As I wrestle with the reality of being bipolar and its affect on my vocational choices I find myself convinced that there is a "no man's land" to which I, and perhaps the mentally ill in general, are confined.
This is the thing. When I was initially diagnosed things had reached a critical level. My depression was spiraling downward at an alarming rate. Abuse of alcohol left me a wreck. I was dealing with a major anxiety disorder, identified as PTSD. I was having partial complex seizures. My functonal capacity was incredibly diminished. I was subsequently diagnosed as bipolar.
Things had gotten to the point that everyone, myself included, was in agreement. I became convinced I was disabled and needed extended time off. My family agreed. My bishop agreed. The congregation supported that (though it wasn't clear at that time the duration). And it was determined that my condition qualified me for long term disability benefits. Everyone was on the same page.
After a period of about three months I decided that I needed to resign my pastorate, and devote myself full time to the process of trying to find some balance again in my life. I found hope in my prior vocation and decided to use this period when I was receiving disability benefits to re-establish my woodworking business that I had pursued many years before prior to my becoming a pastor. What happened was that I cycled out of depression and into a manic phase. I cashed in a significant portion of my pensions to invest in woodworking equipment. I convinced my son to join me in the business adventure. I had unreasonable expectations of the amount of income I could generate. That manic phase lasted a few months. Then some objections to the noise levels were raised by neighbors. And the phone did not ring with all the anticipated business that I had projected in my own mind. I was thrown back into deep depression. I was qualified once again for continuation of disability benefits. Everyone remained on the same page.
There has been some moderation of these major mood swings as a direct result of the therapy that I am on, and the reduction of stress in my life, and the avoidance of 'triggers'.
One of the consequences of this moderation, is that the insurance company that manages the disability benefit program determined that I am no longer eligible for continuation of disability benefits. It is my understanding that they believe that there is nothing that would prevent me from returning to parish ministry. That decision, currently being appealed, has resulted in a situation in which everyone is NOT on the same page anymore. It has created a quandary.
The insurance company believes that I have no cognitive or physical impairment that would prevent me from resuming parish ministry. The bishop has stated on numerous occasions that he would need a release from my medical team to return to work. But, my medical team is hesitant to provide any assessment of my ability to return to pastoral ministry. My psychiatrist has stated that my condition is a permanent disability as it relates to a return to pastoral ministry. Likewise, for my psychologist. The 800 pound gorilla in the room is the legal liability that they would incur if they sent me back to parish ministry with an active mental illness. Specifically, if they sign off on my return to parish ministry and I go into a manic stage and do something inappropriate they could be held liable. And they are not about to do that.
No man's land. Not sick enough to qualify for continued disability benefits. Not well enough to return to my vocation. At least that's the current status, pending the appeal of the determination of the insurance company.
And so I do what I can. I'm working at a cabinet shop for a fraction of what I made as a pastor, with no benefits. I continue to work on Olsons WoodWorks projects as they come in, though it remains to be seen if this will ever be profitable. And I wait.
In all of it, I remain convinced that God is good and gracious. We have been able to pay our bills. I'm not off the charts in either depression or mania. At least for the time being. And assistance has come forward when it was most needed.
Sometimes, that's all we can ask for.
Saturday, January 30, 2016
Sunday, January 24, 2016
Balancing Act
"If you stay away from alcohol for a while, you will eventually be able to resume drinking and everything will be fine." Uh, not such good advice for an alcoholic, but it was advice I received after going through treatment. Actually, there is probably not a single alcoholic that doesn't wish at some point that they could resume drinking, without going to excess. Many times I drank moderately, consuming only one or two drinks and never had a problem. Perhaps the difficulty I had at the end of my drinking was simple the result of circumstances. When circumstances change, perhaps my drinking pattern will as well, and moderate drinking will once again be the norm.
The problem with this thought pattern is that it just doesn't work out that way. Many alcoholics have attempted to resume drinking, and as a rule, such relapses simply don't turn out well. Alcoholism is a progressive disease, even while one is sober, and when alcoholics resume drinking it is usually worse than when they stopped. Don't test it. The consequences aren't worth it.
I don't have the desire to resume drinking at this time. I've learned my lesson and count myself fortunate to now be living sober.
But I have to admit the same thought process is in play with regard to being bipolar.
Am I really bipolar? Was it just circumstances that led to the behaviors that were identified as being manic or depressive? What if those circumstances change? Might I be able to resume life without medication and without the restrictions that this disabling condition has imposed?
Believe me, I would like to. Over three years removed from parish ministry and I am developing selective memories regarding my time in ministry. I remember mostly the good times. The rewarding times. The freedom to pursue that which I was passionate about.
I recognize at one level that parish ministry wasn't healthy for me. But there is always the belief that maybe it would be different now. A different parish. A better sense of who I am. Or perhaps, simply returning to a time when the symptoms of being bipolar were not so pronounced.
Part of this yearning for normalcy provokes a desire to stop medications and just see what happens. I'm neither as depressed, nor as manic, as I was at one time. Perhaps that's the consequences of the medications I am on, or perhaps it is because my life has returned to a healthy, normal, state. How do you know, unless you test the waters and see if you can maintain the balance of a healthy life?
But as with an alcoholic who desires to resume drinking, just to see if its possible to do so and hopes it will be better this time around, it rarely works out well for one who is bipolar to test the waters.
Psych wards are full of bipolar people who thought it was a good idea to go off their meds. Based on my experience, being bipolar is similar to alcoholism in that it appears to be progressive. The highs get higher, the lows lower. Just as I once drank without going to excess or experiencing negative consequence, so also I used to experience life's highs and lows and it was no big deal.
But it got worse. Depression was debilitating. Manic episodes resulted in choices and behaviors that had significant, and in some cases, permanent consequences. Dare one risk testing the waters. What if the depression deepens beyond suicidal thoughts to suicidal actions? What if manic episodes result in high risk behaviors that not only impact me, but others? Dare I risk it?
During the worst of my experiences at the end of my ministry there were "triggers" that set off the depression and manic cycles. But now that I'm at a more balanced place would those things that were once triggers still have the same effect?
Alcoholics have to come to the realization that they are defenseless against the first drink.
I suppose the same is true of someone who is bipolar. They are defenseless against the rise and fall of mood, and the triggers that set everything in motion. Trying to live as though this is not true, trying to live as though one is "normal", trying to live without the extreme ups and downs, probably is just not possible, at least without a rigorous treatment plan that acknowledges the limitations and our lack of a natural defense against these things.
But there is a part of me that just wonders. Is it really all that bad? Could I simply resolve to live my life normally once again?
The problem with this thought pattern is that it just doesn't work out that way. Many alcoholics have attempted to resume drinking, and as a rule, such relapses simply don't turn out well. Alcoholism is a progressive disease, even while one is sober, and when alcoholics resume drinking it is usually worse than when they stopped. Don't test it. The consequences aren't worth it.
I don't have the desire to resume drinking at this time. I've learned my lesson and count myself fortunate to now be living sober.
But I have to admit the same thought process is in play with regard to being bipolar.
Am I really bipolar? Was it just circumstances that led to the behaviors that were identified as being manic or depressive? What if those circumstances change? Might I be able to resume life without medication and without the restrictions that this disabling condition has imposed?
Believe me, I would like to. Over three years removed from parish ministry and I am developing selective memories regarding my time in ministry. I remember mostly the good times. The rewarding times. The freedom to pursue that which I was passionate about.
I recognize at one level that parish ministry wasn't healthy for me. But there is always the belief that maybe it would be different now. A different parish. A better sense of who I am. Or perhaps, simply returning to a time when the symptoms of being bipolar were not so pronounced.
Part of this yearning for normalcy provokes a desire to stop medications and just see what happens. I'm neither as depressed, nor as manic, as I was at one time. Perhaps that's the consequences of the medications I am on, or perhaps it is because my life has returned to a healthy, normal, state. How do you know, unless you test the waters and see if you can maintain the balance of a healthy life?
But as with an alcoholic who desires to resume drinking, just to see if its possible to do so and hopes it will be better this time around, it rarely works out well for one who is bipolar to test the waters.
Psych wards are full of bipolar people who thought it was a good idea to go off their meds. Based on my experience, being bipolar is similar to alcoholism in that it appears to be progressive. The highs get higher, the lows lower. Just as I once drank without going to excess or experiencing negative consequence, so also I used to experience life's highs and lows and it was no big deal.
But it got worse. Depression was debilitating. Manic episodes resulted in choices and behaviors that had significant, and in some cases, permanent consequences. Dare one risk testing the waters. What if the depression deepens beyond suicidal thoughts to suicidal actions? What if manic episodes result in high risk behaviors that not only impact me, but others? Dare I risk it?
During the worst of my experiences at the end of my ministry there were "triggers" that set off the depression and manic cycles. But now that I'm at a more balanced place would those things that were once triggers still have the same effect?
Alcoholics have to come to the realization that they are defenseless against the first drink.
I suppose the same is true of someone who is bipolar. They are defenseless against the rise and fall of mood, and the triggers that set everything in motion. Trying to live as though this is not true, trying to live as though one is "normal", trying to live without the extreme ups and downs, probably is just not possible, at least without a rigorous treatment plan that acknowledges the limitations and our lack of a natural defense against these things.
But there is a part of me that just wonders. Is it really all that bad? Could I simply resolve to live my life normally once again?
Friday, January 15, 2016
Limitations
Just tell me that I can't do something and I will do it just to prove I can. Somewhere in my DNA this simple principle is writ large. And then comes a time when it is necessary for the sake of one's own well being to gracefully accept the limitations that are part of one's condition.
Age will do that to you. I will turn 59 this month and I find myself at a point where my physical abilities simply are not what they once were. In my woodworking, for example, I now need to ask my son for assistance handling heavy materials that in my younger years I could manage all day long. With two bad knees I find myself hesitant to do some activities that aggravate them. For example, last week my daughter and I visited San Francisco and the thought of walking the hills brought about great reservations. I found myself being quite selective about what direction we took as we wandered through China town looking for a place to eat. Always on my mind was the fact that if I walked down a hill, I would have to walk back up. Its not that I can't do it, its that my knees will protest, and I will pay for it for the next few days. Ugh!
I'm over three years into my recovery from alcoholism. I have learned to accept the limitations that come with that. When I first got out of treatment I found it difficult to even go to the grocery store because it seemed that every isle had a display of wine or beer, and every time I encountered one it was like being hit over the head with a 2 by 4. It was a strange combination of an attraction and revulsion all at the same time. (Note: As one who hates shopping, I was tempted to milk this for all it was worth, as in, "Honey, I don't think its a good idea to send me to the grocery store -- you know, all the wine and beer there. . .") As time has gone on, I am much more comfortable in a variety of settings, but there remain two restrictions that I am committed to live by. I recognize that I cannot drink alcohol in even the smallest amounts, and secondly, I have determined that I want to avoid at all cost the smell of Scotch in particular. Limitations.
Having said all of that, dealing with the limitations that come with my diagnosis as a bipolar person is much more difficult.
I still feel the call to be a pastor. And the truth is that much of the time, there is nothing, absolutely nothing, related to the performance of parish ministry that I cannot do. I can preach as well, if not better, that I ever have. I can teach. I can participate in council meetings. I can counsel people. I can plan and organize. I can deal with difficult people, and manage difficult situations. Most of the time.
Except when I cannot. I have to recognize now that my periods of normal functioning are bracketed on both ends of the spectrum with periods of deep depression and manic episodes. During time of depression taking a shower seems like an accomplishment. At the end of my ministry, as I was plunging into depression, a simple task such as taking communion to a shut in was beyond the scope of my capabilities. Dealing with difficult people landed me in the hospital for extended stays twice.
And then there is the other extreme. During manic phases I am no longer able to lead a congregation in doing "their" ministry, I simply take over. I mean well. Its just much more efficient to pursue grand objectives and lofty goals without the restrictions of other people's reservations. Get out of my way. "Yes, we can renew the Church by developing a twelve step program for living that is applicable for all Christians, not just those in recovery from addiction. Let me run with it. New "12 step congregations" could be formed. People's lives can be transformed just as they are in AA. The only requirement for participation in this ministry would be a desire to grow spiritually.
The limitations imposed by being bipolar would be easier to live with if they were constants. But again, during those periods of balance, I remain quite capable. There is nothing that I cannot do. I appear quite healthy. The difficulty is that self monitoring is difficult in the moment. By that I mean that it is hard to recognize when I am currently in a manic state. When others see this, and express their concern, I recoil. They are over reacting. They assume every great idea is one more manic compulsion. Can't they see that this is indeed a great idea????
I think that in the end, this is the restriction related to my condition that is most difficult to deal with. Over the course of my life I have indeed pursued some "great ideas" and experienced significant successes while doing so. Now, that creativity, that limitless energy and drive, that ability to envision the possibilities that are out there, and then to pursue them -- all of this is called into question by my being bipolar. I have to accept the fact that at other times depression will make the simplest of tasks difficult at best.
It is easier to accept the fact that my knees simply cannot tolerate running up and down the hills of San Francisco. Sandpoint is flat. Accommodations can made for that.
But when a condition such as being bipolar affects your very perception of reality-- life becomes difficult. And that is hard to accept.
Age will do that to you. I will turn 59 this month and I find myself at a point where my physical abilities simply are not what they once were. In my woodworking, for example, I now need to ask my son for assistance handling heavy materials that in my younger years I could manage all day long. With two bad knees I find myself hesitant to do some activities that aggravate them. For example, last week my daughter and I visited San Francisco and the thought of walking the hills brought about great reservations. I found myself being quite selective about what direction we took as we wandered through China town looking for a place to eat. Always on my mind was the fact that if I walked down a hill, I would have to walk back up. Its not that I can't do it, its that my knees will protest, and I will pay for it for the next few days. Ugh!
I'm over three years into my recovery from alcoholism. I have learned to accept the limitations that come with that. When I first got out of treatment I found it difficult to even go to the grocery store because it seemed that every isle had a display of wine or beer, and every time I encountered one it was like being hit over the head with a 2 by 4. It was a strange combination of an attraction and revulsion all at the same time. (Note: As one who hates shopping, I was tempted to milk this for all it was worth, as in, "Honey, I don't think its a good idea to send me to the grocery store -- you know, all the wine and beer there. . .") As time has gone on, I am much more comfortable in a variety of settings, but there remain two restrictions that I am committed to live by. I recognize that I cannot drink alcohol in even the smallest amounts, and secondly, I have determined that I want to avoid at all cost the smell of Scotch in particular. Limitations.
Having said all of that, dealing with the limitations that come with my diagnosis as a bipolar person is much more difficult.
I still feel the call to be a pastor. And the truth is that much of the time, there is nothing, absolutely nothing, related to the performance of parish ministry that I cannot do. I can preach as well, if not better, that I ever have. I can teach. I can participate in council meetings. I can counsel people. I can plan and organize. I can deal with difficult people, and manage difficult situations. Most of the time.
Except when I cannot. I have to recognize now that my periods of normal functioning are bracketed on both ends of the spectrum with periods of deep depression and manic episodes. During time of depression taking a shower seems like an accomplishment. At the end of my ministry, as I was plunging into depression, a simple task such as taking communion to a shut in was beyond the scope of my capabilities. Dealing with difficult people landed me in the hospital for extended stays twice.
And then there is the other extreme. During manic phases I am no longer able to lead a congregation in doing "their" ministry, I simply take over. I mean well. Its just much more efficient to pursue grand objectives and lofty goals without the restrictions of other people's reservations. Get out of my way. "Yes, we can renew the Church by developing a twelve step program for living that is applicable for all Christians, not just those in recovery from addiction. Let me run with it. New "12 step congregations" could be formed. People's lives can be transformed just as they are in AA. The only requirement for participation in this ministry would be a desire to grow spiritually.
The limitations imposed by being bipolar would be easier to live with if they were constants. But again, during those periods of balance, I remain quite capable. There is nothing that I cannot do. I appear quite healthy. The difficulty is that self monitoring is difficult in the moment. By that I mean that it is hard to recognize when I am currently in a manic state. When others see this, and express their concern, I recoil. They are over reacting. They assume every great idea is one more manic compulsion. Can't they see that this is indeed a great idea????
I think that in the end, this is the restriction related to my condition that is most difficult to deal with. Over the course of my life I have indeed pursued some "great ideas" and experienced significant successes while doing so. Now, that creativity, that limitless energy and drive, that ability to envision the possibilities that are out there, and then to pursue them -- all of this is called into question by my being bipolar. I have to accept the fact that at other times depression will make the simplest of tasks difficult at best.
It is easier to accept the fact that my knees simply cannot tolerate running up and down the hills of San Francisco. Sandpoint is flat. Accommodations can made for that.
But when a condition such as being bipolar affects your very perception of reality-- life becomes difficult. And that is hard to accept.
Friday, January 1, 2016
Waking the Tiger
"In waking a tiger, use a long stick." (Mao Zedong)
New Years has come. And I wonder what will come in 2016. Life is in most measurable ways, good. Karla and I just celebrated 38 years of marriage. Twelve more years to our golden wedding anniversary. That makes me feel real old. The kids are all healthy and doing well. We are expecting our first grandchild in February. That is delightful. I'm acclimating to my new job and work routine. It's good to have a steady paycheck coming in. I continue to work on Olsons WoodWorks on the side. Sunday I will have the opportunity to preach again. As I said, life is basically, by all objective standards good.
And yet as I anticipate the days and months ahead it is once again with a bit of ominous foreboding.
Sleep has become a barometer for me. In part, due to a change back to a previous medication that I can afford, my sleep patterns have reverted back, as well. On a typical day I will go to sleep at 8:30 or so, and then shortly after midnight start waking up, dozing back to sleep, and waking up again. Usually this lasts until I give up and get up, somewhere around 2:30 in the morning.
I'm making fiends with the solitude of the night. My early morning hours give me time to get ready for the day, which begins when I start my commute around 4:45 so I can comfortably get to Coeur d'Alene by the start of the workday at 6 am.
What concerns me most, I guess, is that I'm rarely able to nap soundly and make up the sleep. My system seems to be telling me that I don't need the sleep. Which concerns me.
Beware the tiger.
The curse of being bipolar is that I have not found it possible to simply relax and enjoy the good times. And there are good times, when neither the manic state or the depressed state are active. At such times it is easy to believe that one is "normal", even to the point of wanting to lay to rest all of the therapy and medication. Embracing "normal" seems like a good thing to do. Walk in the way you mean to go. Do normal things. Be happy or sad in normal ways. Claim a healthy balance.
But the tiger prowls the night.
Both my manic phases and my depressed phases are marked most notably by sleep disorders. And more often than not that has meant that my need for sleep has evaporated. For over a decade I treated this by making friends with a bottle of Scotch. Not a good choice, but effective in its own right. My psychiatrist is quick to point out that I was 'passing out' not sleeping -- but however you look at it, I was getting pillow time. And a break from the concerns of the world.
But it was masking the deeper issues. The issues that my sleep disorders and the rumblings that are heard in the early morning hours point to. That all is not well.
And so I greet the new year not knowing what to expect. Is the tiger rousing? Am I beginning to cycle again in a serious way? Am I ready for the ride?
It would be nice if you could just poke and prod the tiger to see what it is up to. But if you're going to do that, Mao suggests a long stick.
Unfortunately, there is no long stick. When the tiger awakens, it awakens.
New Years has come. And I wonder what will come in 2016. Life is in most measurable ways, good. Karla and I just celebrated 38 years of marriage. Twelve more years to our golden wedding anniversary. That makes me feel real old. The kids are all healthy and doing well. We are expecting our first grandchild in February. That is delightful. I'm acclimating to my new job and work routine. It's good to have a steady paycheck coming in. I continue to work on Olsons WoodWorks on the side. Sunday I will have the opportunity to preach again. As I said, life is basically, by all objective standards good.
And yet as I anticipate the days and months ahead it is once again with a bit of ominous foreboding.
Sleep has become a barometer for me. In part, due to a change back to a previous medication that I can afford, my sleep patterns have reverted back, as well. On a typical day I will go to sleep at 8:30 or so, and then shortly after midnight start waking up, dozing back to sleep, and waking up again. Usually this lasts until I give up and get up, somewhere around 2:30 in the morning.
I'm making fiends with the solitude of the night. My early morning hours give me time to get ready for the day, which begins when I start my commute around 4:45 so I can comfortably get to Coeur d'Alene by the start of the workday at 6 am.
What concerns me most, I guess, is that I'm rarely able to nap soundly and make up the sleep. My system seems to be telling me that I don't need the sleep. Which concerns me.
Beware the tiger.
The curse of being bipolar is that I have not found it possible to simply relax and enjoy the good times. And there are good times, when neither the manic state or the depressed state are active. At such times it is easy to believe that one is "normal", even to the point of wanting to lay to rest all of the therapy and medication. Embracing "normal" seems like a good thing to do. Walk in the way you mean to go. Do normal things. Be happy or sad in normal ways. Claim a healthy balance.
But the tiger prowls the night.
Both my manic phases and my depressed phases are marked most notably by sleep disorders. And more often than not that has meant that my need for sleep has evaporated. For over a decade I treated this by making friends with a bottle of Scotch. Not a good choice, but effective in its own right. My psychiatrist is quick to point out that I was 'passing out' not sleeping -- but however you look at it, I was getting pillow time. And a break from the concerns of the world.
But it was masking the deeper issues. The issues that my sleep disorders and the rumblings that are heard in the early morning hours point to. That all is not well.
And so I greet the new year not knowing what to expect. Is the tiger rousing? Am I beginning to cycle again in a serious way? Am I ready for the ride?
It would be nice if you could just poke and prod the tiger to see what it is up to. But if you're going to do that, Mao suggests a long stick.
Unfortunately, there is no long stick. When the tiger awakens, it awakens.
Subscribe to:
Posts (Atom)