by Sara Ackerson
I’ve become pretty good at getting through each day, actually thriving, and not just managing my illness. You most likely wouldn’t even know unless I disclosed it to you. I live with an extrovert personality, a cup of coffee, and a flexible work schedule that allows for me to have dedicated time for my monthly psychiatrist appointments and other self-care without having to ask for sick time off on a regular basis.
I wake up in the morning and the first thing I do is take my medicine. I’m still unsure if this particular combination is working, but I take them anyway. In the last fifteen years, I’ve taken at least twenty different medications in various combinations. If I forget my medication, it’s a safe assumption that – within about five hours – I will start to feel those “brain zaps”. Brain zaps basically feel like mini-electrical shock sensations. They’re not fun.
Part of the way I manage my particular co-morbid diagnosis (bi-polar and borderline personality disorder, along with ADHD, and PTSD) is by practicing different techniques learned through Dialectical Behavior Therapy (DBT). These include mindfulness, distress tolerance skills, and emotion regulation. For me, I have to have a routine and things have to be orderly and clean. If I don’t have these components, I will find myself getting brain fog, where nothing seems to make sense, everything gets cloudy, and I have to just sit and breathe.
I was officially diagnosed when I was in my mid-twenties. I know I showed signs of my illness much earlier in life, but I didn’t see a doctor until I was around eighteen. At that time, I was diagnosed with major depressive disorder and dysthymia (which basically means you are usually just below that “I feel good” line). By the time I was in my twenties, I started to experience fairly regular episodes of manic and then a crash, of explosions of anger, of suicidal tendencies, on a constant loop. My diagnosis was modified. Often times, I do not notice my behaviors until it is just about too late. I am extremely self-conscious of my actions.. I think about how people always say how much of an extrovert I am, when in reality, most of those actions are truly a result of a start of mania for me.
I used to be very resistant to the idea of therapy. Medications didn’t bother me, aside from the process of finding a working combination. Art therapy had worked, but I couldn’t find a group in Boston. At one point, I had a psychiatrist who said she would refuse to continue to treat me if I didn’t also participate in therapy. The next week I was in the hospital for the third time, followed by a mandated outpatient program. It was in this program that I learned the value of therapy, particularly DBT. These days, I can’t afford both treatment/medications (about $100/month), and therapy groups (about $80/month). I’m hoping that changes sometime soon, but I’m getting by.
Each day I have to be remind myself to be grateful that I have made it this far. Each day I know I am one episode away from another hospitalization. When I am in my darkest moments, I crave the crisp white sheets and routine of the hospital ward. Then I remind myself of all I’ve accomplished in the last year and I do not want to lose it, not to my illness. Because of this, I am extra cautious. I remove myself from conversations that will only do damage. I separated myself from the toxic people I once thought were friends. I practice as much self-care as possible, even if it is in the form of a reality TV show marathon. I work on erasing the tapes that run through my mind of other people’s opinions of me. “You’re the realest person I know”. “I could never be with someone who needs to be on medication just to function”. “You go from 0 to 100 in a minute”.
I’m still working on how to manage my episodes, before they cause too much of a stir. One day I will be on cloud nine, with tons of ideas and plans for the future. The next day, I will snap at you and everyone in my life for the slightest thing. Another day, I will be unable to drag myself from bed. When I maintain a routine and take care of myself, those different days happen less frequently and instead, I have some consistency in moods. I still have fluctuations during the day but I know how to step back to manage them. I have a lot of positive opportunities happening in my life right now and that has helped tremendously. I have hope.
Originally posted at the Student Affairs Collective on May 4, 2015.