally,  and have successfully reintegrated into the real world. Apparently I am a mental health success story. Sadly you don't get a certificate of sanity but I'm just happy to be well. I cry when she says goodbye - its been an emotional journey and she's been amazing.

Although I am free from regular mental health team scrutiny, I am still seeing other professionals. Sadly I'm still not typically "Normal" in the brain area. I'm to see my psychiatrist every 3-4 months and my psychotherapist on a one-to-one basis to do some exposure therapy. This doesn't mean I get forced in front of a pervert in a rain mac to stop me feeling unhinged, but means I get to learn a new technique that'll help me with the intrusive thoughts. I'll explain more later.

I feel like a grown up, healthy person at work, and in my flurry of wellness, I decide to work and extra day and a half a week. I have told everyone with whom I work that I am of a slightly disordered mental disposition and explain that I will be doing certain things that keep me centred. For example, sharing some inspirational quote cards around the office, not doing meetings after 3pm, dispensing joy in amongst the stress to lighten the mood and working from home one day a week. Most people embrace my eccentricity and realise that although I'm bonkers I'm quite good at my job and let me get on with it. There are a few who tell me off for talking in the office and laughing (God forbid I should have fun at work) and the odd one or 2 that look at me as if I were a big lump of dog poop on their shoe. These people I learn to accept and ignore. Get me with my CBT techniques!

I have begun to live a again and the hopefulness continues. I go to my appointment with the psychotherapist and talk about my intrusive thoughts. What I learn is that ALL people experience intrusive thoughts. She gives me a sheet of data relating to 100 people and a list of the intrusive thoughts that pop into their head. Most people, and I mean ordinary folk, have the odd thought that is not really acceptable. You know stuff like, "Shall I let go of the steering wheel?", or thinking you've not locked the door or left the cooker on, thinking about someone else whilst making love to your partner, thinking you might yell an obscenity in a quite place or have an odd sexual thought at what you would deem to be a completely inappropriate time; you know like when you are cleaning out the guinea pigs or something.

When non OCD people have these types of thought intrusions, they ignore it, probably give it a few seconds reflection, think, "That was odd" and carry on. Not so for us with an overactive amygdala:

Amygdala: "a small area hidden within the temporal region of the brain. In humans, the amygdala is the size and shape of an almond (amygdalum is Latin for almond).  [...] this area is the heart of the emotion system. It is "able to process the emotional significance of individual stimuli as well as complex situations. The amygdala is, in essence, involved in the appraisal of emotional meaning"." (The Emotional Brain: The Mysterious Underpinnings of Emotional Life by Joseph LeDoux, Simon & Schuster) Keeping it simple what this means is that an almond blob in my head is responsible for my flight or flight reactions. And mine is overdeveloped, and overstimulated, so my brain, hormones and emotions are all out of kilter. I told you I was a bit on the broken side. Maybe this is where the term "She's nuts!" comes from?
Basically me and my brain overreact. Which is a pain as it means I spend a lot of time being over stimulated by normal day to day things and being hideously anxious. It also gets worse when my mood is low. In classic OCD, people will try to make the anxiety go away with rituals, that make the person feel free from the anxiety. When you speak to about OCD, people will ask you if you clean and wash your hands obsessively. I feel that the thought intrusion side is left out and people don't really get that part. Apparently the overstimulated amygdala can be a result of traumatic childhood, a serious stressful incident, that type of stuff.  Spending too much time on high alert makes you over sensitive.

I remember having a bad depression week and my mood was really low. WHAM the nasty thought pops in and because its hideous, I immediately feel frightened, and worried that I might actually act out on my thought even when I don't want to (That's the compulsive bit), I become incredibly distressed and go to pieces. Most OCD people are conscientious and quite perfectionist in nature. The thoughts are usually massively removed from the values and ethical choices of the person suffering, so the thoughts feel even more disastrous. So for me the thoughts are usually around hurting myself in savage ways. Stuff like swallowing bleach, pouring boiling water over myself, chopping off my arm with a bread knife. My core belief is about living and not death or suicide, celebrating life, gentleness and love, looking after my family and surviving my mental illness. So if I were actually to do those horrid things, it would go completely against my moral code. That is why it feels so awful. And the stimuli is centred around day to day things - making a coffee, loading the dish washer, cleaning the house. Its not like I'm stood in front of an axe murderer and I'm fighting for my life. When I shared about the intrusive thinking in group, they all looked appalled and sympathetic. None of them could identify with my experience, so I felt incredibly vulnerable.  The therapist god love her, explained it by saying,"Its like a devout Catholic sitting in church, suddenly wanting to shout out a swear word, or wanting to flash her breasts at the priest". Its unthinkable that she'd actually do it. 

So the exposure stuff is about retraining my almond blob into what is really terrifying and what is not. The homework is to walk around the house holding glass, putting sharp knives in the sink whilst washing up (Only for me not the rest of the family), putting the nail polish remover next to my coffee cup whilst I'm drinking, and standing near to a boiling kettle for an extended period of time poking fun at it. The plan is that after doing these things over and over again, my brain will learn that I'm not going to do what the thought intended. I'm not going to hurt my self and the anxiety level then reduces dramatically. I also learn that the thought is a lie and I don't need to panic. 

I also get superstitious thoughts too, things like if my husband is late home from work, the almond blob places the, "He's died" thought into my head. If I act out on the thought, I panic, have to ring everybody and ensure that he's not dead in any way, shape or form. Now, I remember its folly, ride out the panic and breathe. I don't phone, I don't imagine horrors and I calm down.

Its hard work but it works. The following few weeks I have to look at my rituals. I thought I didn't have any. oops!

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