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Self-monitoring Mental Health Symptoms - a Personal Essay by Lisbeth Coiman

I first met Lisbeth several years ago in The Literary Kitchen where we were both writing students of American author, Ariel Gore. We reunited two weeks ago back in the Kitchen in a Personal Essay Intensive class. This very personal essay about Lisbeth's experiences living with and managing bipolar affective disorder and symptoms of psychosis lept from the computer at me and I begged her to share it with us at The Psychology of It. We're so grateful she did.

Lisbeth Coiman is a bilingual writer standing (unbalanced) on a blurred line between fiction and memoir. She has wandered the immigration path from Venezuela to Canada, to the US, and now lives in San Leandro, CA. She writes, albeit irregularly, on her blog www.gingerbreadwoman.org, a bilingual conversation about mental illness. Her work has appeared in HipMama Magazine, the Literary Kitchen, and YAY Magazine. Her upcoming memoir, The Shattered Mirror, celebrates friendship among women and draws attention to child abuse and mental illness.

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Research proves individuals with diagnosed mental disabilities do better when they have continuity of mental health care, or live in long-term loving relationships, or have a strong caregiver by their side. For years, I had two of those factors. I enjoyed the best medical service I could afford with a generous medical insurance policy, and lived in a long-term loving relationship.

Since leaving my husband and moving to the East Bay, I have not been able to find adequate therapy. I count on the services of a psychiatrist I don’t fully trust yet for once a month medication management.

Additionally, I can no longer check reality by asking my partner questions.

Do you see that? Is this real?

Nor can I find the emotional support I once had when he used to hold me in his arms if I felt overwhelmed, hunted, or “followed” in any way.

My difficulty in living alone is not that I need help moving furniture, or paying my bills, or not knowing what to do if my refrigerator breaks. The difficulty lies in that I suffer from bipolar disorder and psychosis, and I lack the supportive system to carry on in a crisis.

In the last year, I have gone to work several times feeling close to a mental crisis, once with suicidal ideation. At those times, I repeated to myself in the car on my commute to work, “just put one foot in front of the other, Lisbeth, just keep moving forward, and remember to smile.”

For days like that, I keep my doctor's phone number, and a short checklist to self-monitor my symptoms.

Lisbeth's Self-monitoring Checklist & To-Do List

1. Self-referencing Thoughts
If I believe any of the following:

a. The news reader on tonight's news broadcast is refering to me,
b. The messages on loudspeaker at the grocery store are coded instructions to keep an eye on me,
c. Or, the unknown people with their heads close together at the end of the corridor are talking about me,

I am definitely paranoid, and should call my doctor to adjust my medication.

2. Suicidal Ideation
If I have thoughts that involve any of the following several times a day:

a. Painless forms of suicide
b. Images of myself dying
c. Writing a suicide note

I am suicidal, and need to get out of the house immediately, into endorphin producing exercise. Yoga, hiking, power work-out at the gym, 5K walk, and dancing make me feel better. I should also avoid refilling any prescriptions when having suicidal thoughts.

3. Wrong, Senseless Choices 
Once a small bug in my kitchen sink triggered a panic attack. I was having a bad week already and was prompted to crying over the slightest thing. At that point, my first reaction was to call 911. I’m glad I didn’t. I called the apartment manager and demanded that she removed the bug from the sink. I also asked her to spray the apartment.

If facing the same situation again, I should get my act together and kill the bug myself (But I might still demand that the administration sprays the apartment!)

4. Creepy Crawly Skin
If I feel bugs crawling up my legs while sleeping in the middle of the night, I should consider the following:

a. It might be a symptom of menopause, in which case I should take a shower and chill out.
b. Maybe I’m just reacting to the laundry detergent. I should use some soothing body lotion.
c. There could actually be a spider on my bed. Then, I should check the bed and kill the creature (preferably without calling 911).
d. But if none of the above, then it might be that I just experienced a tactile hallucination.

Tactile hallucinations don’t kill. The annoying sensation irritates me. I should drink a calming tea like chamomile, and strike something soft, like a stuffed animal, or a pillow. Crocheting also helps. The idea is to transfer the tactile anxiety to a pleasurable sensation.

5. Rapid Thoughts
Around bed time, when my chores are done and I have time to relax, my mind starts racing. “I should have replied to that woman in, weak reaction sends, careful with my job, rent in the East Bay, back to Oklahoma, racist there, finish writing my book. What if I get sick, no money or security, …”

If I notice this happening, I should stop and do a simple five-minute meditation, breathing deeply in and out, using a mantra, or just counting my breaths. Also Valerian root tea does wonders for the unquiet mind.

6. Inability to Make Small Decisions 
If any of the following happens:

a. Cry because I can’t decide what to eat.
b. Come in and out of the house four or five times unable to just go.
c. Spend half-an-hour trying on and changing clothes, then run late for work.

Planning ahead helps solve this problem. I plan my menus once a week, knowing exactly what I will eat at breakfast, lunch, and dinner on any given day. I plan my routine a week in advance. Even if I don’t manage to do everything, at least I have a clear idea of when to leave the apartment. Line up a day-by-day weekly wardrobe on Sunday evenings. It's better to be taken for obsessive compulsive than to be late for work because of inability to decide what pair of shoes to wear.

7. Excessive Crying
It’s hard to stop crying when I’m depressed. I cry at the news, at rude comments, when trying to make small decisions, when I am nervous before speaking in public. It's hard to explain to others when I am caught crying,for example, in the office.

I try to be honest if somebody finds me wiping my tears. Anybody can understand, “I’m having a stressful day.” These are a few alternative excuses.

a. Pollen allergies are killing me.
b. I got a reaction from my make up. I shouldn’t use that brand anymore.
c. I laughed so hard at Taco Tuesday jokes, I am crying.

8. Self-pity Party
When the following scenario occurs, I should listen to my friends.

My friends the punk Chicana, my neighbor the tarot reader, and the sexy business woman gather in my small apartment via Skype while I sit in my sofa with a laptop on my knees. They have their margaritas ready. I sip from my 5 oz. glass of wine, and say, “It's the politics I can't handle. I don't know what else to do. I come home crying most days. I’m tired. Why is everything so difficult for me? What is it with me? Why do people tend to hate me?”

I should listen to the punk Chicana when she interrupts, “stop there. You are now officially wallowing in self pity.” Margarita slurps are heard over Skype.

9. Absurdity
Question this reality:

a. If your purse is talking to you, chances are the GPS app on my phone is still on.
b. If the refrigerator is ringing, I must have left my phone inside.
c. If there are Taco Trucks on every corner, maybe Hillary won the elections.

10. Compulsive Behaviors
If I find myself:

a. checking my messages on the phone every two minutes,
b. making minute-by-minute To-Do lists for the next day,
c. or organizing the spice drawer in alphabetical order,

I should engage intellectually in reading or writing, or problem-solving, and leave the telephone at home to avoid checking messages.

11. Lack of Perspective
With a roof over my head, with an income, and a healthy family, there is no tragedy. There is a tragedy in Syria and in Venezuela. Get real.

If everything fails, call the doctor, or the suicide hotline. And repeat the following:

"I am still in control. I can do this."

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1 comment

  • Comment Link paul %AM, %23 %923 %2016 %07:%Sep posted by paul

    way to go Lisbeth you are one strong lass stay positive and happy always, cheers paul

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