I’m having problems with overspending again

I bought way too many records, sheet music books, other books, etc. on ebay and amazon this week. I’m having problems with impulse control. Granted, these are all things I would’ve wanted to buy anyway, but it would be better to buy things in moderation rather than, say, spending hundreds of dollars on just records in a single week.
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A couple weeks ago I swore up and down that I wasn’t even going to buy that picture disc (released on Record Store day), but then I found it for a bit cheaper. I also bought other Record Store Day re-releases.
bowieis1
I’ve spent more than $100 this week just on books related to David Bowie, and I’ve also gotten other books and a buttload of CDs. [*headdesk*]

In addition to all that, I’ve been drinking too much and I often start crying for no good reason. I’ve been having a terrible time sleeping, too.

People giving me advice on coping with bipolar disorder

Somebody told me again that I probably just need good sex and that would help with my problems with having a high sex drive. That might work for other people, but considering that I tried to most of the past 16 years or so to get someone, anyone, to have sex with me, I don’t think it would be reasonable for me to assume I will be able to have sex again anytime in the future. I certainly wouldn’t consider it healthy for me to get my hopes up, anyway, because that would be setting myself up for failure. It’s possible that I will never really get over that, the fact that people don’t seem to find me sexually attractive, but I think I also need to be realistic about things. And I do hate the idea that I “need” sex, (this person’s words, not mine) because I find it highly unlikely that I will ever get any. There was a time when i was in more of a depressed episode and didn’t really care, though, but it’s impossible to predict these things.

It is a difficult symptom of my bipolar disorder, and no drugs or anything seem to help with it. But like they said in The Princess Bride, “life is pain,” I suppose.

I think people just say that because they assume anyone/most people are able to find sexual partners. I’ve had people actually suggest that I hire prostitutes, but I would not be comfortable with that and am too afraid of STDs.

I suppose it annoys people when I complain, but I don’t really care. If they find me annoying, they can stop talking to me, I guess.

I’m back, I think

I spent the past several days heavily intoxicated. I figured it was an appropriate time for another midlife crisis, I suppose. I think I’ve more or less come to terms with the idea that nothing is ever going to change. The bipolar symptoms are not likely to get any better while I am still on prednisone, and I am not likely to be on less prednisone, since nothing else seems to work for my skin. My doctors have never really taken me seriously when I say it fucks me up in the head, and I am apparently unable or unwilling to talk to therapists (and can’t really afford that anymore anyway, but if I could, I still don’t see any point in it). It was a pretty bad week or so, but that’s pretty normal around my birthday.

Psychiatric disturbances and corticosteroids

There doesn’t seem to be all that much in the literature about psychiatric disturbances caused by corticosteroids, but here is a good overview I found:
http://williams.medicine.wisc.edu/steroid_psych_effects.pdf
In the following, I will make some short quotes from the article and respond to them based on my personal experience.

The most frequently identified symptoms include agitation, anxiety, distractibility, fear, hypomania, indifference, insomnia, irritability, lethargy, labile mood, pressured speech, restlessness, and tearfulness.

I’ve probably had all of those at some point. I’ve been on corticosteroids for about 10 years now. I tend to divide that 10 year period into two distinct portions: the first 9 years, where I was severely depressed, often unable to leave my room (causing me to drop out of college), severely indifferent, anhedonia, tearfulness (there were times I cried about things like pizza toppings), insomnia. Then a few years when by in which I was so apathetic I couldn’t cry about anything.

The second portion began in August 2015 with what seemed to be a rather severe psychotic manic episode. The first thing I did was stop seeing my therapist. This episode wound down after about a week and a half, but continues to this day. It would probably fall under the category of a “mixed episode” now, with symptoms of mania and depression at the same time. Overall though, I am much more energetic, I have trouble sleeping, I have a disturbing and constant desire for drugs and alcohol, suicidal ideations, irritability, I cry all the time, I spend too much money (spending money makes me feel good for 10 minutes or so). The major differences are the energy and the ability to enjoy things, though. I am now more or less able to enjoy some things some of the time.

The most commonly reported corticosteroid-induced psychiatric disturbances are affective, including mania, depression, or mixed states.
Most often, patients receiving short-term corticosteroid therapy present with euphoria or hypomania, whereas longterm therapy tends to engender depressive symptoms.

This fits with my experience.

An overly stimulating environment can exacerbate a patient’s condition.

This is why I am largely avoiding Facebook. It’s a constant, overstimulating, unpredictable stream of unrelated nonsense. There is too much going on. Everyone uses it for a different reason. It’s complete chaos. On a related note, this is probably why I can’t stand going to bars anymore. Too noisy, too many people, chaotic.

Among patients with corticosteroid-induced psychosis, as many as 33% experience suicidal ideation.

I am not surprised, and I fall within that 33%, without a doubt. I have spent many, many hours thinking about killing myself. There was only one time I think that I really intended to do it right at that moment, but certainly I’ve done a lot of things that could have killed me, also, and spent a lot of time thinking about how much I want to die. On wikipedia’s page on suicidal ideation, there is also mention of role-playing: I actually purchased an air gun that looks reasonably similar to a real gun, and I keep it in my desk so I can take it out periodically, point it at my head, and pull the trigger. It’s never been loaded with anything and only takes plastic BBs anyway, but that’s not the point; the point is that I like to point a fake gun at my head and pull the trigger. It’s worth mentioning that, before being on steroids, I never had a suicidal thought in my entire life.

While the article says that some people respond to antipsychotics and antidepressants, it also notes that treatment success can be unpredictable. I have not had any success with various mood stabilizers and antidepressants. Due to adrenal insufficiency, my steroids cannot be stopped. At this point, I am not seeing any options other than learning to deal with it on my own, since drugs and therapy haven’t helped, and I can’t afford to just keep throwing hundreds of dollars at the problem anymore.

Why I made this blog

Over the years, I have read a lot of bipolar disorder (and other mental illness) related websites and blogs. I related to bits and pieces of them. What struck me was that a lot of them talked so much about health and wellness and living in harmony with their mental illnesses. That’s all well and good and I am not disrespecting them, but where were the ones who were not well, who were not living in harmony with anything at all? My guess is that they weren’t blogging much.

I have discussed this before, but I have been in and out of therapy for the past 25 years. I have tried dozens of medications. Nothing helped. Everything cost a lot of money. At great length I decided if I can’t find medications that make me feel better, and if therapy has not helped, then I will have to find a way to live with not feeling good, and in some sense, embrace the idea of not being well.

That’s why I am here, I think. I largely left Facebook because I couldn’t relate to anything on Facebook, not even in the mental illness-related groups. A lot of them seemed very anti-psychiatry, and I am not. I choose not to be on meds anymore, and I choose not to see therapists for the time being, but I am not against any of those things and I think people should try things that might help them. The rest of Facebook seems filled with positive-thinking memes and I’ve also discussed why I dislike those. Happiness is not a choice, and may not be attainable for everyone. Additionally, I think/hope there are things in life other than happiness to strive for.

But mainly, this is a place where I can say whatever I want. If you are reading this, it means you are on my turf and I don’t have to apologize for saying anything disturbing. If you don’t like it, you don’t have to read it. I always felt that everything I posted on Facebook was probably considered distasteful by 90% of the people reading it and I find Facebook to be, on the whole, a very unwelcoming and ugly place.

Another big reason I dislike Facebook is I feel it encourages you to post and repost garbage rather than anything with any sort of content, and it encourages people to press “like” rather than participate in any kind of discussion. I’d rather be here talking to myself than promote that sort of thing.

On the other hand, I liked livejournal a lot when people still used it (which is to say, before Facebook became popular). It had the lj-cut option for longer posts, you could add images and links in the things you wrote, and so on. I think that’s because it encouraged people to think about what they wrote, rather than posting nonsense every five minutes. I’m not saying I’m not guilty of that, too, but leaving Facebook would largely solve that problem. If I’m going to post here, it’s going to be in complete sentences and paragraphs, in any case.

Responding to a post discussing “bipolar myths”

In response to this post:

Myth #1: Mania is the “good part” of bipolar disorder.

I can see why that’s a myth, but sometimes it is. Last August I was fucking elated for about a week for no reason at all. But usually I feel pretty awful, yeah.

Myth #3: Everyone with bipolar is violent.

Word. I am probably the most nonviolent person I have ever met. Toward living things, anyway; I beat the fuck out of inanimate objects sometimes.

Myth #5: People with bipolar disorder cannot maintain healthy relationships.

Some can, some can’t. I think the evidence points toward me being one of the people who aren’t able to, though, but I understand why other people would dislike this idea.

Myth #9: People with bipolar disorder are just being dramatic.

I have been accused of this one pretty much since childhood.

Myth #11: When you start taking medication for bipolar disorder, you’re “cured.”

Hahahaha. No. Meds have never have any positive effect on me.

Myth #12: People with bipolar disorder can’t be successful.

I’m sure plenty of people can, but I am still struggling with attempting to have any sort of success in life, and I am not very hopeful about it.

All in the brain?

This article criticizes a TV program on mental illness hosted by Stephen Fry for making mental illness seem too physical, too brain-based, too much talk of “chemical imbalances.” It suggests, and rightly so, that many people are influenced by circumstances and trauma. Certainly, circumstances play a role or you wouldn’t have things like PTSD or situational depression.

What I found interesting here, though, was the idea that emphasizing the idea of a chemical imbalance somehow does a disservice to people with mental illnesses. I’m not sure I’ve heard that particular point of view before.

Additionally, I don’t see where he’s coming from by claiming that, just because people mention chemical imbalance, this somehow means conditions occur “out of the blue.” He then mentions genetic vulnerability, which seems likely since conditions often seem to run in families. But that still doesn’t mean they occur out of nowhere or have nothing to do with circumstances.

And again, I can’t comment on the television program because I haven’t seen it. If it shows up on YouTube or streaming services, I may try to watch it at some point in the future, though.

What I mostly found interesting was this fellow’s extreme emphasis on circumstances (“misfortunes,” as he puts it). While I don’t deny they can play a role, it goes against my own experience, I think. I feel like mental illnesses have largely caused my misfortunes in life, rather than misfortunes bringing on mental illnesses.

I also find it a bit baffling that someone would say that emphasizing the role that neurochemistry plays in mental illness would be doing a disservice to people with mental illnesses. I’ve used the diabetes comparison myself (namely, you wouldn’t tell a diabetic to just “be strong” and “deal with it;” you’d realize they have a problem with their pancreas producing insulin and require medication/insulin injections to remain healthy). Likewise, if a person is clinically depressed, it’s possible that no amount of “being strong” or “thinking positive thoughts” is going to fix it if it is a condition in their brain.

Patients’ dissatisfaction with an exclusively medical approach is well founded, because research has shown that this approach has been extraordinarily unsuccessful, despite what clinicians often assert.

I also can’t comment on the state of psychiatric care in Britain since I live in the US, but the quote above sounds like the way people (usually people with no history of mental illness) complain about psychiatric medications being over-prescribed. I’m sure that’s a legitimate problem in some cases, but people seem to extend this idea so far that they think no one is helped by medication, and that becomes a problem.

I saw something elsewhere today talking about how it’s “too easy” to get antidepressants. In the US, anyway, there are 2 problems with this: (1) when a person sees a doctor, they expect them to try to fix the problem, not send them to long-term therapy or to other specialists, except in extreme cases, and (2) some people can’t afford that long-term therapy or more specialists. That doctor appointment may be their only hope of doing anything about the problems they are having, at least in the immediate future. They want to feel like their doctors are doing something for them. It would be great if everyone had more time to spend with medical and mental health professionals for these discussions, but I don’t see it happening in the near future.

The more that ordinary people think of mental illness as a genetically-determined brain condition, and the less they recognise it to be a reaction to misfortune, the more they shun mental health patients.

I just find this bizarre. Why would something having a biological basis contribute to stigma? He even says earlier in the article that it’s a “predisposition,” which means the person isn’t “broken,” they are just predisposed to either having something go wrong with their mental health, or reacting badly to circumstances. But not all mental illness is a “reaction to misfortune,” that is just absurd. I may not be a professor of psychology like the author here, but from my own experience, I don’t feel like my mental illnesses are a “reaction to misfortune.” I feel like my mental illnesses, which I may well have been predisposed to genetically, have caused me misfortune.

Discussion of mental health problems

Regarding the content of this article: http://ideas.ted.com/how-should-we-talk-about-mental-health/:

I’ve been saying that about crime for a long time. While it’s true that some of the mass shootings have been done by people diagnosed with mental illness, the media seems to portray it as if any mentally ill person is going to shoot up the nearest school or theater if you give them enough time. Most people with mental illnesses are never going to go on a shooting rampage, but that doesn’t make a good headline so that is completely ignored. It’s no wonder people don’t want to talk about mental illness if people think that makes them dangerous and violent.

However, I completely disagree with the avoiding words like “crazy” and “psycho.” As with any word, it depends on usage. I agree with the Ruby Wax quote in the article. What matters is the idea being conveyed, not so much the words you use to convey it. If you’re belittling a person for being mentally ill, it doesn’t matter if you use the phrase “mentally ill” or “crazy;” what matters is that you’re being an asshole.

I’ve encountered a lot of people who refuse any sort of help with mental illness because it’s regarded more as a personal failing than a medical issue, and people should just “suck it up” and deal with it. It is not considered the same at all. If you have high blood pressure, you’re not considered a weak person for taking HBP medication; you’re considered to be a person taking care of their health. Not so with mental illnesses; if you take medications you’re considered to be “running away from your problems” or thinking that “popping pills can fix everything.” If you’re less depressed on your anti-depressants, then your happiness is false and not valid, also.

When I was young, my parents never told anyone that I was seeing therapists, had been hospitalized for mental illness, or was taking psychiatric medication because of the stigma. My mom even shushed me once as an adult because I said I’d been to the therapist earlier that day before going out for dinner with relatives. Apparently seeing a therapist is something so shameful you don’t talk about it. You’re supposed to lie and say you were seeing the optometrist or something. It is regarded as a personal failure and not a “real” health problem.

And this is why I think people need to talk about it more. The more people are exposed to the idea that “crazy people” aren’t necessarily going to kill them, the less stigma there will be. Another thing I’ve encountered with bipolar disorder is that people seem to say it’s somehow wrong for me to show emotions because they are used to me being in a depressed state, where I am very stoic and Vulcan-like, and they seem to try to discourage me from talking at all because this apparently makes them uncomfortable or clashes with their idea of what kind of a person I am. But again, that’s why I turn to blogging: it’s a monologue. I am able to express myself as long as there isn’t anyone else around to act like I’m making them uncomfortable or like they just wish I would shut up. I am not good at talking to people face to face.

Mania and overspending

While manic, I tend to overspend. I am prone to excesses of many kinds, but I tend to allow the spending most of the time because it’s the one excessive thing I do which is least likely to result in my death (unlike randomly taking or not taking medications, abusing drugs and alcohol, etc.). The very first week, I bought an electric piano, various guitar accessories (pedals, cords, new strings, new tuner). I’ve been buying books, records, and CDs at a pretty steady rate since then. I’m sure I’ve acquired at least 100 CDs and well over 100 records in that time. I also have a habit of buying the very same albums repeatedly. The first time I can remember doing that was about 15 years ago.

ebayfeedback

The shift in my mental illnesses took place a little over 6 months ago. This is interesting because you can see a pretty big difference if you subtract the last 6 months of Ebay feedback from the last 12 months. 6-12 months ago, I wasn’t ordering all that much. Most of the orders have been since this past August.

amazon

Here, you can see that I order, on average, about 11 times per month from amazon. Those orders can (and usually do) include multiple items.

Thinking back to about 15 years ago, I can remember being extremely stressed out from work and taking the train to the mall after a night shift. I was working night shifts for a few years and decided it’d be a good idea to just sleep every second day. My days were 48 hours long. That really screws up your sense of time. I was never tired, though. I would sometimes get upset and go to the mall and buy stupid shit I didn’t need. I also bought a lot of books and CDs, but I consider those justifiable purchases. I just bought way too many of them.

In more recent years, it’s become more of an online thing. The spending part is enjoyable, but so is getting things in the mail and then having the things. I suppose you could make some accusation of attempting to fill a void in myself with material items. I enjoy categorizing things, putting CDs/records in chronological or alphabetical order (I switch it up now and then, just for something to do), and searching for items that are rare and hard to find. I also justified some of the spending by telling myself that I had quit therapy, and that freed up some cash money. Buying things, however pointless that may seem, still seemed like a more positive experience to me than therapy, anyway. I don’t blame my past therapists; I think a lot of it’s my fault. I just am not willing to talk about myself in person, to anyone (unless it’s a humorous story or something). If a therapist pushes me, I will quit going right away. If they don’t push me, I just won’t get anything from going there, and that will eventually cause me to stop going.

On motivational quotes and mental illnesses

control1
While there is nothing inherently wrong with attempting to be positive, I do have a big problem with the way a lot of “motivational” images seem to imply that all you need to do is think positive thoughts and your life will be hunky-dory. Maybe it could help someone who is simply having a bad day to focus on being grateful for things or think happy thoughts, but it becomes a problem when you figure in mental illness. It seems to be blaming people for things like depression or anxiety. My mom used to be this way about my anxiety, she acted like my panic attacks were some kind of attention-seeking behavior and I should just chill and snap out of it. You can’t just “snap out of” mental illnesses though, and having a crappy day isn’t the same as being clinically depressed. So when I see things telling me to “focus on the positive” and that I am only as happy as I allow myself to be, sometimes I get irritated.
nature
The same goes for the ones saying pets and nature are better than any therapist. I don’t dispute that spending time with animals or outdoors can be great and even therapeutic; but I do dispute the implication that these things are a replacement for therapy or better than therapy. No reason you can’t have both, but some people are helped by therapy, and talking to your dog is not quite the same as talking to a licensed professional in the mental health field. It minimizes the struggles of the mentally ill and says they’d be ok if they just took their dogs for more walks in the woods. While I can understand the idea that many people are stressed out from their jobs and perhaps being stuck indoors a lot, not all problems are solved by a little sunshine and fresh air.

On a semi-related note, I also dislike seeing the ones saying all you need is love and companionship, or that those things are the only things that matter in life. I sure hope those aren’t the only things that matter in life, or nothing much matters in my life, because I seem to be unable to form close relationships with people as a result of my mental illnesses. I’m not denying that many people have reason to enjoy these memes saying love is what matters in life; I’m just saying that these ideas make me feel very alienated.

rupaul

Additionally, as much as adore RuPaul, I also feel alienated when she closes her shows saying “if you can’t love yourself, how in the hell are you gonna love somebody else?” Maybe the answer really is, “you’re not,” but it isn’t very motivational for those of us who don’t have relationships and have trouble loving ourselves. I’m not saying people should be expected to never say or post something like this or the other love-related ones, I am just stating how I feel when I look at them.