The Behavioral Corner 

Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner, you're invited to hang with us as we discuss the ways we live today, the choices we make, the things we do, and how they affect our health and well-being. So you're on the Corner, the Behavioral Corner, please hang around a while.

Steve Martorano 

Hey, everybody, welcome to the Behavioral Corner. Once again, your head to hang around hear me, Steve Martorano, here on the Corner talking interesting people we think we know about very interesting things. The idea of the Behavioral Corner is sort of inherent in the name, the way we behave affects everything. Our behavioral health is a big topic. It covers those choices we make situations we confront, and how all of that affects our, you know, emotional, spiritual, and physical well-being. So hang with this. It's a spring day, at least where we are on the Corner and we have a real good one for you today. You know, I don't think anybody listening to this has not heard the term bipolar disorder, or might even know somebody who suffers from bipolar disorder. I looked at numbers the other night that said, there are over a couple of million Americans that have this condition, which represents like 1% of the population. That's a fairly well-known mainstream thing. But the details about it can only be I think, really understood if you talk to somebody who's been there, and is doing that with bipolar disorder. We have an old pal and colleague with us to talk about her dealing with bipolar disorder. Tanya Ruhl is the Communications Project Manager for our partners in the Behavioral Corner, Retreat Behavioral Health. And she has in the past, been a great help to this program, and one that preceded it. She's to do a lot of work for us when we're doing some more Facebook stuff. I've known Tanya for a handful of years now, during that period of time note knew her as even-keeled and as steady a person as I've ever met, I had no reason to think that she was suffering from anything like bipolar. So I was really surprised to find out that recently. So we reached out to Tanya and she has joined us on the corner to talk about bipolar disorder. Hello, Tanya.

Tanya Ruhl 

Hi, Steve. Thanks for having me.

The Behavioral Corner 

You're in your office. They're at Retreat. Lancaster County, correct? 

Tanya Ruhl 

I am. 

Steve Martorano 

Yeah, when I was going up there regularly, I'll probably do that again soon we were neighbors. She has a little office next door to where our studio is. So again, thanks for joining us. One of the reasons we wanted to talk to you about this is that you are going to be part of a Facebook Live panel discussion on the 30th of this month. So those of you who make notice is interested in this topic, and you want to know more about it than you'll find out here Facebook Live on the 30th of this month, the end of the month, at six o'clock, and you'll be able to tune in and watch Tanya, she'll be joined by a clinician, there'll be the psychiatrists to discuss the disorder. So Tanya, yeah, I was surprised to find that you had this disorder because I always found you to be pretty even-keeled. When you got stressed, you got stressed for the same reason we were all getting stressed. We forgot to record something or the guest didn't show up. Or, you know, just sort of the garden variety stuff. So let's begin at the beginning. Where are you from? Where did you grow up?

Tanya Ruhl 

Well, I grew up in Lititz, Pennsylvania, which, when I was growing up was a small town. It's obviously not as small anymore and has become more in popularity than what it was back then. When I grew up there, it was so small that I could walk down the street and my grandmother knew who I was with, what time I was with them, and where I was going.

Steve Martorano 

Right, right. Well, I know I know a little bit of that, but it's too It's Wow, it's the thriving metropolis now is it's almost a tourist attraction in the Lancaster County area, right? 

Tanya Ruhl 

Yep. 

Steve Martorano 

Yeah, you grew up in this kind of idyllic little small town in the middle of Lancaster County. You had siblings?

Tanya Ruhl 

Yes, I grew up with two sisters. I was raised by a single mom who worked very, very hard. I didn't get to see her much. It was a lot of times it was my older sister taking care of my younger sisters and spending time with my grandmother

Steve Martorano 

Yeah, yeah. You had two sisters then. Where were you in the birth order the middle or...

Tanya Ruhl 

I'm the middle? Yep.

Steve Martorano 

You're the middle child. You'll never be a middle child. When and under what circumstances did you start to have problems with your moods and what were they like before they were diagnosed as a disorder?

Tanya Ruhl 

I think probably it was more noticeable around the teenage years is when it was starting to get more noticed. It was really i was either sleeping all the time or not sleeping at all were the two main noticeable ones.

Steve Martorano 

Yeah, can I ask you a question what is that noise I'm hearing? What are you doing?

Tanya Ruhl 

My service dog is playing with a toy that has a squeaker in it.

Steve Martorano 

Take that thing away.

Tanya Ruhl 

I just took it. I didn't realize it at a squeaker in it

Steve Martorano 

We do like dogs on the Corner so that's good. So anyway it's interesting because bipolar disorder from what I'm reading over the past couple of days begins to manifest itself around 20 is sort of the average age when people really start to see this thing but it happens earlier than that 15 - 16 at a time when most teenagers said you've got a couple are acting odd anyway they're moody and they're a pain in the neck and they're you know excited one day show I guess for a period of time except for the sleeping or even the sleeping good sleep forever if you let them. Some of what you're going through must have been just dismissed as well Tanya is just a moody kid.

Tanya Ruhl 

Yep and overly sensitive. I got that a lot. It's either oh she's just being her happy self or oh she's being overly sensitive.

Steve Martorano 

Mm-hmm. Did you buy that or did you think oh no something doesn't feel right?

Tanya Ruhl 

Well at that point in time my mom had actually gotten remarried and my mom and I had later in the years our relationship had changed a lot so I do not hold this against her but at that point in time, my mom did not really believe in mental health. So she honestly thought I just needed counseling and I needed Jesus. So she actually believed that the problems that I had were just like satan attacking me.

Steve Martorano 

Rebelliousness. Clashing with her. A new man around the house. How old were you when she remarried?

Tanya Ruhl 

I was 13 but I actually really liked him because my biological father was pretty much nonexistent in my life.

Steve Martorano 

So, you're sure your mom saw it and she's not alone in this that you could pray your way out of this right?

Tanya Ruhl 

Yes.

Steve Martorano 

How'd that make you feel? 

Tanya Ruhl 

It actually made me feel really discouraged because I tried.

Steve Martorano 

And if it wasn't working that means you must be a bad person.

Tanya Ruhl 

Right.

Steve Martorano 

Because if God doesn't want to help you...

Tanya Ruhl 

Right.

Steve Martorano 

So talk a little bit about sleeping all the time and but what were some of the other symptoms you had as a young person that was really causing a problem?

Tanya Ruhl 

Well, I would have liked these grandiose ideas that would pop into my head and i would go and do them with no sense of the consequences that would happen after.

Steve Martorano 

Really?

Tanya Ruhl 

Especially once I got my first job. Like I was responsible for my car insurance and all of that. Like my mom really tried to instill the whole concept of the monetary values of money and being responsible and all of that. She really wanted me to understand all of that and I very much appreciated that as I was older. But you know she would help me with my budget and the way she did it is I would get my paycheck and I would have like envelopes and I would put like so much money per paycheck in each envelope so that when a bill came I would have the money in that envelope to pay it. Well if I got an idea in my head and I didn't have money for that but the bill wasn't due yet. There wasn't because I had no concept of the consequences that the bill was still coming and now most people would say oh that's just a normal teenager except it would be all of the money. Not just like from one envelope. It would be from all of them. And this wouldn't happen once or twice. This would happen repeatedly over and over and over and over again. As soon as the bills came and I didn't have the money the realization hit and that's when the depression hit and then I didn't want to get out of bed. I didn't want to deal with it like the realization hit and it was awful and the spiral was just horrific for me.

Steve Martorano 

Yeah, so the highs were very high. You'd have this orderly system. Then you started to do what a lot of people do it's got to do with teenagers. You started doing that you know rob Peter to pay Paul. How high were the highs you would have when you were in that phase where you say "grandiose ideas" and you're up but how high would those moments be"

Tanya Ruhl 

Um, I mean it's hard to explain like...

Steve Martorano 

I guess what I mean you want If you're around enough people, I certainly have been around people who were bipolar, and even when they were sort of stable, we would all be excited about something, they would be just a little more excited about it.

Tanya Ruhl 

 Yeah. 

Steve Martorano 

You know, they would be just a little more intense about what was going on. I mean, you didn't wake up so high, you thought you were an empress. You just thought there were things you could do and there would be no consequences for it and then when the consequences arrived, boom, you're in trouble, right?

Tanya Ruhl 

Right. When I had these ideas, I was super excited about them.

Steve Martorano 

Right. Yeah, very excited about that. 

Tanya Ruhl 

Right. 

Steve Martorano 

And I guess in a work situation, and even in a personal situation. People must go, Oh, I love her enthusiasm.

Tanya Ruhl 

Yes.

Steve Martorano 

I mean, at work, you get excited about something, you're rewarded for that. So how long were the lows? They sound like they for you were more problematic than the hyper behavior, right?

Tanya Ruhl 

Yes, the depression part of it, for me was always worse, and usually lasted longer.

Steve Martorano 

And you say it would manifest itself but you just not want to get out of bed, right?

Tanya Ruhl 

Yeah, mainly not wanting to get out of bed. Not wanting to talk to anybody, and even at times not wanting to take care of myself.

Steve Martorano 

Right, right. Just sort of what's the point? I guess? 

Tanya Ruhl 

Yeah.

Steve Martorano 

So at some point, someone must have said, you know, "there's a problem here." This is a physical problem that you're going through. Did they first diagnose it as just depression?

Tanya Ruhl 

No, honestly, my first diagnosis was bipolar. But it wasn't until I was 27.

Steve Martorano 

You had a good, what 10 - 12 years of this up and down yo-yo thing.

Tanya Ruhl 

Yep. And it was my mom who encouraged me to go on and get diagnosed.

Steve Martorano 

Did she actually use the words "bipolar"?

Tanya Ruhl 

No, she didn't use the words bipolar she, how she put it to me is Tanya, there's really something going on here that's more than what you going to counseling as you have in the past has seemed to warrant. Maybe we should set up an appointment somewhere for you to go and see what they say.

Tanya Ruhl 

Oh, so you were getting some talking therapy during that period of time?

Tanya Ruhl 

Yeah. Well, I had stopped for a long time because she had me going -- I shouldn't say she had me going -- she had requested I go to her Christian counselors, years prior to this.

Steve Martorano 

So it was a faith-based approach to the problem. 

Tanya Ruhl 

Yeah. 

Tanya Ruhl 

And incidentally, while that may not have worked for you, it does work for some people. But we can't lose sight of the fact that bipolar is a brain disease. There's a problem going on chemically inside people's heads. It's out of whack. Incidentally, from my reading, not something that one cures. This is something that one if you're lucky, like with Tanya, you identify it, and then start managing it. So when you get that diagnosis must be quite a relief. On the one hand, Oh, really? Now we know what it is. It's not this mysterious thing going on. That's the way you felt?

Tanya Ruhl 

I felt confused and conflicted, honestly.

Steve Martorano 

Yeah. Conflicted, how?

Tanya Ruhl 

Because I was raised so long being told that I was being attacked by forces but I couldn't see. And then at the same time, now, I'm being told that I'm not that there's something wrong with my brain. That that is out of my control. Okay, which one is right?

Steve Martorano 

Yeah, talk about bad news and worse news. Oh, you mean, it's not the devil, it's my brain. That's got to be a little disturbing. So you're diagnosed at 27 is having this bipolar disorder. And by the way, in a nutshell, because Tanya is not, nor am I a clinician, she knows way more about than I do, but just very briefly, in a broad sense: Bipolar disorder can be said to manifest itself by wild, fluctuating mood changes. And we don't mean one day or a little blue. The next day, a little happy, we mean, radical shifts in mood. By the way, before we move forward about how you start getting help. The shift in one's mood, when you have bipolar isn't a sudden shift, or is it a gradual change? How did that work for you?

Tanya Ruhl 

For me, it's kind of gradual, but at the same time, it can be sudden. Now that being said, like usually from depression to mania is usually gradual. But then from the mania to the depression, it can be sudden, like that's where it's, it's weird.

Steve Martorano 

The rise up is slower, but the crash is enormous.

Tanya Ruhl 

Yes, but now it's really weird because occasionally, I have to get put on prednisone. And that will put me in mania ASAP.

Steve Martorano 

Well, we're gonna get to your meds in a second because they're key, as we say, to managing bipolar disorder, the medicine that they use is, is critical. We're on the Behavioral Corner with our pal Tanya Ruhl. Tanya is an employee of Retreat Behavioral Health has been for a while she is the Communications Project Manager, as we told you, she's going to take part in a Facebook Live seminar that you can drop in and watch we hope you do on the 30th of March on Retreat Behavioral Health's Facebook page. She's telling us about her struggles with and now managing her bipolar disorder. So can you see these things coming? And are there triggers that you now can identify that would trip me off for the day just come out of nowhere?

Tanya Ruhl 

Now so much I don't really have triggers per se because I stay on my medication. If I would go off my medication seasons actually play a really big role.

Steve Martorano 

Is that right?

Tanya Ruhl 

Yeah. In my mania and depression, big time, as well as this is gonna sound funny, but money. Money plays a huge role in my mania and depression big time as well.

Steve Martorano 

Yeah, well, me too. I mean, I hear you, I hear you. So people should understand that while this is an actual physical problem of a brain disorder problem. Sounds like you saying it manifested itself for you anyway, around mundane, ordinary things that we all face? Money. Your kids. It's not easy raising young people. And those things, when they occur to somebody with a bipolar problem are just exacerbated. When did they say to you okay, we think we can handle this with meds. What was the first medication you began taking?

Tanya Ruhl 

Oh my gosh, honestly, my first, experience with medication was actually not very productive for me, to be honest. 

Steve Martorano 

Okay. 

Tanya Ruhl 

I was actually a single mom of all three of my children. At that time, I did not know how to advocate for myself very well. Um, I've learned over the years how to do that. And I was on so much medication, that I was actually only awake for seven hours a day. And I know, Seroquel was one of the medications, Lamictal was one of the medications...

Steve Martorano 

Is that typically what they do they prescribe these mood classification drugs in combination with one another and see if they can get some kind of balance going. Is that what they do?

Tanya Ruhl 

I think they do. Yes, I think that's what they normally do. They try to find the right balance for everybody. I think, unfortunately, what happened with me is, again, I'm putting a lot of this on myself. I didn't know how to advocate for myself. It was the first time I had ever dealt with a psychiatrist and I didn't know exactly what to say, to explain to him what was going on.

Steve Martorano 

Now, when you say advocate, you mean too many people go into any kind of medical professional, and just sit there and go, "Well, they're the expert. I'll just do whatever they say." You had to get to a point where you went, "Nah, That's not right for me. 

Tanya Ruhl 

Right. 

Steve Martorano 

Yeah. Is that hard to get to that advocacy for yourself?

Tanya Ruhl 

I think it's different for everybody. I think for me, it was harder just because I had like, underlying circumstances because I had a lot of trauma in my background.

Steve Martorano 

Mm-hmm.

Tanya Ruhl 

I mean, because of all of that stuff, it was a little bit more difficult for me.

Steve Martorano 

I can imagine being in a position where if you're a don't make waves, kind of person there's not very demonstrative. You might sit back and let them dictate terms to you. Well, it's good that you found out that nobody's going to look out for you better than you can look out for yourself. How long now -- and I know that this is as again, the nature of diseases that up and down -- I mean, I've known you for a bunch of years now and I know, we're not around each other a lot. But you seem to me to be obviously competent and on a pretty even keel. would you characterize your behavior today as mostly that way with some tough episodes, or is it still fluctuating for you?

Tanya Ruhl 

No, I pretty even keel with some tough episodes. I was actually just at a med check last night, so I just had a med check last night, I actually go every six months.

Tanya Ruhl 

How does that work with a med check? What do they do?

Tanya Ruhl 

So I just go into the doctor's office. My primary care physician actually is willing to deal with this with me. Just because I have trust issues with psychiatrists, because of that first experience, um, as long as I stick to my routine, so I have to be very honest with him that I'm taking my medication. So I go in literally every six months, and we discuss, you know, how the medication is working. If I think it's working, if we need to adjust anything, as we go from there.

Steve Martorano 

Well, people are probably wondering, gee, why would you not take your meds? Why would you forget to take your meds? Oh, there must be some downsides to the medicine. Is that why you would not take them?

Tanya Ruhl 

I told you about my first experience with only being awake seven hours a day with being a single mom with three kids. And I said, screw this, and I stopped taking them. And that's not the first time that I did it. I was on medication again after that. And I was taking it for a while. And I said you know what? I feel great. I'm fine. I feel fine. I feel absolutely fine. I don't need medication. Why do I need medication? I feel fine. So you know what, I stopped taking it. And then guess what? I started having my real highs, I started having my real lows, and like, crap started hitting the fan. And guess what? I said, oh, crap, I need my medication. So I went back on my medication. It's not everybody, but it's actually pretty typical of people that have bipolar disorder. They start taking medication, and then they feel okay. And they don't think that they need the medication. 

Steve Martorano 

That's interesting. 

Tanya Ruhl 

They feel fine.

Steve Martorano 

Yeah, it's interesting because since your emotions are so wildly fluctuating there, the moment you begin to feel good. You feel real good, right? You're like wow I'm really okay. I don't need that stuff. It's very insidious. As I said, I was reading some stuff. Lots of people self-medicate they wind up with problems of substance abuse. You didn't have any of that, in your situation, did you?

Tanya Ruhl 

Addiction actually runs rampant and I literally mean, rampant in my family. So I am actually extremely careful and that's part of the reason also why I have six-month checkups with my primary care physician. Because I also want to make sure that that is really kept in check and made sure that everything's okay.

Steve Martorano 

Are there any other members of the family that suffer from bipolar disorder as well?

Tanya Ruhl 

We're actually waiting for an evaluation for my son -- the possibility that he might. There's a possibility that my biological father does, but I don't think he was ever fully diagnosed.

Steve Martorano 

Yeah, because there's some evidence to suggest that you can inherit this. Your kids, your family, your immediate family, now you're married now -- your kids are they're aware of your disorder, right?

Tanya Ruhl 

Oh, yeah. So I'm very open to them. And they're very much aware.

Steve Martorano 

Yeah. But they're young kids, and they don't give you much slack anyway, right. Yeah. Right. Yeah. Okay, mom, we all got problems, right. Well, you know, what, Tonya, the final thing I wanted to know is that you know, it's difficult The disorder is bipolar is this -- and managing it is the key -- recognizing what you have to do and do it. Never easy under any circumstances, how much more difficult if at all, is managing your bipolar disorder during this COVID?

Tanya Ruhl 

For me, it hasn't been too difficult, really. Because I've still had access to all my medication.

Steve Martorano 

Yeah, I guess in one sense, you know, bipolar, you don't sound like your problems. Were a result of your interaction with other people. Bipolar disorder really affects the person who has it. 

Tanya Ruhl 

Right. 

Steve Martorano 

In one sense, I guess, being isolated would make much of a difference. Well, Tonya, thank you so much. I mean, as I said, I see you occasionally now but I saw you a lot a year or so ago. You doing great. You're to be congratulated. And everybody remembers, Facebook Live with Tanya, some experts in the field of bipolar disorder. It'll be on Retreat Behavior Health's Facebook page, the 30th of this month, March at 6 pm. We'll look for you then again. Thanks for joining us on the Behavioral Corner. Did you ever think you'd wind up a guest on the show? 

Tanya Ruhl 

No. 

Steve Martorano 

Just get luckier or everyday Tanya. Luckier every day. Tanya Ruhl, Communications Project Manager. Thanks so much. We'll look for you on Facebook. Thank you guys, too, for hanging with us on the Corner. You know, we're here. Where ever you find better podcasts. all of them all those platforms out there follow us on facebook like us in general but like us on those other platforms. We appreciate that. We're also looking for folks you know give us a little get an opportunity to tell us what you like about the Corner what we can do we're here to please and serve. That's it for us for now take care see you next time bye-bye.

Retreat Behavioral Health 

Every storm runs out of rain, according to the great Maya Angelou. Her words can remind us of one very simple truth that storms do cross our paths, but they don't last forever. So the question remains, how do we ride out this storm of COVID-19 and all the other storms life may throw our way? Where do we turn on issues such as mental health or substance abuse, begin to deeply affect our lives? Look to retreat behavioral health, with a team of industry-leading experts, they work tirelessly to provide a compassionate, holistic and affordable treatment call to learn more today. 855-802-6600. Retreat Behavioral Health. -- where healing happens. 

The Behavioral Corner 

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