Why Do You Choose to Do That?

It must be eternally frustrating for people without mental illness to see those of us with it doing things that are bad for us. Even though we know all the reasons we shouldn't. Even though our loved one told us we shouldn't. Even though to them it seems like our life is perfect, or at least happy enough that we should not have a problem.

The only thing I can tell you is, that's how you know it's an illness.

When we do things that are detrimental, from eating bad food, to spending our savings, even to suicide, we do them because we really think we need to. We think it is the only way to end the extreme pain and suffering we feel.

I have no idea how to describe this to someone without mental illness. I know that being able to understand this would help end one of the biggest stigmas against this illness, which is people assume we choose to be this way and we are just being irresponsible.

Photo by tommychheng, Flickr Creative Commons

My husband still asks me "Why do you choose to do that?," especially when I eat poorly. As if I sat down and thought, "Yes, I know eating this doughnut will send me into a mania risking my health and the happiness of my family. I don't care about myself or anyone else. I would like bad things to happen so I'll eat the doughnut." That's not the way it happens. It's more like this: "I know eating this doughnut will make me worse and cause issues for my family but I am in so much pain that if I have to spend one more second like this I'll die. I am not that important to my family anyway." That doughnut will increase my serotonin and make me feel good, for an hour, before I get worse again.  But when you have a mental illness you often live your life second by second, hour by hour just trying to stay alive and ridiculous things seem rational at the time. Or like how in the middle of the night when my mania is mixed with my depression I truly, 100% believe my husband doesn't love me and we should separate. Seriously? In reality he loves me 110% and we are like Adelie penguins, together for life.

Photo by linpadgham, Flickr Creative Commons

That is just my experience of how my mind can be irrational. For other people with other illnesses, it will present different for them. For instance with manic spending the person may actually think they are invincible and running out of money is not realistically possible.

Expecting someone with a mental illness never to do detrimental things or irresponsible things is like asking someone with an amputated leg to walk. However, you could get the person an artificial leg which could help manage the issue they have and that is what I hope my blog helps people do, manage their illness. While it is essential that we understand mental illness, that does not mean the bad behavior is ok. Particularly if the person is emotionally or physically abusive. Understanding it means we can then discover appropriate ways to deal with it, not that you don't hold the person accountable for their actions.

Overall, I hope that much of my blog talks about ways in which to manage mental illness (please read some of my other posts for more on that), but I really want people to understand the fundamentals of it first. If we don't understand the true nature of the illness we will try the wrong management techniques and not be able to help our loved ones.

Blessings,

Rev. Katie

Making Your Brain Do What You Want

One of the problems with mental illness is that your brain does not always act rationally. You may have anxiety and excessively worry about unrealistic events happening, like someone breaking into your house every night. You may be depressed and think there is nothing good in your life. You may be manic and think you are invincible. One of the things we need to do in times like these it to remind ourselves that this thinking is just a glitch in our system, just our minds being irrational because of a chemical imbalance. Sometimes that helps us not act on the irrational thoughts we are having.

Other times you need to outsmart your irrational brain. For instance, I have been having trouble and I keep staying up all night. I do this partially because that's when my mind goes on overdrive and partially because I think if I stay up late I wont have to exercise in the morning because I will be too tired. I know exercise is good for me and I actually love it, but when I am either manic or depressed I don't want to exercise because it's a lot of work and I just want to stay at home. It's true, if I make myself stay up all night I am dizzy, exhausted, and can't even stand up straight at times. It would not be safe to exercise in that state. So, my irrational brain has been winning over the past few weeks creating a situation in which I can't exercise.

Finally yesterday I realized I just had to outsmart my brain. True, I was too tired in the morning to go to the gym, however, I eventually do fall asleep and the gym is open in the evening. I realized I had no excuse not to get to the gym in the evening instead. I just had to tell myself over and over again that I could get to the gym, that I could do this, that I deserved to get better, and so I ended up convincing my brain that going to the gym in the evening would be ok. It would not be too hard or too scary and I would not be too tired.

CrossFit Cleveland

I know this seems really simple to people without mental illness who have no problem adjusting their schedule or doing the right thing to stay healthy. However, for those of us with uncooperative brains, we have to work very hard to continually say "no" to the illness and say "yes" to health.

Another thing that can help if you need to do certain things to stay healthy but in the hard times your brain convinces you they are not needed is to write down how doing these things make you feel. Don't write all the reasons why you should do them because your irrational mind will think of a million other reasons not to do them. Write down how you feel when you sleep enough, when you eat right, when you exercise, or when you take your medication. Then when your mind gives you a million excuses, you can go back and read what the reality is and get a sense of what it will really feel like if you make the right choice.

So, the other day I wrote a poem of sorts as a fun way to remind myself how I feel when I am exercising at CrossFit and why I love it. If you are a CrossFitter, I share it now with you.

Ode To CrossFit

O, CrossFit how I love thee.
Each time we meet, I can't catch my breath and I go weak in the knees.
You inspire me to work harder than I ever thought I could.
You prove that I can jump higher, lift more, and be faster than I imagined was possible.
And you never care that my higher, faster, and stronger is not amazing,
you are just glad that I did my best.

CrossFit, you have shown me that I am stronger than I think I am.
You make me feel invincible, like I can do what I never thought possible.
You are fuel for my mind and hope for my spirit.

While I often curse at your existence because you require so much,
I always feel blessed that we worked together.
You have proven to me that I can always fight and work hard, even when I feel like I can't go on.

CrossFit, you let me know that if I can be fierce in the gym, I can be fierce in life.
Each time we meet, my mind is more clear and you prove that the illness I have been burdened with can be conquered.

One day my toes will touch the bar. One day bipolar disorder will hit the ground.
And so CrossFit, I thank you, for proving that no matter where I am in life physically or mentally, I can still kick ass.
 
(Sorry for the language at the end, but sometimes you just have to tell it like it is)

I encourage you to write a fun reflection on how it feels when you follow through on a particular thing you need to do to manage your illness. It will make you feel better and be a reminder when you need help.

Blessings,

Rev. Katie

Managing Bipolar Disorder Isn't Easy

If you remember, I was doing very well on my Paleo diet, exercising, and making sure I got adequate sleep. Well, I had a bad week, as happens every month, and I fell off the diet and everything went down hill from there. I have contemplated writing about this as it feels like such a failure for me and who wants to write about their failures? But then again, this is the reality of this illness. It is constantly up and down. Some people do well for years and have the illness come back, others, like me, do well for a few weeks only to have trouble again. I do have bipolar II, which is rapid cycling and I wonder if that is one of the reasons why I don't do well for longer stretches of time like some people with bipolar I do.

Anyway, even though I have not been doing well for the past few weeks, that doesn't mean I have not learned anything. I have learned that of all the things we have tried to help manage my illness, even medication, diet works the best. The problem is, I can't mess up on the diet at all, or I get worse. And a strict Paleo diet is very hard to stick with in our culture, at least it is for me.

I also learned that the week before my period will always be worse (you can read about how common this is here), even with the diet. It may be the one week where diet is not enough to keep me well. We have decided that I will try some medication for that week only and see if that can keep me on track with the diet instead of having everything fall apart. Then eventually, as I am better for a longer stretch of time and the diet just becomes a habit, I will see if I can stop using medication all together.

Photo by Jeff Norris

Part of the problem we fell into this time was that I was struggling because of my hormones, my husband was out of town, and my son got sick. We did not have food and all the things necessary already made and planned out for me to be able to handle everything myself. So, while we are still working out a system of making sure I am never without food I can eat, which is easily accessible when I am depressed, I might need some help during that one bad week.

I am sad, and a bit ashamed, that I could not keep up with the diet that was working so well. The problem is, when the illness gets bad, you don't see reality. I could not see that the diet was working. You think all kinds of things that are not true. Like you will never get better, you have always been miserable, and that no one loves you so who cares if you are sick. You believe it when other people say eating a little bit of something won't hurt you and you wonder why you can't be "normal" like everyone else. That's the illness, the irrational part of your brain will take over and unless you have a perfected system of management that changes with the cycle of your illness, you will have times when you get worse.

The important thing is that you learn what does work and you get back to doing it again. I am back on the Paleo diet now and can tell that just within a day I have started to feel much better. It is a long process to figure out a good system and it takes a lot of time to make sure we have enough of the right food around at all times. It is time consuming to figure out a schedule where I can eat at the right times, exercise the right amount, and sleep correctly. I am actually amazed at the amount of time, effort, and lifestyle change it takes just to stay well. I told my husband today that I wish we could be like normal couples who go out to dinner, eat what they want, have a few drinks, and stay out late with friends. That is just never going to happen for us.

My next tasks are first to find a way to make the diet, exercise, and sleep requirements just a part of my life. Second, I need to work on ways to stop the irrational thinking that happens when I get worse. I have a few ideas for that which I will be posting about soon.

Blessings,

Rev. Katie

Mindfulness and Brain Health

I preached this weekend about mindfulness and brain health. In specific, how mindfulness has been proven as a treatment for things like anxiety, depression, obsessive compulsive disorder and other forms of mental illness. It is works for chronic pain, eating disorders, and many other illnesses. Mindfulness is something we all can use in order to help our mental state, and it is part of the Dr. Andrew Weil's  regimen in his book Spontaneous Happiness.

Mindfulness means we are fully in the present moment, we do not judge the moment as good or bad, we accept it as it is. We are not looking to the future, worrying about the past, or multitasking. The way we cultivate mindfulness is through meditation which can be done in a variety of ways. You can meditate in the Zen style, sitting still, counting each breath up to ten and when thoughts invade your mind, bring yourself back to breathing and start over at number one again. You can do object mediation where you focus on something like a candle flame. You can practice art meditation such as Zentangles which helps focus the mind.

Zentangles

Here are a few excerpts from my sermon, On Purpose from April 29, 2012. I hope you will find ways to incorporate mindfulness into your life.

Much of the research that has been done showing how mindfulness and meditation affects the brain has been done with the Dali Lama and his monks. Over the years, monks with between five and fifty five years of mediation experience have been tested by neuroscientists. Even occasional home based Buddhists, the ones like you and I who might meditate at home and go to a few retreats have been tested. They were hooked up to brain imaging machines and studied in many different ways. Overall, they have found that people who are mindful have the ability to focus their brains so well they can change their moods, feelings, and outlook on life. You can physically see the difference in their brains through brain imaging. The monks produced gamma waves that were 30 times as strong as the non-meditating participants in one study. Also, larger areas of the monks brains were active, especially in the left prefrontal cortex, which is the part of the brain responsible for positive emotions... (research found in Buddha on the Brain by John Geirland)

Obsessive Compulsive Disorder is a mental illness that is very hard to treat. For years, and still now, many doctors use a method called Exposure and Response Prevention, or ERP. This is when a doctor exposes their patient to their deepest fears in order to show them that they are not really scary. For someone who believes the world is full of germs, the doctor would make the patient touch doorknobs and public restrooms but not allow the person to wash their hands afterwards. While some people improve, ERP is so traumatic that most people can’t finish the process. Finally in the late 1980’s Dr. Schwartz from UCLA came along and said, not only does this not work, but it is cruelty. Instead, he decided to research if mindfulness could be an effective form of treatment for OCD. 

Technically, OCD is a misfiring of the wiring in your brain. Your brain tells you there is some extremely terrifying thing that really does not exist. Dr. Schwartz believed training people to be mindful would allow them to observe the misfire in the wiring, the sensation and thoughts of fear, but to let those thoughts pass, seeing them as a glitch in their mind that is not real. This switches the thinking from “The world is full of germs and I need to wash my hands until they bleed” to “That is a brain-wiring problem, I don’t actually need to wash my hands.”

Meditation cushions. Photo by Jeff Norris

Dr. Shwartz set up a study of mindfulness and OCD and used positron-emission tomograhy, or PET scans, to measure what was going on inside people’s brains. The PET scans showed that the people who practiced mindfulness were able to calm their brain. With OCD, there is an over activity in the orbital frontal cortex of the brain. The PET scans found readings in that area of the brain decreased with mindfulness training, people were rewiring the faulty circuiting, altering their brain chemistry. Not only did this show up on the scans, but the people with OCD actually got better and stayed well, with no medication used. (OCD research found in Train Your Mind, Change Your Brain by Sharon Begley)

Now mindfulness is used for treating anxiety, depression, and other forms of mental illness. The science is able to see the faulty brain chemistry through different types of scans, so it proves there is a medical problem, but the mindfulness practice then proves that there are other things, besides medication, which can change that chemistry. Our brains have the ability to heal themselves. Some people with severe mental illness have been able to decrease their medications to the point that they can go back to work because adding mindfulness to their treatment meant they rewired enough of their brain to need less medication. As you know many of these medications make you shake, sleepy, almost comatose, and severely impair cognitive functioning. Mindfulness has enabled people to not only manage their illness, like the medication does, but get their life back, which often the medication takes away... Management does not mean cure, but it does mean a better quality of life, which everyone deserves. 

Here are some of my favorite resources about mindfulness and meditation:
Wherever You Go, There You Are by Jon Kabat-Zinn
Spontaneous Happiness by Andrew Weil, MD
Mindfulness in Plain English by Bhante Gunaratana
Buddha Mom by Jacqueline Kramer 
Baby Buddhas: A Guide to Teaching Meditation to Children by Lisa Desmond
Zentangles

Blessings,

Rev. Katie

Montessori For Mental Illness

I attended a two day Montessori-based dementia training with the Center for Applied Research in Dementia with Dr. Cameron Camp this week. You can read about my initial thoughts here. As a result we will be using Montessori principles to help my Mom who has Lewy Body Dementia.

As I took the training I realized how much my Montessori education from Pre-K to eighth grade led me into ministry and my philosophy of life. Montessori is also what allowed me to be successful despite having bipolar disorder, anxiety, and ADD since I was six years old. Montessori showed me that I did not need to be defined by what I couldn't do. Instead, I learned to focus on what skills I have in order to function in the world. I learned that I was important and could contribute to society no matter what my limitations were.

Dr. Maria Montessori 1870-1952

I had forgotten though how many Montessori principles I can still use in order to help manage my mental illness. For instance, with the ADD I have a horrible time figuring out how to do certain tasks that seem to have so many steps that I get easily overwhelmed. In the Montessori method you break things down into simple steps. The teacher demonstrates how to do the task and you repeat what they did. You also have everything all set up in one spot with no distractions around the area you are working in. No wonder I have a hard time cooking dinner. Too many steps, all written out in a big chunk of words, needing to be completed on a tight timeframe. If I took the time to break the recipes down and rewrite them so they are easier for me to follow, I could make dinner much faster with a lot less stress.

Also, everything in Montessori has a place. When the kids use work, they know exactly where to put it back. I tend to be disorganized mostly because I don't have have a place for everything. Which is where someone to help me organize will be helpful. But then you need to keep everything organized. Again Montessori can help here. If you forget the steps to things like sorting papers and mail, then write out all the steps and put it in a visible place so you remember each time, until it becomes a habit.

Montessori also uses music to signify different times of the day. Some schools use a certain song to end the day or to let the kids know when to clean up for lunch. I have always used music as a way to signify a change in mood. For instance, if I am feeling anxious, I have certain music I listen to that calms me down. I have other songs I like to use when I am depressed or manic.

I have looked around for any place that uses Montessori in the treatment of mental illness, but all I found was work with kids. I would love to find a place that works with adults so if you know of anything, please let me know. I will be doing some more research and trying out ways to use Montessori to help with my treatment and I will keep you posted. Dr. Camp also introduced me to spaced retrieval which I think will work really well for mental illness so I will write about that in the future too.

Blessings,

Rev. Katie

Triggers

As I wrote the other week, it is getting easier for me to navigate my bipolar disorder through the daily ups and downs. I have found though that the triggers, like a specific event, are much harder to navigate. Those are the times when the bipolar just shows up without enough time to ease the impact.

Trigger: (noun) anything, as an act or an event, that serves as a stimulus and initiates or precipitates a series of reactions.

I have to say, it has been so interesting watching my brain on my new treatment plan. I can see the disorder so much more clearly and it has really given me a new understanding of just how much of an illness this is. I can't will it away, it is just something in my brain. I also have a new understanding of how much I can do to manage it though. I know that this takes hard work, with the lifestyle changes and such, but I feel like I have all these options now. Each day that the disorder sneaks up on me, with my new treatment, I am better able to figure out how to minimize the impact.

It is frustrating though to be doing so well and have a setback, even if it is just for a little while. It amazes me how vigilant I have to be to my program in order to keep things on track. My husband was saying my treatment is a three legged stool of diet, exercise, and sleep. If one leg goes out, you can balance on two, however, if any two of those legs get out of whack, things get much harder. For instance, I stayed up really late a few times this week and also did not have food that I could eat with me so I became very hungry which led to eating unhealthy food. Staying up late once or twice would have been fine if I had kept the other legs of the stool in place, but I didn't. However, now I know that if I just get back onto schedule, I will be feeling better right away. I have a lot more hope now than I used to and I know we will get the systems worked out so I can do even better.

Over the past month I have a new respect for my mental illness. I don't like it any better, but I understand it better. I understand it's power and I understand more how to work with it.

Blessings,

Rev. Katie

Seeing Bipolar Disorder From The Inside

The change in my nutrition in the past three weeks has given me a totally different look at my bipolar disorder. The new lifestyle has made me better without medication, but at the same time it has not gotten rid of my illness. It is weird because now it's like I can see my illness in my own mind. I will try to explain this as best I can, but it is a bit hard to describe.

Whereas before my illness could just take over quickly, in a flash, now I am better able to see it coming. It's like the new diet has slowed down the mood changes enough for me to see them as they are happening. It is weird to be able to fight against the bipolar disorder as it is happening in my mind. I can hear the thought patterns - such as life being pointless and there being complete despair - but at the same time I know that it is not real. Before, I could not see that it wasn't real.

When medications worked (before the side effects got too bad), they just stopped the illness at times, and often I felt nothing or was in a daze. Now I still feel everything but I am better able to see the reality of the situation. I can differentiate what is bipolar disorder and what is not. It is interesting to think I can actually live with this illness in my life every day, yet still function well. It is like the diet change has taken the edge off my illness and I can actually use all the mindfulness techniques I have learned. The ability to see thoughts in your mind and just let them go. Be in the moment rather than get trapped in circular thinking, depression, or mania. I could never figure out how to use mindfulness before because the illness would take over so quickly. Now it's like the bipolar is slowed down a bit and I have the chance to be mindful and process what is going on.

I won't say that it's perfect. For instance yesterday was a hard day and I strayed a bit from the diet. I couldn't seem to get myself to control the bipolar yesterday, but it was not as big of a problem as usual. I ate some stuff I shouldn't have, sat around and watched TV, but there was no big blow up. No huge problems, and today I have eaten well again. The one difficult episode did not spiral out of control like it usually does. I do notice I am more depressed today and my anxiety is much worse but it is so much easier for me to see that this is not going to last. As long as I get back with my program, this will pass.

Clearly we will have to see how this goes over the long haul. You can never tell with this illness if you are actually getting better or you just have a reprieve in the symptoms for a bit. I still have a lot of work to do such as increasing mindfulness practice so it becomes easier to do. And I will have to figure out how to handle days, like yesterday, when I can not see the illness as clearly. I won't discount that things look promising right now, but I know there is still a long journey ahead.

Blessings,

Rev. Katie