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Last Thursday was the International Day Of Persons With Disability. Many of the folk commenting in the thread for the diary Today Is International Day of Persons with Disabilities wrote about their intersections of LGBT and having mental health issues.
Well, I think I need to come out of the closet on this in ALL CAPS — I too have a mental health condition. And, it’s more than just the technically of having Gender Identity Disorder (of having GID — as all transsexuals are officially or unofficially diagnosed). Hey, I’m officially mentally disordered — I was diagnosed as having Bipolar Disorder Type II quite a number of years ago.
To give an example of how I experience my bipolar condition, this past Thursday evening — the same day as the International Day Of Persons With Disability — I experienced a pretty severe bout of hypomania when covering a story form Los Angeles (that I’ll be putting together in the next day or two). It was hypomania that ended in a something akin to a panic attack — I experienced about 2/3′s the symptoms of a classic panic attack; the bout began just before I left to go home to San Diego. I’m assuming it’s a state that is, or is close to, what mania would (or maybe does) look like for me. This is only the third or fourth time in my life I’ve experienced that kind of severe panic/mania related symptoms, but these severe bouts have all occurred within the past two years. So, I think it’s safe to say my bipolar condition is slowly worsening…even with treatment.
[More below the fold.]Normally, I function well enough for day-to-day activity. I take a mood elevator for depression, and a mood stabilizer for the mood swings — these generally keep me emotionally pretty flat.
Stressors can set off my mood swings. One trigger that has in the past has set my mood swings in motion is insufficient sleep, so I make sure I’m well rested, and keep regular hours as much as possible.
Stress is the other of my two main triggers for rapid hypomanic-depressive mood swings…especially extended periods of unresolved stress.
But, when it comes to impetuses behind the beginning of bipolar mood swings, sometimes there are just no known impetus I can point too — sometimes these hypomanic-depressive mood swings just start up for no apparent reason. This happens to me about two or three times a year.
And too, the difficulty of having my mood swings includes very rapid cycling — sometimes I cycle through what I would cal significant hypomanic and depressive moods several times in single day.
So, I know I have bipolar mood swings, and I’ve had these mood swings frequently enough to recognize the symptoms relatively quickly after onset – Well, what do I do about it? This is what the National Institute For Mental Health (NIMH) says I should do these things if I know I’m bipolar:
How can I help myself if I have bipolar disorder?It may be very hard to take that first step to help yourself. It may take time, but you can get better with treatment.
To help yourself:
• Talk to your doctor about treatment options and progress
• Keep a regular routine, such as eating meals at the same time every day and going to sleep at the same time every night
• Try to get enough sleep
• Stay on your medication
• Learn about warning signs signaling a shift into depression or mania
• Expect your symptoms to improve gradually, not immediately.
Yeah, I’ve learned spot my symptoms. As I’m writing this, I’m entering “the zone” — I’m experiencing the start of a hypomanic bout. If you read the link on hypomania you’d have learned that bipolar people in a hypomanic state are often in their most productive place. I know when I’m feeling just a bit hypomanic, that’s where I’m personally in one of my productive places.
So, with or without symptoms of my mental illness expressing, there is a treatment plan for my Bipolar Type II Disorder that I follow. I eat the pills to stave of the mood swings and depression; I talk and talk — going to talk therapy helps keep my stress levels low. I try to keep routines — which is when I say “I don’t travel well,” you can read into that the breaking of routines. I also have two “kats” — pets aren’t on the list, but connecting with them has been extremely helpful in releasing stress…finding warmth and comfort in day-to-day life.
Another of the things I intentionally do is keep my stress levels artificially low. Just normal work stresses have set of those rapid hypomanic-depressive mood swings when I was working (which is why I’m retired at 50), and even before the panic/mania related symptoms started showing up, those mood swings were debilitating — those mood swings left me only intermittently functional as a member of employed society. So, I try not to take on responsibilities I may not be able to follow through with.
I can’t overstate the importance of treating my symptoms systematically, and compliantly within my treatment schema. In the worst of my hypomanic and depressive states, I’ve had suicidal ideation. Most people think that bipolar people are most susceptible to committing suicide during the depressive state — The actuality is that bipolar people often commit suicide in the hypomanic/manic side of the mood swings. This is because one tends to be in “the zone” and connecting thoughts; one can tend to be hypercritical of oneself in a hypomanic or manic state. Suicide can follow that hypercritical take on oneself.
I’ve also found not pulling into my shell — not “turtling up” emotionally — and letting my close friends know when I’m having mood swings. Spending time with my friends helps. I know that my bipolar symptoms pass, yet sometimes working through the mood swings is making sure I keep in mind I’m not alone; others care. I spent this past Saturday with my friends Vicki and Lynda, in part because I love my friends, partially because my friends love me, and partially because I need to especially make sure I’m not alone when I’m having mood swings — that I’m connecting with people. This is for my own long term survival.
People who deal with clinical depression often “turtle up,” thinking that they are alone, and no one else is going through, or has gone thourgh, what they’re going through. I know very, very few trans people who haven’t gone through clinical depression as part of their coming out process. And, as Jos at Feministing reminds us about studies of trans youth and young adults and trans people:
The number of trans folks who have attempted suicide ranges from about 30 percent to over 50 percent in studies. One study found that 83 percent of trans folks have considered suicide.
I don’t know what the suicide and suicide contemplation rates are for trans adults are, but I’m sure the rates are very high.
And, of course, what was one of the stressors that has left me feeling personally distressed these past few weeks? Mike Penner’s (a.k.a. Christine Daniels’) apparent completed suicide.
I’ve missed the Christine I knew for quite a long time. As many of you know, I’ve missed Mike since he stopped talking to me in December of 2007; I mentioned the personal pain I felt upon hearing of the detransition from Christine Daniels back to Mike Penner. His passing from an apparent completed suicide has been incredibly stressful for me.
I thought of Mike as my friend; my eyes have welled with tears several times a day as I mourn his passing. Some days I sob. I suspect that his death had much to do with the internal stressors he felt in large part from having a gender identity that didn’t match his natal sex. However, I’ve heard nothing concrete that confirms that suspicion, and not knowing is a hard thing for me to take.
That said, I can’t help but think about Mike’s apparent completed suicide and his trans experience are connected; and even if it wasn’t connected, depression almost assuredly was connected.
And, this is the hard part — I’ve been diagnosed with a propensity for depression; depression that’s connected to my bipolar condition. Can you see the dots my brain are connecting Mike’s life experiences and my life experiences? And, I can assure you there’s more similarities between Mike and I that I haven’t highlighted in this diary…
So, I talk to my friends; I talk to my therapist. I sleep. I keep a routine. I’ve had my medications adjusted just this past week; I take the pills. I remember that I’ve been through this before, and I’ll make it through this again. And, sometime soon I’ll be back to being as fully functional as I usually am; many if not most people who live with depression or bipolar conditions can and do lead productive lives. I’m not so special as to be an exception to that capability for productivity.
And now, I’m sharing this with you, our blenders. When I talk about the intersections of disability and the LGBT community, I’m one of the folks where these identities intersect. And too, if you met me in person, you’d likely not be able to tell I’m disabled — my disabilities are invisible to the naked eye. My life experience is an example of being invisibly disabled.
So, do you think less of me now? There is stigma associated with being mentally ill, no matter how functional one is in society. I can tell you my personal experience is that my being trans seems to have less stigma to it than my being mentally ill.
Now you know the main reason why I’ve a Veterans Administration Disability Rating of 100%. And since my bipolar condition was diagnosed in late 1996 — four years before I retired from the U.S. Navy — my disability is considered service connected.
And there, I’ll leave it — it’s something for y’all to think about.
~~~~~
Further Reading:
* National Alliance For Mental Health (NAMI): Bipolar Disorder
* SickNTired: What is Autumn Sandeen Smoking lately???
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34 Comments
You are not aloneAutumn, I too have been diagnosed with a mental illness. (Like you, I don’t consider GID a mental illness.) In my case, it’s clinical depression. I was in my early 40′s before I figured out that I’ve been clinically depressed at least since I was 7 years old. (The fact that the psychiatrist I was talking to asked me at least 6 times during the course of an hour, each time with increasing incredulity, “You’ve never been treated for depression?!” was my first clue. LOL) I spent the entire summer that I turned 8 in the house with the curtains closed reading comic books and refusing to go outside to play with my brother, sister or friends. ”Turtling up?” Yeah, I did that, and still do. In fact, I live alone, which isn’t necessarily the best thing for me, but there it is anyway.
For me, I stay on my meds (a couple of times trying to go off them have been disasters) and try not to beat up on myself when I’m feeling depressed and unproductive, instead just trying to remind myself that that’s just how I feel sometimes. I don’t reach out as much as I should. Living in a small town far from most of my friends doesn’t help.
Anyway, I just wanted you to know that I care and you are not alone. You have my number and my email. Call any time. You’re not alone, and neither am I.
Blessings,
Abby
Thank You Autumn for sharing your condition openlyMy hubby also has mental health issues, and needs mood stabalizing meds. As I was going through the abusive relationship which took almost 2 years to get everything financially seperated, I went through bouts where I wanted to suicide. Working on my codependancy in Alanon helped me recognise damaging patterns I can get myself into with addictions, it doesn’tmean they don’t happen,, it means I catch myself doing them earlier and have tools to help myself stop it.
I was concerned about you through the grief of Christine/Mike, but everyone handles grief their own way. Some people have to be doing something physically, cleaning incessantly, just to get through dealing, not dealing with a loss.
You sharing your challenge might make it easier for others going through the same thing. My hubby is a wide open personality….he has no secrets, cuz he tells everyone anything.
Thanks for the share Autumn.Good post, you are very insightful with your condition.As a retired physician, I had a number of bipolar patients. As you note, it is a facet of the increased energy level of hypomania that many are most 'creative' then. It is easy to imagine many many of the worlds great painters, composers, etc with this condition.Just a little note to anyone with a mild depressive downtime. For women (doesnt work for men) Vitamin B-6 is a very good mood med. Slightly upping, and stabilizing. Being water soluble a 50 mg dose lasts only 4 hours or so, the 100 a bit longer, and does not interact with any other prescribed mood meds. Don't push dose, though, makes one light headed etc with too much. It's my firstline recommendation for PMS grumpiness, as that usually lasts only a day or so. Worth a try as it adds to your armamentarium.
Thank you for this, Autumn.Your honesty and personal insight are amazing. People, whether in the LGBT world or not, sometimes forget that we LGBT are just as prone to the same medical conditions as anyone else (or more so due to the anti-LGBT stressors we live with), and that those conditions are not the byproduct of being LGBT per se.
Maybe some day I’ll write a companion diary about hidden physical disabilities. Occasionally someone refuses to believe that I have physical limitations because I “look normal”. Do you experience the same thing?
You left quite a teaser there at the end of the diary. I hope at some point, if it isn’t too personally intrusive, you’ll write about the connection between your disability and your work with the Navy that is considered to have caused it.
Thank youAutumn, thanks for sharing this. Your situation illustrates how important it is that everyone have access to adequate health care coverage, including mental health benefits. Let’s hope that our elected “leaders” understand this as they debate health care reform.
me too.I was diagnosed Bi-polar when I was very young, (in the early 90s or late 80s) and more recently it was amended to Bipolar II. My mother has bi-polar so she recognized it in me and took me to a doctor. I’ve been on and off meds over the years. the past three years I’d been off meds and ok. But in the past 4 months I’ve had a bad depression punctuated with a bit of hypomania and I’m seeing a doctor again.
I’ve cried everyday in the past week and a half. and the doctor says the meds will take a few months to work.
the worst part is that you never know if you are stable. you just find out you are unstable when something happens. You can have periods of stability for a year or so. but then it just falls apart.
I’m so afraid of failing out of grad school. thanks for letting me know I’m not alone.
what really sucks is now that I have used insurance for the doctor for this, I can never let my insurance lapse again. because now I have a “pre-existing condition”
I agreeThe stigma associated with mental illness may be worse than that of being trans. I too have struggled much with mental health and it is why I am also on disability – anxiety, mood swings, depression and PTSD are my diagnoses. Its very difficult to be honest about my struggles when bringing them up in conversation makes people extremely uncomfortable, but my goal is to have no secrets, so here you go.
As far as being trans and having mental health issues, I think they compound each other in disastrous ways. When I finally came out as trans, I naively thought my mental struggles (at the time, anxiety and depression) would work their way out as I furthered along in transition. I was very wrong. My problems started to worsen when I started to be asked “what are you?” and various other anti-trans sentiments on a daily basis. I was constantly depressed, my anxiety exploded into OCD, insomnia and panic attacks and my mood was constantly unstable. I became afraid of going out in public and interacting with strangers. I withdrew from everyone and everything.
For three agonizing years of being gender ambiguous, I was constantly on guard, resulting in PTSD on top of all my other problems. Eventually, I lost any semblance of control, my job, my apartment and my friends because I was too ill to take of myself anymore. I attempted suicide two times and barely survived the first one. This period of my life was hell and I don’t wish it on even my enemies.
I started getting better when I started passing on a daily basis and found new medicine to help with ups and downs (I’m not bipolar in the strictest sense). Now I manage my symptoms with Dialectical Behavioral Therapy (if you’ve never tried it, go out and find a group now!) and feel much better. It’s been over a year since I’ve thought of suicide and that is a wonderful thing.
Mental illness makes you feel as if you are the only one, alone forever, in agony. Being trans magnifies this because the fears you have about being alone are being confirmed when people actually physically recoil from you. Being trans, you also get told often that its all in your head, so you naively believe that if only you had more willpower, you could change everything. This is, of course, is a lie, but the damage it causes takes years to overcome.
I wish more people would come clean about mental illness. So thank you for being so candid, Autumn. I appreciate that you are willing to lay it all out of the table and hopefully encourage other trans people get help beyond their medical transition needs. Of course, finding supportive mental health practitioners is a whole other can of worms, isn’t it?
Thank you for sharing too.…and you guessed my reason for sharing — we aren’t really as alone as we sometimes think we are, and folk need to reach out for help.
And yes, finding a good therapist is a whole ‘nuther can o’ worms.
Yeah. I get that.It is hard. Never knowing what can or will trigger the mood swings — if there even is an anything. So, I know I’ve at times avoided situations and places that appear similar to other situations and places where I’ve had bouts with hypomania or depression. And, sometimes the situation and place “wash, rinse, repeat” paranoia seems later, in retrospect, to be totally irrational.
And yes, you aren’t alone. And sweets, I care.
Thank you so much for sharing your story too. It’s appreciated.
Thank goodness I’m a retired, disabled veteran.The reality is that if I wasn’t a retired, disabled vet, I’d probably be homeless or dead of my own hand.
I don’t like thinking about what my life would look like without the good mental healthcare I have, but I have too. I have peers that aren’t as lucky as I am.
I have no idea whether or not B6 would help me…I take B supplements due to my gastric bypass already — B12 deficiency is common in post-gastric bypass patients.
But, my male karyotype and regimen of female hormones — well, I’ve no idea whether the B supplements help with my mood swings or not.
Thank you.Thank you for sharing this.
I think just as visibility helps with LGBT civil rights issues, visibility with mental health issues will help with its stigma.
Thank you for sharing.Thanks for being public too. Appreciated, for sure.
I come from a family it seems to run in.I don’t see any stigma. But that’s because my mom worked in the field of Mental Health. It’s just another illness. From me, there’s no stigma. In fact, I suffered panic attacks in my young adulthood. They are definitely not fun.
I also think that the Mike/Christine suicide brought unresolved issues to the foreground for a LOT of transwomen. For some, especially the late transitioners who have undergone a male puberty and spent time in male-only spaces trying desperately to fit in, transition is at best a compromise that is better than any of the alternatives. But it still has its drawbacks compared to those having been born cisgender.
Even with this bad [stuff] to deal with, though, I think the world is still too interesting. Come what may, I still want to stick around as long as possible, to see how it turns out.
Thank you for the comment.And, of course you know I work very hard at being amazing.
As one correlative though, I think I’ve been bipolar since puberty, but it became bad enough/clear enough to diagnoses in 1996.
However, applying for a VA disability was directly tied to being sexually harassed in my last year of military service, and the deep depression and depressive-hypomanic mood swings I experienced at the time. That depression and those mood swings were triggered by the stress of being sexually harassed.
So, there is a connection between my being bipolar, my military service, and my VA disability status, but it’s not a causative relationship.
Thank youSomeone I love very much has bi-polar as well. I appreciate this article so much. Thank you for expertly telling your story to help blenders better understand the world. That is a gift.
Thank youFor sharing and shedding some light on bi-polar disorder. I just lost by older brother this year to suicide, and didn’t know until after his death that he was bi-polar. The stigma kept him from sharing his condition with me. His acceptance (the only one in my family that was accepting) helped me through my coming out process. It still upsets me that he felt like he couldn’t tell me.
I’m not sure I’ve seen *any* studieswhere the focus was looking for factors predicting “gender-atypical” response to medication, vitamins, etc. Plenty of the “has x effect in men, y effect in women” descriptions only describe majorities — IIRC a few details in terms of dealing with calcium are the closest thing to an actual male/female dichotomy, chemically. In the meantime, people who don’t completely fit the karyotype/hormone/physiology Platonic ideals of gender are given no guidelines about which “category” we’ll find our experiences most like in terms of any given chemical.
Thanks Autumn and everyoneI appreciate you for posting this. I was diagnosed as bipolar II in 2007. Before then, the dx was clinical depression and I’ve probably tried a majority of the drugs out there. Tried suicide multiple times. I’m in the depressive swing now and just telling myself that I’ve been through it before and can get through it now. But I am most definitely turtling. It is hard to get out of bed in the mornings.
When I mention that I have bipolar disorder to acquaintances, it takes them more by surprise than me being transgender. They are much more uncomfortable with the former. My guess is that they are uncomfortable because they don’t know how they are supposed to act.
We’re lessening the stigma associated with mental illness every time we speak up like this.
I know at least one study was going on this……in my hometown of San Diego. The doctor running the study was looking for participants, but I wasn’t willing to go off of my mood stabilizers to test the B6 theory.
So, I at least know that studies were at one point recently going on regarding this theory.
I agree.As I’ve said elsewhere, I’ve been “out” on being bipolar, but not “OUT” in all capital letters. After Mike’s suicide, I decided it was time to be “OUT” about my mental illness — and call it mental illness.
And yetyou make being amazing look so effortless and easy!
I deliberately waited all day to comment on this post, which I feel is extraordinarily important, timely and necessary.
Any sort of mention of mental illness is such a third rail issue in society- gah! We can only remove the misconceptions, misinformation and stigmas by open discussion, education and support…
THANK YOU, AUTUMN.
I’m so sorry for your loss.And by the way, please don’t feel too upset about your bother not telling you about his bipolar condition. There still is a lot of shame surrounding mental illness — with the potential of the same sort of internalized shame expressed in similarly to that of internalized homophobia and internalized transphobia — and I wouldn’t doubt that internalized ableism played a role in your brother not telling you about his bipolar condition.
Basically, depression, hypomania, and mania can mess with one’s cognative ability. Plus, your brother may not have believed that the people who loved him would still accept him if he were out as mentally ill…and in some families and with some friends, he may have been right. There is still so much stigma with mental illnesses.
You’re so very welcome.
I concur with the not alone comment aboveI’m also bipolar, though I’m bipolar I with ADD and Anxiety NOS. I’m actually recently diagnosed and am having trouble filling my first prescriptions as my insurance company is calling it “pre-existing.” Though I do enjoy talking to others which is helpful.
I sought help when I didn’t leave my house for a year, turn out my doctor told me I should of been hospitalized but my parents never took me to the doctor for that. Once I got a semi-level head, I went to the doctor and have gotten help since.
Anyway, just wanted to share.
Maybe that’s something for me to remember…The field I’m going into gets involved in any of that sort of study, and I have enough friends who could run into this as a potentially life-or-death “oversight” on the part of the medical field that I start to take it personally. I really should consider actually doing something about the lack of real research. (And hell, I’m basically a cis-man, but of the “flaming queen with an unusually high estrogen level” variety, so for all I know I could easily be one of the “exceptions”, too.)
Dealing with a relative’s illnessThough I’ve dealt with major depression and panic disorder in the past, I’m lucky enough to be more or less free of all that right now. But this still strikes close to home for me because my partner’s brother, in his late 20s, has been diagnosed with schizophrenia. I guess it’s been about two years now since he first started having serious delusions and seeing a psychiatrist for treatment, and he has already been through a couple of periods of stability, followed by going off his meds and more delusions.
My brother-in-law’s condition is such that it seems unlikely he’ll hold down a steady job or form a romantic relationship (although who knows). My partner is depressed about the fact that her brother is going to be dealing with this for the rest of his life, and so will we…it falls to us to check on him, give him support, and encourage him to take care of himself. She has told very few people about her brother’s illness, and I’m not sure whether that is from a desire not to stigmatize him or if she feels personally embarrassed somehow. It seems to me that it’s better to let friends know so that they can be supportive, but I’m letting her deal with it in her own time. It’s a difficult situation.
I oftentell people only that I’m anxious (which is definitely my biggest problem) and leave the depression part out because mentioning suicide even in a casual manner is very jarring for most people. Only people who have tried it themselves or work with people who have tried it feel comfortable talking about it. Suicide is a scary thing and it should be. But there needs to be way that it can talked about without people freaking out. Its not considered polite conversation and is overlooked when so many people die this way every day. No one talks about it.
Drug trials barely have taken women into considerationEven such basic things like how it would effect nursing women or pregnant women. So I can imagine the lack of data concerning drugs tested for transgender people, and multiple drug interactions….(which is huge for us with AIDS and dealing with mental health drugs, and so many others. How something else interacts with the drugs keeping us alive.)
Anyone know if the healthcare Bills deal at all with mental health?It always baffled me that eyes, teeth, and brain were all considered SEPERATE from healthcare, like they aren’t parts of your body.
Eyes, teeth and brainWe have the same problem with Canadian health care. As wonderful as it is in most other aspects, it doesn’t cover much of the body above the neck.
Even if you are on disability because of depression, they won’t pay for talk therapy. They will cover electro-convulsive therapy, however.
add another to the groupi’m out with everyone in my life about being a borderline. i couldn’t handle working in the ‘real’ world because i found folks so dishonest and political and it would greatly distress me to have to be a part of that as management. i have been cleaning houses for 14 years now and am able to stay stable with medication and my low stress and a rewarding job. it is great to have a job where people are glad to see you coming and love the work you do. i can’t tell you how much that helps. also, having pets is as important as rx to me. now i am volunteering with a group that builds free fences for dogs living at the end of a chain [unchaindogs.net]. that work is also very meaningful to me and helps me not isolate at home. since i now live at the poverty line i qualify for health care at the va. i’ve been there 2.5 years and still can’t get a student doctor for talk therapy much less a real doctor. the suicide line let me hang up on them last week as did 2 other personnel in women’s health and mental health offices. i’ll never be able to get actual talk therapy unless i win the lottery. at least the other health care i get there is fine and that is still huge. so, add my voice to the crowd. i used to have this great button that was a picture of a carmen miranda type lady with a ‘fruit hat’ and the words were ‘i’m crazy about my mental illness’. i try to have a sense of humor about it. i’m not sensitive about it generally. we all have something and this is my thing, my bear to cross in life. better crazy than a lot of things i can think of.
Awesome sharing hereThanks everyone here who has shared their most personal of stories.
I am a former VA RN and would like to add that I never really learned much of the Transexual community and their health issues of concern while in Nursing school. All of my experiences and learning took place on the job. I too propably made similar inquiries of my trans patients and I was always so grateful for their patient teaching and sharing in such generous of fashions.
Having said that I continue to learn more and more from the honest posts on the blend. thanks again….
Thanks AutumnAnother remarkably insightful post.
I love the way you presented yourself at the VA Autumn. I really see your point about perhaps feeling insulted by your physician’s comments but I personally think one must keep intention in mind when assessing such situations and comments. You freely admit that the guy probably was making these comments in somewhat positive ways. Actually it appears that what you did is to perhaps smash down preconceived negative stereotypes that this guy had heard of the trans community and it seems that he was pleasantly surprised to find out he was wrong and you were his moment of understanding….bravo. Another person educated. I know it is not your job to educate everyone about trans issues but I for one am always so thankful when you share your thoughts so freely here in this forum…..
Best wishes always….xo