Lunar Moth

Being active — but not too much

I’ve discovered something new about my bipolar and what can trigger episodes. In the past I was able to function at a higher level — I could withstand the last-minute frenzy of deadlines, intense classes and studying, caring for small children all day by myself, jet lag and other hazards of travel, and similar stressors. In a word, I could be more active. I did have episodes back then, but they were much less severe and didn’t seriously impair my daily life. And it took a more intense, sustained period of stress to trigger them.

I did not know I had bipolar disorder until I was 33. Like many others, I have stopped and started my medications along the way. I also did not take seriously the suggestions from my psychiatrist on how to adapt my lifestyle. As a result, my condition has worsened.

In the last 6 years, since the serious episode of ‘01-’02, my activity level declined (partly due to medication) to such a degree that sometimes I slept several hours a day. I didn’t have a job or any social contacts where I live, I only had my family and some friends I visited in Dallas. I tried working several times but was not able to maintain it. Each time, I became very stressed and compulsive in my work, developed physical complaints such as pain over my entire body, then rapidly deteriorated emotionally, sometimes requiring hospitalization.

Even my home-based job as a freelance writer led me down that path. Earlier this year I began writing web content, and for awhile everything seemed peachy-keen. What I didn’t realize was that I was already entering a manic phase, which leads inevitably to mixed mania/depression and then deep depression. Once triggered, the cycle usually plays itself out, although some effects can be mitigated with medication and lifestyle. I am just now, in August, finishing the cycle which began in the latter part of January.

Now I know I must walk a very fine line. Too little activity, with its concomitant isolation, is bad for me and will cause depression. Too much activity, with its concomitant stress, is bad for me and will induce mania.

This is when I am very, very glad that God cares about me and will help me along this path. I firmly believe that the spiritual nature of human beings must not be neglected in emotional disorders (or any disorders). I encourage anyone with bipolar disorder to turn to the God of their understanding for assistance. Also, examine your life closely, not to condemn yourself, but to see cause and effect. In this way you will determine your own triggers and, hopefully, ways to avoid them.

Pdoc update

Last Wednesday I saw Dr. Hall for the second time since Timberlawn (it’s hard to believe it’s been six weeks!). He asked how many episodes I usually have per year, and I said 1-2. I didn’t say this at the time, but usually it is one major and one minor. He suggested that we work to decrease that to 0-1 (or even better, just 0), and asked what I was doing to help myself stay stable. I admitted that I had not been doing all the things I know to do. We discussed schedules in particular, and exercise. We agreed that I would do my best to make the lifestyle changes, then we’d reevaluate the situation to determine whether I need a change of medication.

In the past six weeks I have done very well with medication compliance — I don’t think I’ve missed a psych med even once in that time! (I have been less successful with the iron pills) This is a major improvement to the way it was pre-hospitalization. I was missing doses right and left and what’s worse, I didn’t care. Now I do! The next step is to apply the same dedication to the other changes I need to make. It won’t work to fix them all at the same time. One a week or even every two weeks is quite enough.

This week and next week (last two weeks of August) I will focus on Morning and Evening Routines plus Weekly Home Blessing Hour (on Monday if possible).

This is my Morning Routine:

Evening Routine:

Letting go

At the beginning of this week, I let go of a relationship that has been very important to me for 14 years.

There are many reasons I chose to let go. One, the relationship began as a one up — one down scenario. I was dependent on her for many things, most obviously financial support, but also emotionally and mentally. When I met her I was an emotional wreck and she was very stable and calm. I couldn’t support myself financially, which was why I moved in with her in the first place.

When a relationship begins that way (so says my therapist), it is unlikely that the balance of power will ever change enough to approach equality.

Two, I have spent the better part of the last 14 years in therapy. I have learned so much about myself and other people, I sometimes think I should teach classes! Most of what I learned I shared with her, but often she couldn’t see things from the perspective I had. She just didn’t get it. I have changed enormously, like 80%, while she has changed little, perhaps 10% at best. In spite of my mental illness, I have outgrown her.

Three, we are very different, like the sun and the moon. She is concrete; I am abstract. She focuses on logic; I am more emotional. I have empathy — the ability to put myself in another’s shoes, even if I don’t agree with the person — whereas she does not. She is fastidious about housekeeping; I am more relaxed. She thinks in black and white; I see gray areas. I could go on, but you get my drift.

I have determined, after a lot of agonizing and thinking and praying, that these issues are not going to change, and that I don’t want to live with her — I cannot live with her and stay mentally healthy — in the current circumstances.

I feel sad. Yo tengo triste.

Monthly woes

And the menstrual cycle strikes again! I guess I shouldn’t blame it; if I didn’t have one, I wouldn’t have 3 wonderful children either.

But for my emotions, it’s a big pain in the…. well, wherever you personally think the worst pain would be! Yesterday evening I had a relatively brief rage attack. I was irritable and I could have torn the head off anyone within range. I’ve been tracking my moods 3 times a day and while this one was not quite in the cellar, it was heading that direction!

Fortunately I was able to calm myself relatively quickly. I used one of my new entrainment CD’s several times in the past weekend. What, you may ask, is an entrainment CD? It’s a concept from a book, The Tao of Music:Sound Psychology by John M. Ortiz. To combat feelings of depression, he does not advise simply listening to happy music. I can attest to the fact that I often feel repelled by such “crap” when I’m depressed. It only makes me feel worse! Instead, he describes the concept of entrainment, which begins where the brain is — depression — then gradually leads it to the desired mood — something more positive, maybe contentment. Here is one of my entrainment playlists:

Kryptonite — 3 Doors Down
Ashes to Ashes — David Bowie
Why — Annie Lennox
Total Eclipse of the Heart — Bonnie Tyler
You Learn — Alanis Morissette
Under Pressure — David Bowie and Queen
The Sign — Ace of Base
Wedding Bell Blues — The 5th Dimension
Slow Motion — Blondie
Life in a Northern Town — Dream Academy
Killer Queen — Queen
Move Along — The All-American Rejects
Tubthumping — Chumbawamba
Come on Eileen — Dexy’s Midnight Runners

It may not be evident from the titles, but, for me at least, these songs evoke emotions that begin in the depression region, transition to a neutral area, then rise to hopefulness and happiness. This really does help! Ortiz gives some suggestions for songs & albums to use, including classical if that’s your preference, but I think eventually you might want a more personalized list.

I’ve also been reminded of the value of completed projects. They bring about a sense of immense satisfaction. I just completed a photo slideshow for a friend and sent her the DVD’s. I feel as though I accomplished something worthwhile by doing this for her. What a boost for self-esteem!

Therapist Difficulty

My therapist has, herself, experienced episodes of severe depression that required hospitalization.

This is both positive and negative with regard to having her as my therapist. On the positive side, she seriously understands what it’s like to have a mental illness — at least depression. She can easily spot when I need to be inpatient. She has an empathy that a non-mentally-ill therapist cannot have, by definition.

However, the negative of this is that her depression recurs and when it does, she is unable to fully meet my needs as her client. I don’t blame her for it; I know she doesn’t do it on purpose. Yet there it is.

Earlier this year she did spend some inpatient time in a nearby city (not where I went). Since then she has been doing much better, but lately she’s seemed much more stressed and she’s been less dependable about our appointments. I left Timberlawn a week ago yesterday, and I was meant to see her within 7 days. She canceled our original Thursday appointment, then this morning she didn’t show. She called me later and said she “had a sore throat and took some medicine for it and didn’t wake up until late” (it was after 11:00 when she called). Since I am expert at making excuses when I’m depressed, I take what she said with a grain of salt. What kind of sore throat medicine would make a person sleep so long?

I’m really concerned. I care about her personally, for one thing, but also there is the effect on my own mental health. I must have regular therapy, and I’m not sure she’s able to provide it. Because of this, I need to find a new therapist.

Not a Good Day

Today is not a good day for me — or should I say, I’ve had better. I’ve felt very tired all day. Not sure why. I went to Wal-Mart 3 times, but thank God (and sister Shelley & daughter Erin) I did not have to walk in this heat! I finally got my refills on all my meds. The most important one was the Zoloft, because yesterday I took the last 1 (I am meant to take 2) and didn’t have it today until about 4:15. This may be related to my tired feelings, I don’t know.

Being around so many people and especially interacting with them can be so exhausting for me.

On the plus side, I did some more cleaning up around the house. It’s gradually improving.

Stress: Did you know?

Here’s something interesting I learned while at Timberlawn Hospital: Did you know that when you feel stressed, your digestive, reproductive, and immune systems shut down? The pre-frontal cortex in your brain — the part designed for rational thinking — shuts down too!

Here’s why: Most of us have heard of the “Fight or Flight” (sometimes “fight, flight, or freeze”) response. This is what happens to us when we feel that our survival is threatened — if we experience an attack by human or animal, a fire, a tornado, or a similar potentially fatal situation. Stress hormones, adrenaline and cortisol, are released and trigger reactions throughout the organs and tissues. The body prepares to fight or run away by shutting down systems it considers to be not essential to the current crisis, and boosting systems that are essential.

This is terrific when there is actual threat to survival of ourselves or others. A mother may have ’superhuman’ strength to lift a car pinning her child. A middle-aged man runs a long distance quickly although he is normally winded by a flight of stairs. A nurse or doctor works 40 hours straight to save earthquake victims.

But what if, due to some malfunction in the danger alert system, the hormones are being released too often, when there is no actual threat? The digestive, reproductive, and immune systems, along with the pre-frontal cortex, switch on and off frequently and chaotically. The malfunction that causes this is usually a distorted perspective on danger, possibly resulting from past trauma or disruptions of brain chemicals such as bipolar disorder or depression.

…to be continued

Good to be home

I was released from Timberlawn Trauma Unit on Monday July 7 and traveled back home on Tuesday. Riding on the Amtrak this time was tortuously slow, although I tried not to get impatient. Instead, I reminded myself that the delay would make my eventual arrival that much more pleasurable! To a certain extent it worked. But when I finally reached my apartment at 11 pm Tuesday night, I was terribly weary yet hyped up on the adrenaline of anticipation.

I made phone calls to those who care about me, to assure them I was safe, then spent some time alternately petting the cats and running around trying to clean up. I could not believe the mess I’d left! It was a bit scary, because it showed just how bad off I had been. I’m not the best housekeeper even when “normal” but this time it was pathetic.

After awhile I realized it was time to go to bed and that I was just avoiding it by cleaning. Why? I asked myself. It turned out I was scared! No, not scared — terrified! I was afraid to be alone. I sat down and let myself feel it, and I cried some, then I hugged my stuffed cat and reassured myself that it would be ok. I prayed. I still felt scared. So I decided to journal about my feelings. I related my current feelings to times in childhood when I felt terror at going to bed. I slept with a small flashlight and a transistor radio playing all night. I felt bad for that little girl because no one, including herself, understood what was wrong with her. Expressing my feelings (along with the miracles of modern pharmacology!) allowed me to finally fall asleep in the recliner.

Since that first night it’s been easier to go to bed and I’ve actually slept in my bedroom when it was cool enough. I’m having to ease into the changes I planned to make; unfortunately, there is no way I can just jump right into doing all the things I plan to. But that will come, with time. I am sure of it.

Off to the hospital

Yesterday I saw my therapist and, after I told her of my depression and its extent, she suggested I go to the hospital for stabilization. Probably only a week or a bit more. I have been going to Timberlawn Hospital Trauma Unit for almost 4 years now. This will be the 4th time. In my opinion, the Trauma Unit is excellent and targets my needs very well. They treat symptoms, rather than disorders, which I think is a good idea since disorders are just attempts to categorize the wide variety of emotional symptoms. It’s easy to get hung up on exactly what someone’s diagnosis is, and also to make judgments about treatment based purely on the Dx and not on the person’s symptoms as a whole.

In fact, I like Timberlawn so much I wrote a review of the Trauma Unit and posted it to Associated Content:
Review:Timberlawn Trauma Program

I can’t say I’m glad to go though. I’m actually reluctant and dreading it. There is always the fear of people I don’t know, and the fear associated with being locked up and losing control over some aspects of my life. The fact that I’ve chosen to give up the control for my own good doesn’t make it any less frightening.

I’m fortunate to be getting a lot of support and encouragement. I really need it!

where next?

I have known I was bipolar for 11 years and I’ve had a lot of good therapy, beginning even before that when I thought it was just depression. I’ve been hospitalized numerous times as well. I know my disease intimately and I’m familiar with many, many strategies for alleviating symptoms.

But I feel there’s no point in all that anymore. I don’t want to try because it is just hopeless anyway, and I don’t have the energy. Trying to keep a positive outlook just makes me look like a fool, I think. It’s not going to change. It’s not going to get better, ever.

I feel I have an obligation to my family to keep trying, but it’s so painful. I just want to run away. I think to myself, I will just walk out my door to the highway and hitchhike to someplace far away. If I end up getting murdered, so much the better. I won’t really care.