Sarah's Story

- Sarah Spiers

I have battled mental illness as long as I can remember. Looking back at how I acted and little things I did as a kid would send up red flags. But, in the early '80's nobody thought to look for mental illnesses in children. We were just odd, the black sheep of the family.

Unfortunately, that meant I slipped through an important crack. Early diagnosis. Spot the problem before it becomes a problem.

It wasn't until I was 16 that I was forced to go to the doctor to deal with my anger issues and was diagnosed with depression, which changed to depression with anxiety. I remember thinking that I wasn't crazy so I don't need any crazy pills. Life's hard enough for me at school, all I need is word to get out that I'm taking anti-depressants.

I, as a patient and a sufferer felt the burn of the stigma associated with mental illness. I believed in the theory of crazy people do crazy things, there's something "wrong" with us, etc.

I was put on Paxil. At 16 I should not have been on that drug. It's been shown to lead to increased suicidal behavior in teenagers and young adults. It's no wonder that at 19/20 when I entered a high stress job with a hostile work environment I started developing suicidal thoughts. I didn't think much of them. They did concern my brother, though. I ended up being asked to resign from my position as EMT based on my inability to work with others, among other things. Patients had a problem with me, at least that's what I've been told.

I had to move in with my parents after only 2 months of freedom and independence. I went through a couple of bad relationships. I started cutting. (Cut free for about 8 years now). My life spiraled down. I went insane, at least what I'd call insane, and didn't respond well to the rejections being thrown at me.

I tried to commit suicide 3 times in a short time period. That's how the cutting started.

I hit rock bottom. I wanted to die, but I didn't want to die. I wanted freedom from my brain, my demons, myself.

I sought counseling... on my own. I wasn't going to live my life the way I had the previous 2 years. I wanted to live in peace and harmony. The first step to finding a counselor is to go to your general practitioner and get a referral.

I made the appointment with the Nurse Practitioner. I told her what symptoms I was having and that I was suicidal and I thought that I might have Borderline Personality Disorder. She said:

It sounds like you've read one too many books.

To get insurance to cover the counselor for me I had to call the Employee Assistance Program number and go through their red tape. She asked what was going on. I told her that I had been having suicidal thoughts and that I thought I might have Borderline Personality Disorder. Her response:

Hahaha it sounds like you've been reading too much.

Yeah. Like I wasn't depressed enough, now you make fun of me, right?

All of this when I was 22, the perfect age for bipolar to start seriously affecting life. Did I mention I was a Corrections Officer with access to firearms? It's a good thing I loved my job because I had ample opportunity to off myself in the car.

I was diagnosed with Bipolar at 24. It then got changed to Bipolar Type 1. Now, in the last few weeks, it's been improved to Bipolar Type 1 - Rapid Cycling - Last episode unspecified. This means I'll get to go from one end of the spectrum to the other weekly rather than on an extended time frame. It is not fun.

With diagnosis comes treatment. For me that means meds and counseling. All was well for about two years when I was only on Lexapro. Then the Lexapro stopped working. I kept taking it for another 4. This began the game of "Find the right anti-depressant" followed by "Find the right mood stabilizer" followed by "Find the right doses." This went on in exhausting length. I was ready to just give up. I couldn't find anything that worked. This is what I get for not seeking a trained psychiatrist. Although, I'm sure we would have had the same problem if I did get to a trained psychiatrist sooner.

I had super highs and super lows. In Feb. 2011 I felt suicidal again and hospitalized myself. My treatment in the ER was atrocious. They put in my chart that I was combative so they could chemically restrain me with Haldol and Ativan. I was asleep when they decided I needed this. They had to wake me up to give me the shots. After a long 9 1/2 hours I found myself at Shawnee Mission Medical Center where I was watched and released with a treatment plan.

That was a few months after I lost my mother. With her, my entire world went black for about 2 years.

In the summer of '12 I was put on Effexor which changed to Effexor XR. I should have known something was wrong when I vomited within 20 minutes of taking it the first time.

Of the "Call your doctor immediately if:" list, I had these symptoms. Rigid muscles, sweating, confusion, fast heartbeats, tremors, agitation, nausea, vomiting, diarrhea, loss of coordination, trouble concentrating, headache, memory problems, confusion, cough. I'm talking my heartbeat was constantly at 130 for 5 days straight. I literally thought I was going to die.

I cut a few cysts out of my head and sought treatment for the wound afterwards. I had been picking scabs to a seriously abnormal degree... so much that I got an infection. I was allergic to the antibiotics so they didn't work. The wound care doctor fixed me up though.

In my records it shows that another doctor had told my doctor that I might need to be committed. This was Sept. 5 this year. The General Practitioner I was seeing decided she couldn't treat my psychiatric problems anymore. I bawled. It took 10 minutes for me to be able to tell my aunt what had happened.

In hindsight, I was depressed and then spiked to a high mania afterwards. I was so depressed and so sick by this medication that I laid in bed 24-7. I slept during the day, I didn't shower or brush my long, thick, coarse hair. It took my aunt 8 hours to undo my hair so it looked somewhat normal again. I did this for probably 6 weeks. I didn't want to do anything. I dropped off of Facebook, I dropped off of the world... into my well of Hell.

Well, being dropped like I was sent me into a tizzy. I got it in my mind that my aunt had somehow played a part in the doctor dropping me as part of a vendetta against me. I wrote 3 "letters" and released a chapter of a real life book to certain people. The first letter was a letter I wrote to the aunt and her daughter. The 2nd letter was a police report putting forth some suspicions and concerns I had about a couple of people. The 3rd letter was really an explanation of my actions.

It was deemed by the Sheriff and Judge that I was unstable, a threat to myself and a threat to others. I was involuntarily committed for 5 days. On the day I get released, someone claiming to be from the sheriff's office called the psych ward that I was on and told them that I was using the phone to make threatening calls. They released me anyway.

While I was in the hospital I was served with 3 ex parte orders. It came out in the ex parte's and court that I had threatened to kill the doctors, their spouses, their children and grandchildren, the staff at their clinic and all the patients I could find.

I just wanted to out some corruption. My aunt and cousin got upset and actually convinced these people that I'm a threat to everyone.

In court, I remember thinking "these people don't know what they're talking about. Seriously, I'm bipolar so that makes me a potential babykiller somehow?" Luckily the judge found in my favor, but not before telling me that my behavior was completely unacceptable and had it been someone else that put the ex parte's up against me he would have granted it for them. Nice. Thanks. Bye. I'm not sticking around to make you any more upset with me.

This whole episode has had its consequences. Some good, like I found my meaning and my purpose in life. Some bad, like it set me back emotionally in ways... but kicked me forward in others.

I've never been able to regain my complete independence. I never will, either, with as bad as this bipolar is. I will literally have to have moderate supervision for my entire life to help make sure I'm not swinging too far one way or the other and that the proper steps are taken accordingly.

It is a good thing that I was forced to take a vacation from college for awhile. That stressor on top of everything else would have been a bit too much to carry.

I've picked myself up by the bootstraps, started this support/advocacy group and prospered so far. I leave every Tuesday night with a smile in my heart because I know that one or two hours meant a lot to the people there and I helped them in some way find peace for a little bit.

Triggers

Triggers
Sarah Spiers

Let's start by saying triggers are evil. Anyone who has a mental illness, or cares for someone who suffers needs this word in their vocabulary. The sufferer needs to learn to actually communicate these triggers with those that care about them and avoid the trigger or lessen the effects. Yes, this means the sufferer has to take responsibility (unlike say, Lohan or Spears). Those that care need to take into account the seriousness of the trigger, learn what that person's likely response is going to be, learn to try to avoid the trigger (or at the very least, lessen the effect), and how to handle the person when they're triggered.

Face it, when we are in full trigger mode we are not thinking correctly. Our animal instincts have taken over and we're basically working on hormones, electrons and chemicals. As much as it sucks for the sufferer to give up that bit of independence in our battle with ourselves, occasionally you as a carer are going to have to step in.

Trigger: something that acts like a mechanical trigger in initiating a process or reaction. (Merriam-Webster).

Again, triggers are evil. Generally some outside source sets off a complete psychological disturbance within the person. Triggers can be anything, really. I've known people who would freak out at the smell of Tic-Tacs or seeing a certain type of flower. - These triggers are even more exacerbated (and sometimes weird) if the person is a survivor of some form of abuse.

Many things can trigger a bipolar episode. Some examples:

•     stress
•     sleep issues
•     problems at work/home
•     isolation (a big issue with me personally)

Read more from David E. Oliver 

Reactions to triggers are awesome!

One frequent response to a trigger is a full on panic attack. 
Breathing becomes difficult. Your heart races. Your adrenaline dumps into your system. Your brain shuts down to everything around you except the memories, thoughts and feelings associated with that trigger and trying to get away from it.

Other responses aren't as "mild."

1. One can easily turn into this: An angry wolverine. A raving beast that even grizzly bears will run away from. A badger the size of a German Shepherd who, when angered, is a whirling dervish of teeth and claws. Believe me, you will always lose the battle against a wolverine. Always. 

OK, you may win if you stab it with Haldol or some other chemical restraint.
In my case, I feel absolutely no pain when I hit this stage of rage (which luckily is rare and takes a strong trigger often associated with my natural protectiveness of others). 

Any police officer, corrections officer or psych ward employee will tell you that the ones that cannot feel pain are the worst to deal with. All you can do is overpower and restrain them (tactic of choice) or hope to talk them down (rarely tried at first).

This demon within me is perhaps the one I am most afraid of because I know I can do serious damage to someone else, not realize I'm doing it, and sadly, not even care at the moment. When this demon comes out, it is seriously like I'm another person, a very scary, if not evil, person, that will not back down when challenged. 

Fortunately the majority of the time this wolverine comes out seems to be when I'm defending someone (including myself), who is the brunt of douchebaggery, abuse, etc... especially if the person is another mentally ill person, Autism, Aspergers Syndrome, Downs Syndrome or simply just slower than the people who think they're the Alpha dogs. I guess I'm just a guardian for the weaker. 

The biggest problem is getting my family to understand that this ravaging demon comes out at the simple mention of my "brother" (I use the term loosely) or he just shows up, leaving me feeling rather bombarded and assaulted in my peaceful castle. (See the first paragraph).
I literally black out. The only thing I can see is him. Nobody else is in the room to me, even if there's 30 other people there. 
Whatever the exact trigger is with him, one could liken the response to being high on PCP and having a blood feud.

2. Triggers can leave us completely incapacitated, crying, enduring the pain, thoughts and/or memories that are waging an assault on us - leaving us looking something like this:

Depending on the state of mind we were already in, a full on depression caused by whatever trigger can last days or weeks. Personally, when I hit a serious depression I can be laid up for 2 weeks easy, sleeping at least 16 hours, often 20 hours a day. I honestly think that this is not only a recuperation device, but a way of "avoiding the pain," or letting the mind and heart heal itself a little bit so I can survive. That being said, recuperation after a week or two of this is slow, agonizing and frankly, quite annoying. I'll go deeper into the depression aspect in a later blog.

3. Even worse than just a laid up depression, many  find themselves self-harming. Some people with no clue what it's like to be in our shoes call it "self-mutilation," which fits, but makes us feel worse for doing it. Again I'll go further into detail about Self Injury in a later blog.

The important thing about self injury is (pay attention) it is the step BEFORE suicide attempts.

As a cutter, I can tell you that cutting prevented several suicide attempts (though I do have 3 attempts on me). As difficult as it is to wrap your head around if you are not a self injurer, it works. Yes it's highly dysfunctional, yes it's bad... but damn it, it works. It calms you down enough to maybe be able to sleep the suicidal phase off, or even makes you forget about committing suicide for awhile. The bad thing is, since it does work, it's addicting, like alcohol, heroin, or crack, and just as difficult to stop. Self medicating is called self medicating for a reason, it works; it takes the pain away, even if only for a few minutes, and that's a few minutes we can have relative peace inside our chaotic minds.

4. Well, you're not going to like this one, but triggers can be so harsh the sufferer simply cannot handle the pain and torment within their soul and chooses to remove themselves from this mortal world. Suicidal episodes tend to develop over a long period of time, with explicit warning signs. These warning signs should NOT be lightly taken as a life really is at risk, whether you as a carer can handle the thought of it or not.