This is really not a good time of year for me, which I've noticed for at least the last 5 years. It's kind of sad, because I used to love winter when I was a kid.
Now it just makes me nocturnal -- which is weird, given that the lack of sunlight seems to aggravate my depression. These are also the months when I start obsessing about every bad decision I've ever made, & life in general starts looking darker.
Also, I'm on jury duty, which isn't really helping. I'm not at all the anti-jury-duty type. I'd love to sit on a jury, even if there's not a snowball's chance in hell I ever will (lawyers work hard to keep other lawyers off their juries). But sitting on a jury is one thing; waiting for confirmation that you never will is another.
Anyway, I'm sure I'll have more to say soon (probably too much more), but right now I need more sleep.
Wednesday, December 17, 2008
Tuesday, December 9, 2008
Is Blagojevich Nuts?
The latest national media rumor following Rod Blagojevich's arrest is that he's mentally ill in one way or another. He's a "sociopath," he's "insane," he has "delusions of grandeur," according to various sources who know him.
Many, many people hate the idea of anyone diagnosing a public or historical figure from afar. Me, I love it (makes me feel all warm & self-important). And I think it's likely the man is mentally ill, though I'm not quite stupid enough to try to pin a specific illness on him.
Still, mental illness in no way precludes stupidity.
Many, many people hate the idea of anyone diagnosing a public or historical figure from afar. Me, I love it (makes me feel all warm & self-important). And I think it's likely the man is mentally ill, though I'm not quite stupid enough to try to pin a specific illness on him.
Still, mental illness in no way precludes stupidity.
Rod Blagojevich & Me
Most people understand that crime doesn’t exactly breed the upper end of humanity, intellect-wise. But Rod Blagojevich is apparently so stupid he gives Chicago's most venerable tradition a bad name.
And it’s not because he’s a crook. No, it’s because the jackass got caught. Chicago political sleaze has worked long & hard to build its reputation over the decades, & now Blagojevich might tear it all down in the time it took the G-men to cuff him.
Plenty of places swim in the cesspool of political skullduggery, of course: New Orleans, the outer boroughs of New York, L.A., Las Vegas, the entire state of New Jersey (which even manages to smell corrupt). But none of them quite compare to Chicago in their mastery of the game. This is the city that gave the world Big Bill Thompson, “Bathhouse” John Coughlin, Michael “Hinky Dink” Kenna, & "Fast Eddie" Vrdolyak.
And then there's Blago. What a shame. And what an idiot: The man knows he’s under federal investigation – by way of the Bush administration & its warrantless wiretapping, no less – & he yaps about selling a U.S. Senate seat on the fucking telephone?
The whole point behind political crookery in Chicago – the whole point behind Chicago, period – is not getting caught. This is the city where getting away with it has been elevated to high art. The hammer falls on someone every once in a while (prosecutors need work, too), but the likelihood a pol will face jail time correlates almost perfectly with his intelligence.
By which measure Blago should have been born in solitary confinement.
He won the governorship in 2002, at a time when that task was easier for a Democrat than it had been in living memory. As someone I know once put it, but for Chicago, Illinois would be as backward as Alabama, & almost as Republican.
When Blago ran, his predecessor, GOP Gov. George Ryan, was under federal investigation for vacuuming up illegal money (some of it in the form of bribes from unqualified truck drivers who later killed several people on the freeways). Ryan got sent away in 2006, by which time the Illinois Republican Party had eaten itself alive & handed the office to Blago with a bow on top.
But at least Ryan knew when to quit. The feds never recorded him talking shop on the damn phone.
Now, I don’t care how corrupt an Illinois politician you are. When you follow an exposed criminal as governor, something in your mind should scream, “Hey! This is probably a bad time to go around taking kickbacks for open Senate seats & telling anyone who will listen that I'm doing it.”
Political crime in Chicago is measured against political crime in other parts of the United States not based on the amount of money it brings its practitioners, or how high they rise in national politics, or even how badly they harm government where they live. No, Chicago’s prowess in the field comes from the quality, the ingenuity, the dedication of its crooks.
And rule No. 1 among these artists: Do. Not. Get. Caught.
Blago got caught. And now he’s tarnished the crown jewel of Chicago’s reputation. Shame on you, you half-wit.
And it’s not because he’s a crook. No, it’s because the jackass got caught. Chicago political sleaze has worked long & hard to build its reputation over the decades, & now Blagojevich might tear it all down in the time it took the G-men to cuff him.
Plenty of places swim in the cesspool of political skullduggery, of course: New Orleans, the outer boroughs of New York, L.A., Las Vegas, the entire state of New Jersey (which even manages to smell corrupt). But none of them quite compare to Chicago in their mastery of the game. This is the city that gave the world Big Bill Thompson, “Bathhouse” John Coughlin, Michael “Hinky Dink” Kenna, & "Fast Eddie" Vrdolyak.
And then there's Blago. What a shame. And what an idiot: The man knows he’s under federal investigation – by way of the Bush administration & its warrantless wiretapping, no less – & he yaps about selling a U.S. Senate seat on the fucking telephone?
The whole point behind political crookery in Chicago – the whole point behind Chicago, period – is not getting caught. This is the city where getting away with it has been elevated to high art. The hammer falls on someone every once in a while (prosecutors need work, too), but the likelihood a pol will face jail time correlates almost perfectly with his intelligence.
By which measure Blago should have been born in solitary confinement.
He won the governorship in 2002, at a time when that task was easier for a Democrat than it had been in living memory. As someone I know once put it, but for Chicago, Illinois would be as backward as Alabama, & almost as Republican.
When Blago ran, his predecessor, GOP Gov. George Ryan, was under federal investigation for vacuuming up illegal money (some of it in the form of bribes from unqualified truck drivers who later killed several people on the freeways). Ryan got sent away in 2006, by which time the Illinois Republican Party had eaten itself alive & handed the office to Blago with a bow on top.
But at least Ryan knew when to quit. The feds never recorded him talking shop on the damn phone.
Now, I don’t care how corrupt an Illinois politician you are. When you follow an exposed criminal as governor, something in your mind should scream, “Hey! This is probably a bad time to go around taking kickbacks for open Senate seats & telling anyone who will listen that I'm doing it.”
Political crime in Chicago is measured against political crime in other parts of the United States not based on the amount of money it brings its practitioners, or how high they rise in national politics, or even how badly they harm government where they live. No, Chicago’s prowess in the field comes from the quality, the ingenuity, the dedication of its crooks.
And rule No. 1 among these artists: Do. Not. Get. Caught.
Blago got caught. And now he’s tarnished the crown jewel of Chicago’s reputation. Shame on you, you half-wit.
Sunday, December 7, 2008
Away Too Long
I've been a little overwhelmed lately, sort of a low-grade depression with too much sleeping. But I promise all my readers (yes, both of you) I will post again soon, probably tomorrow.
Sunday, November 30, 2008
Under Pressure
My apologies for talking about myself so much, but it was probably inevitable (& if that kind of groveling annoys you, please keep in mind that I'm a Minnesotan, & we apologize like we drink: far too much, far too often).
That said, the saddest thing about bipolar disorder, from my experience, is the loss of a consistent ability to cope with stress.
It hasn’t been a total loss for me, but I used to be much better at it. That was a big part of the reason I started out as a newspaper reporter: the thrill of a deadline, the pressure of talking a reluctant source into telling you what he knows, the daily anxiety over what your readers & sources & editors will think of what you wrote.
But the stress eventually got to be too much, & I left journalism for law school. I knew that carried its own stresses (ridiculously competitive first-year classes, for one; ludicrously competitive second-year summer-job hunts, for another), but I also knew I could study at 4 a.m. & pull all-nighters before exams. I found that harder to manage with a day job.
Now I find it hard even to remember being as ambitious as I was when I graduated from college, or when I started studying law. I usually do what I can to avoid stress now, & I rarely look forward to it. I feel guilty about that once in a while – like I should contribute something to the world but never quite get around to it.
I suspect I’ll be that ambitious again, during one upswing or the next. I also know it won’t last.
Wednesday, November 26, 2008
'Tis Not the Season for Me
The most pathetic, miserable time of year starts tomorrow. Goddamn the holidays, & goddamn all the puke for which they stand.
Really, is there anything more painful than ignoring every dysfunction in our lives -- & doing it for a month and a half out of every flippin' year?
I do love my family & friends, I swear. But I love them because they're flawed, like me (though usually they're more subtle about their shortcomings). The last thing I want to do is sit around & pretend we were all invented by Norman Rockwell, complete with the fat uncle who smells like rum punch & Chesterfields yet retains his jolly sentiment when he plays Santa Claus every year.
Such families -- such people -- do not exist. Never have, never will. I've done enough genealogy over the last five years to know this.
'Tis the season, for those of us with seasonal mood patterns anyway, to get depressed, sleep until noon every day (claiming we "worked from home" in the morning), & gorge on pure starch constantly. I always make sure to keep a bag of flour, a soup ladle & a spare bucket of insulin handy this time of year.
Besides which, turkey sucks ass. Yes, I said it. Did these flightless freaks of nature never learn to drink water? No matter who cooks them, no matter how lovingly & carefully they do it, no matter how freely the damn things range before someone whacks their heads off, turkeys always taste like tree bark, only drier and stringier. Trytophan helps with depression, apparently, but only if you're willing to eat a U-Haul full of Butterballs. Goose I can stand, but who the hell actually cooks geese anymore?
One thing exists to make the holidays survivable: rich, yolky eggnog, by the half gallon. Also, lefse.
Really, is there anything more painful than ignoring every dysfunction in our lives -- & doing it for a month and a half out of every flippin' year?
I do love my family & friends, I swear. But I love them because they're flawed, like me (though usually they're more subtle about their shortcomings). The last thing I want to do is sit around & pretend we were all invented by Norman Rockwell, complete with the fat uncle who smells like rum punch & Chesterfields yet retains his jolly sentiment when he plays Santa Claus every year.
Such families -- such people -- do not exist. Never have, never will. I've done enough genealogy over the last five years to know this.
'Tis the season, for those of us with seasonal mood patterns anyway, to get depressed, sleep until noon every day (claiming we "worked from home" in the morning), & gorge on pure starch constantly. I always make sure to keep a bag of flour, a soup ladle & a spare bucket of insulin handy this time of year.
Besides which, turkey sucks ass. Yes, I said it. Did these flightless freaks of nature never learn to drink water? No matter who cooks them, no matter how lovingly & carefully they do it, no matter how freely the damn things range before someone whacks their heads off, turkeys always taste like tree bark, only drier and stringier. Trytophan helps with depression, apparently, but only if you're willing to eat a U-Haul full of Butterballs. Goose I can stand, but who the hell actually cooks geese anymore?
One thing exists to make the holidays survivable: rich, yolky eggnog, by the half gallon. Also, lefse.
Monday, November 24, 2008
My Medical History & Me, Part 1
On average, manic depressives wait eight years, & four doctors, from the time symptoms show up to the time the psychiatric world makes an accurate diagnosis. I got there in nine & six, but count me lucky anyway: I spent only 24 hours under hospital lock-&-key, received some relatively effective treatment for the depressive end of things, & got a chance to see the sausage factory that is American mental-health-care up close.
At the risk of becoming permanently self-referential, here's a bit of my experience with the insanity industry.
As I've noted before, my crazies struck early, but they waited until I was 23 before they started breaking to the surface (in the form of drunken antics unusual even for a drunk). They waited another four years to make their formal appearance.
When they did, they showed up first as insomnia: I went at least one night a week, sometimes two, sometimes two in a row, without a wink of sleep. Some nights I got in my car & drove around for hours; other nights I watched TV in bed (I firmly believe Homicide: Life on the Street reruns staved off insanity), gave up around 3 a.m. & brewed a pot of coffee; others I drove to my office at 4 a.m. & worked all night through the next day.
Next came the anxiety attacks. These weren't full-blown panic attacks, with all the physical symptoms, but they weren't far off. I typically ended up hyperventilating & dysfunctional, or pounding the holy living Christ out of my dashboard at every red light; driving during these things usually ended with my throat raw from screaming through the windshield at anything that moved.
My first stop: the endocrinologist who treated my diabetes at the time. He had nothing to offer for the sleeplessness, not even a psych referral.
A couple years later, during my first year of law school, I met with the student-health-service "shrink." She was a real psychiatrist (as far as I know), but student health-care in this country is an oxymoron. Campus clinics tend to attract bottom-of-the-barrel medical talent, & student-patients are treated as whiny spoiled annoyances. The urban legend at my undergrad college (& most others, I assume) held that male students routinely had to undergo pregnancy tests before they could get any medical help. The school where I met the shrink has a top-notch teaching hospital, but ironclad rules prevent university students from using it without a referral from the student clinic (which almost no one could get) -- whether or not their insurance would pay for hospital treatment.
So not surprisingly, this psychiatrist was a touch out of her depth. She agreed I probably suffered some degree of depression, but didn't think it was worth doing anything about it. She even suggested my insomnia (which by this point was chronic & repetitive) was a good thing because sleep deprivation is sometimes used to treat depression. It is, but typically only in severe cases, & even then only by psychiatrists who know what they're talking about.
My next try for help was in Manhattan, where I was a summer intern between my first & second years of law school. I happened to be there for the rainiest June in the city's history, & by the end of it I was loopy. I drank for the first time in three and a half years, and strong suicidal ideation crept in.
This time I decided to go with the nearest emergency room. Big mistake. The place turned out to be an assembly line for the sick poor who live around Columbia University. The triage nurse sent me for an interview in the psych ward, which could obviously handle only severe cases of mental illness -- the kind of cases that require cops, restraints & massive amounts of drugs. I could still walk & basically function, so they told me I'd have to wait at least a month or two for an outpatient appointment with a shrink. I didn't really expect to live that long.
And best of all: The "social worker" who interviewed me in place of the on-duty shrink actually asked how often I masturbate, in a way that suggested I should do it as often as possible because that would make me feel better. I don't know about you, pal, but a good wank isn't quite enough to get me down from the window ledge.
There's more to come in a later post . . .
At the risk of becoming permanently self-referential, here's a bit of my experience with the insanity industry.
As I've noted before, my crazies struck early, but they waited until I was 23 before they started breaking to the surface (in the form of drunken antics unusual even for a drunk). They waited another four years to make their formal appearance.
When they did, they showed up first as insomnia: I went at least one night a week, sometimes two, sometimes two in a row, without a wink of sleep. Some nights I got in my car & drove around for hours; other nights I watched TV in bed (I firmly believe Homicide: Life on the Street reruns staved off insanity), gave up around 3 a.m. & brewed a pot of coffee; others I drove to my office at 4 a.m. & worked all night through the next day.
Next came the anxiety attacks. These weren't full-blown panic attacks, with all the physical symptoms, but they weren't far off. I typically ended up hyperventilating & dysfunctional, or pounding the holy living Christ out of my dashboard at every red light; driving during these things usually ended with my throat raw from screaming through the windshield at anything that moved.
My first stop: the endocrinologist who treated my diabetes at the time. He had nothing to offer for the sleeplessness, not even a psych referral.
A couple years later, during my first year of law school, I met with the student-health-service "shrink." She was a real psychiatrist (as far as I know), but student health-care in this country is an oxymoron. Campus clinics tend to attract bottom-of-the-barrel medical talent, & student-patients are treated as whiny spoiled annoyances. The urban legend at my undergrad college (& most others, I assume) held that male students routinely had to undergo pregnancy tests before they could get any medical help. The school where I met the shrink has a top-notch teaching hospital, but ironclad rules prevent university students from using it without a referral from the student clinic (which almost no one could get) -- whether or not their insurance would pay for hospital treatment.
So not surprisingly, this psychiatrist was a touch out of her depth. She agreed I probably suffered some degree of depression, but didn't think it was worth doing anything about it. She even suggested my insomnia (which by this point was chronic & repetitive) was a good thing because sleep deprivation is sometimes used to treat depression. It is, but typically only in severe cases, & even then only by psychiatrists who know what they're talking about.
My next try for help was in Manhattan, where I was a summer intern between my first & second years of law school. I happened to be there for the rainiest June in the city's history, & by the end of it I was loopy. I drank for the first time in three and a half years, and strong suicidal ideation crept in.
This time I decided to go with the nearest emergency room. Big mistake. The place turned out to be an assembly line for the sick poor who live around Columbia University. The triage nurse sent me for an interview in the psych ward, which could obviously handle only severe cases of mental illness -- the kind of cases that require cops, restraints & massive amounts of drugs. I could still walk & basically function, so they told me I'd have to wait at least a month or two for an outpatient appointment with a shrink. I didn't really expect to live that long.
And best of all: The "social worker" who interviewed me in place of the on-duty shrink actually asked how often I masturbate, in a way that suggested I should do it as often as possible because that would make me feel better. I don't know about you, pal, but a good wank isn't quite enough to get me down from the window ledge.
There's more to come in a later post . . .
Monday, November 17, 2008
Gleevec, Sutent & Me
From Reuters today:
"CHICAGO (Reuters) - Two popular leukemia drugs, Gleevec and Sutent, kept lab mice from developing type 1 diabetes and put 80 percent of diabetic mice in remission, an international team said on Monday."
I'm always skeptical of claims that Type 1 diabetes is about to be cured. I've had this shit for almost 17 years, & news of a possible cure has come along at least once in every one of those years. I don't want to get my hopes up, but this one sounds a little more promising.
Given the choice between losing diabetes & losing the crazies, I'd choose diabetes in a heartbeat. They both suck, obviously, but my mental health problems come & go. A touch o' the sugar is constant. I worry about it when I wake up, when I shower, when I brush my teeth, when I get to work, when I buy coffee, when I eat lunch, & on & on & on. I can't even daydream freely: Whenever I fantasize about life on an uninhabited island, à la Cast Away (though usually with some hot woman who otherwise wouldn't acknowledge my existence), I quickly give up because I know I wouldn't last a month without insulin (which doesn't exactly grow on coconut trees).
Mental illness, at least, offers some unpredictability. When you're diabetic (& pessimistic) you basically know how it's going to end: blind, footless & on dialysis.
So here's keeping my fingers crossed, if only so I can live to see Eli Lilly take it in the ass.
"CHICAGO (Reuters) - Two popular leukemia drugs, Gleevec and Sutent, kept lab mice from developing type 1 diabetes and put 80 percent of diabetic mice in remission, an international team said on Monday."
I'm always skeptical of claims that Type 1 diabetes is about to be cured. I've had this shit for almost 17 years, & news of a possible cure has come along at least once in every one of those years. I don't want to get my hopes up, but this one sounds a little more promising.
Given the choice between losing diabetes & losing the crazies, I'd choose diabetes in a heartbeat. They both suck, obviously, but my mental health problems come & go. A touch o' the sugar is constant. I worry about it when I wake up, when I shower, when I brush my teeth, when I get to work, when I buy coffee, when I eat lunch, & on & on & on. I can't even daydream freely: Whenever I fantasize about life on an uninhabited island, à la Cast Away (though usually with some hot woman who otherwise wouldn't acknowledge my existence), I quickly give up because I know I wouldn't last a month without insulin (which doesn't exactly grow on coconut trees).
Mental illness, at least, offers some unpredictability. When you're diabetic (& pessimistic) you basically know how it's going to end: blind, footless & on dialysis.
So here's keeping my fingers crossed, if only so I can live to see Eli Lilly take it in the ass.
Friday, November 14, 2008
My Crazy Family & Me
I'm way too fascinated by the crazies in my family history. Whenever I read about the debate over heredity vs. environment, I instictively jump to the genetic side of the argument. No doubt that's in part because I'm no fan of self-blame, but it's also because the statistics support the hereditary position.
And damnit, it just makes sense. Does it really seem likely that bipolar disorder appears repeatedly in the same families solely because of environmental quirks? Mood disorders generally, maybe: Your childhood & family life are fucked up, odds are good that you will be too, someday, & odds are good that your kids' childhoods will be fucked up, etc., etc. But something as specific as manic depression? That's kind of like chalking cystic fibrosis up to shitty luck.
My family's bipolar branches include a grandfather who drank himself to death years before lithium hit the scene; probably a grandmother, who's undergone electroconvulsive therapy (ECT); probably a sibling; an aunt; at least one first cousin; at least four first cousins once removed (first cousins of my parents on both sides); and probably a great-great-grandfather, who killed himself 26 years after he fought in the Civil War (his family covered up the suicide, so I can't be positive, but it's the only explanation that fits).
Personally, I think the fact that the debate continues has a lot to do with magical thinking: If we wish really, really hard, we'll make the world a place where we're all individually responsible for every aspect of our circumstances in life, or at least a place where we can blame specific people for their misfortunes. The only alternative is to believe that our lives are almost entirely outside of our control -- & that thought scares a lot of people shitless.
Obviously some number of fruitbaskets stand out as the only crazies in their families. But those could be families where the disease just lay dormant, genetically speaking, for enough generations that its presence is lost to memory. They could also be families where the illness is especially hard to trigger. Or they could be families where bipolar disorder expresses itself mildly in most cases -- too mildly to land anyone else a diagnosis or even suspicion.
And clearly environment plays some role in bipolar disorder, but is it anything more than a trigger that sets off sleeping manic depression?
My personal theory of life (for what little it's worth) is that far more shit happens to us than we make happen. Call it the Moby-Dick school of thought: The harder we try to shove fate into the boxes of human philosophy, the more slippery fate becomes. Life does whatever the fuck it wants -- not what we think it should. And that includes sticking us with hereditary ass-pains that mock our need to believe we live in a meritocratic world.
And damnit, it just makes sense. Does it really seem likely that bipolar disorder appears repeatedly in the same families solely because of environmental quirks? Mood disorders generally, maybe: Your childhood & family life are fucked up, odds are good that you will be too, someday, & odds are good that your kids' childhoods will be fucked up, etc., etc. But something as specific as manic depression? That's kind of like chalking cystic fibrosis up to shitty luck.
My family's bipolar branches include a grandfather who drank himself to death years before lithium hit the scene; probably a grandmother, who's undergone electroconvulsive therapy (ECT); probably a sibling; an aunt; at least one first cousin; at least four first cousins once removed (first cousins of my parents on both sides); and probably a great-great-grandfather, who killed himself 26 years after he fought in the Civil War (his family covered up the suicide, so I can't be positive, but it's the only explanation that fits).
Personally, I think the fact that the debate continues has a lot to do with magical thinking: If we wish really, really hard, we'll make the world a place where we're all individually responsible for every aspect of our circumstances in life, or at least a place where we can blame specific people for their misfortunes. The only alternative is to believe that our lives are almost entirely outside of our control -- & that thought scares a lot of people shitless.
Obviously some number of fruitbaskets stand out as the only crazies in their families. But those could be families where the disease just lay dormant, genetically speaking, for enough generations that its presence is lost to memory. They could also be families where the illness is especially hard to trigger. Or they could be families where bipolar disorder expresses itself mildly in most cases -- too mildly to land anyone else a diagnosis or even suspicion.
And clearly environment plays some role in bipolar disorder, but is it anything more than a trigger that sets off sleeping manic depression?
My personal theory of life (for what little it's worth) is that far more shit happens to us than we make happen. Call it the Moby-Dick school of thought: The harder we try to shove fate into the boxes of human philosophy, the more slippery fate becomes. Life does whatever the fuck it wants -- not what we think it should. And that includes sticking us with hereditary ass-pains that mock our need to believe we live in a meritocratic world.
Tuesday, November 11, 2008
Barack & Me
I'm gonna milk this shit for all it's worth:
Back in 1999-2000, I worked as a metro reporter at a newspaper on the South Side of Chicago, & in June 2000 I wrote a half-ass story about the christening of a new commuter-rail station in a poor South Side neighborhood. Congressman Jesse Jackson Jr. led the thing, breaking a bottle of sparkling grape juice against the edge of the station platform (& joking, after the TV cameras left, that some of it was "for the homies"). He was joined by a really, really tall state senator (who laughed at Jackson's lame joke).
I'd forgotten that Obama was at the ceremony until an ex-colleague reminded me about the story last night, & the fact that I quoted Obama.
If I were still a journalist, I wouldn't be able to pawn this anecdote off on the janitor. But as a) I'm not still a journalist, b) I gave up on professional dignity long ago, & c) I dropped my marbles down a storm drain, I don't give a goddamn. I knew the dude back when.
Back in 1999-2000, I worked as a metro reporter at a newspaper on the South Side of Chicago, & in June 2000 I wrote a half-ass story about the christening of a new commuter-rail station in a poor South Side neighborhood. Congressman Jesse Jackson Jr. led the thing, breaking a bottle of sparkling grape juice against the edge of the station platform (& joking, after the TV cameras left, that some of it was "for the homies"). He was joined by a really, really tall state senator (who laughed at Jackson's lame joke).
I'd forgotten that Obama was at the ceremony until an ex-colleague reminded me about the story last night, & the fact that I quoted Obama.
If I were still a journalist, I wouldn't be able to pawn this anecdote off on the janitor. But as a) I'm not still a journalist, b) I gave up on professional dignity long ago, & c) I dropped my marbles down a storm drain, I don't give a goddamn. I knew the dude back when.
Thursday, November 6, 2008
My Problem with CBT
Saw a new shrink today. He was very good, very empathetic, very sharp, & he made his diagnosis based on my narrative history & recollections rather than on the standard bipolar checklist. This helps, since I tend to answer "no" to most of the classic bipolar trigger questions (did you ever believe you were King Henry VIII? Did you ever drop $50,000 on lawn ornaments? Did you ever try to break your way into the porn industry?).
He seemed to peg my diagnosis as bipolar not otherwise specified (NOS), that funky-ass catchall category that acknowledges you can be manic-depressive without drawing up plans to build a nuclear power plant in your backyard. This reading certainly makes sense. Like I said in an earlier post, I worry that I see manic depression where it doesn't exist. But this shrink pointed out specific symptoms that do suggest a bipolar-spectrum disorder: My depressive episodes often involve some sort of high-stress trigger (Kerry losing in 2004, for example); my mood changes tend to be seasonal, at least when they're relatively stable (OK in the summer, up a tick early in the fall, then noticeably down around January, & back up again in early spring); and my sleep patterns fit, at least at their worst (staying up later & later every night until I'm sleeping during the day, then crashing & snapping back to a pseudo-normal-human schedule).
I switched to this guy mainly because I was getting tired of the behavioral dreck I was getting from my therapist. It helped for a while, but I keep seeing cognitive behavioral therapy (CBT) as a kind of modern-day blame-the-patient approach: It's not your fault that you never learned to behave properly, but we'll fix that. As much as I appreciate the need for personal responsibility, you won't get very far telling me the reason I'm crazy is that I failed to grow up. My therapist never went so far as saying he didn't consider bipolar disorder a real disease, but he always seemed to lean in that direction -- taking medicine is a good idea, & you shouldn't stop, but our biggest concern is making sure you learn how to behave like a responsible adult. More than a little condescending, frankly -- I doubt many therapists who've actually lived with mental illness would feel that way.
He seemed to peg my diagnosis as bipolar not otherwise specified (NOS), that funky-ass catchall category that acknowledges you can be manic-depressive without drawing up plans to build a nuclear power plant in your backyard. This reading certainly makes sense. Like I said in an earlier post, I worry that I see manic depression where it doesn't exist. But this shrink pointed out specific symptoms that do suggest a bipolar-spectrum disorder: My depressive episodes often involve some sort of high-stress trigger (Kerry losing in 2004, for example); my mood changes tend to be seasonal, at least when they're relatively stable (OK in the summer, up a tick early in the fall, then noticeably down around January, & back up again in early spring); and my sleep patterns fit, at least at their worst (staying up later & later every night until I'm sleeping during the day, then crashing & snapping back to a pseudo-normal-human schedule).
I switched to this guy mainly because I was getting tired of the behavioral dreck I was getting from my therapist. It helped for a while, but I keep seeing cognitive behavioral therapy (CBT) as a kind of modern-day blame-the-patient approach: It's not your fault that you never learned to behave properly, but we'll fix that. As much as I appreciate the need for personal responsibility, you won't get very far telling me the reason I'm crazy is that I failed to grow up. My therapist never went so far as saying he didn't consider bipolar disorder a real disease, but he always seemed to lean in that direction -- taking medicine is a good idea, & you shouldn't stop, but our biggest concern is making sure you learn how to behave like a responsible adult. More than a little condescending, frankly -- I doubt many therapists who've actually lived with mental illness would feel that way.
Tuesday, November 4, 2008
Vote Early, Vote Late -- But Vote Often
In response to a questionnaire from the National Alliance on Mental Illness, Obama answered "Strongly Support" to every question asked. Note especially Nos. 22-24, dealing with incarceration of the mentally ill.
From http://www.nami.org/:
1. Support mental health and substance abuse coverage in all plans to provide affordable health care?
2. Support federal parity legislation to provide equivalent coverage of mental health and substance abuse conditions?
3. Ensure that active duty military, veterans and reservists receive the mental health care and disability payments they need to live successfully with mental illness?
4. Support parity of mental health coverage in the Medicare program?
5. Support policies that remove barriers and promote full access to mental health medications in Medicare, Medicaid and other programs?
6. Support renewing Medicare Part D guidance ensuring access to mental health medications?
7. Support Medicaid coverage and reimbursement of effective, recovery-oriented and evidence-based mental health services?
8. Support repealing the Medicaid IMD policy that excludes coverage for inpatient care in certain facilities?
9. Support parity of mental health coverage in the SCHIP program?
10. Support investing new resources in the Mental Health Services Block Grant?
11. Support policies that eliminate the inappropriate use of seclusion and restraint and foster humane alternatives?
12. Support accelerated investment in National Institute of Mental Health research on mental illness, co-occurring disorders, recovery and reintegration into the community?
13. Support incorporating cultural competence standards in requirements for federal mental health funding?
14. Support federal incentives to recruit and train mental health professionals, particularly to increase workforce diversity and serve rural areas?
15. Support the integration of mental health and primary care to achieve better health outcomes, particularly for older adults and communities of color?
16. Support increased funding for the Garrett Lee Smith Memorial Act to expand youth and young adult suicide prevention and early intervention strategies?
17. Support full funding of the Individuals with Disabilities Education Act (IDEA) and passing legislation to fund school-based mental health services?
18. Support passing Keeping Families Together legislation to end unnecessary custody relinquishment by families seeking mental health services for their children?
19. Support increased investment in permanent and supportive housing for people living with serious mental illness?
20. Support programs and policies that result in competitive employment for people living with serious mental illness?
21. Support maintaining health care coverage for people with disabilities who return to work?
22. Support increasing programs to divert people with mental illness from jail into appropriate community treatment?
23. Support increasing programs to identify youth with serious mental disorders at first contact with juvenile justice systems and increase diversion to community treatment?
24. Support access to SSI/SSDI, Medicaid and other federal benefits upon release from jail or prison for people with mental illness?
McCain, meanwhile, refused to answer any of NAMI's questions, responding instead with a one-page statement packed with boilerplate bullshit, including the following:
"Mental health is a necessary complement to physical health in all aspects of our daily lives. Fortunately, the path to greater quality and lower costs is to recognize this fact and where possible provide incentives to treat physical and behavioral health together. Chronic disease is a dominant component of the growth in spending on health care and many of our citizens with chronic illnesses have a behavioral health problem as well. For example, untreated depression raises dramatically the cost of treating the physical ailments of a diabetic. A sensible goal is to design reimbursement for taking care of the whole patient, whatever ails them, and recognize the essential role mental health treatment plays in the overall health of the patient and the reduction in physical health needs.
I have stressed the central role of personal responsibility in leading to lower health care costs. Personal fitness and better lifestyles, especially reduction in addictions of all types – food, narcotics, or cigarettes – can yield dramatic improvements in the cost of chronic illness and high‐cost medical care. We can do a better job of treating addictions, but we also have an obligation to do a better job of teaching our children the benefits of good lifestyles and the perils of addictive activities."
The Arnold Schwarzenegger school of mental health: "Personal fitness & better lifestyles." And this from a guy whose wife is a recovering addict.
I just hope the Obama landslide predictions pan out tonight.
From http://www.nami.org/:
1. Support mental health and substance abuse coverage in all plans to provide affordable health care?
2. Support federal parity legislation to provide equivalent coverage of mental health and substance abuse conditions?
3. Ensure that active duty military, veterans and reservists receive the mental health care and disability payments they need to live successfully with mental illness?
4. Support parity of mental health coverage in the Medicare program?
5. Support policies that remove barriers and promote full access to mental health medications in Medicare, Medicaid and other programs?
6. Support renewing Medicare Part D guidance ensuring access to mental health medications?
7. Support Medicaid coverage and reimbursement of effective, recovery-oriented and evidence-based mental health services?
8. Support repealing the Medicaid IMD policy that excludes coverage for inpatient care in certain facilities?
9. Support parity of mental health coverage in the SCHIP program?
10. Support investing new resources in the Mental Health Services Block Grant?
11. Support policies that eliminate the inappropriate use of seclusion and restraint and foster humane alternatives?
12. Support accelerated investment in National Institute of Mental Health research on mental illness, co-occurring disorders, recovery and reintegration into the community?
13. Support incorporating cultural competence standards in requirements for federal mental health funding?
14. Support federal incentives to recruit and train mental health professionals, particularly to increase workforce diversity and serve rural areas?
15. Support the integration of mental health and primary care to achieve better health outcomes, particularly for older adults and communities of color?
16. Support increased funding for the Garrett Lee Smith Memorial Act to expand youth and young adult suicide prevention and early intervention strategies?
17. Support full funding of the Individuals with Disabilities Education Act (IDEA) and passing legislation to fund school-based mental health services?
18. Support passing Keeping Families Together legislation to end unnecessary custody relinquishment by families seeking mental health services for their children?
19. Support increased investment in permanent and supportive housing for people living with serious mental illness?
20. Support programs and policies that result in competitive employment for people living with serious mental illness?
21. Support maintaining health care coverage for people with disabilities who return to work?
22. Support increasing programs to divert people with mental illness from jail into appropriate community treatment?
23. Support increasing programs to identify youth with serious mental disorders at first contact with juvenile justice systems and increase diversion to community treatment?
24. Support access to SSI/SSDI, Medicaid and other federal benefits upon release from jail or prison for people with mental illness?
McCain, meanwhile, refused to answer any of NAMI's questions, responding instead with a one-page statement packed with boilerplate bullshit, including the following:
"Mental health is a necessary complement to physical health in all aspects of our daily lives. Fortunately, the path to greater quality and lower costs is to recognize this fact and where possible provide incentives to treat physical and behavioral health together. Chronic disease is a dominant component of the growth in spending on health care and many of our citizens with chronic illnesses have a behavioral health problem as well. For example, untreated depression raises dramatically the cost of treating the physical ailments of a diabetic. A sensible goal is to design reimbursement for taking care of the whole patient, whatever ails them, and recognize the essential role mental health treatment plays in the overall health of the patient and the reduction in physical health needs.
I have stressed the central role of personal responsibility in leading to lower health care costs. Personal fitness and better lifestyles, especially reduction in addictions of all types – food, narcotics, or cigarettes – can yield dramatic improvements in the cost of chronic illness and high‐cost medical care. We can do a better job of treating addictions, but we also have an obligation to do a better job of teaching our children the benefits of good lifestyles and the perils of addictive activities."
The Arnold Schwarzenegger school of mental health: "Personal fitness & better lifestyles." And this from a guy whose wife is a recovering addict.
I just hope the Obama landslide predictions pan out tonight.
Monday, November 3, 2008
My Election Anxiety
Jesus, does election season put me on edge. I swear to God, my moods seem to cycle according to the political news in the months before a presidential vote.
Back in 2004, I did pretty well most of the year, still recovering from a nasty depression but feeling a hell of a lot better. I even worked as a poll watcher, which I don't think I could've pulled off in a bad state of mind.
Then John Kerry lost, & I couldn't get out of bed for two days straight. It was the start of the third major depressive episode I've been able to pinpoint.
This time around I promised myself I wouldn't get so emotionally attached to the race. That worked until about two days after Barack Obama announced his campaign in 2007.
So vote Democratic tomorrow, or I'll have a nervous breakdown. And it'll be on you.
Back in 2004, I did pretty well most of the year, still recovering from a nasty depression but feeling a hell of a lot better. I even worked as a poll watcher, which I don't think I could've pulled off in a bad state of mind.
Then John Kerry lost, & I couldn't get out of bed for two days straight. It was the start of the third major depressive episode I've been able to pinpoint.
This time around I promised myself I wouldn't get so emotionally attached to the race. That worked until about two days after Barack Obama announced his campaign in 2007.
So vote Democratic tomorrow, or I'll have a nervous breakdown. And it'll be on you.
Thursday, October 30, 2008
Hey Norm -- Sue Me (I could use the press)
So Sen. Norm Coleman has sued Democratic opponent Al Franken for calling him a crook.
Well, Norm, I think you know it's a very poorly kept secret here in Minnesota Nice that you're not only a crook -- you're an adulterous, womanizing crook.
Not that there's anything wrong with that. Unless, of course, you're just another self-righteous prick.
Well, Norm, I think you know it's a very poorly kept secret here in Minnesota Nice that you're not only a crook -- you're an adulterous, womanizing crook.
Not that there's anything wrong with that. Unless, of course, you're just another self-righteous prick.
Wednesday, October 29, 2008
My Daily Affirmation
I really shouldn't find this reassuring, but I do. I've been reading Francis Mondimore's Bipolar Disorder: A Guide for Patients & Families, & came across this nugget toward the end:
"Stress doesn't make people manic or send them into a major depression unless they have bipolar disorder. Neither does drinking too much or sleep deprivation or the loss of a job or the end of a love affair or the hundred other things that you can convince yourself explain your symptoms better than a diagnosis of bipolar disorder."
My bouts of denial usually show up in a weird-ass kind of way. I don't worry so much that non-crazy people will think I'm repulsive because I'm nuts -- I worry they'll think I'm being melodramatic by declaring myself nuts. I've had the same anxiety over declaring myself a drunk: I hear the war stories of other recovering alcoholics & fear mine will sound lame (though when I tell mine in detail, I usually get a few gasps & "you're-still-alive?" looks that ease that concern a touch).
What often gets me (especially, for some reason, right before psychiatrist appointments) is the thought that maybe I'm not really bipolar. Maybe I just had a few bad depressions & drank myself into situations my shrink sees as manic. Maybe I talked myself into a bipolar diagnosis just because it seems sexier than straight depression (does that make me a pervert?).
Which is why Mondimore made me feel better. Apparently sane booze hounds don't typically drink themselves into situations that end with 4 a.m. paddy-wagon rides to a hospital suicide-watch room.
Who knew?
"Stress doesn't make people manic or send them into a major depression unless they have bipolar disorder. Neither does drinking too much or sleep deprivation or the loss of a job or the end of a love affair or the hundred other things that you can convince yourself explain your symptoms better than a diagnosis of bipolar disorder."
My bouts of denial usually show up in a weird-ass kind of way. I don't worry so much that non-crazy people will think I'm repulsive because I'm nuts -- I worry they'll think I'm being melodramatic by declaring myself nuts. I've had the same anxiety over declaring myself a drunk: I hear the war stories of other recovering alcoholics & fear mine will sound lame (though when I tell mine in detail, I usually get a few gasps & "you're-still-alive?" looks that ease that concern a touch).
What often gets me (especially, for some reason, right before psychiatrist appointments) is the thought that maybe I'm not really bipolar. Maybe I just had a few bad depressions & drank myself into situations my shrink sees as manic. Maybe I talked myself into a bipolar diagnosis just because it seems sexier than straight depression (does that make me a pervert?).
Which is why Mondimore made me feel better. Apparently sane booze hounds don't typically drink themselves into situations that end with 4 a.m. paddy-wagon rides to a hospital suicide-watch room.
Who knew?
Tuesday, October 28, 2008
My Moody Circles & Me
Why start another bipolar blog? Especially a bipolar blog that no one in his right mind would ever willingly read? Well, I’m not in my right mind, so I can do whatever the hell I want.
I’m a Minnesotan, a lawyer & ex-newspaperman, a fruitcake, a recovering soak, a diabetic, & still alive, & on most days I’m at least a little proud of all those things. I’m an unabashed liberal who was raised in the congressional district currently represented by Michele Bachmann, protégé of Joe McCarthy (though hopefully that will change after November 4). My hometown has a population of 17,000, & it’s surrounded by miles of right-wing farm country. I prefer big cities, Danish cigarettes & socialized medicine. So I’ve got something of an inferiority complex about my origins.
The crazies started their invasion at least as far back as high school, but they didn’t make their presence fully known until I was a year into law school in 2003. If I can offer just one piece of advice to anyone bored enough to read this: Go nuts before, or after, but never while studying for a professional degree – especially if you’ve ignored common sense & passed up scholarships in favor of the most expensive school you can find. I’m ass-deep in debt, with poor long-term job prospects, three law schools on my transcript, & grades that scream “nervous breakdown!”
So anyway, here’s a basic outline of how I became acquainted with insanity:
Bipolar disorder runs in most of the recent branches of my family tree, though I didn't know it until a few years ago. I grew up with a vague but constant sense that I didn’t see the world like most other people: In high school, the lumps of life-related shittiness that other people put behind them seemed to stick to me, to gnaw at me long after I should’ve forgotten them.
I bucked family tradition & went to college out of state, where I figured I’d have better luck. It seemed like I did for a while, but eventually I started taking everything – every rejection, every failure – too personally. I had a habit of building up fierce ambitions, then dropping them for no good reason. I also started drinking, & by the time I graduated I’d developed a nice cozy relationship with the sauce.
About a year after graduation, I had an episode that was probably part suicide attempt, probably part manic episode, & definitely part alcoholic blackout. I can’t remember most of it, but I almost died, which scared the living Jesus out of me, & I quit drinking, for a while. The emergency room doctors assured me my problem was purely liquid, so I had no reason to suspect I might have been driven to booze by genuine clinical madness.
I survived the next few years working as a newspaper reporter. That was fun, at least until anxiety attacks & a long run of insomnia convinced me I should try something else, maybe law school. So I took the LSAT (talk about the benefits of hypomania: I managed to pull off a high score despite getting not a minute of sleep the night before the test) & went back to school.
But the insomnia & anxiety didn’t stay behind, & I keeled off the deep end during the summer after my first year, in 2003. I’d been depressed before, but not like this. This was the kind of depression where the color fades out of buildings, where you stop seeing anything more than 10 feet away (you know it’s there, but your eyes are too tired to focus), where every approaching subway train starts to look like a decent way out. I repeatedly stuck my head out of my ninth-floor apartment window, estimating how badly I’d scar my neighbors if I jumped. I wrote a suicide note on my laptop, deleted it, then wrote it again.
So I ended up in the psych ward of a
I eventually moved back to Minnesota & finished law school, but it took an extra two years, & I spent a good part of that time back inside 110-proof bottles of bourbon (along with scotch, vodka, 151 rum, & the occasional splash of 160-proof almond extract). I finally quit the juice again a little more than two years ago, went through outpatient rehab, (re)joined a 12-step group, & remain as sober as a judge – a judge who doesn’t drink, anyway.
In February 2008, my diagnostic status was upgraded to bipolar disorder type 2 vs. other. The “vs. other,” as I understand it, indicates that my current shrink suspects I really have type 1. She told me during my last appointment that she thinks my personality tends in that direction. I took it as a compliment.
I presently see the shrink & a behavioral psychotherapist. I’m not terribly hot about either. The doctor is good at her job, but she only does medication management, & she keeps appointments disappointingly short (medication management my ass: I try to squeeze in talk therapy wherever I can get it, as more than a few relatives, friends & telemarketers can attest). My therapist is also pretty good at what he does (cognitive behavioral therapy). I just don’t take to it very well. At the moment I’m aiming to move to more traditional psychotherapy, with a psychiatrist who actually talks to patients, but that shit’s expensive, with or without insurance. And what with being manic-depressive, prudent financial planning isn’t exactly my strong suit.
I still take pills, obviously, but I draw a very serious line in the sand on this issue: I refuse, ever, under any circumstances whatsoever, to refer to my medications as “my meds” (well, OK, besides in this sentence). I can’t really explain it – there’s just something about it that pisses me off. It’s too hip, too apologetic, too obnoxious. It sounds like the aging ponytail hippie who won’t shut up about “toking reefer.”
That said, I started Lamictal earlier this year. Before that I was on a relatively short roster of other drugs: Celexa (worked for a while), Lexapro (sucked ass), Remeron & Wellbutrin (couldn’t really tell), & Prozac (can’t really tell, but I still take it). My psychiatrist put me on the Lamictal – an anticonvulsant mood stabilizer – after several weeks of bizarre sleeping patterns last winter: I was switching back & forth, every two weeks or so, between sleeping at night and sleeping during the day. She told me that can happen with bipolar disorder; I haven’t seen anything in print yet that confirms this, but a few books come close.
I’ve been extremely lucky with side effects since the very first pill: some GI issues & a touch of dry mouth, but that’s about it. Given what I’ve read from other manic-depressives, I’ve gotten off easy on this front, but I like to believe I’d stay compliant even with side effects. I’m a staunch believer in aggressive treatment of mental illness – with the caveat that the treatment should never cause problems as serious as the disease.
Lately my moods have been pretty consistent. But it’s hard for me to judge. My episodes of severe depression (I’ve had at least two more since 2003) stand out – clearly something was fucked up. I can’t pinpoint much mania, though. There are certainly stretches that look like hypomania in hindsight, & my shrink says she suspects my blackout/suicide attempt involved full-blown mania. But I have a hard time tracing distinct mood cycles. I hope that’s partly because of the medication, but I also suspect I have some less-than-classic symptoms – maybe some mixed states, maybe some mania that involves more irritability than expansiveness (I have, on a few inappropriate occasions, become more than a little snippy).
Anyway, that’s me & my crazy. Make of it what you will. I may run out of things to say too quickly to keep this joke of a blog going very long. But I obviously like the sound of my own typing, so maybe not. I shall remain semi-anonymous, at least for now – if only so this blog's abject failure won't trace directly back to me.
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