13 December 2010

What do you mean by "triggers?" - Revised

**updated now that I'm more awake
Let's start by saying triggers are evil bastards. Anyone who has a mental illness, or cares for someone who suffers needs this word in their vocabulary. The sufferer needs to learn to actually communicate these triggers with those that care about them and avoid the trigger or lessen the effects. Yes, this means the sufferer has to take responsibility (unlike say, Lohan or Spears). Those that care need to take into account the seriousness of the trigger, learn what that person's likely response is going to be, learn to try to avoid the trigger (or at the very least, lessen the effect), and how to handle the person when they're triggered.

Face it, when we are in full trigger mode we are not thinking correctly. Our animal instincts have taken over and we're basically working on hormones, electrons and chemicals. As much as it sucks for the sufferer to give up that bit of independence in our battle with ourselves, occasionally you as a carer are going to have to step in.

Trigger: something that acts like a mechanical trigger in initiating a process or reaction. (Merriam-Webster).

Again, triggers are evil bastards. Generally some outside source sets off a complete psychological disturbance within the person. Triggers can be anything, really. I've known people who would freak out at the smell of Tic-Tacs or seeing a certain type of flower. - These triggers are even more exacerbated (and sometimes weird) if the bipolar is a survivor of some form of abuse.

Many things can trigger a bipolar episode. Some examples:
  • stress
  • sleep issues
  • problems at work/home
  • isolation (a big issue with me personally)
Read more from David E. Oliver 

Reactions to triggers are awesome!

One frequent response to a trigger is a full on panic attack. 
Breathing becomes difficult. Your heart races. Your adrenaline dumps into your system. Your brain shuts down to everything around you except the memories, thoughts and feelings associated with that trigger and trying to get away from said bastard.

Other responses aren't as "mild."

1. One can easily turn into this: A pissed off wolverine. A raving beast that even grizzly bears will run away from. A badger the size of a German Shepherd who, when pissed, is a whirling dervish of teeth and claws. Believe me, you will always lose the battle against a wolverine. Always. 

OK, you may win if you stab it with Haldol or some other chemical restraint.
In my case, I feel absolutely no pain when I hit this stage of rage (which luckily is rare and takes a strong trigger often associated with my natural protectiveness of others). 

Any police officer, corrections officer or psych ward employee will tell you that the ones that cannot feel pain are the worst to deal with. All you can do is overpower and restrain them (tactic of choice) or hope to talk them down (rare).

This demon within me is perhaps the one I am most afraid of because I know I can do serious damage to someone else, not realize I'm doing it, and sadly, not even care at the moment. When this demon comes out, it is seriously like I'm another person, a very scary, if not evil, person, that will not back down when challenged. 

Fortunately the majority of the time this bitch comes out seems to be when I'm defending someone (including myself), who is the brunt of douchebaggery, abuse, etc... especially if the person is another mentally ill person, such as someone with Autism, Aspergers Syndrome, Downs Syndrome or simply just slower than the dicks who think they're the Alpha dogs. I guess I'm just a guardian for the weaker. 

The biggest problem is getting my family to understand that this ravaging demon comes out at the simple mention of my "brother" (I use the term loosely) or he just shows up, leaving me feeling rather bombarded and assaulted in my peaceful castle. (See the first paragraph).
I literally black out. The only thing I can see is him. Nobody else is in the room to me, even if there's 30 other people there
Whatever the exact trigger is with him, one could liken the response to being high on PCP and having a blood feud.

2. Triggers can leave us completely incapacitated, crying, enduring the pain, thoughts and/or memories that are waging an assault on us - leaving us looking something like this:

Depending on the state of mind we were already in, a full on depression caused by whatever trigger can last days or weeks. Personally, when I hit a serious depression I can be laid up for 2 weeks easy, sleeping at least 16 hours, often 20 hours a day. I honestly think that this is not only a recuperation device, but a way of "avoiding the pain," or letting the mind and heart heal itself a little bit so I can survive. That being said, recuperation after a week or two of this is slow, agonizing and frankly, quite annoying. I'll go deeper into the depression aspect in a later blog.

3. Even worse than just a laid up depression, many  find themselves self-harming. Some assholes with no clue what it's like to be in our shoes call it "self-mutilation," which fits, but makes us feel more like shit for doing it. Again I'll go further into detail about Self Injury in a later blog.
(note on above picture: only beginner injurers tend to injure on a place like the wrist. Often, with more experienced ones, well, you won't see our cuts, burns, whatever method of injury unless you see us naked.)

The important thing about self injury is (pay attention) it is the step BEFORE suicide attempts.

As a cutter, I can tell you that cutting prevented several suicide attempts (though I do have 3 attempts on me). As difficult as it is to wrap your head around if you are not a self injurer, the shit works. Yes it's highly dysfunctional, yes it's bad... but damn it, it works. It calms you down enough to maybe be able to sleep the suicidal phase off, or even makes you forget about committing suicide for awhile. The bad thing is, since it does work, it's addicting, like alcohol, heroin, or crack, and just as difficult to stop. Self medicating is called self medicating for a reason, it works; it takes the pain away, even if only for a few minutes, and that's a few minutes we can have relative peace inside our chaotic minds.

4. Well, you're not going to like this one, but triggers can be so harsh the sufferer simply cannot handle the pain and torment within their soul and chooses to remove themselves from this mortal world. This is rather rare, and suicidal episodes tend to develop over a long period of time, with explicit warning signs. These warning signs should NOT be lightly taken as a life really is at risk, whether you as a carer can handle the thought of it or not.


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  2. k, WOW, yes, I so understand. From my vantage point looking from the outside at my son. Pain?? There is NONE during a manic moment....It's actually not a thought. So yes, you described EVERYTHING to a "T". I know how it can feel to be walking on egg shells, just because anything I say can be taken wrong or just plain be at the wrong moment.

    Self medicating is a first step to dealing with it. Cutting isn't seen, it's always covered. If it is seen it's by accident. Usually after the manic stage is over, it's almost one of those situations where it's an embarrassment and the cutter does everything in the world to try to hide it.

    When you live with someone with Bi-polar disorder, you have to remember they HAVE it, they aren't Bi-Polar. It doesn't define you, it is an illness just like any others. As if you have heart disease or diabetes, it's not curable it's only controllable through the right medications. It can take YEARS to get the cocktail of meds right. It is a genetic disease as most mental disorders are. Some just are more genetically prone to the harsher depressions. FINALLY the medical community sees it as a disease and not as a stigma.

    Ok, gonna step down off of my soap box and take it with me....I do need it! Love ya girl and you are doing a great job with this blog....B

  3. Someday I could tell you about the time I went off and it took six orderlies to stop me. Except I don't remember a damn thing about it.

  4. Generally, yeah we do get a bit pissy when our manics are interrupted. We kind of like the feeling of being high... especially when we get to compare it to the sobbing, cutting, suicidal low that's sure to come.

    As far as cutting, yes, we know it's bad. It's embarrassing enough. But like I said, god damn it works. That's the sad part.

    IDK that the medical community sees it as a disease yet. There are still a lot of old fogie teachers and doctors around. The big problem though is the stigma we face from the "normals."

    Like we don't feel like shit enough, we get to hear the whispers, deal with the taunts, bullying and whatever else they can do to help destroy what bit of self esteem and self respect we have... just because we're different.

    Then again not even 50 years ago my kind would have been thrown in a state hospital somewhere and given a frontal lobotomy. I could be a bit biased.

  5. Even in the late 70s, my mother was subjected to electroshock therapy. And Haldol and Thorazine are essentially chemical restraints - they keep the subject from doing anything.
    They _still_ use Haldol and warehousing, if they can get money from keeping someone. Look up the situation in NY state - and you will never, ever set foot in their jurisdiction.

  6. I'm personally not impressed with the mental health care system at all. But yeah, people need to realize what is really going on.

    P.S. They still use EST. They give you a paralytic first, then zap the fuck out of your brain, giving you a "seizure." Sadly, nobody ever comes out the same. And not in a good way.

  7. I guess we got lucky here and came across a good group of Dr's and Psychiatrists. Of course all best help in the world does no good if the one receiving the help refuses the meds required to keep you from hitting the super highs & the super lows which are unbearable to watch, much less what it must be like to live.

    The biggest issue with D. was that he didn't like "Dealing" with his own thoughts after the meds evened out. So he quit taking them.

    Help me understand that please?

  8. I am not a cutter, I do self distruct though. I throw up a wall or kill friendships. I become verbally out of control. I get stuck on certain subjects. People say I beat a dead hourse when I just can't let things go. I get very defensive and I find myself taking things people say the wrong way. my mind wont shut off until something else triggers it to go on. most people think I am a snob but really I am afraid of most people when I am in a funck. I am out going a lot of the time and can't seem to say no to people whoasked me to do something for them. I am not as strong as a lot of people with Bipolar. There are nights I cant sleep my body and mind will not let me. there are days at a time I do not want to leave my home. I panic in large crowds if I am in the middle of it. how ever if I am facing the crowd I am ok. People making fun of me triggers a lot of moods. I get to where I have to push and push a subject until it just blows and I have made a person so mad that I am out of their life for a long time. I can remember as a child sitting in a cornner saying that no one liked me. I could cry for hours. things were very difficult for me. I can remember singing and laughing and then two hours later feeling hopeless and wanting to run away or kill myself. That was when I was only about six.

  9. Triggers are an important part of the "illness" because they make it USEFUL, evolutionary speaking. Having the ability to go into a hyper-active mode, where you really are sharper, more alive, more aware, and more able to handle things is a huge advantage. Being able to drop into a slow state where you use a low amount of energy and resources is also a huge advantage. But they are only advantages if they happen at the right time for sane reasons having to do with survival.

    The problem is our high-stress society tosses things around us that trigger these useful states when we DON'T REALLY NEED THEM. And then we are cursed by our bodies to an inappropriate response pattern, which was good right and proper in the proper season.

  10. Momma B: Sorry for taking so long to respond. Busy with school and trying to come up with a decent way to respond.

    - I've said it before and I'll say it again; The sufferer HAS to take responsibility for his own ailment. I know you're feeling helpless, especially when you watch him crash and burn so much. Do not feel like you've failed. It is really not your fault. He's just not at a spot where he's willing to "man up."

    - Now for the real answer from my perspective as a sufferer: Bipolars are notorious over-thinking and emotional beings. When you start a new med, depending on the med, your brain sort of gets a break, like being high. When the meds even out the high is gone, and the thoughts come back and you have to deal with whatever is in your head. That's why therapy should be used, but then again, he has to be honest with the therapist. When you go off of your meds, you can hit that wonderful high manic phase where nothing bothers you, nothing can knock you down, you are the ruler of your own world. Whatever demons are in your head are laying down when you're manic. Take the manic away, the demons come back until the next manic. I guess it's manic chasing. Anything to get the thoughts and shit away for a bit. He needs to learn to deal, to cope. But, it's all on him. He's going to have to hit his bottom and pursue the help on his own. You just need to be there and support him.