Words like “struggle” and “suffer” describing my depression are words perhaps for others and don’t reflect how I am while in bipolar depression. My words for how I am are “dull” and “uninterested” and “trapped” and “too depleted to be confused” and “don’t care about a universe that might as well not exist.” This is how I am in the midst of severe bipolar depression.
I’m not “struggling” or “suffering.” That’s what others see of me. These words have no meaning or relevance during my episodes of bipolar depression.*
*I recognize many post these types of insights and observations during a depressive episode. Assuredly, this is an insight and observation where – right now and currently – my bipolar depression symptoms are successfully managed.
Upon Facebook, I read this morning a provider solicitation for a synonym/euphemism for the medical term “non-compliant.” It turns out peers don’t appreciate being called “non-compliant.”
Here is my contribution:
I’m my own person and I hire a provider to provide medical advice and I decide if it’s worthwhile advice and it’s my body and I have agency and I make the best decisions for myself based upon my needs.
Any provider who scribbles down “non-compliant” is imposing their medical training upon the wishes of the patient. This provider isn’t listening to the patient. A provider like this (I’ve had a few) gets fired and I find a collaborative provider instead.
I need a new word for “boundary” for mental wellness. The word “boundary” sounds a border skirmish on a Milton Bradley board game. Something tougher, something rugged. Barricade. Barrier. Fortification. Yes.
Today, I empowered myself. After writing many letters to Representative Gabe Vasquez, Senator Martin Heinrich, and Senator Ben Ray Lujan, and having never received a reply to my many letters, and being four years later and I’m still strongly emotionally invested in my inability to qualify for unemployment under the pandemic lockdown CARES Act, today I decided to write Representative Michelle Steel of my hometown congressional district where my Dad still lives.
And now I feel better. I’m hoping for a response to let me know I exist as an American. Acknowledging my story is all I ask, that’s my attitude and solution.
The letter explains my issue with CARES.
December 12, 2024
Dear Rep. Steel,
I’m writing to you from my home of the past 30 years – Albuquerque, New Mexico. My childhood home from the age 3 through 17 (1973 through 1988) is Fountain Valley, California. My childhood bedroom is still there, as my parents have remained in Fountain Valley. Even though I left for college in 1988, Fountain Valley will always be my home.
I’ve decided to write to you because I’ve received no reply from my representative and my senators, and I’ve tried to reach them several times since the summer of 2020. To be fair, I did receive autogenerated confirmation emails but not any actual communication to address my issue.
My issue is with CARES. But before I get to the specific point, let me give you some background on me to help explain why I’m now feeling disappointed, rejected, and quite honestly furious.
As said, I grew up in SoCal. I went from K-8 at Roch Courreges (it’s a shame the Courreges Farm is razed) and from freshman to senior year at Fountain Valley High School. I played in AYSO Region 5 for over a decade, I was in Huntington Beach City Junior Lifeguards, and during high school I was an officer in our Key Club. (secretary and then vice president).
It was my time volunteering for Key Club where I found my passion for community service that has stayed with me to this day. It’s more than a passion. Community service in behavioral health advocacy is a fixture for me. I came to New Mexico to study geology and as things played out for the last 14 years I’ve become a prominent and active peer advocate in our state.
How I ended up here is fairly mundane. During college symptoms of bipolar flared up and created havoc for over a decade before I was finally diagnosed. During that span I failed out of college, I lost a cherished career with the Bureau of Land Management, my marriage imploded, and I was fired from one job after the next. There is a criminal history from going so long without a diagnosis. I wasn’t accustomed to failure. I had always exceeded my own expectations. And in no way did I ever think I’d be convicted of a felony.
Like so many Americans, I discovered having a mental illness is incredibly destructive. For how mundane bipolar is as a widespread disease, the negative impact of bipolar is disproportionately huge.
So I was diagnosed in 1999 after my first failed attempt to kill myself. Suicide is a good indicator of mental illness. And over the next 15 years there were many more inpatient stays and constant talk therapy and the challenge of trying medication after medication trying to find a regimen that significantly helped manage the bipolar symptoms.
Of all the treatments I employed the one that I never considered until October 14, 2010, is a bipolar peer support group. On that day, I went to a Depression & Bipolar Support Alliance (DBSA) meeting here in Albuquerque and the direction of my life changed positively and forever.
I’m not certain of your familiarity with mental health support groups and how they function, so in brief colloquialism I explain peer support as this:
Mental health peer support groups are a place I can go where others also live with mental illness; where I can be understood through shared experience and empathy; and where I can share I feel like crap or I’m having a great day and not have to explain myself.
I can also say this about mental health peer support groups: The groups save lives. In my case, in October 14, 2010, I gave myself a choice to either go to a support group or kill myself successfully this time. The community provided the place. My choice to attend saved my life.
So I mentioned my passion for community service beginning in high school with Key Club. After only a month I volunteered for our DBSA chapter, to update the chapter website and increase the chapter SEO profile. It was in immediate need of attention. I had to click through at least three search results pages and the website looked like it was created in 1997 using a Compuserve wysiwyg editor. Had I not known how to view the html code directly I would have never found the group.
That first act of volunteering led to ultimately receiving a Lifetime Achievement Award in Behavioral Health Innovation from the State of New Mexico. A far cry from geology for sure. And since I haven’t had an economy of words thus far, I’ll examine a few positive accomplishments I’ve been blessed with on my journey:
– Elected to President of DBSA Albuquerque, a position I held until 2017.
– Elected to the board of NAMI Albuquerque, from 2013 to 2016.
– Expanded our support groups from a single group on a single night. Prior to the pandemic lockdown, we offered peer support groups in five locations around the city, Monday through Friday.
– Assisted in developing peer support groups on the Navajo Nation. These groups are for co+occuring, which is having a mental health condition and a substance issue concurrently. My involvement was background advisement and facilitator training due to cultural competency concerns; the Dine are distrustful of mental health services provided by outside organizations.
– Organized mental health education events, collaborating with community partners like NAMI to reach and educate the public, legislators, and mental health services entities.
– City of Albuquerque Settlement Agreement, US Department of Justice. The DOJ sued the City of Albuquerque because of excessive deadly force with mental health peers in crisis. I was named to the Mental Health Response Advisory Committee (DOJ mandated committee of community stakeholders) where I developed Crisis Intervention Training (CIT), and recruited and trained peers to share their stories with police personnel. Given two hours of the 40 hour training, I developed with APD “Perspectives In Mania and Psychosis” – peers shared what it’s like being in crisis – and “Crisis De-escalation” – peers shared what works and what doesn’t work in crisis encounters with police. The idea is if police understand better what we’re going through they will feel safe, prepared, and skilled in how to get peers cooperating and direct peers to services.
– Bernalillo County Forensic Intervention Consortium Peer Board Member (BCFIC). This is a committee of community stakeholders dedicated to jail diversion, directing peers to mental health services rather than incarceration. The premise is we often only commit crimes when we’re symptomatic and in crisis. Keep us from crisis and keep us from becoming criminals.
– Stand Up To Stigma (STS). This is what I’m most passionate about. STS is my community education organization where peers are trained and empowered to share their life stories in a variety of communities and venues. The mission is through our personal experiences we can help others understand what it’s like living with mental illness. We have many education programs developed.
My Recovery Adventure
Peer & Police Safety
I’m More Than My Symptoms
Get To Know Me
You Can’t Always See It
Laugh It Off
Laugh It Off is our most requested presentation. The idea is if we can laugh at the horrible things then the horrible things aren’t so horrible. So, we tell stories of the events that were horrible at the time of crisis but in retrospect are hilarious. STS presented Laugh It Off in many venues. My favorite was inpatient at Turquoise Lodge Hospital, our state substance detox and rehab treatment center. We would tell our stories, get people laughing together, and then spin the presentation into a peer support group. It’s immensely life affirming taking part in others’ recovery treatment.
Two more notes: In 2016 I ended our affiliation with DBSA and brought our support groups to STS. During the lockdown, STS offered facilitated Zoom support groups twice a day on weekdays and once a day on weekends. I also launched a midnight Zoom group named Negative On Dreaming for those peers with sleep disruption who felt alone because of it. We continue to offer weekly Zoom groups, and we are offering two in person groups again.
That’s a lot of exposition, I know. This is the last bit and then I’ll explain the purpose of the exposition. There is an industry standard where the expectation of peers is to volunteer our time and effort. When I sit at a committee table with providers, legislators, and government personnel, nearly all of these stakeholders have paid employment in the industry. Peers don’t. So at the end of 2019 I decided to create financially compensated positions within STS so peers at the very least would earn a stipend for helping to run support groups for a couple hours. Our time has value beyond “doing good in the community.”
This was also intended to be the majority of my livelihood. For nine years I volunteered in the community, and this was an essential first step to gaining the confidence and skills to be in the workforce again. Volunteering allowed me to contribute, rebuild leadership acumen, and succeed without the spectre of getting fired for bipolar symptomatic behavior. This happened a lot.
Beginning in early 2020 I began reaching out to community partners to gain financial sponsors and was very successful with local businesses who believed in our mission. This includes our local AAA baseball team, the Albuquerque Isotopes, farm team for the Colorado Rockies. The sponsorships were significant, and the agreements were to begin on the first day of 4th quarter of FY2020. April 1, 2020.
New Mexico locked down at the end of March 2020.
Our sponsors asked to revisit the sponsorships when things reopened, but for the time being things would be put on hold.
Two years later New Mexico finally reopened. I approached our sponsors. Some businesses had shuttered permanently. The others had two years of no revenue to contend with and were unable to financially sponsor STS.
The timing between sponsorship agreements and pandemic lockdown never allowed for “proof of income.” And what I was told each time I applied for unemployment through CARES is I didn’t qualify. After many attempts, I contacted my representative and senators. And, as I said, I never received any reply nor assistance from my federal legislators.
Hurtful. Infuriating. And when people were coming to our Zoom groups offering ways to cheat and defraud CARES, I never attempted their schemes. This is because my mother and father instilled morals, ethics, and integrity in me. Admittedly, as a thought experiment I considered doing so because the stimulus checks weren’t covering expenses and there was no employment to be had due to the lockdown. But my parents did a good job raising me. Fortunately, my father subsidized me during this time, but he is retired on a fixed income and I know it was a strain upon his resources.
That’s my story and my issue. I get that the lockdown was unprecedented and I’m not the only one to have a business stumble because of our locked down economy. It just would have been appreciated to know I exist. While my unique issue was an unintended “falling through the cracks” issue with CARES, the very fact not one of my congressional communications was acknowledged makes the acronym CARES at the very least ironic. And in actuality, the lack of response really is hurtful and infuriating.
I’m very happy to share my treatment for bipolar is very successful and has been since 2012. Medication, therapy, peer support groups, community activity, hobbies, sports, and geology field trips are just a few tools in my toolbelt. There are unavoidable symptoms that flare up from time to time, but overall I’m in a very solid and successful place in my recovery adventure. And my passion for mental health peer advocacy hasn’t dwindled at all despite the illustrated setbacks.
I appreciate you taking the time to read my experience with CARES. For whatever reason my legislators decided not to respond to my many communications made election day very easy for me.
Does it ever feel like everybody but mental health peers are super stoked for World Mental Health Day and mental health awareness week and suicide prevention month? Having bipolar, it’s just another day, just another week, and just another month, with the only noticable difference being a bump in the numbers of people telling me how “brave & inspirational” I am for talking so willingly about that part of my life that is bipolar.
Okay, I get it, it’s important to have the open conversation and I’m active in that conversation . Still, hubris be damned, I’m pretty cool the rest of the year, too, and I 0know this because my Mom told me how very special I am every day.
You should be praising my bravery every day!
Living with bipolar, for me every day is world mental health day for as long as I’m in this world.
The term “med noncompliant” must never appear in a mental health peer’s medical records, and any psych provider who notes this in a peer’s medical record must be stripped of licensure and never be allowed to treat peers ever again.
Sure, that’s obviously hyperbolic, but it’s no less extreme than such front end loaded nonsense, that a peer must take psych meds or be branded as difficult, stubborn, and not serious about their treatment. Bite the big green weenie, you psych providers who use “med noncompliant” in a peer’s notes. You don’t make the choice for a peer and you have no authority over a peer’s treatment options and decisions.
It’s the peer’s decision on all treatment strategies. As a psych provider, you are like our mechanic. We tell you what’s wrong under the hood and you make recommendations based upon your professional training. You are a professional collaborative advisor and not a legal treatment guardian.
With few exceptions, notating “med noncompliant” is an inappropriate assessment that assumes an authority not given by the peer. It’s okay to notate something like “peer chose not to try meds at this time” because that is factual information useful to the peer in future treatment. It’s also the type of honest information useful to other providers, because when you write “med noncompliant” in a peer’s medical charts enough times that peer will fire you and find a new provider. This happens, providers being fired by the peer.
Recap: Never say a peer is “med noncompliant” for saying no to your medical advice. Medical advice is not one size fits all and it’s the absolute and ultimate choice of the peer whether to accept your medical advice.
When someone doesn’t care about harming you they’ll care even less about apologizing for harming you. Waiting around for accountability and justice is as useless as rummaging through the shrapnel trying to piece together a bomb that’s already detonated long ago.
If ever a stronger reason exists for healing oneself, any reason conceived wouldn’t rival healing oneself from the abuse of an emotional bully. The bully erodes confidence, composure, success, joy, stability, identity, strength, and the list goes on and on and on. The list goes on even after removing the bully’s direct influence, and the list never lessens when the goal of treatment and recovery is requiring the bully understand they’re a bully; and accept they’re a bully; and recognize the harm they caused as a bully; and apologize for being a bully.
That’s most likely never going to happen. Yet Americans crave this. And Americans feel entitled to this. Americans have a cliche word for this:
Closure.
Time spent envisioning the relief and satisfaction of the bully being held accountable is time better spent learning to live with the personal trauma. How is it possible to fully heal without the bully owning their consequence? The answer is self-evident and right there.
It’s not possible to fully heal from the trauma of bullying.
In my own experience with a less-than-angelic wife who was supremely creative in her range and escalation of new ways to abuse, I spent many years and went through many therapists who perpetuated that goal of closure. This went as far as encouraging me to write the ex-wife a letter explaining what she did and how it affected me. Because this is empowering, I was told. Because this would help with closure.
Not so. What I often explained to therapists certain I needed to contact the ex-wife – effectively creating communication I purposely spent years actively ignoring and avoiding – was this was in no way empowering because I was just as happy leaving the abuse in the past and instead learn ways to regulate the emotional responses caused by being married to the Queen of the Netherworld. Here is your crown, your majesty. The last time I saw her she was at the Gates of Hell in the midst of a hostile takeover, and I’m better off letting that be the last memory of her to enter my life.
And writing a letter admitting to her she messed me up is just the sort of information she would revel in knowing about me. That her abuse was lasting and still affecting me would be like Christmas morning baked into a pumpkin spice muffin served upon my subjugated back while she sits high upon her throne built of the skulls of her abused and conquered enemies.
Maybe Christmas is the wrong holiday; she was moderately dyslexic and I happened across her “letter to Santa” one year that read, “Dear Santa, You are my Dark Lord. Guide me in my abusive whims, oh Most Unclean One.” In retrospect, perhaps Santa wasn’t the intended recipient.
So here’s the thing. Eventually, after many years, I broke ties with any therapist who promoted “closure.” That’s such an American conceit, really. Will any of the children of the Israel-Hamas War ever be afforded “closure” for the horrors they’ve lived? I’m confident in saying “not likely at all.”
Moving past therapists whose therapy was “closure centric” allowed me to find self-empowering treatments that built skills for me to live with the trauma and residual traumatic responses. I can accept the trauma of abuse but not be held paralyzed by the trauma of abuse.
For me, Dialectrical Behavioral Therapy was the skill set I was looking for.
For another series of articles I’ll be talking about my DBT course, how much it helped, and how it kicked my ass big time and solid because it dredged into the muck and horror of being married to the High Priestess of Agony Desired. DBT was an expedition into emotional realms unknown, and being emotionally, physically, and psychologically prepared for the course work was absolute and essential. If I’d entered DBT soon after the divorce, I would have been messed up in a whole new way. Being prepared for DBT took time and experience.
What did DBT do for me? I like to think of it as emotion regulation. By this my take is DBT built skills where I can feel the strong emotional trauma response while not allowing myself to be adversely affected by the ingrained trauma. My worst trauma response is “freezing” in the fight, flight, or freeze school of study. Through DBT I learned to live with the trauma of abuse and still be able to function in my life and in society.
I can have trauma but I don’t have to be ruled by it.
Okay, I’ve built up the ex-wife with allusions to her evil, and I’m not going to leave it hanging without an instance of her evil. And I use the word “evil” with purpose. So here goes:
A stipulation of the divorce was she and I had 50/50 custody of my wonderful son. She wanted full custody or even majority custody so she could move him out of New Mexico and away from me. She didn’t get this because the judge just didn’t like her at all. And my divorce attorney worked extra hard for me because in all her years as a divorce attorney she never truly hated an opposing party as much as she hated the ex-wife. So I had that going for me.
And how was she evil? When she dropped my son off for my 50 percent custody she was fond of saying, “I know how to push all your buttons and then you’ll kill yourself and then I’ll get full custody.”
I have bipolar. Keeping my symptoms in check so I can function in society following the same rules of the same social contract we all agree to is really hard for me. Perhaps it’s harder for me than others who don’t have bipolar. I can’t determine this. I don’t live their life and don’t know their challenges.
What I do know is I’m responsible for my life and how I live my life. I’ll never disempower myself by believing in “their privilege” and “it’s not fair” and “it’s so much harder for me.” All of these things may be true and to that I say “So what?”
If I have fewer opportunities and have more challenges, that’s my life to contend with. What we all share is the social contract implicitly signed by taking part in community, society, and civilization. So I work hard to live up to that, because in the final run through only I have authority over me. Anything less is disempowering and I work too hard to let that happen.
With bipolar depression, there’s a sooper sucky quality to suicidal thoughts. The harder I try to quiet the suicidal thoughts the more pronounced the suicidal thoughts become. Why is this?
The reason is easy. Because I’m actively thinking “Shut up, suicidal thoughts” I now have the original suicidal thoughts plus additional thoughts of thinking about suicidal thoughts. It’s doubling down on the suicidal thoughts creating an amplifying Suicidal Thoughts Feedback Loop. Sooper sucky.
This is along the lines of micro-epiphany after many rounds with suicidal thoughts over the years. Wisdom borne of bipolar misery. That’s kind of cool.
