What’s Really Scary

It’s very nearly Halloween and there are lots of scary things out there, from costumes to movies. But here’s what I find scary.

My number one fear is the return of my bipolar symptoms, especially the depression. I’ve been mostly stable for years now, with only occasional and relatively mild symptoms when I relapse. But I still remember what it was like and I don’t want to go back there. The misery and the hopelessness. The numbness and the pain. The lack of joy, or contentment or, for that matter, even blankness.

Hypomania isn’t as scary, though I know it can and does recur from time to time. I don’t have a history of extreme symptoms and, with my husband’s help, I’m able to navigate the ones that do occur.

I can handle it if I get mild “breakthrough” symptoms when I encounter triggers. I have coping mechanisms in place, including simply waiting for them to pass, because I know they will. That trust in my resiliency — and my medications — has grown over the years.

Still, there’s always the thought in the back of my mind that the efficacy of my meds could wane. I could crash again. There’s no guarantee.

Then there’s the fear that I could develop a batch of new symptoms, triggered by God only knows what. I know that some people with bipolar disorder have hallucinations, hearing or seeing things that aren’t there. One friend of mine has heard voices for years, and another one is visited at times by an imaginary animal. (He doesn’t mind it; he says it’s always been pleasant.) Again, not likely, but then again, my brain has already been proven to be glitchy.

Of course, I do find other things scary. I am terrified of bees, wasps, ticks — anything that impinges on my dermal boundaries. I’ve been stung once and suffered no symptoms beyond the usual, but it did nothing to allay my fears. In fact, I took beekeeping in college, hoping that I would get over the fear. That didn’t work either. I still freeze, shake, scream, cover my head, or run. It’s a phobia, though not a crippling one. It doesn’t bother me enough to try eradicating it via therapy. Besides, if the beekeeping class didn’t help with desensitization, I’m not sure what would.

But there are less personal fears that I have too.

Some are societal problems. Stigma regarding serious mental illness still exists. And although people increasingly seem to be concerned about “mental health,” it turns out what they really mean is usually substance abuse or crime. Initiatives and funding tend to focus on those problems, sometimes to the exclusion of actual brain illnesses — except maybe schizophrenia, and then only as it relates to violence or homelessness. Of course, those are real problems, but there are a lot more people who need to be helped that aren’t getting attention, funding, or treatment.

Speaking of treatment, that’s another subject that’s frightening. It just isn’t available in many locations. I don’t know what the situation is regarding available beds in my geographic area, but I doubt there are many, given national trends and the complete lack of an inpatient ward at the hospital nearest me. If I did experience more extreme symptoms, I’m not altogether sure I could get good, prompt treatment.

Finding a psychiatrist or a therapist can also be difficult, bordering on impossible. When Dr. R., my longtime psychiatrist, retired, I tried to find a new one. I called the doctors he recommended, but none had openings. I turned to my primary care physician, who at least agreed to continue my psychotropics until I could find a psychiatrist. Six months later, I got in to see someone. And that was only for med checks. I had slightly better luck finding a therapist, but it was by no stretch of the imagination a breeze. Fortunately, both have managed to avoid retiring.

Call me a pessimist (okay, I’m a pessimist), but I also fear that things aren’t going to get much better anytime soon.