Mental Health Check-In

Today, my therapist and I did a symptom review where we ‘sorted’ my current and very recent symptoms into three categories: Anxiety, Depression, and Hypomania. Then we looked at the intersection of these symptoms, this sorting, with my trauma symptoms.

I was struggling to distinguish between Anxiety and Hypomania, so she literally created a divide in the conversation and the exercise by inserting depression between them. It is a mental exercise to stop one train of thought, pick up another, and then go back to what was causing the conflict in the first place.

The conclusion is that I’m on the softer border of a ‘mixed state’ or ‘rapid cycling’ of my moods, exacerbated by my anxiety. Well, that’s not new.

For example, my wife told me that I’ve been yelling more often lately. Not necessarily yelling at people, but just yelling. At first, I attributed this to feeling unheard and unacknowledged, part of my trauma reaction to any family gathering. Then I considered it might be hypomania because my speech can become rapid and louder as I try to say all the things at once (and fail miserably.)

After our conversation, we determined it was more likely bound up in my anxiety and irritability than anything in my subconscious self. I’m very irritable of late. The world sucks. My plate is full. I’m perpetually stuffed up and unable to breathe. The list goes on and on, like it always has. Managing my anxiety a bit more intensely has been helpful. I’ve been laying low these past days, not going anywhere unnecessary and it has been a true relief after several ‘on the go’ days.

The reason I am blogging about this is not so much because it is scintillating content as it is an exercise in the practice of ‘stretching’ an experience by just a few seconds or minutes to get all of my brain cells focused on that positive experience. For example, our cat Muriel was on the back of the sofa this morning where I was able to secure her and administer her daily medication. Typically, she runs away after release. Today, she stayed there (the meds are working!) and let me stroke her for awhile. The sun was making the sofa warm, she was purring, I had coffee. It was a good few moments. Even just talking about it, I can feel her warm fur against my hand and my heart is slowing down a bit.

So revisiting that few minutes and allowing myself to stretch the good feelings a bit is a good exercise. It helps me to remember that I can feel happy/peaceful/smart/funny/content/whatever. And my trauma brain tends to have prepared me to revisit experiences in more vivid color than the the typical mind.

My therapist also asked me which cluster of symptoms was causing the most disruption to my life. I answered pretty quickly: Anxiety was disrupting my sleep and my schedule. Hypomania was disrupting my productive self and forcing me to slow down – no shopping, no new projects. Depression, now that’s the tricky one. Bipolar depression can be vicious and lethal. I feel a few signs of it, but it isn’t out of control. I’m acutely aware that depression can end my life more so than the other symptoms.

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It is uncomfortable to be experiencing all of these at one time, there’s no clean line between any of them like you might see on a TV Movie of the Week about bipolar disorder. A previous therapist urged me to stop trying to parse “mixed state” from “rapid cycling” in terms of understanding my moods, because treatment is the same.

Living with mental illness takes a lot of work, courage, and flexibility. I spend a lot of time actively trying to reset the pieces of my mind that aren’t cooperating with the vision of my life that I have ‘in mind’ so to speak. Some are broken pieces, but others are just a little damaged. The intersection of my anxiety, mood disorder, and trauma is unique to me.

Please don’t underestimate the amount of time, effort, and energy people you love spend managing their mental health symptoms. Yes, I take my meds, but it is so much more than that. I go to therapy 2x week and spend time every single day practicing what I learn, incorporating these practices into my routine, I need a lot more rest, both physically and mentally, than the typical person. I need accommodations when I go out in public so I spent even more time requesting and explaining those. Or finding work arounds when that feels impossible. I have to monitor if I’m eating, drinking, sleeping. I’m constantly assessing myself. And I feel like I’m always recovering from … pretty much everything. Maintaining my mental wellness takes a lot, it is like my fulltime job.

And then there are the perpetual “helpful suggestions” I have to duck and avoid like Pac-Man, having to backtrack, inevitable awkward collisions where I want to give up the ghost *metaphorically from exhaustion, and always looking for an exit route. And the emotional laden bombs people drop on me – I miss you, constant apologies, assuming anything I write (like this) is about them, so much peopling to navigate, so many good intentions that I have to reassure, and so much other people’s stuff. No matter how much I explain that I can’t give those things to other people, people who do care about me, they still bring it. And I feel guilty. I get frustrated that I am not given the grace to vent or emote like other people. (If you read this and think I mean you, that’s the problem. This is a general statement that requires people who see themselves to assess their own way of moving through the world, not find a different way to access me emotionally. For the love of God, don’t reach out to apologize & explain. Just try to respect what I’m asking.

Much like any illness could trigger or flare an old injury – a wonky knee, a GI reaction – unprocessed trauma can also have the same effect on both physical and mental health symptoms. Our immune systems are complicated, but it makes sense that when my mind is defending itself from trauma processing – it would throw everything it can at me to distract and delay me.

So tonight, we ordered Chinese from How Lee then we went for ice cream at Antney’s. I fixed my trail camera and I’m picking up my latest Denise Mina novel in a few. Maybe I’ll get lucky and encounter Muriel on my way upstairs.

I have a good life right now thanks to many layers of privilege and resources. And thanks to all the work I do. And the medication and other treatments. That’s what I hope you take away from this – more empathy for the genuine work it takes to manage a chronic health condition. Or at least a better understanding.

Muriel hanging out with me and her crew


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