Monthly Archives: May 2012

Hypomanic Menagerie

I’ve been having general symptoms of hypomania for the last week or so, insomnia, momentum, ideas, but my mood and energy both felt like they were in a normal/stable place. I wrote it off to a mini-episode, something I call a “point 5” (as in, it only registered as a .5 on my 0-5 mania rating scale), basically half a hypomanic episode.

Then yesterday, the hypomania broke through the flat dirt road of my stable mood and energy level, sprouting into a crazy tree of twirly branches and colorful birds.

I updated the blog. Read through 7 costuming books. Created 2 garment patterns. Spent a little time on online research. Then it was time for lunch.

I find myself constantly thinking of ways to describe what this feels like, when really I could just say,

“I find myself constantly thinking of ways to describe what this feels like”

Those moments of thinking long and hard about something are duplicated until there are 15 of those moments occurring at once, every once in a while I turn my attention to one of the topics to give a thumbs up or a thumbs down. I am the CEO sitting at the head of a round table of creatives busting their asses to make me happy.

And whenever this happens, I feel genuinely amazed. I mean, almost an awe. How did I ever live without this? Slow and inefficient? Having one idea at a time? Barely making a decision on my own?

(I can’t help but feel like anyone who scoffs at the idea of mania/hypomania addiction hasn’t experienced it, because when it happens, all other functioning feels insufficient.)

Meanwhile, all of this increased brain activity is coupled with a physical feeling in my chest. Something akin to eating a large bowl of pho (Vietnamese noodle soup) at my favorite restaurant and feeling warm to my absolute core. It says (very much like the pho), “bring on the rain Seattle because I am warm, I can take it!

(If you haven’t had pho, I would highly recommend it, especially in cold weather!)

That warmth radiates from the hum of a chainsaw, the energy pulsing through that rotating chain just aching to fell some trees. To tackle an obstacle hundreds of feet high. If I listen hard I can hear the hum as it pulses to my fingertips. My nose. My toes.

Needless to say, it is quite nice. This is where things become confusing for those of us that have felt this. I couldn’t call this experience evil (at least, not at these levels), and it feels life-altering. Right, even. It is hard to understand that, though people abuse various substances to try to achieve something similar, we are given substances that tend to erase it. Very tricky, and -as I said, confusing for folks.

Why can’t I keep, “quite nice”?

Anyway, those 15 creatives sitting around my board room table can get cranky at the end of the day if I don’t feed them enough bagels and good quality coffee. They start to slack off and text everyone they know instead of working. Or work too hard until they become obsessed. Or put on a slide show that contains repeated images of different types of drawstrings.

“Arrrrrg!”

I cried last night,

“Drawstrings! Drawstrings! Too many drawstrings!”

(I wish I was joking. If you want your boyfriend to think you are crazy, start ranting about drawstrings.)

Monkeys start jumping on the boardroom table. The copier breaks, blank paper shoots across the room.

By 9pm last night, my board room had become a menagerie. I wouldn’t exactly call it “quite nice” anymore. Maybe “not quite so nice”.

As I woke up this morning, the hypomania was just breaking through the flat dirt road of my stable mood and energy level, sprouting into a crazy tree of twirly branches and colorful birds.

A warmth begins. A chainsaw hums. And my group of creatives gather around the board room table, swept clean by the overnight crew.

DSM-5 Draft Criteria Open for Final Public Comment

I don’t know about everyone else but I have a hunch this is typical: when first receiving a psychiatric diagnosis I inevitably wanted to know where the names and criteria of these disorders came from. I was led directly to the Diagnostic and Statistical Manual; version 4 (also referred to the DSM-4). This is the book that holds the categorization and criteria for diagnosing an inexplicable range of mental illnesses.

Well, the DSM has been under revision lately, and the latest draft of the new version (DSM-5) can be found at the American Psychiatric Association’s DSM-5 Development page. May 2nd through June 15th is the last opportunity for the public to submit comments on the draft (posted on the website), and after that we will be able to watch the final proposals posted to the website (without the ability to comment) until it is published.

Many things have been changed (though some only minutely), but bipolar disorder (as well as borderline personality disorder, and major depressive disorder, to name a few) is something that has had some tweaking done.

Have you checked out the website yet, or the changes made to the criteria for bipolar disorder? Most notably, increased energy/activity has been added to the symptoms of mania/hypomania, which I think is a big step in the right direction. Had this been considered an indicator ten years ago, I am certain my diagnosis would have happened much more quickly.

Bipolar NOS (not otherwise specified) is now NEC (not elsewhere classified) which seems a bit silly to me to keep changing the name when people already have a hard time understanding these sorts of disorders. However, there are a few subcategories of NEC and a couple of “pace-holder” sorts of subcategories which may prove useful to some.

Mixed episodes are now proposed to be categorized by a manic or depressive episode (whichever is the dominant episode) with the label ” with mixed features” tagged onto it. The criteria is much more specific, and I’m not sure if this change is really for better or worse. Personally, I find mixed episodes to be some of the most confusing states I’ve ever experienced, so I don’t know if I believe the new criteria will make them easier to spot or will just exclude mixed sorts of episodes that don’t meet the full criteria for being “mixed features”.

Anyway, this is just a taste of the revision, and since we are approaching the end of the commenting period I’d definitely urge you to take a look at the website, you can find Bipolar and related disorders here, and consider shooting a few comments their way if you feel so inclined!

The Nature of Nature

I went camping with a girlfriend for the holiday weekend (since Corey has been out of town for work) at a historic themed event that we generally just call a rendezvous. A family friendly recreation of when the fur trappers used to get together to party and trade in the summers before the country was devoid of nice pelts (namely beaver) pretty much entirely.

I spent all week preparing the gear we would need, and I found it to be an interesting change of pace that I was feeling more excited than anxious about the impending trip. There was a lot of responsibility involved in getting ready, but these events send me into a specific kind of mode.

Relaxation mode.

I am not someone who can relax easily. I usually pull every trick I can think of out of my hat to try to make it happen, but in reality there is something about living in a modern setting that makes me feel completely destroyed more often than not. After only about 6 hours of returning to my apartment after camping the tension in my body was back to 80% or more of what it was before leaving, and after waking up in a bed this morning my body was screaming in pain.

This is a huge difference from waking up 24 hours ago on the ground. I do find sleeping on the ground painful, but it is painful in a completely different way. Body parts falling asleep in the middle of the night because of being pinned to the ground is painful, but if I move the pain is gone. While here, in daily living, the pain is constant -and everywhere. I expect it must have something to do with being unable to relax, which I just mentioned.

Even monday morning before packing up to leave I sat in an uncomfortable wooden chair looking up through the trees thinking,

“I honestly can’t remember the last time I felt this relaxed.

When I look at the bigger picture, it doesn’t seem possible that the experience is more physically relaxing than being anywhere else. Hard chairs. Sleeping on the ground. Cooking over a fire. Having to trek to the closest available bathroom. Not bathing. These things wouldn’t seem to be relaxing, by all means they would appear to me to be much more difficult than how we live today.

But the pace is slow. And nature is inviting.

The piece of land we camped on had a major thoroughfare on one side and a housing development on the other. It wasn’t exactly wilderness, after all I did just spend the last 3 days walking nearly barefoot on gravel roads. At the same time, nature was able to fool the senses a little bit. Tall trees blotting out planes and other lights. Shrubbery creating cocoon-like pockets of camps and winding trails to… someplace.

If there is one thing I’ve learned from camping all these years it is that nature’s elements can overpower all internal clocks and sense of urgency. Even Luna (my dog) who has an internal clock that goes off at 5 am every morning at home suddenly slept in, internal clock wiped clean.

I wake up when nature wakes me up with the sun or birds or rain. I sleep when I am tired. I eat when I am hungry. As the idea of time becomes less of an issue, so does the tension in my body. There is nothing to be late for, and if something is going on somebody’ll walk by and say, “hey, something is happening over there if you didn’t know.” It is a perfect recipe for living in the moment.

I had a small depressive dip that lasted about two hours on Saturday and I walked out into the woods, sat on a patch of moss in the sunshine, and it passed. In nature I didn’t have to worry about feeling trapped or claustrophobic by my apartment when this happened, and I didn’t have any reason to feel guilty for not getting anything done. As bad as I felt, it was the best I’ve felt about just letting it happen and moving on.

I guess I don’t have any specific conclusions, really just a reiteration of knowledge I already had. When doctors say, “avoid stress,” living in nature is the one situation I know that I can genuinely say I can do that. For someone who can’t usually relax, even just laying in the grass in the park can make me feel like some of the pointless modern drama I find so overwhelming has melted away momentarily. I can’t seem to decide if it is our culture, or if I’ve just been born into the wrong time.

The Power of Excitement

Excitement or anticipation are things that I think are often overlooked by those in the mental health community, which is a bit of a drag because I find excitement to be one of the biggest motivators of a good mood.

Over the last week, my boyfriend Corey has been out of town. This is something I usually have a lot of trouble with, and beyond the fact that I don’t have him around for his amusing (and helpful) company is something I really hate to admit; I find myself bummed out that he is off on an adventure traveling and working while I am sitting alone with our (rather needy) dog Luna.

His excitement and promise of a fun time away only seems to shed light on the fact that I don’t seem to be doing as much, having as much fun, or that my life has (well, let’s face it, it has a bit) come to something of a screeching halt due to my oh so delightful psyche.

What’s there to do?

The answer actually fell into my lap – memorial day weekend begins tomorrow. Each year there is a camp out held this weekend, a sort of “living history” event where people dress like it is in the span leading up to 1840. It is a family friendly version of a rendezvous, the sort of event where fur trappers would get together once a year in the same place to party and trade and tell stories.

This may sound a little wacky, but my family has been involved in these trips for three generations, I even attended in-womb, and I can’t help but imagine this setting has had something to do with the notion that my psychotic moments generally involve wanting to become a gypsy.

Anyway, I set things up to attend this weekend, and I will be delightfully cut off from technology and living in a canvas tent for three days.

You can not imagine how excited I was when I found out I could make this work and I could attend while Corey is away.

Suddenly my life had purpose! I needed to pack! I needed to find the lantern! I needed to season my cast iron skillets! And the anticipation of this impending fun has kept me busy, distracted, and upbeat almost the entire week.

In the past, this is something I’ve known to be true. I feel much happier having something to look forward to, and even in those times where I feel much less than stellar I can say, “oh, well at least I get to _____ at some point.”

On a much larger scale, I know that many parents have the milestones of their children to look forward to. Starting school. First dance. Graduation. Getting married. I’ve heard some people say that these long-distant events that a parent anticipates (especially a bipolar parent) can keep the proverbial motor running.

Other people travel and have trips to look forward to. Other people eagerly monitor which bands will be in the area to have concerts to look forward to.

In a life that involves constantly moving from point A to point B, excitement is something that gets us to point B feeling hopeful. Knowing there is something fun in our future when it can feel easy to think nothing is coming our way.

What I think is the best part about the excitement that comes with anticipation is that we can create it ourselves. Plan something in the future, something fun! Give yourself something to look forward to, and a reason to trudge from one day to the next -especially if you don’t feel like doing the trudging. You just might notice it can be a boost to your mood and a positive distraction.

A Balancing Act

As I’m attempting to navigate the waters of this week (I am now on day six of Corey’s absence) I am doing a much better job of finding the right balance of time engaged with others and time alone.

I wrestled for about an hour last night with the fact I was planning on going to a weaving guild meeting first thing this morning, the idea of which was making me feel incredibly stressed and I felt my mood begin to sink (though ever so slowly). The decision I made was that going would only be more stressful, which would cause more harm than good at this point.

I still woke up feeling a bit more morose than yesterday, but “a bit morose” is worlds better than day six of the last few times Corey has been out of town.

That balancing act is so hard for me to achieve, all of the things I want to do vs. the things that will help or hinder my mood, or even what I can realistically achieve. The process is about as far from my default action setting as possible, which is namely,

If I want to do something, I do it.

And if I don’t want to do something, I usually just still do it.

I find it extremely confusing to consider that the things that I like, like going to the weaving guild meeting, sometimes produce a considerable amount of stress and anxiety. This stress and anxiety makes me feel bad, which is the completely opposite of what I’d expect when it is an activity I like. Shouldn’t liking it make doing it make me happy?

No, apparently not.

This is where I give therapy a thumbs up, because without it I never would have reached this (seemingly backwards) conclusion.

So here I am, 9 am and still in pajamas, ready to take on the long list of things I have to do today (though feeling guilty about missing the meeting), I might be able to tilt things back in the other direction just a smidge. I can feel excitement starting to trickle back in where the anxiety was, but that is something I’ll tell you a bit more about tomorrow.

Insomnia; A Sign or Coincidence?

Insomnia is tricky business.

I instinctively attach it to an up swing, usually, because sleep becomes so unnecessary feeling (or impossible sometimes) while hypo/manic.

BUT insomnia can also happen during depression.

OR due to anxiety.

Or any other number of causes, either related or completely unrelated to mental health.

Insomnia is a symptom that I can’t readily identify what it means. I need it to be accompanied by something else in order to point me in the right direction.

I think many people are unaware of the fact that bipolar disorder isn’t just shifts in mood, but also shifts in energy. Sometimes we have to cut back on the amount of activity we’ve planned for, other times we need to do twice as much in order to expel that excess energy.

For me these energy drains and surges can happen in a matter of minutes, or happen gradually over a series of days or weeks. I know these energy fluctuations play a huge role in my sleep patterns, insomnia included. Sometimes I feel so drained all I can do is sleep, while other times I simply can’t seem to sleep at all.

When anxiety is involved, or a mixed episode, I get far too caught up in my head to be able to sleep. My body can be exhausted, but my mind is completely awake contemplating whatever the heck is going on, which sometimes is practically everything!

I have a hunch that the insomnia I’ve had the last couple days might not be related to bipolar disorder or anxiety at all, because it hasn’t been unpleasant, my mood is not awry (either up or down), and if it was a hypomanic sort of insomnia I almost always feel the need to get out of bed and walk around or use up extra energy that is in the rest of my body. There’s no series of racing or obsessive thoughts, no tenseness associated with the anxiety I generally have, so I’d take that off the table too.

Really the conclusion I’ve reached is that I don’t know where it is coming from, but if it isn’t a road sign for some kind of mood-apocalypse I really don’t mind too much. I seem to be getting enough sleep to keep everything fairly balanced (of course, I’m sure I just jinxed myself there), it just was eating away for a moment at the corner of my mind.

I do my best to follow the road signs to anticipate what my mood is doing/going to do next, but it can be difficult because they are in another language. Some signs I’ve seen enough times to recognize and know what they mean, but there are others I am still learning. And, given the ability for this disorder to change over time, it is possible I may be learning them for the rest of my life.

Bipolar Gamers & Programers

It might be my locale, but I would guesstimate that 50% of the people I’ve met in Seattle with a bipolar diagnosis have been (or are still) involved in computer/video game programming, game or software testing, or the like.

At first I thought it had to be some kind of fluke, how could this be such a common pathway that such a large chunk of the bipolar community I’ve met is involved in it?

Again, I realize I live in Seattle, and we are a bit of a hub for that sort of thing. BUT, is there something about the bipolar mind that makes for successful programmers? Does our introverted nature and ability to work in intense bursts make the perfect recipe for software and game development, or is it something different?

Personally, even as a girl, I have been enamored with video games since childhood. One of my early memories is waking up in the wee hours of a Saturday morning to wield that big red Duck Hunt gun hooked up to my Super Nintendo before my parents woke up. One could argue that this is long before any bipolar symptoms ever set in (though if you knew me as a child you might consider that slightly questionable), but it was my imagination that was transfixed with the notion that someone had created another world, a fictional one, that I could interact with.

Talk about escapism!

That said, I did plenty of other, regular sorts of kid things too. Made mud pies and fed them to my sister. Dug a giant hole for no apparent reason. Dressed friend’s little brothers in drag. The usual.

The trouble is that the feeling of escapism came back as a crutch in a big way in the early part of high school. As the world celebrated the millennium, I quickly found myself neck deep in a game you may have heard of called Everquest.

When does someone become addicted to a game? Well the fact that I was depressed certainly didn’t hurt. I was also young and a bit awkward and had braces, someone who tried to be invisible the first two years of high school.

But, in an imaginary place I could only reach through my dial up internet, I was a sought after companion. I was a girl. When you’re a girl and you are a gamer, you are a rare breed -a bit less rare today. Though I could have been a dude pretending to be a chick the whole time, I was treated like royalty, and was given an exceptional amount of attention that I was not receiving in real life.

Frankly, the whole thing was ludicrous, you can’t imagine the number of men who claimed they’d fallen in love with this (very blocky) elf character I made (who was a total prude -thank god I didn’t know anything about how to be sexy), and at 15 or 16 years old you can imagine that the attention felt very nice on my end. There was an imaginary land where I was someone popular who everyone wanted to be around, which was nice to think about because in real life I was sitting at home alone.

Anyway, when people are in the throes of depression (even mildly), escape can feel like an instant cure. There isn’t time to wallow in anything, or muse about life, or feel dread about whatever next awkward and painful milestone is coming next. When you feel alone, it is nice to have a place (even a virtual one) where everybody knows your name.

For these reasons specifically, I have to be very careful about how much time I spend playing video games today.

Part of me can’t help but wonder if this notion is one of the things that coaxes those of us with too many thoughts, or negative thoughts, to peruse a career around this virtual form of escape.

And, I wonder if the work in the programming industry itself takes on some of the same sorts of feelings of escape? Some jobs just don’t take up enough attention to act as a form of escape from the sorts of thoughts that people with bipolar disorder are often struggling with pushing out of their minds, and I can’t help but think that might be why so many people with bipolar disorder have such demanding jobs (and why some, it seems, can’t hold a job if it isn’t a good distraction).

Having a place for our minds to wander, whether that is a good book, a movie, or someplace virtual (like a video game) can really help get us “out of our head” and get a break from those unruly or overwhelming thoughts. An escape is a great thing to have in your arsenal of “tools”, so if you are someone who is able to spend maybe an hour a day enjoying an escape from reality I would definitely recommend it.

Just don’t pack your bags and live there.