Here’s what happens when you break up with a narcissist

It is challenging and exhausting being romantically involved with a narcissist, but they can also cause havoc when they leave. Breakups are always hard, but when you’ve been in a relationship with someone who uses others and is obsessed with themselves, it can be even harder.

On the surface, narcissists can seem charming, engaging and charismatic, which can make them difficult to leave in the first place.

Dr Judith Orloff, a clinical psychiatrist at the University of California Los Angeles, wrote in a blog post on Psychology Today that narcissists can make you “fall in love with them so hard that it feels like you’re giving up a part of your heart to leave them,” because they’re very good at becoming the center of your universe while you’re with them.

Here’s what to expect if you break up with a narcissist.

It can feel brutal and sudden

It can feel brutal and sudden

One minute you may feel like everything your partner has ever wanted, and the next you’re left wondering what on Earth went wrong. This is because narcissists are great at playing a part while they’re getting something from their source, according to Orloff. But when they’re done using you, they have no difficulty in casting you aside like a used tissue.

There will be no apologies or remorse, and you may well never hear from them again, regardless of how long your relationship was. If they do return, it will be because they’ve realized they can get something from you.

Be prepared for begging, pleading or bargaining

Be prepared for begging, pleading or bargaining

If you’re the one who chose to leave, good for you because Orloff says that’s hard to do. They are likely to give you the fight of your life because they’re not done with you yet. Narcissists hate losing their supply so they won’t let you go easily.

Prepare for them to promise “to change.” They might suddenly start doing things for you that you’d been complaining about. They may say “you’ll be lost without me,” or “you’ll never find someone like me.”

Don’t listen, Orloff advises. It’s just a trick to get you to come back to them out of fear.

What next? Establish no contact

What next? Establish no contact

No contact is exactly what it sounds like: no contact whatsoever. That means blocking their number, making sure any emails from their address go into your spam folder, and deleting them off social media. This is tough, but mental health counselor Dr Stephanie Sarkis explains in a blog post on Psychology today that it’s the best option because sooner or later the narcissist will find a way to return.

The narcissist will try to contact you if you cut off their supply, and they know just what to say to make you come back. So you have to be brutal, and fast. It may be best to break up with them over text also, so they can’t manipulate you any further.

If you left something at the narcissist’s house, Sarkis adds, you should just leave it and let it go. Consider it a very small price to pay for your own sanity and well-being.

Remove people you have in common from social media

Remove people you have in common from social media

It might seem harsh, but sometimes it’s just better to start completely fresh and remove any association of the narcissist from you life, psychologists advise. This includes their friends and family, from all social networks: Facebook, Instagram, Twitter, LinkedIn…

The more connections you still have to each other, the more opportunities the narcissist has to slide back into your life somehow. They could also use their friends to try and make you jealous.

So unless you’re very good friends with them, and you trust them completely, you should probably wipe the social media slate clean.

Remind yourself of why it ended

Remind yourself of why it ended

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When you break up with someone, a few selective good memories can come flooding back, prompting confusing feelings of regret. These feelings are usually false and unrepresentative of the relationship, psychiatrists say.

You might remember a time when your partner was sending you loads of messages every day and continually complimenting you. Compliments are great when they’re sincere, but when a narcissist uses them it may be part of a technique called “love-bombing” in which the person bombards you with affection but has an ulterior motive.

As a reminder to yourself, jot down the reasons you split up. Did your partner frequently put you down? Call you names? Make you feel guilty or like you were crazy?

They will ‘move on’ quickly — and tell you about it.

They will 'move on' quickly — and tell you about it.

Most true narcissists don’t need time to heal from a break up as their initial feelings about the relationship were likely insincere or absent. It’s not unheard of for a narcissist to have someone already waiting in the wings as a new source of support, or have their exit strategy carefully planned out.

This is one of the reasons removing them from social media can be helpful — there’s likely to be a lot of loved-up selfies.

In reality, they may simply be love-bombing a new target. On the bright side, it isn’t you anymore.

Expect grief and embrace it

Expect grief and embrace it

Grieving will be an important part of your recovery, so embrace it when it comes, advises Sarkis. After all, you have a lot to grieve over: the end of a relationship, and the person you thought your partner was. They love-bombed you when they first met you, and these feelings are still there, and they are strong and intense.

However, you figured out enough reason to get out of there, so remind yourself that many of these feelings were likely built on something false. The narcissist may have appeared to sweep you off your feet, but did they really deliver on their promises? Probably not.

Nevertheless, you probably had, and still have, a strong emotional bond to the narcissist and only time can heal that wound. Sarkis says be glad you ended things when you did because otherwise, you’d still be in that toxic environment, losing more of yourself every day. The pain is only temporary.

Focus on yourself and do things that make you happy

Focus on yourself and do things that make you happy

Most importantly, you’re going to need to focus on yourself, Orloff says. Take this time to try a new hobby or gym class, or go out and meet new people. This may sound daunting — being with a narcissist can use up a lot of energy and make you timid around new people.

But you’re out of that situation now. It’s time to reconnect with people that make you happy.

Sarkis and psychologist Dr Guy Winch recommend writing an “emotional first aid” list of things you can do as a distraction when you find yourself thinking about your former partner. You have pushed aside when you were with the narcissist because your needs weren’t important. Now it’s time to look after you.

You’ll realize relationships aren’t supposed to be that way

You'll realise relationships aren't supposed to be that way

When the time is right, you’ll find someone new. Dating is an important part of recovery. Still, you shouldn’t expect to find “the one” right away. Just go out and have fun. Maybe you’ll meet someone amazing, or maybe you’ll make some great friends. Either way, these people will be a breath of fresh air.

Plus, you’ll likely have a deeper understanding of your own boundaries than you did previously, so give yourself more respect if someone isn’t treating you the way you want.

When you finally develop your first crush after a relationship with a narcissist, it feels really great. It might not work out, but you’ll be reminded of all the reasons someone actually likes you — and there are a lot!

What to Expect After Inguinal Hernia Surgery

Most patients experience a certain amount of pain after a hernia operation. This is usually accompanied by bruising and swelling around the incision. Some other manifestations that may be felt up to a year after the operation include pulling, burning, and tugging sensations in the groin area. These sensations can be expected after any operation.

On the other hand, each person may undergo a different experience—meaning that what you sense may be less dramatic than what other people feel. The important thing after undergoing a successful operation is to make sure that you take adequate precaution; let your body heal properly and, if anything seems out of the ordinary, check with your doctor to make sure that nothing is amiss.

How well or quickly people recover from hernia surgery can differ greatly from patient to patient. For instance, someone having open surgery may experience mild pain while another person that underwent a laparoscopic procedure may experience significant pain. Laparoscopic surgery is supposed to be less painful, but this simply isn’t a blank check guarantee. In the end, your experiences may be drastically different than the so-called “norm.”

 

TIMELINE OF RECOVERY

 

Day One through Four

The patient should not be engaging in any activities that are too physically stressful. In fact, only basic functions should be engaged in so soon after the operation; these may include light shopping not requiring too much walking, getting around the house, eating, showering, etc. Expect to be off from school or work for a few days so you can give your body adequate time to heal. You will experience mild to moderate pain which may require prescription-strength painkillers.

Day Four through Seven

Many people may be able to return to school or work by day four. Because your body is still healing, don’t lift anything heavier than 10 pounds. If you do return to school or work, make sure that you limit yourself to 50% or less of what you are generally expected to do, including any walking, physical exertion, etc. By this time, you should be able to engage in any activity that doesn’t burden excessively or require you to lift too much weight. You may still experience pain requiring OTC painkillers (Ibuprofen, Acetaminophen, etc.). You may (and, in fact, should) engage in light exercises, such as short-distance walking, simple stretching, etc.

By the 2nd Week

You should be able to return to your job or school, though some precautions may still apply, including not lifting in excess of 20 pounds. Expect to be at a 75% level of your usual self. Exercises you may consider include biking, jogging, Pilates, yoga. Even though a whole week has gone by, you may still feel some soreness & stiffness, discomfort, and some occasional pain; you should be able to treat these light symptoms with OTC painkillers.

By the 3rd Week

You should have been able to return to your school or job responsibilities by this time, although some mild restrictions may still apply, including not lifting more than 20 pounds. You should be at about 85% of your usual capacity.  Exercising may increase in quantity and intensity and may include cycling, running, Pilates, yoga, surfing, swimming, golf, tennis, and limited weight lifting (no more than 20 pounds). You should no longer need painkillers.

By the 4th Week

Most patients will have by now returned to their school and work responsibilities without any lifting restrictions. You should be about 95% of your usual self; you may expect to be at 100% within a few days or weeks, depending on your age, how quickly you usually heal, and whether you were healthy before the operation. In most cases, patients can return to their normal schedule of physical activities, including heavy lifting, contact sports, and full competition/training.

Even this far into the healing process, you may have lingering sensations, including some tugging, pulling, burning, aches, swelling, heaviness, sharp pain now and then, and the occasional discomfort—this is normal for most postoperative hernia patients. You should see a gradual, consistent reduction of these intermittent symptoms as time goes on; if this isn’t the case, talk to your doctor.

 

POST-OPERATION EXPECTATIONS

This is what you should normally expect after undergoing hernia surgery:

Sexual Activities

You will find that whether you can engage in sexual activities without experiencing too much pain is a good way to gauge how quickly you are healing. Your ability to return to such activities should be on par with your returning to work or school schedule. In other words, there is a gradual recovery gradient to go through that may also be expressed in terms of percentages not dissimilar to those given in the recovery timetable given above.

Just as you had to wait before you were ready for school, work and exercise, you may have to wait a reasonable amount of time before returning to pain-free regular sexual functions.

Constipation & Avoiding Straining

Some of the medications commonly taken for pain/discomfort following surgery may induce constipation; in fact, if you aren’t used to taking pain medicine on a regular basis, you may be especially vulnerable to side-effects and unusual reactions.

For many patients, the use of a stool softener (e.g., Colace) may be in order as a proactive measure. In fact, you might start doing so on the day of surgery, thereafter continuing to take such until normal bowel movement returns.

General Activities

If you were subjected to general anesthesia during the operation, your reasoning and motor skills will, of course, be off for a short while after the operation. As a matter of fact, for the next 48 hours, until all your faculties return to normal, avoid operating any kind of sophisticated machinery, consuming alcohol or signing any legal documents.

You should be able to perform most simple activities within a week after the operation. You may even return to school or work after the first week of healing. Keep in mind, though, that some people may need additional time for recuperating, especially if your job is physically demanding.

You will be instructed to avoid heavy-duty exercising but keep in mind that exercise can help the healing process, as long as it isn’t too strenuous. That may include sex, which you may resume as soon as doing so isn’t too painful.

Driving Ability

Consult with your doctor regarding when it would be okay to resume driving. One way to gauge whether you are ready to drive is to determine if you can safely and quickly react to an unexpected situation, such as your having to stop suddenly or swerve.

You are not ready to drive if you are still even slightly groggy from the anesthesia or painkillers or if driving is too painful to do. Although people heal at different rates, don’t be surprised if you may have to wait a week or two before you are fully ready to drive a vehicle safely and with the same ability you enjoyed before the operation.

You might also contact your insurance agent to see what restrictions (if any) are imposed by the insurance carrier for people undergoing surgery.

Activities You May Perform Soon After Surgery

–You may resume a normal diet soon after surgery, depending on how you feel.

–On the same evening after surgery you should be able to walk, stand or climb stairs, though you may feel discomfort at doing so.

–On the day following surgery, you may take a shower, though bathing and swimming should be off-limits for at least 5 days.

–On the day following surgery, you may, if you want to and feel up to it, do limited-scope exercises, including walking and using a treadmill or stationary bike. Of course, more intense exercising should be avoided until at least 2 weeks after the operation, preferably when the pain/discomfort is no longer a major issue.

–Some patients can go back to work and/or school after 3 to 7 days.

–Report any unusual circumstances (anything that wasn’t mentioned as something you should expect) to your doctor ASAP after surgery. Make sure that you follow recommendations as to when to report back to the surgeon for a follow-up.

–Although laparoscopic surgery patients generally recover sooner and faster than open surgery patients, you should nevertheless allow approximately 3 weeks to get back on track in terms of normal routines.

Possible Post-Operation Complications

Do contact your surgeon/doctor, if any of the following symptoms emerge after an operation:

  • Any kind of bleeding
  • A fever that persists
  • Increasing pain or swelling near the incision site
  • Any pain you can’t control with OTC painkillers
  • Ongoing vomiting or nausea
  • Chills
  • Persistent shortness of breath or coughing
  • On-going redness around the incision
  • Urinating with any difficulty

THIS IS THE BEST DIET IF YOU STRUGGLE WITH SILENT ACID REFLUX

Acid reflux is one of the most common reasons why my patients visit me in my office in Michigan. Recent statistics from the American College of Gastroenterology say that 60 million Americans experience heartburn at least once a month, with 15 million having symptoms of acid reflux or GERD every single day. (5) There’s a certain type of reflux that is referred to as “silent” reflux because those who have it don’t show the typical symptoms of acid reflux, such as heartburn. Silent Acid Reflux or Laryngopharyngeal reflux (LPR) is a condition that happens when acid from the stomach travels up the esophagus all the way to the laryngopharynx in the throat. It is commonly seen in GERD patients but may occur on its own without GERD.

Symptoms of LPR include:

  • The sensation of a lump in the throat
  • Need to clear the throat frequently
  • Mild hoarseness
  • Mucus
  • A chronic cough
  • Difficulty swallowing
  • A sore throat
  • Red or swollen voice box

WHO IS MOST LIKELY TO DEVELOP SILENT REFLUX?

Anyone can develop silent reflux, including men, women, infants, and children. There are some lifestyle factors that may make adults more susceptible, including:

  • Poor diet (lots of acidic and spicy foods, too much caffeine)
  • Overeating
  • Alcohol and tobacco abuse

In infants and children, LPR can develop due to the developmental immaturity of the esophagus.

THE BEST DIET TO HELP ALLEVIATE SYMPTOMS OF LPR/SILENT REFLUX

Research has shown that diet plays an important role in managing silent reflux. A study published in the Journal of the American Medical Association Otolaryngology found that a Mediterranean diet may be as effective as proton pump inhibitors (PPIs) in treating symptoms of acid reflux. (1,2) I am not suggesting you forgo all medication and attempt to treat your symptoms with diet alone unless advised by your doctor. Drug-free treatment may not be suitable for everyone. I am saying this: food is medicine. And what you put into your body every day plays a massive role in the condition of your health.

WHAT IS A MEDITERRANEAN DIET?

The Mediterranean Diet comes historically from the eating habits and lifestyle of those living in southern Italy, Greece, Turkey, and Spain. The diet consists of lots of high-fiber fruits and vegetables, quality fats and proteins, and an occasional glass of wine. Due to its many proven health benefits including reducing inflammation, supporting healthy weight, improving heart health and reducing disease risk, the Mediterranean Diet is considered one of the healthiest cultural diets in the world. (4)

FOODS INCLUDED IN THE MEDITERRANEAN DIET

The most common, day-to-day foods of the Mediterranean diet include:

  • fresh fruits and vegetables (leafy greens, eggplant, cauliflower, artichokes, tomatoes)
  • olive oil
  • nuts and seeds (almonds, sesame seeds)
  • legumes and beans (lentils, chickpeas)
  • herbs and spices (oregano, fennel, rosemary, parsley)
  • whole grains
  • wild-caught fish/seafood
  • pasture-raised chicken and eggs
  • goats milk
  • fresh water
  •  red wine

Some foods moderately consumed include:  

  • red meat (once weekly)
  • coffee
  • tea
  • kefir and yogurt

How To Choose High-Quality Olive Oil

Much of the research surrounding the benefits of the Mediterranean diet focuses on the consumption of olive oil. Olives have been a staple item in the Mediterranean region for over 5000 years, and those living there consume olive oil as a part of nearly every meal. Not all olive oil is created equally, however, and many of the “olive oil” brands you see on store shelves are fake imitations or devoid of their original nutrients. Always pick the olive oil that is cold-pressed and extra-virgin.

PARTHA’S PRESCRIPTIONS FOR SILENT REFLUX

  1. Eat More Fiber. Fill your diet with plenty of fresh fruits and vegetables. A 2004 study found that dietary fiber is protective against reflux. (3  ) Fiber also helps to promote regularity of bowel movements and improves digestive health. Daily, women should aim to consume at least 25 grams of fiber and men, 38 grams.
  2. Eat Small Meals Every 3-4 Hours. Overeating can aggravate symptoms of reflux because it puts a lot of pressure on the stomach and can push acid up into the esophagus. This is why I recommend eating smaller meals several times a day instead of traditional large meals.
  3. Limit Sugar Intake. Most Americans are eating way too much sugar. This leads to weight gain and obesity which in turn increase the likelihood of developing silent reflux. The American Heart Association recommends women eat no more than 20 grams of sugar and men eat no more than 36 grams.
  4. Limit caffeine and spicy foods. Caffeine relaxes the esophagus, making it easier for acid to travel up from the stomach and cause reflux symptoms. Spicy foods tend to irritate the esophagus and have found in many studies to exasperate heartburn.

CONCLUSION

If you’ve made changes in your diet and lifestyle but have yet to feel better, it may be time to consult with your doctor. Silent Reflux can often be a symptom of a more serious condition like GERD. Working together with a healthcare professional will help you make the best decisions for your unique health needs.

References

  1. http://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2652893
  2. https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-09-11-could-a-mediterranean-diet-be-as-good-as-drugs-for-acid-reflux/
  3. https://www.ncbi.nlm.nih.gov/pubmed/15542505/
  4. https://www.nhs.uk/Livewell/Goodfood/Pages/what-is-a-Mediterranean-diet.aspx
  5. http://abcnews.go.com/Health/acid-reflux-rise-study-finds/story?id=15208938

I Thought I Was Depressed But It Turns Out I am Bipolar

“Maybe you’re just feeling better,” my psychiatrist said, “because something good has happened in your life.” He was the only psychiatrist who was open on a Saturday and covered by my insurance plan, provided by a job I couldn’t stand.

I pondered this as I stared out the window on a dull, gray February afternoon in Queens. The monotony of my desk job hadn’t changed in the nearly two years I’d been there, except that I was barely making deadlines because I couldn’t focus. My personal life was the same—still solid with my long-term boyfriend, but nothing particularly life-changing going on. I saw my friends regularly, and my family was good. Which is to say: Things were fine, but nothing that great was happening—at least, nothing to elicit days’ worth of feeling euphoric, barely sleeping, being hyper-creative, and starting a million projects I knew in the back of my mind was never going to get done. I would later find out that this was a form of mania. My psychiatrist at the time, however, didn’t believe me when I explained the symptoms.

“Why don’t I keep you on the same dosage of Wellbutrin, and you come back in a month to see how you feel?” I took the paper prescription and headed out of the office, knowing the “crazy-sexy-skinny pill” wasn’t going to be the answer to my problems. I would eventually be diagnosed with bipolar II—a milder yet more confusing form of bipolar disorder. But it would take some frustrating trial-and-error to get there.

“Bipolar I is anyone who’s had a full-blown mania, and you only need one [manic phase] to meet those criteria. Bipolar II is the people who’ve never had a full mania, but have had mild manias called hypomanias,” psychiatrist Michael Gitlin, professor of clinical psychiatry at the UCLA School of Medicine, explains. People with full-blown mania experience what he calls significant functional impairment. “They’ve done damage to their life because of the mania: getting arrested, getting fired, ruining a long-term relationship, pissing away life savings, getting hospitalized, being psychotic. Anyone of those will make you manic, not hypomanic.” Hypomania, on the other hand, isn’t as life destructive but is still accompanied by racing thoughts, an increase in energy, and feelings of grandiosity.

While the manic phases in bipolar I and bipolar II are different, the depression is equally severe. People with bipolar disorder are depressed most of the time. Some people have manic phases frequently, while others only have a few in a lifetime and may not experience mania until later in life. This is why it’s so often overlooked and misdiagnosed.

I was first diagnosed with depression during my freshman year of high school. I went from being a straight-A honor student to barely pulling in Cs and Ds. When I wasn’t in school, I was in my room sleeping, ignoring my homework. I would pack my lunch, only to toss it in the trash once I got to the cafeteria. I lost 20 pounds. There was nothing to be depressed about, which was the most frustrating part: I had the typical privileged white upper-middle-class upbringing, with a loving family and vacations and a nice home on a golf course. The more I reflected on this, the worse I felt; it would have been easier to pin my depression on childhood trauma. People who say things like “happiness is a choice” have never known what it’s like to be trapped in the prison of your own mind, ashamed of simply existing and believing you don’t deserve to live to see another day.

When my parents scolded me one day for not focusing on my schoolwork, I finally broke down into uncontrollable sobs. “I don’t see the point of doing homework,” I choked out through tears, “because I don’t see the point in living. Every day, I want to die.” It sounds like something any melodramatic teenage girl would say, but I meant it. I spent each day trudging through a dark fog, thinking about how I could hang myself from the second-story banister in our foyer without traumatizing my parents. Luckily, they believed me and made an appointment with the nearby children’s hospital. I would spend the next few months visiting a rotation of a psychologist, adolescent physician, and registered dietitian trying to treat my various mental illnesses with Zoloft—which increased in dosage every few weeks—and a meal plan.

With psychotherapy, medication, and a healthy diet, I seemed to be doing well. So well that I took myself off the medication and therapy cold turkey before my senior year. That’s the funny thing about antidepressants: When they’re doing their job and making you feel better, it tricks your brain into thinking you don’t need them anymore.

Over the next ten years, I naively thought I could treat my “mood swings” with good old-fashioned diet and exercise, no matter how bad they got. Despite my years trying to ignore it, my depression and its dear friend, suicidal ideation, started hounding me worse than ever after I moved to New York. Instead of a rope and a noose, New York brought its own set of suicide opportunities: I could wait until the subway came barreling through a station and toss myself off the platform like a used tissue flung towards a wastebasket. Or, in a landscape of towering skyscrapers, ride an elevator to the top floor, seek an open roof deck, and jump.

Every once in a while, through my dark depression, I would emerge to find myself light, happy, and extra motivated. As a creative person, I welcomed these surges of energy. I would be flooded with dozens of brilliant new ideas: an outline for a book, a new blog I must launch, or an article that would be just perfect for a magazine feature. I would ride this wave of creativity, typing diligently away on my laptop for hours, trying to jot down the words as fast as they came to my brain. I could survive on little sleep and would wake up feeling excited to take on the day, despite my racing thoughts. It was a welcome reprieve from the heavy cloud I was normally under. This is what a hypomanic episode looked like for me.

“Hypomanic people by definition are not causing major damage in their life,” Gitlin says. “In fact, they usually feel terrific. They’re more productive than usual, they sleep a little less, they have more energy. They and lots of people around them would say, ‘Gee, they’re doing great. There’s nothing wrong with them.’ It’s only later in retrospect that we realize that they actually have hypomanias.”

Under Wellbutrin’s influence, I stayed up until 4 AM one night completing projects for my apartment. I DIY’d a chalkboard frame, painted a new tray for our coffee table, backed up all the files from my laptop to an external hard drive, and organized all the shoes in my closet, carefully labeled with washi tape and a Sharpie marker. It was the most productive I had been in ages.

I was also more emotional than ever. As someone who has struggled with anxiety since her first depression diagnosis, I found myself routinely overcome with unexplained feelings of nervousness, sometimes with my heart beating so fast, I thought I was having a heart attack. Other times, I would be so angry and irritable, I would lash out at my live-in boyfriend. “Why would you throw those ripe bananas away when you know I like to freeze them for my smoothies?” I screamed one evening, my blood boiling in my veins and surging to my head. For someone who used to be so laid-back and even-keeled, this felt like an out-of-body experience. Turns out, manic stages can also manifest themselves as feelings of irritability instead of grandiosity.

So I found another psychologist covered under my insurance and snuck away to his office on the Upper West Side during my lunch break. After explaining my symptoms of both depression and what I thought was mania (thanks to Dr. Google) during the patient intake, he asked what the most irrational thing I had done was. I knew my form of mania was more subdued (i.e. typing on my laptop all hours of the night instead of, say, draining my bank account and going on a shopping spree), and my previous psychiatrist didn’t take me seriously, so I took some creative liberties.

“Umm, sometimes I spend a lot of money I don’t have.” True, I haven’t always been the most financially-savvy person, but it was a gross exaggeration. I don’t think to spend $100 at Target counts as a mania-fueled shopping bender. Regardless, he bought it. He prescribed me Equetro, an anticonvulsant used to treat seizures and bipolar disorder. When treating bipolar patients, Equetro is usually paired with something else, such as an antidepressant. My doctor said to come back in a couple weeks to see how I was doing on the medication and if we needed to combine it with another prescription.

We never got that far. He didn’t have a receptionist, so there was no one to take my calls to schedule a follow-up appointment, and he wasn’t returning my voicemails. Meanwhile, taking Equetro felt like I was shot with a horse tranquilizer (or, what I imagine being shot with a horse tranquilizer feels like). I was constantly tired, and my depression was worse. Every morning when I woke up, I felt like I had been hit by a truck. I had to literally peel myself out of bed, barely making it through brushing my teeth and dry shampooing my hair before slogging towards the subway. It’s not safe to take yourself off medication without a doctor’s permission, but I couldn’t spend one more day of feeling like a zombie.

It took seeing yet another psychiatrist, whose office was filled with woodland fairy-inspired trinkets and signs emblazoned with phrases like Life isn’t about waiting for the storm to pass; it’s about learning to dance in the rain to arrive at the diagnosis of a milder form of bipolar disorder. She seemed to believe me when I explained my hypomanic symptoms and prescribed me Latuda. Latuda is used to treat bipolar depression, which is different than unipolar depression, or what people normally think of as standard depression.

“If you have either one manic or one hypomanic episode in your life and you have depression, then you have bipolar depression,” Gitlin explains. “You can have a bipolar I depression and you can have a bipolar II depression.”

Although I was doing all right on Latuda, I wasn’t taking anything to address the mania and irritability. I was able to focus at work and get up in the morning after a good night’s sleep feeling refreshed, but the side effects weren’t great. My doctor instructed me to take Latuda at night with at least 350 calories, so I popped one in with dinner; eating another heavy snack before bed wasn’t ideal for someone who has always struggled with her weight and had to count calories diligently.

Within an hour of taking it, I would get a weird sense of foreboding and dread, like I couldn’t even fathom brushing my teeth or washing my face. This isn’t that uncommon of a symptom, according to drug forums I read. Then, it would knock me out. I felt all right during the day, but my bedtime routine felt like torture, and I couldn’t take my medication if I knew I had plans during the evening. (Hint: When prescribed medication for mental illness, don’t skip doses).

About a year and a half after my first Wellbutrin experience, I finally visited the last remaining psychiatrist on ZocDoc who was covered under my insurance and had manageable office hours. He believed me when I described the depression, the random bouts of energy, and the irritability. He kept the Latuda but coupled it with another mood stabilizer. I would take one of each before bed. After a few weeks, I was starting to notice a major difference. I hate to say I was feeling like “myself” because in my life before depression I was still a kid, but it was the closest I had ever felt to normal.

My journey to a proper diagnosis is not at all uncommon. Aside from the lack of access to proper care, even under insurance coverage (which is a whole other issue), bipolar disorder itself is still widely misunderstood and murky to diagnose.

“Most people with bipolar disorder have depression before they have a first hypomania or mania. In that case, you can say, ‘Well, they were misdiagnosed,’ but there was no reason to know that they have bipolar disorder. They haven’t had their first episode yet,” Gitlin explains. “Hypomania is very easy to miss and since people tend to have a first depression before they have a first mania or hypomania, a lot of those people will emerge into bipolar disorder, but in fact, at the time that happened there was no reason to know that.”

Bipolar disorder may not present itself until later in life—after all, it only takes one manic phase to technically be diagnosed—and is usually brought on by a major life change: the loss of a loved one, the end of a relationship, a new baby, and subsequent lack of sleep. For me, that was moving from a small town in Southern Illinois to the biggest city in the US, jobless, and with no money. And it shouldn’t be all that surprising; mental illness runs in my family and can be traced back to at least my great-grandparents on my mom’s side.

I’ve reconciled the notion that mental illness is a chronic condition that needs a constant course of treatment, including lifestyle changes, to stay healthy. For me, that means the proper combination of medications, a healthy diet, regular exercise, and sleep. If I slack on my workouts or get less than six hours of sleep a night, extreme irritability or a slippery slope into a dark depression are sure to follow. Although psychotherapy is also highly recommended, I’m still trying to find a therapist under my insurance who keeps atypical office hours. (Note: Bipolar disorder is covered under the Americans with Disabilities Act, but explaining to your employer that you need at least an hour off every week for therapy still feels embarrassing and self-indulgent).

People with bipolar disorder are also warned to stay away from heavy alcohol use, which is difficult for someone like me, whose entire social life revolves around drinking on the weekends.

“I don’t care if people have a drink, but excessive alcohol use is going to be problematic on a variety of levels for people with mood disorders,” Gitlin says. “It [makes] you disinhibited, so whatever you’re doing, you’re going to do more of and unwisely. Secondly, high dose alcohol is a depressant.” Trust me, I’m working on cutting back.

Accepting the label of bipolar II is more difficult than depression was, but it’s a relief to pinpoint an explanation for my weird hodgepodge of symptoms. Treatment also doesn’t mean the symptoms of your illness go away completely. I still have days where I’m depressed, or can’t focus, or irritable for no reason. And there’s always the fear that I’ll never be as creative as I was during my hypomanic phases, although I’d gladly trade being uninspired for feeling like an out-of-control crazy person.

My current combination of prescriptions also may not work for me forever. Gitlin says it’s common for patients to change medications and dosages several times throughout treatment. But for now, it’s working, and that’s something to be thankful for.

7 Things You Need To Know About A Narcissist

“Inflated sense of self…”

“excessive or erotic interest in oneself and one’s physical appearance…”

“extreme selfishness…”

“grandiose views of one’s own talents and a craving for admirations…””

“self-centeredness arising from failure to distinguish the self from external objects….in either babies or as a feature of mental disorder…”

Congratulations! By reading though these snippets of personality traits attempting to define narcissism, you have a good sense of nearly every affective, narcissistic symptom!

In reality, more narcissists exist than we may believe. Consider this statistic: it is estimated that over 6% of the population suffers from a narcissistic personality disorder (NPD). It is important to distinguish between traits of narcissism and the actual disorder as defined by mental health experts.

Many people, from time-to-time, may exhibit some type of narcissism. However, constant display of five or more of these behaviors is a strong indication of NPD:

– Frequently showing arrogant attitudes and/or behaviors.

– Consistent displays of envy whilst believing everyone else in envious of them.

– Lack of empathy.

– Using exploitative techniques against others for personal gain.

– Incessant need for attention and/or praise.

– Believes themselves to be in a “higher class,” often only associating with those similar.

– Fantasizes about fame, wealth, beauty, power and success.

– Grandiose beliefs pertaining to self-importance.

– Exaggerates upon their successes and talents.

Now that you’ve got a good understanding of narcissism, here are 7 other things you should know. 

7 THINGS YOU NEED TO KNOW ABOUT NARCISSISTS

1. THE CAUSES OF NARCISSISM ARE UNKNOWN

Narcissism is considered an enigmatic condition by medical professionals, in that the root cause(s) are unknown. The consensus, if one can indeed call it such, is that narcissism may arise from some combination of environmental and genetic factors. Maladjustment – the inability to “fit in” to traditional social circles – is generally considered to be a contributor, and is often observable from an early age.

2. NARCISSISTS CAN BE NEARLY UNDETECTABLE

Many narcissists are clever folk in that they disguise themselves very well. First off, narcissists don’t often exhibit traditional signs of ‘mental illness’ in the traditional sense. In fact, a narcissist may appear to be gregarious, outgoing and charming – all desirable traits to have in a friend or acquaintance. However, it may become apparent that something may appear to be “off” due to their inflated sense of self-importance and an insatiable need for attention. However, a clever narcissist is often quickly able to dispel any notion of emotional or psychological imbalance.

3. NARCISSISM MAY BE ON THE RISE

According to research, there are increasing numbers of narcissists among us. Social scientists and other experts state that over 9% of 20- to 29-year olds exhibit traits of extreme narcissism, as opposed to just over 3% of people over the age of 65. These disproportionate numbers have led some to conclude that society’s penchant for narcissistic behavior is on the rise. What is to blame for this increasing trend? Some point to our fascination with social media, selfies, and consumerism.

4. TREATING NARCISSISM IS EXTREMELY DIFFICULT

Narcissistic disorders cannot be treated in the traditional medical sense. There is no regimen of pills or other scientific means of curing someone of narcissism. To complicate matters, most narcissists do not believe there is anything “wrong” with them; quite the contrary, actually – narcissists have an innate sense of superiority. In other words, everyone else is wrong and, quite possibly, jealous. Uh-huh.

5. NARCISSISTS CAN BE FOUND OUT

While some narcissists can slip by undetected, there indeed are ways of discovering if someone is indeed narcissistic. One way to do this is to simply attempt to have a conversation with them. Narcissists are notorious for attempting to dominate conversation. They love to talk (usually about themselves), but hate to listen; they generally don’t care much for other people’s problems, opinions or observations.

Also, narcissists almost always display some degree of manipulation. They’ll twist words, facts and situations to make themselves appear better to everyone else, often at the expense of others. Additionally, they often won’t follow through the generally-understood social contract: most of us will be accommodating and display some semblance of selflessness, while narcissists almost never display such nobility.

6. LOVING A NARCISSIST IS VERY DIFFICULT

It goes without saying, but having a narcissist as a family member is extremely difficult on those that unconditionally love and care for the person. Narcissists are very taxing on other people’s emotions, particularly for people that are close to them. As such, it may be wise – in order to save themselves from continual pain – to remain “close yet distant.” This can be extremely hard to do, as narcissists are master manipulators – often playing on others emotions to garner sympathy and support when, in fact, they are not deserving of such.

7. NARCISSISTS ARE PEOPLE TOO

The vast majority of people reading this article are kind, selfless and sympathetic to others. We will almost always give people “the benefit of the doubt” and forgive them of their innate flaws. Simply put: we value the sacredness of human life. As such, while it may be tempting to completely disavow a narcissist, it is important to remember that they are human beings as well. Do we need to interact with them? No. Do we need to appease them? Absolutely not. But, at the same time, we can at least “do no harm” while still standing our ground against their attempts at deception.

When Myasthenia Gravis Changes Your Sense of Purpose

Having a sense of purpose is innate to the human experience. It gives us direction, satisfaction, and motivation in the present as we build for our future. Purpose drives innovation, invigorates passion, and stirs the embers of better days ahead. Just as it breathes life into every day, a lack of purpose stagnates hope and squelches the ability to reach beyond ourselves into something bigger than what we imagine — a legacy that will last long after we are gone. 

Myasthenia gravis is a quiet, determined thief. It has a knack for finding a way into our lives in the most unexpected ways. We wait for medications and the skill to tame it, and we fight relentlessly to repeatedly sculpt and rebuild a new life despite the relentless changes. But myasthenia gravis returns and rearranges the new life that we have made, seeking to subdue our breathless wonder of tomorrow. 

Each day is like a quiet echo of itself, brimming with the hope of purpose while grieving a lack of it. Days spill into each other, passing in the shadow of what once was and what we wish them to be once again. 

I listen to the sounds of life and laughter surrounding me, which clash with the quiet frustration of restless rest. I struggle mightily against the endless days relegated to unavoidable rest, my bed a close companion, and I am thrilled when I’m able to accomplish something again, even if just for a little while. It feels so good to the human spirit to be able to accomplish and do things; to find purpose in our days, which is as vital a medication as any we could ever consume. 

MG has taught me that my body is master to none. We listen to the counsel of others as they discuss how we must find our new normals, but they don’t speak to the longevity of lives that must be continually remade. No one talks about the ever-present, albeit silent, the standard of maintaining a productive and full life in spite of our diseases, or how our lack of productivity can become a sense of sorrowful purposelessness. We are, after all, taught to value and esteem the busy and fruitful individual, inherently making busyness and purpose mutually inclusive, and in the process, we forget the very nature of human value along the way. 

What gives us value? What makes us feel as though we have accomplished something, done well, and been good, contributing members of society — members who are esteemed and considered worthy? And why do we struggle so mightily under the weight of self and familial or social recrimination over the changes in our purpose, caused by MG? 

For me (and I suspect for many others), it’s a clash between the very human and normal call to find purpose within our passions, work, relationships, ability to earn, raise families, and care for our homes, and the very real need to refocus how we think about our purpose and where that purpose can now be found. MG changes every dynamic of how we relate to the world, and those transformations can be infinitesimal or wholly life-changing. It also alters where and how we find our purpose.

A very dear and wise friend shared with me recently how her daughter reminded her anew that her value and purpose were not tied to her accomplishments or contributions. She related how her child was fully dependent on her for everything while contributing very little to the lion’s share of adult responsibilities in daily living. Yet, her daughter’s life and presence held irreplaceable value and purpose simply by being who she is. And so, too, do our lives retain unconditional purpose and value, regardless of the changes wrought by MG. 

What I Mean When I Say ‘I Have Anxiety’

For most people I talk to, when I tell them I have an anxiety disorder, they nod their head and tell me it’ll be okay. When I tell them, “I’m sorry, I’m having a bad anxiety day, can we reschedule?” They smile and tell me there’s nothing to worry about and if I just get out of bed, I’ll see that everything is fine. When I don’t want to go bar hopping because I know that alcohol only increases the anxious tendencies I hear, “You’re fine. It’ll be fun. Let off some steam!”

Meanwhile, my heart is pounding so fast that I’m afraid it may be visibly beating out of my chest. But it isn’t. My head isn’t actually spinning in circles. My eyes are not crossed like my blurred vision indicates. My knees aren’t wobbling along with the trembling muscles fighting the urge to collapse. My face isn’t pale and my eyes aren’t bloodshot. No, on the outside, I look like I do every day. My hair is clean. My clothes match. I am awake, alive and breathing fine. So nothing is wrong, right?

Wrong.

That’s the thing about anxiety disorders. We look fine. Of course, we look fine. Our legs aren’t broken. Our tongues haven’t been cut out. We aren’t cut or bruised. Because anxiety is not a physical disability. That, however, does not make it any less debilitating.

Anxiety is a complex disorder and it is nothing to simply smile and nod away. You telling us everything is okay not only doesn’t help us, but it hurts us more because nobody seems to take it seriously.

So here are some things I would like you to know about struggling with anxiety.

It is not constant.

There are days when I can make it through without having to stop and breathe or pop a Xanax. I can smile and laugh. I can be productive and go to work, go out to dinner, go see a movie with my friends. And trust me, I know how difficult it is to understand how I can be fine one day and the next, not be able to get out of bed. That’s just how it is.

Which leads me to my next point:

It comes in waves.

Anxiety is a strange beast. It will let me have some fun for a couple of days and I think, hmm maybe it’s finally left me alone. Then a few days go by, and I wake up one morning unable to even think straight because for whatever reason, the beast has once again emerged and there is nothing I can do to stop it from coming because I have woken up to it sitting on my chest smiling as if I’m welcoming it home.

It can be completely paralyzing.

I don’t know if this one applies to everyone, but I know it is a very big piece of my anxiety disorder. When anxiety hits, I am frozen. I can get up and go through the motions of my day but my brain is elsewhere, held captive by whatever “demon” is inhabiting me this time. I cannot think about anything except for my inability to think or breathe or feel. Let that one sink in. My brain feels like it is literally paralyzed as if it is stuck in some kind of limbo with no doors or windows or exits of any kind.

The worst part? I’m completely alone in there.

It can ruin relationships.

Not just romantic relationships, but a relationship of any kind. Friendships and relationships alike can be destroyed by this condition. I have experienced both, and it is the most devastating kind of loss. Why? Because it is not our fault.

It is a disorder that, without the knowledge of how to care for it properly, can explode over time. Eventually, it can become too much for someone else to carry around with them. If they become close enough to you to experience firsthand the effects of your anxiety, it can become too much for them and they might sever the ties for their own mental health. And it hurts like hell.

But I can’t blame them because if I could choose to stay as far away from anxiety as they can, I would in a heartbeat.

It can make trust nearly impossible.

I know it sounds awful to blame trust issues on anxiety but in all honesty, it’s not placing blame, it’s placing responsibility. Anxiety almost never fails to make you think the worst of every situation.

If someone doesn’t answer my text, well then that’s it, they no longer like me. If someone doesn’t text me first, they don’t think about me. Someone is busy? Forget it. They just have better things to do with their time than spend it with me. I sound ridiculous, right? Welcome to the anxiety life. We do not have cookies, sorry, but can I interest you in crippling loneliness at a table for one? No? Didn’t think so.

do not want this.

Do you really think that if I had a choice I would choose to let down the people who love me because I can’t handle a simple outing? Do you think that I want to be so afraid to get out of bed that, instead I call out of work and cry to Grey’s Anatomy for 13 hours in a row? Probably not. Would you choose that? Doubtful.

So when you tell us that we’re being dramatic and just looking for attention, take a second and think about what you’re saying to us. Nobody, I repeat nobody, wants this.

I wish every day that I wasn’t like this.

Not a day goes by that I don’t have that little voice in the back of my head telling me just how great my life could be if I wasn’t this way. If I could just not have anxiety, everything would be okay. I could actually be happy and trust that the happiness was not a joke or a trick; that the other shoe was not, in fact, ever going to drop. There is no other shoe. But that’s not how I am.

To me, no matter how many times I tell myself that everything is okay and I’m being ridiculous, nothing is ever just “alright.” In fact, even the smallest things are a disaster.

There are treatments, and I am willing to try them all.

Many people who are diagnosed with anxiety are prescribed medication control it. Most of the time, it works to take the edge off and can make me a bit more functional in everyday life. However, simply using medications usually isn’t enough.

I have tried going to the gym. The endorphins usually help immensely. A lot of people take up yoga and breathing exercises. Those are supposed to help, I haven’t tried them yet but they are next on the list.

I do a lot of things that make me happy. For me, writing, singing, and coloring in my adult coloring books are very comforting. In addition to all of these things, I have found talk therapy to be the greatest tool and worth every penny. Having a therapist who is constantly on your side and there to just let you talk without ever once judging you or blaming you for the condition you’re in is the such a freeing experience. I highly suggest it to anyone struggling with anxiety.

will overcome it.

But it will take time. Fighting anxiety can be a never-ending battle with frequent slip-ups and breakdowns along the way. I am still in the process personally, and it is not easy. At all. This is by far the hardest thing I have ever had to do in my entire life. And I have been through a lot. Anxiety, however, takes the cake.

Learning how to overcome anxiety is the most difficult task anyone has ever asked me to complete. But these thoughts, the ones that are not truly mine, feel like poison to my soul. But on those days when I can mark a check in the win category, I feel like I can take on the world. I want every day to feel that way, and I won’t stop until every day does.

So here’s the thing: Anxiety can be pretty heavy and scary stuff. It is not a visible injury, but that doesn’t make it any less legitimate. We need people in our lives who are willing to help us and support us and understand that we need a lot of that help and support. I don’t think any less of you if you don’t think you can handle the commitment of being a part of my life, but I do ask that you do not get my hopes up and let me down.

So when I say “I have anxiety” here’s what I really mean. Treat me nicely. Be patient with me. Support me. Know that everything I do, I am thinking about how it affects you. I am fighting for control over my life every day, understand that. I am a handful, and I know it. I am not always easy to have in your life, but if you let me, I will always be there for you. I will never forget the way you held on when most people would let go.

When I say “I have anxiety,” I am both warnings you what you are in for and thanking you for choosing me anyway.

Understanding the Mind of Your Asperger’s Mate

“My 29-year-old wife was recently diagnosed with Asperger syndrome. This is all relatively new to me (although I have recognized some behavior that seemed rather odd to me over the 2 years we have been married). They say that Asperger syndrome is just ‘a different way of thinking’. How can I understand the way she thinks? I love her dearly, but we are definitely not on the same page much of the time!”
People Asperger’s and High-Functioning Autism have some deficits in the brain that cause problems in certain areas. For example, communication, focusing on “the real world” as opposed to becoming absorbed in their own thoughts and obsessions, learning appropriate social skills and responses, and understanding the thoughts and feelings of others. In addition, they are very literal in their interpretation of others’ conversations and have difficulty recognizing differences in speech tone, pitch, and accent that alter the meaning of what others’ say.
Non-verbal communication is particularly problematic in that these individuals have difficulty understanding the appropriate distance to stand from another person when talking, how to tell when someone does not want to listen any longer, and how to interpret facial expressions. Also, they tend to be highly aware of right and wrong – and will bluntly announce what is wrong. They often recognize the shortcomings of others, but not their own. Thus, some of their behavior seems rude or inappropriate (through no fault of their own, in most cases).
Most people on the autism spectrum need routine and predictability, which gives them a sense of safety. Change often causes anxiety, and too much change can lead to a meltdown or shutdown. Routines and predictability help these individuals remain calm.
Other interesting (and sometimes problematic) features of Asperger’s include the following:
  • “Aspies,” notice details, rather than the “whole” picture. The importance of the detail prevents them from understanding the bigger picture so instructions may get lost in their focus on a single detail.
  • They are not able to access their frontal cortex or prefrontal lobe efficiently, so they must call on social skills from their memories. If a particular social skill was not taught when they were younger, they won’t have it. Thus, imagination, conversation, and other people’s points of view cause great difficulty.
  • Anger in Aspies often occurs due to over-stimulation of the senses or a change in routine. It is often the only response they know. Anger-control presents problems because these individuals only see things in black and white, which can result in offensive behavior when they don’t get their own way or when they feel threatened or overwhelmed. Some Aspies bottle-up anger and turn it inward, never revealing where the trouble is.
  • One of the most difficult thinking patterns for people with Asperger’s is mind-blindness, which is the lack of ability to understand the emotions, feelings, motivations, and logic of others – and not care that they don’t understand! Therefore, they sometimes behave without regard to the welfare of others. The only way some Aspies will ever change their thinking or behavior is if it is in their own interest to do so. Even then, convincing them to change their mind may turn out to be an uphill battle.
But, so much for the “bad” news. People on the spectrum also have many positive qualities, for example, most are:
  • smart
  • respect authority
  • gentle and somewhat passive
  • especially talented in a particular area
  • amazingly loyal friends
  • able to adhere unvaryingly to routines
  • honest
  • perfectly capable of entertaining themselves
  • able to remember a lot of information and facts
  • able to notice fine details that others miss
…just to name a few.
Everyone has a mixed bag of strengths and weaknesses. People with Asperger’ are different – but they are not flawed. We need all different kinds of minds – including the Aspie mind. The way a person on the autism spectrum thinks should be viewed as a positive trait, which the rest of us can learn from. When our differences are embraced, the positives definitely outweigh the negatives.