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Steve Martorano:

The Behavioral Corner is produced in cooperation with Retreat Behavioral health, where Healing Happens.

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've discussed the ways we live today, the choices we make to 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:

Hi, everybody. Welcome to the Behavioral Corner. It's me again, Steve Martorano. You know, here I am, hanging on the corner again, waiting for somebody really interesting and informative to come by. And darn, if they don't always do that, at least we hope you find them interesting. We certainly hope so. Behavioral Corner, real briefly. I call it a podcast about everything because everything is what affects our behavioral health one way or another. And it couldn't be more appropriate to talk about, uh, mental health than, uh, here in the beginning of, uh, may, which has, uh, traditionally been designated Mental Health Awareness Month, the entire month of May, we'll be focusing on all aspects of our mental health, uh, the disorders, how they're treated, uh, the whole, uh, nine yards concerning mental health. Big topic, uh, in addition to, which is a special carve out in the first week of May, which we find ourselves in right now and that is mental children's mental health awareness. A very important subtopic about mental health: and we're gonna do that, as you can see with, uh, a, a duo today. Uh, as our guest, Tanya Rule is a, uh, contributor to the program in the past. She is a member of Retreat Behavioral Health, our underwriter partners, uh, but she joins us as a civilian today, uh, civilian, uh, mom and a, uh, person diagnosed with a bipolar two disorder. Her son, Dominic, he's the one with the cap on, joins us to discuss his struggles with a similar diagnosis, uh, with an additional wrinkle that I think is exclusively, uh, the, the domain of young people. Uh, that's an oppositional disorder. You remembered. There's kids that don't listen, I guess. I don't know. We'll find out about O D D as well as we, uh, take a look at, uh, both children and generally mental health awareness month. Guys, thanks for joining us, Sonja. Thanks so much. We had some technical difficulties to begin this thing, but we got it straightened out. Thank you for your patience, Dominic. Thank you. Tanya. We've talked about your struggles with, uh, your successful struggles and your ups and downs with mood disorders. I don't know that we've talked specifically about bipolar. First of all, what's there's, there are several levels. There are two levels, right? Bipolar one and bipolar two.

Tanya Ruhl:

Yeah, there are two main levels. Bipolar one and bipolar two. Yeah.

Steve Martorano:

Yeah. And the, the difference is one more severe than the other, or how does that work?

Tanya Ruhl:

Not necessarily more severe. Bipolar one, um, has more ups than downs. So there can be a lot more transfer between the manic and the depressive episodes. Where when you're classified as bipolar two, you usually have more depression episodes. than manic episodes. But you have to have at least one manic episode in order to be diagnosed as bipolar two.

Steve Martorano:

Yeah. And how long ago were you diagnosed as bipolar two?

Tanya Ruhl:

2006 is when I was diagnosed.

Steve Martorano:

And before that, that you were being treated with just strictly for depression, or was there something else going on?

Tanya Ruhl:

No, I wasn't treated for anything. I didn't think there was anything wrong with me. <laugh>.

Steve Martorano:

Yeah, yeah, yeah, yeah. Yeah. Well, I've heard that from so many people who wind up with a diagnosis of either just depression or bipolar more, more likely. And that is that, well, you know, except for those manic episodes, which often were thought of as well. Just, you know, you know, he's, he's excitable or he's, you know, he's rambunctious or he's compulsive, uh, until they go, you no, there's something else going on. Here's this, another thing going on. Was it a relief or was it frightening to find out that you had a mental disorder?

Tanya Ruhl:

Um, a little of both. It was a relief because there was a reason why I was feeling the way, I was feeling a little bit scary because I mean, even now there's still a lot of stigma with mental health disorders mm-hmm. <affirmative> and 2006 was worse than what it is now. So it's one of those things where how is this gonna affect my life? Do I tell people, do I not tell people? Like, there's a lot of different caveats to it. Mm-hmm.

Steve Martorano:

<affirmative>. Yeah, I know. It's amazing. As in as, uh, forward thinking, uh, we've become on these issues, it still lingers. It's the stigma, the fear, and it all comes out of really not knowing a lot about what's going on. Just for, for, uh, purposes of description, there are two essential positions you can be in as a person with bipolar disorder. One is a, when you're, when you're, when it's in full bloom, you have these manic episodes mm-hmm. <affirmative> often followed by depression. Well, we know what a depressive, uh, episode is like, but talk a little bit about the manic episodes. How did they manifest themselves for you? What were those manic episodes like?

Tanya Ruhl:

For me, I was very irresponsible. I would spend money, even though I didn't have it. I wouldn't pay bills because I decided that something else seemed a lot better. And a lot of times it came down to I literally was broke and I had to move around a lot because of that, because I wasn't paying my bills. Mm-hmm. <affirmative>, um, I would have irresponsible relationships. Mm-hmm. <affirmative>, there was a lot of different things that Yeah. I did before I was medicated <laugh>.

Steve Martorano:

You know, you know, it, it is so remarkable, uh, because I've spoken to many people who've been diagnosed with bipolar two disorder and their behavior, uh, is very often, uh, the same as you've described, particularly, uh, with regard to impulsivity and lack of control and, um, recklessness.

Tanya Ruhl:

Yeah. It's like an idea pops into your head and it's the greatest thing ever, and you have to do it. You almost get like hyper fixated on it.

Steve Martorano:

Yes. Yes. And all during that manic period, ironically, you are feeling fine. Right? You feel great.

Tanya Ruhl:

Yeah. You have no sense of consequences at all. Right.

Steve Martorano:

And when confronted by your behavior from others, what was your reaction to it?

Tanya Ruhl:

Well, it would depend on like, where I was in the cycle. Sometimes I would just blow it off and be like, you don't know what you're talking about. And then like, if I was starting to go towards the depression cycle, I would be like, oh my gosh, what is going on? And like, that would almost like flip things for me, which would then automatically put me into the depression.

Steve Martorano:

Depression. Yeah. The, I've heard people describe like, interventions or, or family members or, or employers going, why are you behaving like this? And the bipolar, uh, person would go behaving? Like, what? I feel great. I feel like Superman. What do you, why don't harsh my mellow, I'm doing okay. Tell me about the transition in your bipolar disorder. Could you feel the, the manic episode coming, or does it sort of gradually occur?

Tanya Ruhl:

For me, like, even now, because I occasionally have breakthroughs, obviously but like, I just remember feeling like really, really good or feeling really, really bad, like I don't really ever remember the transition, if there is one. It's really hard for me to explain <laugh>.

Steve Martorano:

No, I, I understand. I mean, and in managing this thing, my, in my experience, talking to people, uh, if, if there were a better understanding of those transitions or triggers, you know, you might be able to manage them better if you felt them coming on. But you say it didn't work like that for you one day you were real up and you don't know how that started. And then the next day you were deeply almost dangerously depressed. Right?

Tanya Ruhl:

Yeah. There were times where I just wouldn't wanna get outta bed and I was a single mom and three kids

Steve Martorano:

During the depressive period.

Tanya Ruhl:

Yeah.

Steve Martorano:

Yeah. Yeah. What made you finally go and see somebody to, to find out what was going on?

Tanya Ruhl:

Um, my mom actually had encouraged me to go.

Steve Martorano:

Had anybody else in your family ever exhibited behavior like this as you were growing up?

Tanya Ruhl:

My biological father. Now, he's never been diagnosed with bipolar as far as I know, the only condition he was ever diagnosed with was depression.

Steve Martorano:

Mm-hmm. <affirmative>. Mm-hmm. <affirmative>. Mm-hmm. <affirmative>. It's such a mysterious, uh, and tragic condition that we don't know what causes it. As I understand there is no cure, but we're gonna talk to you a little bit about treatment ahead. And Dominic, I promise I'll get to you. I'm not ignoring you, man. I see you. Uh, so you, you go to see a, uh, specialist, a doctor, and they diagnose you. Was the diagnosis pretty quick? Did they pretty much go Well, you're bipolar.

Tanya Ruhl:

Well, I had to fill out this like, literally like a 20 page questionnaire and then after they reviewed that, I believe it was the same day, um, they told me You have bipolar disorder.

Steve Martorano:

Yeah. And they can do that just and ask you a series of questions concerning your behavior. Yeah, yeah. Yeah. It, it, it's a pretty standard diagnosis. I mean there, there, there aren't many shades of bipolar two. People pretty much act the same way, right? Bipolar?

Tanya Ruhl:

Yearh. Very similar. Yeah.

Steve Martorano:

The symptoms are, are, uh, almost exact across, uh, different people. So what did they do? How are they treating your, you've been now, did you say two, uh, 2006 was when you were diagnosed?

Tanya Ruhl:

Right.

Steve Martorano:

You've got a bunch of years, uh, under your belt and you're handling it. I hope, uh, I know you are. How do you treat bipolar two disorder?

Tanya Ruhl:

Are different medications that everybody can be on? I had a real struggle in the beginning with medication. Not only medication compliance, but the medication itself. When I was first diagnosed, the medication I was on had me only awake for seven hours a day. And that wasn't all at the same time. And again, that was a huge concern for me because I was a single mom of three kids, you can't be awake for seven hours a day. It doesn't really work. I mean, Dom was less than a year old at that point. So I was, I was able to find somebody to work with me on the medication aspect. And I've actually been on the same medication now for over 10 years. But finding that one can be extremely frustrating, um, discouraging. And again, it's, it's medication compliance because when I was first diagnosed, as soon as I would feel okay, I'd stop taking it. And that's because like, especially for me growing up, you stop taking a medication once you, you feel better. Like you don't, you're not always on it. And again, because of that stigma, as soon as I felt like I was okay, like I was stable, I would stop taking it and then it would happen all over again.

Steve Martorano:

Yeah. There's a couple of things about that that I want to explore with you. One is that although we're talking about a mental health disorder, that behavior about stopping medication, we do that generally. And every doctor you ever go to, I don't care if he gives you something for a cold, or he'll say, finish the medication. The minute you feel good, don't stop. You gotta take the medication. We all wanna stop taking medicine. Nobody wants to take medicine. The application of, of medicine with bipolar. And correct me if, if you or just disagree if you disagree, I think finding the right medication that would help a bipolar, uh, disorder sufferer is equal parts science and art. In other words, you don't hit it the first time. Right?

Tanya Ruhl:

Right. You can sometimes.

Steve Martorano:

If you get lucky, right?

Tanya Ruhl:

Yeah.

Steve Martorano:

Yeah. So they have to adjust your medication. And as you point out during that period of time, can be very frustrated. Were there times when you just said, this isn't gonna work for me, this stuff's not gonna work for me, or, I hate the way it makes me feel.

Tanya Ruhl:

Definitely the first ones I was on were absolutely awful for me. Now I know they work for a lot of other people, but for me they don't.-Hmm.

Steve Martorano:

Well, you know what I mean? It's so important that people talk about this and can see you, you know, you don't look like you're having any problems and I know you're like anybody else. Uh, you have good days and bad days. So, um, finally for you, Tanya, let me ask you this. Uh, you're on the medication, you've been on the medication, you've, uh, straightened out, um, what you should take and when you should take it. Great job with great people, a family. You still have ups and downs, don't you? Are your ups and downs more your garden variety or do you still view them as symptomatic of bipolar two?

Tanya Ruhl:

I would say they're still symptomatic, but not as extreme as if I was on medication.

Steve Martorano:

Well, I get it. I mean, the idea is to manage this condition, not to conquer it. Right?

Tanya Ruhl:

Right.

Steve Martorano:

Because we just don't have way. So having set the stage for us, Tanya and, uh, uh, been very candid about how difficult this is would be difficult for anyone, but for a, uh, person trying to raise, stay in, stay in gainful employment, get their finances under control and raise their kids, the last thing you need. All right. Dominic, sit up straight, is a kid that just doesn't seem to wanna do what you tell him to do. Is that the situation you confronted with Dominic? And when did it start?

Tanya Ruhl:

Well, actually, both my sons have a bipolar diagnosis, but Dom's here with me today. You know, it started when he was younger. He was, when he was in elementary school, he was diagnosed with, uh, A D H D.

Steve Martorano:

Right.

Tanya Ruhl:

So we were trying to treat that all these years. And about a year ago, we were like, there's no way that this is the only thing that's going on. So we talked to his counselor and his counselor recommended a place that does really intensive testing. Um, and he went like every week for four weeks. And then we had to wait six weeks for the results because like, that's how crazy this testing is. And he actually wasn't diagnosed with a D H D at all. He was diagnosed with oppositional defiance disorder and bipolar two.

Steve Martorano:

Talk about good news, bad news. Uh, bad news is obvious. The good news is, oh my God, they finally know what they're talking about. Let's see if this works. Uh, Dom, how did you, you know, everybody knows about the terrible twos. You probably, we don't remember being two years old, but anybody's been around a two year old. Uh, even when they flip out, uh, generally speaking, most of the adults in the room will go, oh, it's the terrible twos. They're just the tantrums and all that. Describe yourself for me when you were, when you were little, when you could remember what you were like. Were you, what kind of kid were you?

Dominic Ruhl:

Chaotic. Horrible. Like, I'm sure I was good at some points, but like most of the time all I remember is hearing stories of me, like just being bouncing off the walls or just, just going crazy.

Steve Martorano:

Was the behavior, um, confined to just your home? Or did you, uh, were you all over the place at school and in and with your friends when you were playing?

Dominic Ruhl:

Everywhere. It was everywhere. I was crazy. Yeah.

Steve Martorano:

Yeah, yeah. Yeah. It must have made it tough for you and your friends. Tanya. He's a handful. Right? I mean, you know, everybody does the same thing when they have a kid who's hyperactive or, uh, or throws, has a short fuse. Did Dominic, did you have a short fuse? Did you get angry real quickly?

Dominic Ruhl:

Yeah. Yeah. Very quickly.

Steve Martorano:

Real quickly, were you bad at sharing your toys?

Dominic Ruhl:

Not really. I don't think so.

Steve Martorano:

Oh, really? Oh, so there's no way of knowing what would set you off, right? You just would go off?

Dominic Ruhl:

Yeah.

Steve Martorano:

Yeah. When they were treating you for a hyperactive uh, disorder, what was it Ritalin? What were they, what were they treating him with?

Tanya Ruhl:

Ritalin and vyvanse.

Dominic Ruhl:

Yeah, I was adderall when I was a kid.

Steve Martorano:

Adderall as well? Yes. How old were you when they started medicating you with, uh, things like that?

Tanya Ruhl:

Eight.

Dominic Ruhl:

Yeah.

Steve Martorano:

Do you remember how you felt as a seven or eight year old taking that stuff?

Dominic Ruhl:

I didn't like it.

Steve Martorano:

Why?

Dominic Ruhl:

Um, on one of 'em, I was like losing weight really, really badly. Like, it was like unhealthy amount of weight that I was losing.

Steve Martorano:

Is that typical Tanya, that that can happen?

Tanya Ruhl:

Yeah. Which one was that?

Dominic Ruhl:

The Adderall.

Tanya Ruhl:

Adderall. Yeah. The doctor had said like, we had to go in every month specifically, not only to get new medication for him, a new prescription, but also he was small to begin with. So they were very, they said from the get-go that they were concerned about weight loss and it was like three months consecutively. He had lost a decent amount of weight and they finally said, you know, he can't be on this medication anymore. And the doctor told me this, so I did it on doctor's orders. But he literally had a milkshake with protein powder in every night before he went to bed.

Steve Martorano:

Just to keep from losing weight?

Tanya Ruhl:

And he still lost weight.

Steve Martorano:

That must be, you know, that's gotta be terrifying cuz the last thing in the world you want to do, your kids shouldn't be losing weight, they're supposed to be getting bigger and, and chubby. How did Adderol, for instance, make you feel? Dominic? Did it dull you or were you in a fog or what was it like?

Dominic Ruhl:

It helped, like, it honestly helped, but like, it was just like the weight loss part that was like...

Steve Martorano:

Side...side effects were, yeah. Yeah. So it it calmed you, it calmed you down.

Dominic Ruhl:

Yeah.

Steve Martorano:

You were able to have, uh, a normal relationship. You were able to sit in class, pay attention but you're wasting away, right?

Dominic Ruhl:

Yeah.

Steve Martorano:

Right. Um, before they got a handle on your diagnosis, Dominic, did you just think people were picking on you? They, you know, leave me alone. I'm okay. What they they weren't treating you like you were sick, they were treating you like you were bad, right?

Dominic Ruhl:

Yeah. Yeah. Yeah. Like my teachers would be like, you need to calm down in class. And I'm like, I like, I thought I was like being normal. Like, I didn't think I was like being a disruption or anything. Like in my mind, like it was perfectly normal for me to be like, bonkers in class or at home or anything.

Steve Martorano:

Right. You were just, you were just an exuberant kid. Right? As, as far as you were concerned and everybody was acting like there's something wrong. Not that there was something wrong with you, but that you were annoying. Let, let's face it, that's what it's really about. You were just upsetting the room, right?

Dominic Ruhl:

Yeah.

Steve Martorano:

The teacher couldn't get the job done cause there's, there's Dominic in the back jumping up...How bad was it? I mean, would you like not sit in your seat or,

Dominic Ruhl:

I was, I'd just be walking around the classroom like constantly like breaking my pencil so I could go sharpen it. Like, I just had to constantly be moving.

Tanya Ruhl:

So the one teacher he had was actually really good for him, and I kind of wish he'd be able to have her all through school. She had him on like an exercise ball as a chair so he could bounce up and down. Ah, but she also put bungee cords around the front of the desk so he could put his feet on them and bounce them up and down.

Steve Martorano:

Just to burn off some of the nervous energy, right? Yeah, yeah, yeah, yeah, yeah. Yeah. Fidgeting around is something you see a lot of kids do. Um, and most, you know, in the bad old days you would be told to "Stop that, put that down, stop that." Which gotta, it's gotta lead to like great frustration, right? If you couldn't move around like that, it would be awful. Right?

Dominic Ruhl:

Yeah. It would be awful.

Steve Martorano:

Tanya, what was it? How many times were you called into the school and said, we we gotta do something here?

Tanya Ruhl:

A lot. Yeah.

Steve Martorano:

Yeah. Yeah. Did you ever have the occasion to tell the, uh, counselor or the teacher, well, you know what? I got problems. I think my son's got the same kind of problems. Did you have the conversations like that with the educational establishment?

Tanya Ruhl:

I did. And I, I got a lot of opposition back from them. They would have to take steps to, um, I don't wanna say correct things, but like more would have to be put out. So he would have, um, yeah. An acceptable environment to learn. And unfortunately where we were at at the time, they didn't wanna do that.

Steve Martorano:

Yeah. Even 10 years ago, which is around the time you're talking about.

Tanya Ruhl:

Yep.

Steve Martorano:

Um, schools were not very proactive in kind of accommodating these children with these disorders. Their goal they felt was the other 20 people in the class, not the one that's the problem. Right. Um, you know, as well as anybody that the only advocate for your kid is you.

Tanya Ruhl:

Right.

Steve Martorano:

You know, and no matter how helpful they say they want to be, if you're, it's the squeaky wheel. Right? Dominic, let me ask you some, let me ask you some questions. You're now, would we say you were 16 years old, right?

Dominic Ruhl:

Yes, sir.

Steve Martorano:

So you've been managing, um, the O D D, uh, and the bipolar for a bunch of years now. How has it improved, um, your friendships, your schoolwork? Uh, do you look back on those days and wonder how you survived?

Dominic Ruhl:

I'm still wondering how I'm surviving sometimes, but yeah, like over the years, like having like good friends and like opening up to my mom or my dad about like, what's keeping me like from like, what's holding me back or anything like that. Like doing stuff like that helped a lot. Like, like I would talk to my mom more about it because like she has the same diagnosis as me with bipolar. So like that helped.

Steve Martorano:

Strange bonding. Uh, strange bonding. A young person like yourself, it must be very frustrating, uh, you must have known was a problem and not be able to explain it. Uh, much less, you know, manage it. But were your friends aware how I should say how, how early were your friends aware that you, you were take for instance, taking medicine? Are they aware now?

Dominic Ruhl:

Um, probably only two of them are aware.

Steve Martorano:

You suspected there are more of your friends or, uh, people in your school that are on the same kind of medication you are and you don't know about it either?

Dominic Ruhl:

I wouldn't be surprised.

Steve Martorano:

People don't talk about it. The kids don't talk about it, do they, uh, Dominic?

Dominic Ruhl:

Mm, not really. Some, it just depends on like, if, like, some people like think it's wrong for them to like, or like embarrassing.

Steve Martorano:

Yep. Yep.

Dominic Ruhl:

Like, they think that it's like just an issue when it's really not an issue. It's just something that you have to live with and like work on.

Steve Martorano:

Yeah. Yeah. Yeah. Are you, are you still, um, I don't know. I mean, I'm not suggesting that you should go to a school assembly and stand up and say, hi, I've got bipolar disorder, <laugh>. But, but are you, uh, does it sometimes still bother you, um, that you haven't been diagnosed with something like that?

Dominic Ruhl:

Yeah, like...

Steve Martorano:

I mean, in terms of, in terms of being open about it?

Dominic Ruhl:

Yeah. Like, I wouldn't like go around and like, just openly like tell everyone, like if someone asks me like, Hey, like, do you have any mental disorders? Or like, have you been diagnosed with any, like, I would obviously like, be welcome to like, answer their questions or like, tell them about it.

Steve Martorano:

You would? Yeah.

Dominic Ruhl:

Mm-hmm. <affirmative>. Yeah.

Steve Martorano:

Uh, Tanya, uh, well that I bring it up because I think one of the reasons we have something like Children's Mental Health Week or May as, you know, mental health awareness month is so that more people like you guys, um, can do stuff like this, come on a, a podcast and talk about it. Uh, but, you know, just widen the circle of people who understand what this is about, uh, do you feel, do you feel, um, Tanya, that, that that's something that you've been more and more willing to do as the years have by?

Tanya Ruhl:

Oh, definitely. As years have gone by, um, I am not really afraid or ashamed to tell people. Um, and honestly, a lot of it too, for people who have a diagnosis and don't talk about it, I really think a lot of it comes down to like a little, a little bit at least of shame. Because, you know, everybody wants to put out like their best persona, and as soon as someone hears that you have a mental health diagnosis, many times automatically you're judged by that. Mm-hmm. <affirmative>, you know, so part of the reason why I don't have a problem speaking out about it, especially now, one, I have it as best under control as I can. Um, but two, I know where I to be and from where I used to be to where I am today is miles and miles between Astronomical, um, I didn't before, before I was on medication, I couldn't hold down a job. I'd have a job for a couple months and that was it because I'd be like, oh, I have money. I think what I want now. and I don't need my job, you know?

Steve Martorano:

Right. Right.

Tanya Ruhl:

But I mean, I've been with Retreat now since June of 2015.

Steve Martorano:

And, uh, listen, I've worked with Tanya on a couple of projects over the years that I've been, uh, partnered up with, uh, retreat and just, you know, as a, as a, uh, an endorsement. She's, uh, as competent as anybody I've ever met. Um, you know, uh, and worked with you two are great. I mean, you two are great. I mean, the idea that you're sitting there and you both, you know, you know, both look healthy, you both are smiling, uh, and you're managing this, uh, this very serious problem, or can be a very serious problem of a mental health disorder and willing to talk about it is really, uh, encouraging. It really is. Congratulations to both of you continued success, and I know you know this, but it's worth reminding other people, at the end of the day, we all get up and we're all struggling to get through that day. I don't care if you've never been diagnosed with a problem in your life. It's only a matter of degree that separates us from somebody with bipolar disorder every day. <laugh>, you gotta get to the end of the day and hope the wheels don't fall off. Um, for people with, with mental health disorders, it's a, it's more difficult, there's no doubt. Uh, but we're all in this together, so we help. We thank you so much for your, your, uh, you know, personal testimony here. It's, uh, encouraging that people are open about this. We appreciate it. Tanya Ruhl and, uh, her son, Dominic Rule, thanks for joining us on the Behavioral Corner.

Tanya Ruhl:

Thanks for having us. Thanks for having us.

Steve Martorano:

Always a pleasure, guys. Uh, and, uh, for, for those of you, um, with us, don't forget, push the subscription button. Follow us on Facebook and wherever you get your podcast. I'm there. Okay. See you next time on the Corner. Bye-bye.

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