Rescue dog helps Fargo woman manage challenges of bipolar disorder
FARGO -- Naomi Woods describes her psychotic break as sliding into an abyss with no way out.
The experience terrified her husband, best friend and son, but she doesn't remember it.
"All I knew was I couldn't control anything. I mean, I could barely control my breathing, and I wasn't real conscious of anything," she said.
The 50-year-old Fargo woman later learned the episode was part of her bipolar II disorder.
Dr. Michelle Jorgensen, who's worked with patients with bipolar disorder at Fargo's Sanford Eating Disorders & Weight Management Center, calls it a "two-pronged illness."
Although bipolar can exist without depression, symptoms primarily consist of mania-depression cycles that vary in frequency and severity.
"It's so much more than being up or high or down or low. It can rapid-cycle in a day. It can go from way up high to wanting to commit suicide within a day," Woods said.
She compares her fast-talking, "Tasmanian devil" manic state to her lethargic, not-wanting-to-do-anything depressive state.
"It wasn't even 'didn't want to,' it was 'couldn't.' A lot of people confuse couldn't with wouldn't," she said.
Depression usually comes first, followed by mania, Jorgensen said. But it's characterized by extreme -- not normal -- ups and downs.
"It's not just a vacillating in mood; it's not 'moodiness.' Moodiness is moodiness. Bipolar disorder is wild fluctuations that meet full criteria for mania and full criteria for major depression," she said.
After she was diagnosed, Woods' past started to make more sense.
"When we looked back, we went, 'Oh look, there was an episode and there was an episode and there was an episode,'" she said.
She'd been hospitalized before, but until her psychotic break, no one had put the pieces together or given her symptoms a label.
"It wasn't just 'hysteria.' It wasn't 'made up in my head,'" she said.
While in mania, people with bipolar disorder often get into trouble with their friends, family or the law.
They might exhibit reckless behavior, including sexual promiscuity, drug and alcohol abuse, gambling, speeding or running up their credit cards.
"Your filter's gone, so you do whatever feels good," Jorgensen said.
Woods, who lived in San Diego before moving to Fargo, recalls impulsive behavior during manic episodes.
"The boys loved mom on mania because I would wake them up at 5:30 in the morning on a school day and say, 'Get dressed, we're going to Disneyland,'" she said.
Like others with bipolar disorder, she doesn't like to sleep when she's manic.
"It just wastes time. I could be doing something," she said.
Jorgensen said it's not insomnia; it's not that you can't sleep -- it's that you don't need to.
"You can imagine that if in your mania, you're drinking more or using drugs more or not sleeping or doing these dangerous behaviors, you can get hurt and worn down," she said.
Woods later realized that when she was younger, she was using drugs to try to "balance" herself out.
Jorgensen bristles at the flippant use of the word "bipolar" ("Ugh, she's being so bipolar.")
"If you truly have bipolar (disorder) and your brain chemistry can't be brought into balance, that's different from the person who's being called bipolar because they're being mean or unwise," she said.
Jorgensen said patients struggle with whether to take their medication long term in order to prevent big episodes.
"Because when you feel OK in the interim, and you're taking medicine with side effects, it's hard to take it every day for the rest of your life," she said.
Woods, who calls herself "med-compliant," is currently taking a mood stabilizer and an antidepressant.
She estimates that medication keeps her within a manageable range 85 percent of the time.
"Every now and then, I'll break either high or low," she said.
Finding the right medication takes trial and error, and a medication may stop working for someone.
"I learned it's the 'practice' of medicine, and it really is a practice," Woods said.
But she stresses that medication isn't the be-all, end-all to treatment.
To avoid potential cycle triggers, she carefully monitors her sleep schedule, diet, exercise and stress management.
"Like an addiction, it doesn't go away. You manage it. It's very similar," she said.
A rescue dog from a San Diego drug house plays an important role in Woods' day-to-day life.
"By the time she was 6 months old, we started noticing that she was capable of sitting at my feet when I wasn't OK. She already knew that she was supposed to take care of me," she said.
Black Lab/boxer mix Fargo senses when a chemical change begins to occur in her brain. Sometimes, it's evident when Woods is rocking or shaking.
When that happens, Fargo sits next to Woods and leans into to her.
"She 'marks' my behavior for me, which is different from 'Mom, I don't feel good,' 'Mom, I'm hungry,' 'Mom, I want a treat,' 'Here's a toy, will you play with me?' All those are different behaviors," she said.
They've been working together for the past two years, and their bond is undeniable.
With her service vest on, Fargo is allowed to go anywhere the public's allowed, but strangers are discouraged from interacting with her while she's "working."
Woods sometimes gets looks when she explains what Fargo does, but she doesn't want people to be afraid just because they don't understand.
"This is what 'normal' looks like. I'm a normal person who's a recovering drug addict, who has a bipolar disorder, who is a mom, who's a wife, and who has dark, curly hair," she said with a smile.