I Spoke in Public!

Thank you Belmont High School for inviting me to speak on mental health

Thank you, Lianne Sauvage, for inviting me to share my mental health journey at Belmont High School’s Mental Health Assembly!

For my speech, I adapted content from My Bipolar Thoughts, my memoir work-in-progress. The speech was scheduled for 25 minutes!

Honored to speak in front an auditorium of Belmont HS students!
Honored to speak in front an auditorium of Belmont HS students!

I plan to refine these speaking notes and use them again for future speaking engagements:

My Mental Health Journey

Expectations

  • When my parents introduced me as a child, they always said, “Kitt is going to go to Harvard medical school and become a doctor when she grows up.”
  • High school, I aspired to become a brain surgeon. Total overachiever. Medical Explorer Scout. Emergency Medical Technician training. Active on campus. Drama geek. School newspaper. High GPA.
  • Applied to colleges with the highest acceptance rates into medical school.
    • Didn’t get into any of those schools.
    • Receiving rejection letter after rejection letter hit me hard.
    • I had always been told I could go to school anywhere I wanted and could do anything I wanted. Wrong.
    • Instead of attending an East Coast Ivy League school, I started my freshman year at UCLA as a biochemistry major.
  • Letter from UCLA saying I had to take remedial summer courses since my SAT scores totaled under 700.
    • Back in the 80’s the math portion totaled 800, the verbal portion 800. My math score alone was 720 (yes, I was once a math geek).
    • Apparently, the Educational Testing Service (ETS) incorrectly reported my scores to UCLA.
    • When I showed UCLA my SAT scores, not only did I not have to do remedial work, but I was eligible for College Honors, in which I became active as a freshman.

College Student

  • As a freshman at UCLA I fell into a deep depression,
    • believing that my parents, my sister, the whole world would be better off without me alive.
    • When I told my friends of my suicidal thoughts, they made me promise to get professional help.
    • I saw a UCLA psychologist whose cognitive therapy, which works on rewriting your thoughts, helped me with my suicidal thoughts.
    • Still, my underlying mental illness remained.
    • Very active on campus, I volunteered in UCLA Medical Center’s emergency room, participated in College Honors’ Social Committee (glorified party planner), and trained as a peer health counselor.
    • For all but my closest friends, I hid behind a mask of competency, social skills, and overachievement.
    • But I was miserable and wanted to get quit.
    • The August before my sophomore year I came down with mononucleosis and used that as an excuse to quit UCLA.
    • For the next year and a half, I visited family and friends, worked part-time, and attended community college part-time.
    • Then, I transferred to UC Berkeley as a legal studies major, an interdisciplinary program I loved.
  • During my junior year at Berkeley, symptoms of depression returned.
    • My mother was diagnosed with non-Hodgkin’s lymphoma. I was devastated to learn of my mother’s diagnosis. At the time, studies indicated a five-year prognosis, that she would die in five years. She’s still alive thirty-five years later thanks to clinical trials at UC rival USC Keck School of Medicine.
    • That same academic year, my maternal grandfather died. My grandfather always held a special place in my heart. He was a kindred spirit as a gifted orator (I’ve always loved the stage) and storyteller (here I am telling you my story). When he died, it hit me particularly hard. My mother’s family asked me to give his eulogy, which was a huge honor. In speaking at his memorial mass, I was carrying on his legacy.
  • On my way home from the funeral, as I was driving over the San Francisco Bay Bridge, I fell into a trance state.
    • I felt a tingling all over my body, an energy pushing out, and a warm cleansing energy replacing it. The fact that I was driving over a bridge at the time disturbed me. At the time it seemed safer to continue off the bridge than stop on the bridge in the middle of traffic.
    • Now, I see that experience as a euphoric state of hypomania. At the time, given my history of depression, I knew if I went to a mental health professional and described the experience, they would diagnose me with a mental illness. But I found the experience meaningful, as somehow related to my grandfather’s death, and did not want the meaning dismissed.

Working Adult

  • Having graduated from Berkeley as a legal studies major, my first profession was as a legal assistant in Los Angeles and San Francisco. Working twelve-hour days six days a week, I crashed after a year on the job. What looked like over-achievement was a symptom of unrecognized, undiagnosed hypomania that came with a steep cost – my mental health and stability.
  • After working two years as a legal assistant, I quit, took time off, and applied for graduate school in psychology. While in graduate school, I worked as an administrator at a battered women’s shelter and completed my field placement doing play therapy with severely emotionally disturbed children in day treatment.
  • I got my master’s in psychology and became a licensed therapist. I worked with pregnant and parenting teens and severely emotionally disturbed adolescents in residential and day treatment.
  • Though my career as a psychotherapist was short-lived, only five years from ages twenty-five to thirty, it influenced how I think about mental health. My understanding is colored by both my experience living with depression and bipolar disorder and treating others living with mental health issues.
  • At thirty, my grandmother died, a dear friend from high school died, and a client threatened to rape me during session. I had a complete major depressive breakdown and found myself unable to get up out of bed and return to work. For the first time, I sought medical help for depression, seeing my regular doctor and then a psychiatrist for medication. Up until then, I had managed my depression with psychotherapy alone.
  • Rapid changes in prescribed antidepressant medications triggered mania. I ended up spending a week awake, thinking simultaneously at rapid speed in binary with ones and zeroes streaming through my head like I was a computer, about chaos theory, and about mystic saints. At the time, I wished that there had been a way to record my thoughts, so later I could decipher them and see if any made sense.
  • Though I clearly had a manic episode, I was not diagnosed bipolar at the time. Those who knew me then find this fact shocking. Since the episode was likely precipitated by antidepressants, I was not prescribed a mood stabilizer. My psychiatrist prescribed a three-day regime of antipsychotics which stopped the racing thoughts in their track and allowed me to sleep, which I needed.
  • After the manic episode, I was unable to function on my own. I would fall asleep driving to my temporary job. When at work, I couldn’t even read. The words were all jumbled. I appeared competent. No one could see that I, a highly educated and articulate former professional woman, COULD NOT EVEN READ A SENTENCE.
  • To my parents’ home and care I returned. They were supportive and encouraged my recovery. While living with my them, I received psychiatric treatment and psychotherapy. My new psychiatrist carefully administered an antidepressant, slowly increasing my dose. I remained stable on a low dose of antidepressant for almost a decade.
  • Once I was up for it, I returned to work, starting as a temporary file clerk for a commercial real estate firm. What followed was a decade long career in commercial real estate. It was a welcome change, not emotionally draining as helping severely emotionally disturbed youth, and it used my analytic and problem-solving skills.
  • Still, I continued my pattern of overdoing it, working long hours and neglecting myself, leading to repeated burn out and cyclical depression. As a result, my résumé lists numerous short stints at various jobs — shooting high, crashing hard — time and again.
  • Soon after moving back home and starting work as a temporary file clerk, I met my future husband. Three years after we met, we married and later had a son. I found being home with an infant difficult. At the same time, I found being at work, away from him, heart-breaking.

Mother

  • Depression during pregnancy and after pregnancy poses risks to both the infant and the mother. With my doctor’s blessing, I took an antidepressant when I was pregnant and nursed my son.
  • After my son was born, I returned to the workplace part-time. My job consumed more and more of my time. I went from working two days a week to four days a week until 7PM. At that point, I decided to quit work and stay home with him.
  • Staying home with my son full-time lasted a year and a half. Then symptoms of hypomania returned. I thought that God was calling to one church for spiritual direction and another church for bible study. Though going to church wasn’t “bad” for me, I recognized the feeling of religious euphoria as hypomania.
  • To be a good mother to my son, I sought treatment for symptoms of bipolar. Finally, at the age of thirty-nine, I was diagnosed with bipolar disorder type 2.
  • Fearing that I was now an unfit mother, I proceeded to put my son in daycare and reenter the workforce.
  • Once my diagnosis changed from depression to bipolar, my internalized stigma reared its head. As a clinician, I knew bipolar is considered a serious progressive mental illness. I believed that I could be a danger to my son and he’d be better off in the care of someone else.
  • I was wrong. I was the same person before and after the diagnosis. The only change was my treatment. Instead of only taking an antidepressant, now I was also taking a mood stabilizer.
  • Despite the challenges of bipolar disorder, and those challenges are real, I’m a good mother. I work hard to be a good mother.
  • Keeping with my history of hypomanic workaholism, I worked increasingly long hours until I once again fell apart. I broke down crying in the parking lot at the office and found myself unable to pull myself back together and return to work. To get myself stable, I had myself voluntarily hospitalized when my son was four and haven’t returned to work since.

Acceptance

  • For me, acceptance has been an ongoing process. I’ve overcome denial and internalized stigma about what it means to live with bipolar disorder. I’ve owning my diagnosis and allowing others in to help me.
  • I had been a high achiever, a perfectionist. Accepting that I have a mental illness involves accepting myself as broken, as imperfect, as fallible, as human.
  • That acceptance has allowed me to forgive myself for not living up to early life expectations. I never became a doctor or a lawyer.
  • But I did get my bachelors, a master’s in psychology, and much later even attended graduate school studying religion twice after my psychiatric hospitalization.
  • Given my history of mental illness, I’ve questioned my sense of calling, of having a higher purpose. My mental health journey has led to purposeful mental health advocacy.
  • I am not weak. I am vulnerable. There is strength is being vulnerable. I accept that I’m not perfect and flawless. I am loved, lovable, and loving the way I am. My life has meaning.
  • My life experience gives me purpose in helping others. I am grateful that I can speak and write to share my journey with others, hoping that it inspires others to accept themselves and others living with mental health issues and to get help if they need it.
  • Thank you.

Who, Me, Dating?

DatingNews.com
interviewed me about dating and marriage while living with bipolar disorder.
Here’s how the article starts:
Kitt O'Malley: Love, Learn & Live with Bipolar Disorder. Blogger Kitt O'Malley Opens Up About Her Experiences Living, Loving & Laughing with Bipolar Disorder

At age 30, Kitt O’Malley moved in with her parents after treatment for debilitating depression resulted in psychotic mania which left her unable to do her work as a licensed marriage and family therapist. She left her career aspirations behind, and she started seeing a psychiatrist and a therapist who treated her for what was still thought to be chronic depression.

So when the guy she was dating said “You’re the most independent woman I’ve ever met,” Kitt couldn’t help but laugh. She had never been more dependent in her life, but he didn’t see those circumstances or her mental illness. He saw her, and that in itself was a small miracle…

Read the rest of the interview here. Thanks!

Recovering from Hypomania

Cut Back Taking it Easy

Recovering from hypomania and subsequent low energy which could be called depression. Honestly, I do not experience the fatigue following a hypomanic or mixed episode as depression. Now, rarely do I experience depressive thoughts during these recovery periods. I simply need to relax. I need to heal. The low energy, the fatigue, calls for me to slow down. My body can no longer sustain hypomania.

In January, I overdid it. I took on too much.

My Son Began College

My son began community college, which I drive him to and from.

My Freshman Experience

Yes, when I was his age (and younger), I could get myself to and from college, sometimes commuting by bus from Hermosa Beach to UCLA. Honestly, though, as my dad worked in Westwood, I’d usually catch a ride with him for summer school classes and hang out in a library or volunteer in the medical center for the rest of the day.

During the school year, I lived on the seventh floor of Dykstra Hall facing the fraternities lining Gayley Ave. I despised dorm life. Too much noise. Not enough privacy. I couldn’t sleep, went home most weekends, ended up suicidal, turned to cognitive psychotherapy, and quit UCLA.

My Son Isn’t Me

My son is not like me. Yes, we both have struggled with depression. But, ever since he was a toddler, he’s suffered severe debilitating migraines (involving headache, nausea, and vomiting). His migraines are much improved with medication, but he still gets them, just less often and less severely.  He also gets motion sick and catches whatever virus is circulating. When he gets sick, it takes him down hard. So much for taking the bus to and from college.

Going to College is a Huge Achievement

Now, it’s a major achievement for him to attend class at all. For those not familiar with my son’s struggles, his migraines, getting sick often, depression, and social anxiety, prevented him from finishing high school. He decided to take the GED, instead.

Unfortunately, he was sick last week (all three of us were), throwing up, not eating, sleeping all day… I hope and pray that he pulls himself together and gets back on track this upcoming week.

Still Visiting My Mom

Remember, I still visit my mom about once a week. Doesn’t sound like all that much. I wish I had the energy to do so more often. Visiting her or taking her out for a meal is challenging. Draining. Emotionally exhausting.

Her stroke in 2015 severely damaged the left hemisphere and frontal cortex of her brain. She has global aphasia and can no longer communicate using language – verbal, written, drawn, or symbolic. She understands facial expressions and emotions. She communicates using face expressions and pointing. She lets me know if my driving makes her uncomfortable with a simple sound, clearly expressing disapproval and warning. (The syllable clearly translates to slow down or watch out.)

Still, I to speak to her, narrating our time together, gesturing and animating what I’m communicating (luckily, I’m a drama geek, very theatrical), and treating her as if she can understand. She’s still a highly intelligent woman who knows what’s going on.

We enjoy visiting diners with photographs on the menu. She chooses what she wants to eat with my help in navigating the written portions of the menu.

Over-Enrolled, Over-Extended

Same week my son began his classes, what did I do?

Creative Writing Course

Started taking a creative writing course through our local community college emeritus program. Great class, but I need time to relax, solitude, not more demands on my time.

For me, social stimulation and demands on my time trigger hypomanic symptoms. I get “energized” in a negative way. My mood cycling begins.

I prefer and need SOLITUDE!

Qigong

As someone living with bipolar, I’ve experienced hypomania and mania with energetic, euphoric, spiritual symptoms. Enrolling in Qigong backfired.

The instructor had us visualize taking the energy of the universe (that’s a LOT of energy) in through the top of our heads, channel it through our bodies, and then into the ground.

Now this may be great for someone else, but I’m highly suggestive. I can imagine the energy of the universe, and it’s simply way too much for me to channel. Needless to say, the exercise triggered hypomania.

I experience hypomania energetically. I’ve had hypomanic and manic episodes where energy filled me up, pushed through my skin, and cleansed me, and I’ve experienced energy that was deceptive, tried to tell me that it was good for me, but felt scary, false, and threatened my sanity. Some of these experiences, I’ve framed as mystical. Some, dangerous. Because I cannot control which way the experience takes me, and because they come at a cost, I no longer seek them.

I MUST BE GROUNDED IN REALITY.

Personal Training Contract

In my hypomanic spree, I signed up for an expensive annual personal training contract with a gym. Gyms are not good places for me. Again, overstimulating.

Overspending, over-committing, over-zealous activity — all symptoms of hypomania and mania — all factored into my signing that expensive contract.

Now, I’m trying to cancel it…

Invested Too Much Money in a Venture

In my hypomanic state, I invested WAY too much money in my friend Sarah Fader‘s publishing house, Eliezer Tristan Publishing (ETP). I’m a HUGE supporter of Sarah and the work ETP does. Sarah did not solicit the money from me.

Riding the high of hypomania, I offered an angel investment that was ten times what she thought I was offering. Think of that. Someone thinks you are generous offering an investment of x. Then you say, “No, I meant x times 10.” For those not algebra inclined, move the decimal point over once to the right:

If x = $100, x times 10 = $1,000.
If x = $250, x times 10 = $2,500.
If x = $500, x times 10 = $5,000.

She was thrilled with an angel investment in the hundreds. I made an investment in the thousands! Yikes!

Honestly, though, Sarah and ETP need the money more than I do. The money is going to good use. It’s doing good things for the writers published and for the world.

ETP’s co-founders, Sarah Fader and Sarah Comerford, are mental health advocates. The publishing company specializes in publishing “nonfiction and fiction works largely focusing on survival, in its many iterations.

Still… Didn’t think it out. Was impulsive.

Yes, I’m impulsive, especially when hypomanic.

Oh, well.

Trying to Do the Right Thing

All these activities, in and of themselvs, seem to be good. I was trying to do the right thing. Writing. Relaxing, meditative exercise. Exercise to improve my health, my cholesterol and triglycerides, which are high in spite of taking medications for them. Still, none of these things were, in fact, good for me. Maybe, if I had taken just one on. Maybe, if I wasn’t exhausted by caretaking responsbilities.

But, as I age, I find more and more, that solitude suits me.

Solitude is Not Isolation

Solitude is not isolation. I am not lonely. I am not alone. I am very much a part of a family. I am very much a part of a community. You are part of my community.

I am loved.

I love.

Michael Pipich Guest Post: Are You Just Depressed or Is It the Onset of Bipolar Disorder?

Are You Just Depressed or Is It the Onset of Bipolar Disorder_

This guest post hits close to home. For twenty-one years, from ages eighteen to thirty-nine, I was diagnosed with chronic depression (dysthymia). I’d tell doctors that I was at least cyclothymic, for I my over-productive workaholism led to cyclical depressive crashes. Finally, at thirty-nine years old, I was diagnosed bipolar II. — Kitt

Are You Just Depressed or Is It the Onset of Bipolar Disorder?

Michael G. Pipich, MS, LMFT

About two-thirds of people with bipolar disorder are misdiagnosed with other mental health problems before bipolar is discovered.[1] Among those individuals, a significant majority are given a diagnosis of major depression. Most people with a major depressive disorder that is unrelated to bipolar disorder (typically known as non-bipolar depression or unipolar depression) can be treated safely and effectively with a combination of antidepressant medications and psychotherapy. But when people with undetected bipolar are treated this way, a host of mental health problems can occur, making the underlying bipolar condition much worse.

It’s understandable that someone may not immediately be given the bipolar diagnosis if their first mood swing begins in a depression mood zone. This seems particularly true of people who have bipolar II disorder. And sometimes, there may be more than one depressive episode before a manic or hypomanic episode happens in a person with bipolar.

If you’re wondering about whether you may have depression or the beginning of bipolar, there are some keys to keep in mind when seeking treatment.

First of all, when assessing if your depression is a part of bipolar, know that bipolar disorder has distinct genetic foundations. In other words, it runs in families and is passed through family genes. So if you suspect that any family members may have had bipolar disorder, it’s important to inform your doctor or therapist when entering treatment. If the information is available, a thorough family mental health history can really support a proper bipolar diagnosis. Unfortunately, such information isn’t always asked for, so be prepared to volunteer all that you know during an evaluation or treatment session.

Next, your personal history of mood swings should be explored. If you’ve had severe ups and downs during childhood or adolescence, these may be more than the common tumult of growing up. They may instead be early expressions of bipolar disorder. It’s especially important to review periods of hyperactivity, bouts of unexplained rage, self-harm, or suicidal thoughts or actions that could have occurred at any time in life. There certainly may be other explanations for these, such as early life trauma or severe loss and grief experienced during these formative years. But if explosive behaviors or deep depression occurred at different times, especially with little or no provocation, it can point to underlying bipolar disorder.

Usually, most people with bipolar who seek treatment on their own are currently or recently depressed, or are experiencing consequences of untreated bipolar disorder. Any history of mania or hypomania is less obvious, however. And often, bipolar patients will either not understand manic symptoms or will avoid discussion about them. If you have had at least one occurrence in your life of intense euphoria, excitability, unexplained energy and creativity, avoidance of sleep, or impulsive behaviors, inform your treatment professional. But also bear in mind that mania and hypomania may be marked by intense periods of irritability and agitation, know as dysphoria. This is in contrast to the euphoria that most people think about with bipolar mania. Often a dysphoric type of manic or hypomanic episode can be mistaken for the kind of agitation seen in major depression. This can mislead the course of treatment to focus only on depression, while missing the full bipolar condition.

This brings us to the most important part of knowing whether you have depression or bipolar onset. According to the Diagnostic and Statistical Manual of Mental Disorders (5th edition), if a patient is given an antidepressant medication, and it produces manic symptoms, the person is then diagnosed with bipolar disorder.[2] While this is a very clear indication of bipolar, how the mania surfaces in the individual may take different forms. For example, a person in a depression mood zone can improve early in the treatment, and as a result, may not show manic symptoms right away. Any slight improvement may provide a hopeful sign that treatment is working, but when the person starts to get worse because of emerging mania—especially if it’s dysphoric—the unwitting response may be to apply more antidepressant medication. Now we have some real problems.

So, if at some point in your treatment, an antidepressant medication makes you feel more agitated, more irritable, more aggressive, or you start to experience hyperactivity or greater impulsivity, tell your treatment professional right away. This could be the start of a manic episode that is revealing a previously undiagnosed bipolar disorder. Even more importantly, any increase in suicidal thoughts or possible psychotic symptoms, such as hallucinations, should be reported immediately, as these can be life-threatening. Any antidepressants will either likely be eliminated at this point, or possibly paired with a mood stabilizing or antipsychotic drug to keep a lid on mania.

With bipolar finally recognized, bipolar medications can be introduced to decrease manic-type symptoms, while keeping depression in check. Alongside medications, it’s important to have therapy focus on the unique challenges facing people with bipolar disorder. Major depression is frequently considered an acute condition because it often can resolve in time, so medications may be discontinued at some point, along with a shorter overall approach to therapy. But bipolar disorder is a lifelong condition. Even though its symptoms can come and go in episodes, the genetic nature of the condition means the bipolar patient will need continuing care through the lifespan.


[1] Hirschfeld R. M., Lewis, L., & Vornik, L. A. (2003). Perceptions and impact of bipolar disorder: How far have we really come? Results of the National Depressive and Manic-Depressive Association 200 survey of individuals with bipolar disorder. Journal of Clinical Psychiatry, 64(2), 161–174.

[2] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author, 128-130.


Owning Bipolar: How Patients and Families Can Take Control of Bipolar Disorder by Michael G. Pipich, MS, LMFT. Foreword by Joseph Shrand, MD.

Michael G. Pipich, MS, LMFT is a psychotherapist and author of Owning Bipolar: How Patients and Families Can Take Control of Bipolar Disorder, (Citadel Press, Sept 2018). He practices in Denver, Colorado, and can be reached at MichaelPipich.com.

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