#part of it also might be that during the worst of my unmedicated health issues

[tj-crochets]

Follow up question on this topic that is going to sound like a joke but it isn't: How do you tell when you are stressed enough that you need to stop what you are doing and go do something to de-stress if you don't have "oncoming allergy migraine symptoms" to warn you? Like, the silver lining of all my health issues is that they give very unignorable signs when I need something (I can't always interpret them correctly, but that's a different problem). My "uh oh better go take a five minute break and calm down" sign was high blood pressure, low (for me) heart rate, shakiness, and a feeling like I was about to burst into tears despite not feeling sad Yesterday, I got very, very stressed at work. I accidentally pushed right past the threshold that normally would have been my stop point, because I did not have the physical symptoms, until I realized I was so overstimulated I couldn't listen to music (a thing that has literally never happened to me before) So I have to re-learn how to tell when I am stressed. It's not the first time I've had to relearn a basic life skill when I got a health issue more under control, but I admit I'm kinda stumped on how to figure this one out

So on the plus side I apparently unexpectedly reached some threshold of stabilizing my mast cells and have had a few reactions with no migraine or nausea! I'm experiencing acute stress without having bad tachycardia or shaking or having a little bit of that whole "impending sense of doom!" On the minus side I seem to have gone back to hives????? I used to get hives from like 2015ish to like 2019ish, when I finally mostly got my allergies under control*, and then I mostly just stopped having hives. Like. At all. I might have contact dermatitis on like hands knees or elbows if I happened to touch pollen from the Mystery Plant I am allergic to** but I did not get the spontaneous hives on my joints all the time, and now I had one on my hip and I feel like my hand is trying to get one and maybe my knee????? This is definitely a huge step down in terms of severity, significantly less likely to have side effects that land me in the hospital, but I am so confused. Happy about it! Hope it lasts! But so confused. Also (and I do remember this from the few times I got hives once I started antihistamines), feeling a hive try to form while on high doses of antihistamines is so weird. I feel like if I get into too much detail it might squick y'all out but trust me it's a weird feeling. Each individual hive since I've been on daily antihistamines, with one notable exception, lasts less than an hour instead of 24+ hours. *read: four times the daily recommended dose of 24 hour antihistamines, as my allergist told me to do **was not able to narrow down what, exactly, it is, but it was seasonally limited and limited to a certain geographic area so like I think it was a plant? Forgot to mention: I had very little overlap between the "all hives all the time" era of my allergies and the "severe migraines leading to severe dehydration" era of my allergies. Like, very occasionally my hives reaction would get bad enough I'd get the migraine and nausea as well, but very, very rarely. They aren't mutually exclusive they just seem to be for me?

[loveanywayliveanyway]

reality check.

last year, before this bar exam hearing hellscape began again, i was giving lectures to law students on the importance of dealing with one’s mental health before the issues derailed their careers, and how our state lawyer’s assistance program can help.  i haven’t done one since this whole character & fitness hearing was called, since i can’t bring myself to give this lecture to students while not having a clear answer on whether or not i’ll ever be allowed to take this exam (that will be determined somewhere around march, since my hearing is in january).  but i wanted to post the lecture here, because, well, i want it to be somewhere where it might be useful.  maybe it’ll make someone feel a little less alone.

Good afternoon.

Years ago, I sat in the same seats as you, listening to this same lecture from Mr. Caimi, rolling my eyes and thinking, “No way will I ever need this help.”  I wasn’t an alcoholic.  I’ve never touched a non-prescription drug in my life.  If you’d told me years ago that I’d be standing here as an advocate for OLAP, I’d have laughed in your face.  And yet, here I am, because I want to keep you from making the same mistakes I did.

I’m sure most of you know about bipolar disorder from the movies or television.  Maybe you actually know someone who has it.  The way it usually works is that someone with bipolar will report depression, be put on antidepressants, and then swing into a manic state as a result.    The symptoms of depression are easy to spot, but the symptoms of mania are a little more tricky: feeling overly happy, “high,” or elated for long stretches of time, feeling easily agitated or angry, talking very fast, racing thoughts, extreme restlessness or impulsivity, impaired judgment, unrealistic overconfidence in your abilities or powers, and engaging in risky behavior, such as having impulsive sex, gambling with life savings, or going on big spending sprees.  

That’s what happened to me.  When I was nineteen, I reported depression to my primary care physician.  My doctor wasn’t qualified at all to diagnose a mental health condition, but he put me on antidepressants anyway.  While I didn’t realize it at the time, those antidepressants caused my first manic episode - and my episodes were defined by paranoia, anger, and tons of energy - not a good combination.  My doctor told me I was bipolar, even confirmed it when I applied to take the bar, but he used the words “depression” and “bipolar” interchangeably, and I never bothered to see a psychiatrist to discuss any of it.  I was on and off those antidepressants for almost a decade; sometimes I would take them, sometimes I wouldn’t.  I made a lot of stupid decisions financially and personally.  But the worst decision I made was professional - or, rather, extremely unprofessional.

I worked as a paralegal in a small firm where my mother was the office manager and head paralegal.  At some point, I left that office, and then my boss fired my mother.  I wasn’t taking any medication at the time, and I remember clearly the feeling of absolute rage I had at this man for daring to fire my mother when my parents were in a precarious financial situation anyway.  I felt she had been wronged, and I felt wronged on her behalf.  So what did I do, in my unmedicated, irrational, angry state of mind?  I reported this man to Ohio disciplinary counsel for what I can only call a bullshit reason, just to get revenge.  I also made the unbelievably stupid decision to call him an array of colorful names on Facebook.  Then I completely forgot all about it.

This decision changed my life.  I received a letter back from disciplinary counsel a few months later, in which they essentially told me that I had been unprofessional in almost every aspect of my choices in this matter, and that they had evidence that I had posted inflammatory things about this man on Facebook.  So what did I do?  Without bothering to confirm their allegations, which would have reminded me of what I’d said, I chose to tell them that they had been lied to and that I never said anything about him on Facebook, that I only reported him after he fired my mother because I was afraid doing it beforehand would jeopardize her job, and that it had nothing to do with revenge.  Once again, I forgot all about it.

Over the course of the next two years, I applied for the bar exam, was provisionally approved by the CMBA, and graduated school in 2012.  Except I never received my bar exam approval and instructions.  What I got instead was a letter from the Board of Commissioners on Character and Fitness, telling me that a sua sponte investigation had been initiated as a result of my false statements that I’d never posted anything about my boss on Facebook.  At that point, I was sent a copy of everything that the NCBE had received from my references - which included copies of my Facebook posts which my boss had sent in to them with his response.  I had a hearing before the Board in January 2013.  In the hearing, the Board discussed several other indiscretions that, bar counsel admitted, wouldn’t have been much of an issue if not for their cumulative reflection on my character and fitness.  My bipolar disorder was discussed as well.  I told them I was back on my antidepressants and felt much better, but because my diagnosis date was a moving target, and because my doctor wasn’t available for testimony (and I had no other records showing bipolar disorder), the Board determined that it was a convenient excuse for what I’d done.  The ironic part is that, looking back on that hearing and the excuses I was making, I believe was in the midst of a manic episode during my testimony.  By March of that year, I was told I would have to wait three years more before I could apply to take the bar.  

And you know what?  It was the best thing that could have happened to me.

After the decision came down, I spent a couple months being angry at the world.  I didn’t think it was fair, I felt persecuted, and I continued down my path of destruction until May, when I had a moment of clarity and realized that I felt horrible and, hey, what could it hurt to see someone?  So I did.  Soon, I was diagnosed with Bipolar I - officially - and was put on a course of antidepressants COUPLED with mood stabilizers, which is the right way to treat bipolar disorder.  It wasn’t an easy road - I had manic episodes when they were adjusting my medications at first, and my lowest point was six months into treatment, when I stood in my kitchen, looking at the knife block, hearing a clear voice in my head, telling me to end it all.  But three years, several doctors, a half-dozen medications, and over a hundred therapy sessions later, I feel better than I ever have.  I feel normal, healthy, and clear-headed.  And I’ve reapplied to take the bar examination, a year later than they told me I could, because I’ve reached a point where I feel confident that I can capably, ethically, and competently practice law.  I haven’t had a true manic episode in years, and the depression, while it occurs, is at least manageable.  

Part of my treatment was OLAP.  I enrolled voluntarily rather than by court mandate, just after I was diagnosed.  I wanted to fix my life, and I wanted any help I could get.  I’m not going to say that was easy, either.  There are strict requirements for participating, including a monthly payment (which can be deferred if you’re unable to pay), weekly or daily check-ins, and - the hardest of all when you’re around lawyers - refraining from any mood-altering substances including alcohol.  My doctors all had to send twice-yearly reports disclosing my health status and whether or not I’d adhered to a treatment plan.  I had to update Paul whenever I changed medications.  And I definitely struggled with these things.  I wasn’t always perfect.  I made missteps.  But I can tell you that the accountability that OLAP required of me was the best thing for me.  It can be very difficult when you are first starting treatment to remember to take your medicine or go to therapy or to even want to.  But if you know that you have to report to someone and that you are being monitored, it gives you the push to do it.  And the more you take the medications and go to therapy, the more you'll be able to do it on your own without that push.  By the time you're out of your program, it will be easier to commit to taking care of yourself because you'll realize how much better you feel.  Plus, the Character and Fitness Committee highly values OLAP, and OLAP can report to it about your compliance with your contract - which carries much weight in its decision to allow you to take the exam.

You all know that you’re required to disclose any “psychotic disorders” on your bar exam applications.  These include, among others, bipolar disorder and schizophrenia.  The bar examiners tell you that evidence of a psychotic disorder isn’t in itself disqualifying, but I know that not everyone actually believes that.  I’m sure there’s at least one person in this audience who has felt that something is “off,” and that they don’t know how to fix it, but if they get professional help, they’ll be blacklisted.  After all, whenever you see a bipolar or schizophrenic person on television, it’s always some crazy person who can’t control themselves, commits crimes, hears voices, or has delusions.  But that’s not always the case - you may just notice that you’re producing at a drastically higher level, getting unreasonably angry when the library has closed early, or being able to stay awake for three days to write a paper.  It’s also quite common for mental health issues to present themselves during law school because stress and disturbed sleep patterns can trigger them.  My illness presented early in my adulthood, but just because you didn't notice a problem beforehand doesn't mean one can't trigger later in life.  If you're not aware of yourself and your baseline for emotions, you might not even notice a problem at first.  But believe me when I say that asking for help is so, so much easier than having to explain yourself when you do something tremendously stupid because you think you’re invincible and don’t care or think about consequences.  

I want you all to understand something: my illness does not define me, but it did define the course of my life.  I don’t make any excuse for what I did.  My choices were my own, despite having a mental illness.  Bipolar disorder may EXPLAIN why I did what I did, but it doesn’t excuse it.  I didn’t treat my illness as I should have.  I didn’t obtain any help for it before facing the ultimate consequence of leaving it mistreated.  I made excuses.  I don’t make excuses anymore.  In fact, as I said, the best thing that could have happened was the Board’s decision.  They protected me from myself, and they protected others from me until I could fix the mess I’d made.  I don’t regret anything except the hurt I caused others.  But at the same time, I don’t want any of you to have to go through what I went through.  I don’t want you to have to explain poor decisions to the board, especially when they could be easily prevented.  That’s why I’m here, and that’s why Paul is here.  To be a bit nerdy and paraphrase Albus Dumbledore,  “Help will always be given to those who ask for it.”

I’m happy to answer any questions you all have.  And if anyone wants to speak to me confidentially to ask where to go from here, please feel free.