Tapped Out

This week I went to not one, but two family reunions back to back (with a total of 12 hours spent in the car between the two days). At this point I will take the fact that I didn’t have any major meltdowns as a huge sign of success, I used the crap out of my DBT skills to remain on a fairly even keel the whole time.

Had I gone to only one event I think the aftermath would have been less jarring, but since I, an erratic and sensitive introvert, essentially spent two FULL days around large groups of people I felt quite a lot like I had been hit by a truck on Monday and could do little more than lay around in a grouchy state of exaustion. Moods have been touchy since then, I have definitely been crying more than usual, but I’m doing my best to manage while things even back out.

So I’m getting better at this, but as I’ve been saying the past six months taking it slow is still a big priority for me with these things. Unfortunately when sick grandparents come into play, taking things slow tends to get put on the back burner.

To some extent I feel like I am in a place where I can plan for social situations so I am having less issues with them, but at the same time there is a natural sort of suction that happens around people where my life force appears to be depleted simply by being in the same room. I’ve always just chalked that up to being an introvert, but it would be nice if there were some kind of anti-soul-suction suit I could purchase for these outings (like a diving suit?)  to keep me in the social waters longer without being completely tapped out.

At any rate, I’m still working toward un-exhaustion so this week’s post is short. I just wanted to mention some good news in that the T3 (thyroid hormone) medication Cytomel I’ve been trying for my treatment resistant symptoms of bipolar disorder & depression has officially been tolerated by my system for an entire week! Considering the fact that my body doesn’t want to tolerate medications at all most of the time (not even nasal spray) I’m feeling really encouraged. Whether it will work or not is a different story, but having gotten past this first week’s hurdle of not having any mind-blowingly horrific side effects is huge considering how few medications make it this far for me!

 

 

Bright or Blight

There is something strange about being old enough to see fashion recycling itself. I have a degree in fashion design, so I have been finding myself acutely aware of the fact that people half my age are now wearing reissued platform sandals and overalls.

I’m thirty and despite growing up on an island a few hours from Seattle I missed grunge. I don’t remember the kids in my school having many options in terms of fashion, my high school wasn’t awash with much style diversity. A lot of us wore whatever odd second hand clothes we could come by, and even those that seemed to linger on the fringes of the social structure typically didn’t make it all the way into the realm of “goth”.

I was infatuated with punk rock and found myself seeking out skinny jeans before they became a staple. I listened heavily to the Clash as a teenager and, bored with the social norms I had grown accustomed to every day, began dying my hair in bright, new, interesting colors.

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Me at the Denver Art Museum in 2003, Photo by Michael Putlack

 

That was a lot for a small rural town to handle at the time and every day I was greeted politely by someone telling me I didn’t belong. To be fair, they usually said, “you ought to be living in the city!” but no matter how it was phrased, I knew that we agreed on something: I didn’t quite fit where I was.

Experiencing the budding effects of bipolar disorder and psychosis in my teens made it hard for me to see a place for myself among my peers and as funny as it might sound, dying my hair orange (or blue, or pink, or green) was one of the only ways I felt like I could express that. Trying to avoid how different I felt, how much I felt like I didn’t fit in only acted as fuel for my depression and a little hair dye went a long way in helping me accept those differences and realize that being myself was something worth doing.

*

Living in Seattle the last ten years and working in the fashion industry in particular has meant seeing all kinds of trends come and go, both in style and in my own life. Some seasons I am happy about some cute boots and sweaters, some seasons I am happy with where I fit in the world. Other seasons everything in stores is mustard yellow (which is crap for my complexion), other seasons I find myself hating Seattle. The city has been tumultuous that way, and every March I tell myself I can’t stand anothe Seattle winter… but here I am.

I gave up the neon colored hair almost nine years ago. It was hard to keep up as a broke student and then, even working in fashion, it wasn’t something that was exactly welcomed when the economic crisis hit in 2008. Making my departure from the fashion realm didn’t pave the way for brilliantly colored hair either, there were no studies I could point to that suggested pink hair might sell more condos.

Somewhere in the interim I slipped back down into depression first, and then found myself with post traumatic stress disorder after a slough of unwelcome male attention. It seemed to be something that was all around me, coming from bosses and strangers and people I couldn’t seem to get away from. I found myself wanting to fold myself up like a tiny note and hide in a crack somewhere. I was having so many panic attacks that I had to wear sunglasses on the bus in an effort to hide the fact that I was crying most of the time.

So even when it began, when the citizens of Seattle began showing up more and more with brightly colored hair, it wasn’t something I could celebrate. I was too busy hiding to be willing to put a neon sign on my head, too busy wanting to be invisible.

That hesitation followed me for several years. I felt too afraid of the police, too afraid of anyone noticing how agitated I might be at any moment, how aggressive I might seem without realizing it, how manic I might be acting to feel like drawing attention to myself. I obliterated my wardrobe in an effort to remain unseen, packing anything noteworthy up in boxes or giving it to charity. I became an expert at blending in, even when I found myself so overcome by my symptoms of bipolar disorder, PTSD, & psychosis I was only really blending in with the rampant population of those living with mental illness on the streets in Seattle.

I told this to my therapist a few weeks ago and she seemed confused by the idea that I didn’t want to be seen, she kept asking why I would be afraid of people looking at me and if I was always afraid of attention from other people. Instead of try to explain how much anonymity has eased my anxiety about a local police force with a poor track record regarding those with mental illness and the expanse of men who have always seemed to believe that I owe them something simply for existing I revised my statement to say that so many people are dying their hair “just because” that it didn’t feel punk rock anymore.

Gross, I feel gross for saying that. At this point doing something because it is in fashion is not enough to motivate me, but not doing something just because everyone else is doing it is something I find equally disturbing. I don’t want trends or what people want or expect to play into the decisions I make about what I wear or how I look or the confidence I feel in myself. I want the freedom to look however I want, and even though chipping away at my own anxiety is what will eventually help me tear through all of that (though hypomania seems to work too) it is important to me to work toward doing what I want, regardless of any other opinion.

You know, when the idea came up of changing my hair again I really wrestled with it. I had so many excuses not to, I didn’t want to relive the past (heck, I’d already done every color), I didn’t want to spend the money, I didn’t like the idea of people looking at me… but ultimately I had nothing to lose (well, except hair and mine grows so fast it would only be a travesty for a month or two). Without remembering the sense of peace it gave me the first time around, the confidence, the comfort, I had a hypomanic sort of upswing a few weeks ago and just let it happen.

It’s true the fashion police in my head were in an uproar (“you’re just trying to recapture your youth!” they cried furiously) but something funny happened that I didn’t expect. I didn’t revert to a past version of myself, I just found her in one of the deep recesses of my mind reading John Irving. I tapped into her sense of levity and found that I feel more like myself than I have in several years. That might sound goofy, the idea that orange hair could produce such an outcome, but I find that I’m remembering what it was like back before I felt the need to hide all the time.

Whatever I thought might happen when people looked at me, well it hasn’t. Heads haven’t exploded, I haven’t had strangers trying to talk to me every five minutes, and I haven’t been approached by dozens of creepy stalker suitors because even though my hair is different, that isn’t the key. I am different too. I am older, yes, but also wiser. It has been important for me to realize that I don’t need to hide from unwanted attention, I am strong enough and capable enough to deal with it when it comes, even if there are times I don’t feel that way.

 

 

 

Thyroid Hormone for Depression

I mentioned recently that my psychiatrist has decided to change directions in how we try to treat the mood swings I have emanating from treatment resistant bipolar disorder (type 1).

In the past six years I have actively tried several benzodiazepines (like clonazepam, or lorazepam) , antipsychotics (risperidone, ziprasidone, olanzipine to name a few), mood stabilizers (lamotrigine, oxcarbazepine, gabapentin & more), and antidepressants (sertraline, fluoxetine, bupropion, etc.) but have always experienced either:

  • worsening symptoms
  • side effects severe enough to warrant stopping the medications
  • or tolerable side effects with no response from my symptoms.

The only psychiatric medication I’ve been able to keep taking regularly is Lithium, and while there is some debate on whether it is helping I’ve been taking it for long enough that I am having no side effects so the consensus is usually just to keep taking it.

Starting any of these new medications has typically made my mood swings worse (more frequent and more severe) so it has been a bumpy ride. After my new(est) psychiatrist got a good look at this happening she decided it is probably useless at this point to keep trying in these same classes of drugs I’ve had problems with. Needless to say, this was both a relief (hooray for no more psychiatric drug barrages!) and a little disheartening (alright then, now what?) but after all I’ve been through I’m more than willing to break away from this cycle and try something new.

Like anyone who finds themselves chained to the great lithium beast I have to go get my blood checked every few months to monitor the level of lithium in my blood. During these times I often also undergo other tests to check things like kidney and thyroid functioning.

Apparently my thyroid level doesn’t appear to be outside the range of “normal”, but my doctors have found that for me a tiny change can make a huge difference (as seen with my reactions to most drugs). My psychiatrist also told me that sometimes thyroid medications can be used to treat resistant depression, so our next route is to give liothyronine (cytomel) a shot and see what happens.

I always get a little nervous when I’m given a new drug to try and my doctor asked if I thought it would be better to start it when I am feeling more stable or unstable. That has always been a tricky question for me because if there are significant side effects a drug can easily take me from stability to a place of being unstable, and having less stability I tend to want to take advantage of those times as much as possible. At the same time if side effects occur when I am already very unstable I am less likely to cope in a healthy way so I told her don’t think there is a right answer here.

Ultimately, I’ve had the flu for the last week so as soon as I feel better physically I’ll start the liothyronine regardless of what my mood decides to do. This one comes with all kinds of obnoxious directions (take on an empty stomach at least 30 minutes prior to eating, no antacids for at least four hours after taking it, can’t be taken at the same time as vitamin or mineral supplements -sheesh!) so I need to do some work shifting all of my medications into a system that will allow me to follow those rules.

As scary as it can feel not knowing what will happen, I always feel some element of hope that this time might be different. If I didn’t feel that I’m sure I would have given up ages ago. It might be that I’m just stubborn or absurdly optimistic at times too, but it is easy to gamble when I feel like I don’t have much to lose and there is potential for increadible gain.

Putting Myself Out There

Despite how busy summer has been I have found myself doing very few of the things I wanted to do. I’m fully aware that feeling helplessness doesn’t look good on me, so I decided to try a few things outside my comfort zone in an effort to feel more in control of my own life and to pep up a potentially dangerous sense of boredom.

For better or worse, my sense of curiosity has always been able to steer me into the mindset of, “well let’s try _____ and see what happens!” Sometimes the results have been wonderful and sometimes they have been devastating, so when I went to work trying to decide what new thing to try I wanted to be a little conscientious of that fact. Ideally trying something new and maintaining whatever scrap of emotional and mental stability I have is the goal, but knowing that living with treatment resistant symptoms of bipolar disorder means that any little detail could potentially rock my brain-boat is challenging. I have often found myself opting to do nothing at all because doing anything is potentially risky (in terms of creating instability in my mental health) but, tired of doing nothing, I decided the reward was potentially worth the risk.

I have been described as having an “overactive imagination” and more than one therapist has told me that when things are perfectly fine my mind has a tendency to imagine problems that aren’t really there… these days I would consider this description to be something like a cute version of saying, “psychosis”. For a time I thought this might lend itself well to writing fiction, but back in 2007 when I tried my hand at writing a novel I found that I lost track of where the novel ended and reality began. The problems in the story became the problems of real life, and I abruptly vowed never to venture down that path again.

All this time I’ve been writing nonfiction instead, and while I’ve enjoyed writing for this blog the past five years I feel like I am constantly moving toward the point where I wont have anything more to say without being redundant. I’ve been learning a lot about myself and writing in the process (and I don’t expect to stop any time soon) but part of me has wondered if I could write about something else. Anything else, really. I admit there are times where I don’t want to think about my own mental health. I want the freedom to think of other things, of other problems, and for the love of Pete, to talk about something other than myself.

With a little experimentation I found that while writing fiction that takes place in a modern setting (like my writing in 2007) is too close to my own life for me to separate myself from it, writing about situations on other planets or in places I’ve never actually been seems to create enough distance to keep my mind from getting the two confused. It seems that following an odd story down a rabbit hole makes perfect use of my (previously useless) problem-generating brain because stories need conflicts to be interesting.

Writing any fiction at all certainly took me out of my comfort zone, but in the past few weeks I decided to take things one step further and I joined a local writing group. Frankly just getting out of my apartment to meet with them was a huge step and even though I was anxious as heck to make my first appearance I did my best to remind myself that they’re strangers, so who cares if they like me anyway?

It turns out they are all quirky, imaginative, and intelligent individuals and just passively listening to them share about the different projects they are writing was both interesting and encouraging. Within an hour or two I found myself holding conversations with people casually and I left knowing that I wanted to go back again.

Of course, I put it off a little. Since it is a critique group I knew that at some point I would have to share something I had written, and when I’m working on something I’m typically very private about it until the final version is completed. Even though I don’t like sharing something unfinished because of how vulnerable it makes me feel, I have had a lot of questions that I knew would probably be answered if I just powered through my anxiety and shared my work.

So the thing I did this week to step out of my comfort zone was to read something I had written in front of a group of people and listen to their feedback. I had a knot in my stomach all day leading up to the group and every five minutes I could feel myself changing my mind, thinking, “well… I’ll print these read along pages and bring them, but I don’t have to read them.” Then, “well… I will tell the moderator I have something to read, but maybe they wont get to me before the group ends.”

Finally, that night at the group after an hour and a half the moderator asked me, “do you want to go next?”

I knew that if I left without reading I would feel twice as anxious the next time around and I knew I couldn’t handle a double dose of anxiety driven irritable gut another day. I had already gone through 5 or 6 tums and it seemed there was little to do but press on.

I decided to take a leap of faith and even though it was wildly uncomfortable, even though my hands were shaking and my ribs were contracting as I powered through a panic attack while I read, I reached the last page in a triumphant (and slightly dissociative) stupor.

I never used to have problems reading aloud, not when I was in school. I gave so many presentations, so many speeches (even publicly at the state fair) that I never expected to feel so overwhelmed when speaking publicly. I know my anxiety is much worse these days, but I also think that the unfinished nature of my story and the effort I had put into it were huge in informing how nervous I was.

I also know that my Achilles heel is judgement. I’ve never taken criticism particularly well, never felt good about the idea of being examined and torn apart. I feel like I can say that I generally feel good about who I am, but there has always been the fear of judgement present in some form in my life. Fear of God’s judgement as a child, fear around the judgement from my peers in school, fear around critiques in college, and fear around the scrutiny of Social Security and the government as a disabled adult.

By the time I stumbled into the critique portion of the reading I had catastrophized the whole situation so much that it inevitably went much better than I expected. Some of my concerns were confirmed, some new issues were brought to my attention, but for the most part everyone seemed excited about what I had written, which acted as a cork in my odorous anxiety bottle.

My boyfriend, sweet as he is, went to work right away when I got home to remind me that I don’t need to take any of the advice I was given. I don’t need to change anything I wrote if I don’t want to. I know he has continuously witnessed the way other people’s opinions have acted like quicksand for me in the past. The defiantly obsessive portion of my brain loves to latch on to those statements without letting go, and I immediately found myself wrestling with them as they echoed (ironically) in my mind, “redundant, redundant, redundant…”

The difference now comes from the knowledge that has come from my DBT group. I know that when I’m closed in with the garbled echoes of disappointment or disapproval or judgement I can open the windows in my brain-house and let that stuff escape. I don’t have to be hosting the equivalent of a mental dinner party six years from now and set an extra place setting for “redundant” because it’ll be long gone. That’s the hope, anyway.

Having said that, I don’t know if I will read my writing aloud again any time soon. I need time to practice letting go of these comments, time to sort them out of the “terribly important, don’t stop thinking about this,” pile into the, “backlog” bin. If I can manage it without much incident I expect to have another go, because having the opportunity to practice letting go of, “this sentence is redundant,” is infinitely easier to me than having to let go of considerably more cruel and pointless scrutiny. Anything I can do to help myself learn and grow is good, but anything that also helps me learn to be less reactive and less prone to destabilization is a serious win.

 

Coping with Coping

Of all the things I’ve read and researched and talked about in terms of coping with mental illness I don’t think I’ve ever quite been prepared for the notion of coping with what comes next. Having poured my full attention (alright, we’ll say about 75%) into how to cope with living with treatment resistant bipolar disorder I’ve found which strategies have been helpful for me (DBT, ongoing therapy, group therapy, limited drugs and herbal remedies) and which haven’t (CBT, psychiatric medications -though my doctor is now trying a new approach which I’ll discuss later on, and the old fashioned I’m-going-to-stuff-all-my-feelings-down-and-ignore-them trick, to name a few).

In the time I have spent with the majority of my focus on mental health related topics (about 5-6 years) I often found myself growing in helpful ways, but then sort of falling behind every time I had a major episode. I would say that in that time I very rarely felt like I was able to get ahead of the curve when it came to my mood swings or anxiety and even when I was able to rebuild my own sense of self and self-worth from the ashes of a major depressive or psychotic funk my treatment resistant symptoms had a habit of pulling the rug out from under me all over again, requiring me to start at square one.

While I don’t like the idea of calling myself self-absorbed or self-involved, living this way (without continuously going full ass-over-tea-kettle) has meant spending a LOT of time crawling my way out of the dark corners of my mind with nothing but a spoon and a flashlight, or untangling myself from the intrusive thoughts that pop up, or needing to ask people to help me by doing things that seem strange to them, to say the least, in order to keep from constantly triggering me. I’m fully aware that this sort of living probably doesn’t look good to those on the outside looking in, and having to spend so much time focusing on my own issues has meant having a hard time with personal relationships (wait, when is your birthday again?) and generally seeming like a distant asshole.

That life, though, that sort of living and coping with the constant need to pay attention to every little detail inside myself in order to keep from being overwhelmed by it, that is honestly where I have built a (we’ll say -though not exactly) comfortable existence for many years. This is the world I know, the world that is 75% me dealing with my own mental health issues and having 25% of my time and energy and interest left over for things like relationships with other people, doing housework, leaving my apartment, having a job, and being creative. Showering. Playing with my dog. Discerning which banana has reached peak ripeness. Important things. If you consider it, 25% of my time isn’t a lot to try and do all of those things and I’ve had to cut out a lot of them, especially since that 25% has encompassed when I’m feeling at my best. In a full blown episode I might have only 5% of my brain available for all of those things, so obviously taking advantage of every resource available to me to try and increase that number has been my main priority.

Alright, so if that is a general approximation of how things have been the past 5 years, what does it look like when the numbers begin to change?

Even without a medication to help stabilize me my doctors and I are beginning to realize that I am more stable when not subject to a constant barrage of new medications to try. My system is simply too sensitive to keep playing medication wheel of fortune on repeat, but given the proper amount of down time to sweat out all those side effects I can function better without them (go figure). It isn’t the difference between being totally stable and in crisis, more like 25%-30% stable or in crisis. I’m not suddenly a rocket scientist or anything, but every little bit helps.

After that important discovery, DBT (dialectical behavioral therapy) coming into my life has made a huge impact. Again, not cured or totally stabilized by any means but I’m learning to cope more effectively. Instead of having to crawl through the dark recesses of my mind with a flashlight and a spoon it’s like I’m learning where all of the light switches are. When I’m getting tangled in obsessive or anxious thoughts I’m learning that the less I struggle, the less hold they seem to keep on me (like that plant in Harry Potter, oh, you know the one). With all of the things I am learning, I am definitely making changes in my life that are allowing me to go beyond having that limited 25% external focus.

But here’s the kicker. I’ve found that working on coping with my mental health issues isn’t enough. No, there is actually a subplot here where I am rapidly discovering that having time to focus more on the world around me, and particularly the people in that world, has meant having to learn a whole new set of skills to cope with the clarity that my newfound perception is affording me!

Being in a position to improve my own mental health has made it difficult for me to watch the people in my life who may not be coping with their own situations very well… and I may not have noticed how frequently many of them were struggling until I was able to look away from my own problems enough to see it. In a sense, I’m having to find ways of coping with the realizations and discoveries brought on by my initial coping and it feels like the most bizarre twist life has thrown me in a while (and I’ve had psychotic episodes so that’s really saying something).

Somehow… being more self aware has led to me needing to spend less time being self aware, and all that extra focus I’ve been able to put on the people around me because of it has made me see things I really didn’t notice before. The most maddening part of all of it is discovering that most people aren’t even aware these issues exist, or are quick to deny them, or cope in ways I know are wildly self deprecating and dangerous.

In that way, the coping that has been afforded me through DBT really started out as all hearts and stars (and horseshoes, clovers and blue moons… pots of gold and rainbows, and the red balloons!) but I’ve concluded that with the knowledge I’ve gained I inadvertently stumbled upon a double edged sword. I never asked to be able to use this strange, newfound mental health x-ray vision on others… I only wanted to use it on myself! Damn.

I’m doing the only thing I can do (or at least, what I can do and keep the relationships) and try to practice being nonjudgmental and accepting and all of that exceptionally difficult stuff, but there seems to be a natural shuffle where many aspects of my life (including my different relationships) are currently up for reevaluation because I’m seeing everything in a whole new light. I want a healthy life that will help reinforce the positive strategies I have been learning because without the aid of medication, they’re one of the only tools I’ve really got. At the same time we’re all human and I can respect the fact that no matter where I go or who I meet, the vulnerable flaws of humanity are not escapable.

As always, I’m working to find the balance between these things, even if the ride has been wholly unexpected.

 

 

PokéMania

I remember waking up early on a Saturday morning before my parents were awake to play Duck Hunt on the NES as a child. I wouldn’t call that my introduction gaming induced mania, but it certainly had me hooked on gaming.

By the time I was a teenager and my mood had begun to destabilize (even though I didn’t know it was bipolar disorder at the time) I found that the power I felt beating my teenage boyfriend at Mario Kart 64 on vs. mode 82 times in a row was obviously feeding something, and I didn’t quite know what it was or how to stop it -but then again I didn’t want to. It felt incredible.

By the time Everquest was in full throttle in the early 2000’s I was able to limp our computer and dial-up to a place where I could play it, and I discovered some very important things.

  1. I didn’t want to stop. Not to pee, not to eat, not to shower. Heaven forbid any of my family members needed to make a phone call, that was outrageous.
  2. The main reason I didn’t want to stop was because of how miserably depressed I felt in my daily life, and when I played Everquest I found myself feeling like a million dollars.
  3. Constantly choosing the sleepless mania of gaming and feeling good also seemed to have negative consequences in all other aspects of my life, but for a while I was feeling far too great to care.

After that blew up in my face I went years without playing another substantial game, I swore off of anything more rigorous than Wii bowling or Zelda. I hadn’t really displayed the ability to make good choices when engrossed in a fantasy world (particularly a social one) so I figured it would be best to let it lie.

But then, as an adult, I started dating a gamer. I started out trying to be careful, but before long I was being swept up by the Xbox 360 and then the Xbox One, feeling overwhelmingly tempted to stay up until 3 am because, well, everyone else was.

I wish I could say that the release of Pokémon Go this week didn’t rattle me, but the original debut of Pokémon landed right in the age-range sweet spot for my sister and I the first time around. We played the games, we watched the show, and our binder full of cards probably weighed a metric ton.

I knew it might be a slippery slope for me, but I had an easy out. With a windows phone I couldn’t download the Pokémon Go app, and my brand loyalty to Microsoft started out feeling like a blessing until I was sucked down into a vortex of depression. After two days of not being able to play the game everyone else around me seemed to be playing I felt miserable, and the safety of going without this game somehow transformed into a wretched despair over missing something potentially profound.

That night I couldn’t sleep, I could hardly eat breakfast, and as soon as the clock struck nine I was out the door headed to the mall. Before I had time to think, before I had time to react, really, I’d signed up for a brand new phone and spent the next eight hours setting it up so I could play Pokémon Go.

In hindsight it is hard to say if manically buying a new phone to play a Pokémon game is more or less embarrassing than last week’s manic interlude (after all, catching socially acceptable pretend creatures is probably less alienating to people on the street than collecting the dead corpses of real ones) but after the jolting, humming, rush of ecstasy subsided a day or two later I’ve been able to be a little more objective.

After spending the last five years getting to know my brand of bipolar disorder intimately and getting a grip on some of the things that trigger it for me I think I’m able to do a better job of regulating something I know can amp me up if I’m not careful. I intend to follow all of the rules I’ve set for myself playing any videogames in order to avoid issues with triggering hypomania and mania, things like:

  • No games after 10 pm (11 at the latest on weekends). Part of the reason games can trigger mania for me is that I lose track of time, and without having a set time in place for me to detach myself from the games and work on winding down before bedtime I wont be able to sleep. I’ve found that anything after 11 (and I try to be safe and stick to 10 pm) only makes me more alert and is huge for triggering insomnia for me. Guess what? Insomnia breeds mania!
  • Play at set times. I like to have a routine, to have structure in my day to make me feel less useless (since I’m just at home alone most days). My boyfriend and I play Xbox in the evening after dinner before we watch tv and I try to limit my Xbox time to that window (even if I am not always successful). Likewise I’m trying to limit Pokémon time to specific times of day (lunch time, walking home from an appointment (not to it or I’m likely to lose track of time), waiting for the bus, etc).
  • Limit my interaction with others. Ok, this might sound odd, but if I am starting to feel amped up and then I begin talking to other players who are equally amped up, I can easily become hypomanic or manic. Being aware of my mood state before interacting with people online or in person has been really important to help me understand how much I should interact and when to just be silent.
  • Food Food Food Food. I need to eat, and I need to eat more than candy and chocolate. I have to keep eating on my regular schedule, and not settle for eating a few handfulls of stale fruit loops becuase I am not willing to walk away from a game. If I don’t eat my mood gets all out of whack, and it doesn’t always mean a date with hypomania but that is one of the (less sucky) outcomes that could occur. Limiting caffeine is also huge, it has also triggered hypomania for me in the past as well as insomnia if I have any too late in the day.

As the case has been with everything lately, I’m working hard to try and find a sense of balance in as many areas of my life as possible. I want to be able to enjoy the things I want to enjoy (like catching them Pokémons) while remaining as stable as I can. It can be a tough nut to crack, but I’m hopeful that a little extra effort I can do it.

The Bees Knees

Though I do have mania that occurs on its own it has always attacked me more like a lightning bolt. It hits rapidly and jolts me into some kind of dream world before disappearing as quick as it came on.

When I have manic symptoms for an extended period of time they are almost always mixed episodes where depression intermingles with the lightning long enough to keep it grounded. In those cases the result tends to be more like ongoing electrocution, quite unpleasant really.

Of course, that is only naturally occurring mania. For someone who has spent five years cycling through medications to try to find one that helps out with my treatment resistant bipolar disorder, you can be sure I am no stranger to medication induced mania too.

Generally speaking, pairing an antidepressant with a depressed person can send that depression packing… but when you give an antidepressant to me (and to many people with bipolar disorder) my depression suddenly busts through its shirt like the incredible hulk and screams, “I’m the King of the world!” before doing a keg stand.

For whatever reason my body takes this phenomenon one step further. I can have mania induced by many different kinds of medications, anything from nasal sprays to opiate painkillers to antipsychotics.

I was reminded of this fact in full force over the holiday weekend while I was trying my hand at taking Geodon again. I slipped into mania without even realizing it, being far too wrapped up in my new life plan to become a ventriloquist to sleep and then crawling around in the bike lane of Seattle streets collecting several dozen dead bees that had gotten too much sap on their wings to fly, dying along the streets and sidewalks.

The funny thing in these situations is when I can actively think about what I’m doing and how it must look to all of the people walking past me but feel powerless to stop it, and then I go on to notice that I am totally comfortable with that powerlessness so I might as well just enjoy the ride.

It wasn’t until I realized that I hadn’t paid any of our bills, our rent, and hadn’t renewed our lease on time that I began to think that I might need to stop taking Geodon. Even then, I didn’t feel completely sure… thank goodness it was also giving me periodic headaches and stomach cramping or I might have let it carry on a few more days.

As expected, within forty eight hours of discontinuing it I was rapidly sliding down into depression. I had strained one of my quads at some point -probably when I was picking up all those bees, I can’t typically feel pain during mania so it is hard to say- and had to spend two days resting because I couldn’t walk!

It’s funny to me how even with medication induced mania I feel some sense of shame after it’s over. Like maybe I could have done something to stop myself, or recognize it earlier, or whatever. Of course my doctors and therapist have all told me that I shouldn’t be embarrassed because it wasn’t my fault… but there is something difficult for me about resigning to the fact that sometimes I really don’t have control over myself.

Needless to say, I haven’t been posting as regularly as I would like but now that I’ve experienced the worst mixed episode I’ve had in at least five years, the most intense period of mania I’ve had in five years, subsequent intense depression, and psychosis (a story for another day) in the span of about two months I’d say I’m doing pretty well, all things considered.