23 March 2015

A Lifetime of Triggers


My therapy sessions went from 2 or 3 days a week to only once a week during the course of six months during the middle of 2009. They were a large part of my recovery during this period, they were the “hooks” that I was hanging the canvass of my recovery upon; the canvass being, of course, my life. I spent a lot of time outside of therapy thinking or working on the issues which had been discovered and discussed during the therapy sessions. My journals, which I now used almost all day long to record and reflect upon each and everything that happened every day, had become a vital tool in my recovery. I opened a new file each week, then every day I opened a new page for each day. I recorded the time, date, day, location and where in the apartment I was writing from and then started my day there; during the course of the day, typically every time I would switch tasks or have a cigarette, I took a few moments to make note of this in my journal. I write my journal in the first person and to myself, although I suspect one day when I am long gone and dead, one of my kids might stumble upon these files and read just how crazy their father was at that time! Another almost daily habit for me was posting and spending a lot of time making comments on that little blogging community I found. I typically stayed away from religious or political topics and a lot of those blogs posts were simply what I term “life updates” where I truthfully shared with these strangers on the Internet what I felt or how I was doing. These other blog site members soon became, in a very real way, my friends. In my real life experiences I still had a very difficult time connecting to other people in person. Even with family, except Kelly and the kids, I couldn’t find that heartfelt bond I needed from my friends. I did find that feeling, however, in this community of strangers who had become my only friends during that long slow year of 2009.

During the summer, I tried to go to all the various community sponsored events in Palatine. I went to the parades and farmer market events, I tagged along to see music in the park or volunteered with the local Rotary chapter for their Oktoberfest event. I still had a very hard time being in public, I kept it together when I was out, but when I got home again, I always caved and felt like I was broken. With the help of a medication Dr. Kahni had recently introduced, Ativan, I found it easier to manage my anxieties. I was now on a new medication cocktail which included Lamictal, a drug to treat mood disorders, Ativan to help with my anxiety symptoms and Ambien, a sleeping aid. Although I was responding to this combination of medications better, it was still not right and I was not having success in dealing with the side effects of the Lamictal. In particular, as Dr. Kahni introduced a slightly higher dose, it started to trigger my anxieties, I was feeling clumsy and unable to balance. My eyesight was blurry or difficult to adjust in bright lighting. 

One day, during my September monthly visit with Dr. Kahni, we discussed a new strategy for treating my disorders. “You understand, d’Philip, each patient reacts differently to medications…” Dr. Kahni, a soft spoken man in his 50’s of East Indian decent, explained in a calm, rational tone, “Likewise, each individual will manifest their disorders in different ways and deal with them in their own unique way, correct?”
“Yes, I understand that…” it was easy to talk with Dr. Kahni because I always felt like he was listening to me just as closely as I was listening to him, “That’s been my experience, at least.”
“Alright, well there is some recent research that suggests both BiPolar and Anxiety disorders are often triggered by some kind of life event, would you agree?” Dr. Kahni has this practice of lacing his fingers together to create something of a “hand bridge” which he would then open and close while he was speaking, “Therefore, if this is true, perhaps you might confirm for me, has this also been your experience?”
“Well…” I had to think about it, I started by remembering the most recent episodes, the one that got me to where I was now; was there a trigger of some kind? I couldn’t remember exactly, “It’s hard to say because I don’t remember a lot of the details of what was going on inside my head while I was having an episode.”
“Okay, I understand.”  The doctor opened his hand bridge, leaned forward and asked, “In your life, ever since you started showing symptoms of being BiPolar, going back as far as you can, were there traumatic life events?”
“Like my parents getting divorced?”  I was unsure but I had an idea of where the doctor was steering this discussion, “Or my best friend dying when we were only 17 years old or my hero being murdered when I was 19?  Things like that?”
“Yes, exactly!” Dr. Kahni separated his finger hand bridge and sort of made happy jazz hands and chuckled, “Now we’re onto something!  I am going to step you off the Lamictal and we’re going to try a different approach to treating your ailments.”
“Okay…” I listened as the doctor continued, “How do I do that?”
“I want you to start by breaking your pills in half and take only that, once a day for two weeks…” he started writing a new prescription as he continued explaining, “then, after 2 weeks, take the half pill only once every other day for a week and then just stop taking them all together.”
“Alright,” that made sense, “What about the Ativan and Ambien?”
“Leave that alone for now…” he finished writing out the script and ripped it from his pad and as he handed it to me, he explained, “This is a prescription for Zoloft, it is an anti-depressant medication, I want you to take it twice a day, in the morning and before bed, but not for 2 weeks, not until you are reducing your Lamictal to every other day, you understand?”
“Yes.” I glanced at the prescription, “How much Zoloft is this?”
“We’re going to start with 200mg. per day…” Dr. Kahni then made a note in my chart and asked, very casually, “What kind of work do you do?”
“I’m disabled, on disability.”  I shrugged, “I have a degree in media communication and marketing, but I don’t use it very well.”
“I will be sending some notes to share with John…” he was referring to my therapist, they all worked together there at ACMH, “When do you see him again?”       
“Next Monday…” we had a standing 11am appointment every Monday by this time, so it was easy to answer, “At 11 in the morning.”
“Alright, very good.”  The doctor closed my file, stood up and extended his friendly hand, “We’ll see you next month!”
“Thank you Dr. Kahni!”  I firmly shook his hand, “Have a great week!”

The weekend between my appointment with Dr. Kahni and my Monday morning session with John went quickly and I remember writing about my life a lot in my journal. I tried to find various “traumatic” events which might have triggered my disorder.  Eventually I made a chronological list of life events, simply as I perceived them, which I considered to be of major significance. I did this because I thought I’d need it for my next session when, in truth, it was something that just needed to be done.

·         Birth (12/7/1961)
·         Brother Born (1964)
·         Moved to California (1967)
·         Found out that dad cheats on mom (1969)
·         Parents Divorced (1970)
·         Lost Virginity (1974)
·         Met Best Friend Todd (1974)
·         Best Friend died (1979)
·         John Lennon killed (1980)
·         Met Rachel-moved to California (1981)
·         Valerie was born (1983)
·         Tried to Commit Suicide (1984)
·         Started first company (1984)
·         Rachel disappeared with Valerie (1985)
·         First Company failed (1987)
·         Met & Married Susan (1987)
·         Cassidy was born (1990)
·         Separated/Divorced Susan (1994)
·         Started Split/Apple-2nd business (1994)
·         Met & Married Kelly (1995)
·         Left Split/Apple-Julian was born (1996)
·         Nervous Breakdown #1 (1997)
·         Moved to Arkansas (1998)
·         Re-united with Valerie (1998)
·        Started 3rd company (2000)
·        Margaret was born (2000)
·         Valerie died (2001)
·        September 11th Event (2001)
·        Ken Kesey & George Harrison die (2001)
·         3rd company failed (2002)
·         Relocated back to Illinois (2002)
·         Nervous Breakdown #2 (2006)
·         Deemed as being “disabled” (2008)

I took this laundry list of life events to my session, I was keen to discuss the insights I thought I had but John had a different agenda. He had orders from Dr. Kahni to identify and assess my current symptoms, we had to focus on developing a Cognitive Behavioral Treatment plan. To do this, we started with a few tests, like on paper, John gave me homework to do and I had to complete it as soon as I could and drop it back to All Care office. John explained how Dr. Kahni will develop a different medication plan for me, one that will fit in with my CBT plan. I opened the folder of tests, they were intended to identify irrational thinking styles that contribute to problem solving skills. I continued to scan through these pages while John assured me, “The doctor has a lot of insight to this disorder and he really knows what he’s doing.”  John pulled out a legal pad and pen, “So let’s make a list of your present symptoms for starters and maybe, if we have enough time, we’ll take a look at your list too, okay?”
“Sounds like a plan.”  I nodded, “So what symptoms do I have?”
“Well, the obvious one is your depression, right?” John asked, “How are your anxiety levels?”
“Levels?” I half laughed, “There is no level, just constant high anxiety, I’m nervous all the time, even when I’m home alone, I feel anxiety.”
“Okay, there’s another one…” John wrote it down, “What else?”
“I still have social problems, communication problems.” I closed my eyes, “I don’t really feel comfortable leaving my abode, even though I hate it there, I never feel like getting out at all…”
“So, social anxieties?” John jotted it down, “Are you agoraphobic?”
“Maybe a little.” I shook my head, “I don’t know, maybe.”
“How about sleep, how’s your sleep been d’Philip?”
“I have trouble falling asleep unless I take Ambien…” then I added, “I always wake up after about 4 or 5 hours, however so I either pop another sleeping pill or, if it’s close to time to wake up anyway, I’ll just lay there, maybe watch the television.”
“What time do you go to bed?” John asked, “Are you on a regular schedule?”
“I guess, I mean…sometimes.”  I thought about it, “I guess between 10 and midnight, most nights.”
“What time you usually get up?” the interview continued, “Typically?”
“I have my alarm set for 5:17 every day.” I said proudly, “Most of the time I get up and stay up, but once in a while, on a Sunday maybe, I sleep until whenever.”
“How long is that?”
“I don’t know…” I shrugged, “I guess the longest I usually sleep is maybe 6 or so hours…I wake up a lot though, you know, every hour or so, I’ll sit up, roll over…maybe go to the bathroom.”
“Okay…” John made some notes and then asked a strange question, “Do you ever get up and do anything while you’re asleep?”

“Like sleep walking?” I asked, “Kelly tells me I eat while I sleep sometimes.”
“Really?” John jotted quickly, “Tell me about that…”
“I had a package of Oreos next to the bed…” I laughed, “I guess I was sleeping and I rolled over and started eating!”
“That could be dangerous.” John warned, “You could choke!”
“There was one time,” I continued to remember and recount, “I think it was about a month ago, but Kelly said I got up and cooked a burger, ate and then went back to sleep and I did not remember doing that all!”
“Okay, that’s interesting…” John took a few moments to write some detailed notes and as I sat there waiting I looked around the room at the various pieces of art John hung on his office walls. There was an old family shot, from the late 70’s or early 80’s and another photo of John hugging a pretty woman who I imagined was his wife. There were a couple of hand-made looking pieces of art and a diploma, a state certificate and an emergency exit plan next to the door. The room had fluorescent lights but John typically had them off and instead illuminated the room with a desk lamp and standing light next to a big green plant. It was a comfortable room, professional and yet relaxed, it showed a little of who John was and still, I felt comfortable in his conversant hands. He finished his notes, glanced at the clock and reiterated, “Okay, remember d’Philip, take these tests when you’re well rested. There’s no hurry, no time limit, but follow-up with it before our next session, okay?” John jotted another appointment reminder card for me, but it was our standing Monday morning 11am session, like always. He handed the card to me and smiled, “I think you should focus on your sleep schedule, limit your caffeine intake, try to get a solid six hours or more every day.”
“I can’t do that…” I laughed, “My caffeine intake, John, is one bottomless pot of Good Morning America from when I wake until dinner. I’ll even drink coffee after dinner on some nights, coffee is my elixir!”

“Okay, well maybe no more coffee after dinner for starters?” John smiled and again glanced at the clock, it was time to go, “I will be away the rest of this week, I’ll be in Colorado for a conference.”
“Lucky bastard!” I groaned, “So when will I see you again?”
“Next Monday, the 28th of September…” John jotted it on the card and handed it to me, I stuck it in my day book and John stood up to shake my hand, “Have a good week, remember to check in with the doctor and I’ll see you next week!”
“Okay, thanks John…” I smiled, “Enjoy Colorado!”
“Thank you, I will!”

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www.dphilipchalmers.net
This excerpt from “My BiPolar Reality; How Life Goes On…” is from chapter 8 (“The Long Road Home to Me; The Recovery Process”) and takes place in 2009, just before I started to turn a big corner in my recovery process. At the time, however, I didn’t realize how close I was to making a “breakthrough” and, truthfully, I was still feeling frustrated by my lack of progress. I had made strides while working with this new medical team, but it had not even been a year yet, so I was not very patient. I was still taking an (un)healthy dose of mood stabilizer medications which, as I learned, were causing me to do strange things like getting up in the middle of the night to cook and eat an entire meal and not even remembering doing it…or feeding myself cookies while sound asleep. Strange, even dangerous things to be doing but I was not even aware of my doing it and that’s a really freaky feeling. The assignment, however, making a list of potential triggers in my life, was something which became a fulcrum by which the scales of change, from no progress to making good progress, tipped upon. Although we never technically used that list in my treatment process, I used it on my own to both gauge my life’s pivotal experiences and as a “hit list” of issues to deal with on my own.  

I personally would recommend this exercise to those who are struggling with sorting out all of life’s various issues that either prevent your healing progress or keep coming up in your therapeutic sessions. There are so many things that are a “big deal” which happens to EVERYBODY in life, a lot of people keeping tripping up on their past experiences and feelings. With people like me or you, perhaps because we’re more sensitive, but these issues can sometimes loom large and long in our lives. I cried over my best friend’s death or my hero’s murder over 20 years, I tripped and stumbled over myself because of either “daddy issues” or my own lack of self-confidence. I did this to me, nobody else, I was the one who held onto these matters, made them bigger or scarier than they really were and convinced myself they were the reasons why I was the way I was; it was a blame list, all the shit done to me that fucked me up.
But I was wrong, as I learned from continuing my therapies, these obstacles and unfortunate events, although some tragic and severely damaging, were NOT the cause of my problems. My problems were being caused by my own inability to over-come these hurdles that I created. I suspect there’s a lot about life that is like this, we are often our own worst enemies!

In conclusion, I think the general gist of this article is that if one were to list out all of the “most important” significant events in one’s life and then, one by one, deal with each matter, you’ll make progress in resolving a few of your own particular road blocks to success. Every day we are faced with stress, every year we encounter significant changes which can impact us, both positive and negative, but it’s all on us how we choose to deal with it; we can choose to be the victims of these events or we can choose to be a survivor. I was being a victim without even realizing it, but once I did, I found the strength, will and ability to turn these victimizing situations into opportunities to build me character, to gain some insights and, perhaps, get a little bit more wise about life’s events. Some of those items on my list, by the way, although I listed them more than 5 years ago, still haunt me and I struggle with keeping a grip on them…being labeled as “disabled” is still an issue, I don’t like that feeling and I work to demonstrate (to myself more than anyone else) that I can and do function in a productive and useful way every day. The murder of my daughter, that’s a scar which lasts a lifetime and a few times a year (around her birthday, holidays, her date of demise), I struggle with the tidal waves of powerful emotions…but that’s to be expected and besides, if I crossed off everything on my list, then what would I have to work on myself?

Lastly, in the here and now, life is going well. I managed to get through last week, I was having a big problem adjusting to a medication change which created many (uncontrolled) emotional issues for me. I was very irritable, then I couldn’t stop crying then I would fly into a ranting rage…crazy feelings that kept sweeping my feet from under me and knocking me on my ass all week! By the end of the week, after trying this medication for two weeks, I notified the doctor that I was going to stop taking it all together. He was disappointed, he encouraged me to try and ride it out, but I declined. The medication, designed originally for people with hypertension and heart problems, was having an awful effect on me. The doctor, who is new to me, disagreed…he fucking disagreed that I am feeling bad from the medications, but trying to argue with me is futile, especially if I know what I’m talking about, like for instance, my mind, body and the effect of various drugs I feel. I took my last dose of it last Wednesday, but truthfully, today (Monday) is the first day I’m actually feeling more like me again…that’s a very good thing because this week, for the next couple of months, I need to be the best version of me as possible.

I will be video recording a special interview to air next Monday, March 30th…aside from being Vincent Van Gogh’s 162nd birthday, it’s also “World BiPolar Day” so I am creating something special for that date. The months of April and May will find me deeply engaged in the book promotion tour, I’m still planning some final dates but it’s looking like two big events are going to be the annual “420 Festival” held in Golden Gate Park and May Day (5/1), with a concert event in San Jose…there’s a few other cool events I’ll be at too…Wavy Gravy’s Birthday Bash in May will be groovy and there’s a chance of an “Acid Test Class Reunion” event in the infamous Haight/Asbury area. I’m also looking for ANY GOOD OPPORTUNITY to come and talk about the book, the issue of mental health or legalization in California during these couple of months, so if you think of someplace, or something where I can talk to 10 or more people together, please let me know, cool? It’s getting half past the day already and I have several more tasks to accomplish before my siesta time, so I should address that stuff before too long. I am always very Grateful for your time in reading this, I adore it when you make a comments and if you’re willing to re-share this blog article…you fucking rock in my book!

As always…please take care, be well and stay safe!










Peace,
d’Philip
Monday 23 March 2015
The San Joaquin Valley
Republic of California

Earth