Category Archives: Mania

Total Eclipse of the Gut

For many years now I’ve been avoiding my gut instincts. Maybe avoiding is the wrong word, I’ve been wary of them and I haven’t been implementing them when they come up. I guess that is probably one definition of avoiding, but for whatever reason it feels important to me to add that part about feeling wary.

I’ve been thinking of my gut feelings as the product of an inner-office anonymous comments box and I’m the poor sap who has to sift through the comments that have been left there.

“This is a place to leave comments,” the box says, “ideas, and suggestions on how to make the office run more smoothly. They will be reviewed by management in the consciousness department.”

Of course, I haven’t been able to take the program very seriously when many of the comments have read things like:

Absolutely trust that guy who is inviting you inside his house and says there is free taco bell inside.

or

Can we please collect more roadkill? The IT department won’t even notice the smell.

or

Make Fridays “casual werewolf” day.

In the beginning I followed through with most of the suggestions in the box only to realize there are one or two A-holes in the office (damn you Psychosis! Mania! And don’t think I don’t see you sneaking around over there too Depression!) who keep leaving these bizarre notes they expect me to follow through on.

Without a filter to keep the odd comments from the important ones the results historically turned out poorly.

But that’s always the story, isn’t it? One or two bad apples ruining it for everyone. As the manager of the office inside my brain I’ve had to stop allowing comments from within myself simply to keep from doing some totally stupid and irrational things. The trouble is… all of the good, useful comments have also been discarded in the process.

In the meantime I’ve worked to try to improve the comments program. It has been temping every time someone has told me “just trust your gut” I feel like I ought to give it a second chance, despite constantly winding up in situations where I’ve taken away all of the pairs of scissors and staplers in the office during a busy week or deprived my employees of contact with the outside world for days until they go on strike and say, “you know, we really aren’t getting any work done at this rate.”

As someone who wants to manage this office well I’ve taken it upon myself to try to find answers. To research and test through trial and error what I could do to keep the team running. I’ve scoured the anonymous comments with handwriting analysis in hopes of being able to pull Psychosis’ notes from the rest (and the rest of those who love to throw a wrench into things) with no luck. I even hired on a new employee (Rationalization) to help manage the comments department but ultimately it didn’t seem to make much difference. Before long Rationalization seemed willing to justify why casual-werewolf-Fridays would be great and I had to halt the project over again.

While I was searching for a solution I wasn’t expecting things to get worse. One of my employees, Sexuality, began leaving notes in the comment box in an effort to make the break-room more LGBT friendly. I discarded all of those comments with the suspicion that they may have come from Psychosis playing a prank. Denying all of the comments meant denying the legitimate ones too, and before long Sexuality was upset and launching a full scale mutiny, bringing all of her closest co-workers on board. Depression wailed, Energy dropped dramatically and wouldn’t come out from under their desk, and Self-Worth made a very rude gesture at me during my 3 pm coffee break.

When Intimacy made a request to work harder on relationships in an effort to feel more connected I ignored it. I was certain it was Psychosis again, and even though I hadn’t seen them in weeks I thought for sure it was some game of misdirection. Pretty soon Anger snapped after a paper jam and ripped the feeder tray off the unit and Productivity simply stood up and said, “I can’t work in an environment like this, I’m going home.”

I watched chaos erupt from my cubicle and that’s when my phone rang.

“Yes, Department of Consciousness here,” I answered.

“This is HR,” a voice said. “It has come to our attention that you’ve denied a request to make the breakroom more LGBT friendly and I’m afraid Sexuality has come to us to file a complaint.”

Sexuality filed that comment?!?” I asked astounded, “Are you sure it wasn’t Psychosis?

“Sarah, Psychosis hasn’t been in in weeks, hasn’t even booted up to work remotely, there hasn’t been a need. I’m afraid the issue at hand is bordering on discrimination at this point so it needs to be addressed immediately. If you can’t take care of it, we’ll find someone who can.” The voice said.

“Of course!” my mind reeled, horror struck that I had ignored something so important. “Right away!”

“Good day.” The voice added.

“Wait!” I quickly cried upon realizing I’d never encountered anyone from HR, “Who is this?” But all I heard with a click followed by a dial tone.

 *

I’ve gone through years of therapy trying to figure out how to discern which piece of my internal dialogue to listen to, how to pinpoint the difference between when my gut says something to me and when it is mental illness pushing me in a specific direction.

Ultimately I reached the point where I felt the need to scrutinize everything that ran through my head before making any decisions. It didn’t keep me from having manic episodes, or depressive episodes, or psychotic episodes or doing wildly irrational things. All it did was create a backlog of personal issues that built up and began contributing to my anger and depression and paving strange avenues that I’d find myself trying to take to solve those issues when I was psychotic or manic. In some ways it seems as though Psychosis was trying to help me, attempting to take back doors to solve issues I wasn’t solving directly.

That is part of what has made everything so blurry. I was so worked up and emotional about some issues when I was psychotic (or depressed or manic) I couldn’t see how important the same issues were to me when I wasn’t. I simply didn’t feel the same level of intensity about them when I was feeling stable, even though they still mattered.

All this time I’ve considered psychosis to be like a bubble, like I could discard anything that happened within the bubble in which the episode took place and discount any aspect as being useful or informative (though usually a good story later). The psychosis bubbles that arose eclipsed my gut instincts entirely, or at least discounting anything within those bubbles often also meant discounting real and important instincts. Really, the more time I take to understand the issues I’ve been avoiding, the more it seems that my episodes have acted more like a magnet drawn intensely to those same issues rather than provoke or direct me toward new useless ones.

I’m sure all that is confusing, and it is to me too. Even so, this has been a huge revelation for me because it means the eclipse is ending. I’m realizing that there is value in every comment in that comment box, even the ones I considered to be a joke.

“You mean, you’re listening to yourself again?” My therapist asked last week.

*

I imagined myself in that office, smeared with printer toner and covered in paper cuts climbing on top of my desk and waving my arms.

“Alright! Alright!” I shouted at them. “I’ve been a terrible manager, I can see that now. Ignoring you isn’t helping us get things done and the box,” I kicked the comments box off my desk onto the carpet littered with remnants from the three hole punch and paper clips, “screw the box. The box isn’t working! From now on we’ll have an open door policy and if you need something you can come directly to me. Even you Psychosis,” I added as a fit of giggles came from over one of the speaker phones.

“I’m sorry I went behind your back,” Sexuality said to me as the last of the internal raging died down and we began cleaning up.

“I don’t blame you,” I replied, dumping the old comments box into the trash. “I guess I was so wrapped up in working on communicating to the outside world that I forgot the importance of communication here.”

*

“Um, yes,” I replied to my therapist, blinking for a moment. “I am listening, and I expect I have a hell of a lot to say.”

 

Advertisements

Big Picture Mood Charting

I’m sure those of you that have been reading a while know that I am a big mood-charting enthusiast and for those of you who haven’t, well, I get a real thrill from any kind of chart or graph in general. Don’t even get me started on those that can convey something as mysterious as the inner workings of living with bipolar disorder… that’s my jam.

I’ve spent a lot of time messing around with different charts and graphs as a result and ultimately I’ve found that there is one type of mood chart in particular that has been very helpful in providing a big-picture look at how my symptoms operate. I call it the “color band mood chart” and it is a way to visualize what types of episodes I have and when they have taken place over a period of time.

I’ve spent some time sharing about this type of charting before (here) but I wanted to revisit the topic because with nearly five years of data now on my chart it becomes very easy to see the comings and goings of my episodes. I live with mood swings that can occur over a long period of time (months) but also swings that can happen several times in a day so this method of charting is really useful for seeing my episode length and severity of symptoms in a single glance.

20160908_105507

This type of charting is done on graph paper and the key above denotes how the element of time is displayed in the chart. I have opted to leave out any mood swings taking up less than 3 hours in a day (even though they are often present) to chart the moods that encompass the longest period of time each day. I also limit the mood swings represented in a single block to 3, any more than that and I typically just consider it a “mixed episode” day.

20160908_105446

The key above shows what each colored box represents. Green areas are periods of stability. Blue represents depression, but darker blue signifies more severe depression (generally with some symptoms of suicidality). Yellow denotes hypomania with red representing full mania. Brown represents mixed symptoms and black represents more severe mixed symptoms (usually with psychosis or suicidality).

The chart below begins in 2011 and I’ve been compiling data every day (with the exception of a short period in June, 2011) since. Looking back and looking at the chart below I can certainly say that 2011 and 2014 were both pretty hard years for me and both required psychiatric hospitalizations. There have been other times I may have benefitted from hospitalization that I only really recognize by looking back at the chart as well.

20160908_105349

Sarah’s Color-Band Mood Chart showing bipolar episode length and severity  from 2011-2016

 

If you have been reading the past few months you might remember I had a pretty severe mixed episode in June and part of July and if you look here at the bottom of the chart you can see the dark shapes that represent that period as I fluttered between depressive, mixed, and elevated symptoms.

The information on these two pieces of graph paper have been huge in helping me convey my symptoms to my doctor and also to avoid undergoing treatment that isn’t potentially helpful to my own personal brand of bipolar disorder (as not all types of treatment are useful for all types of bipolar symptoms). I began the chart because I really wanted to find the patterns in how my episodes work, but as you can see there is really much more to my illness than experiencing symptoms at a specific time of year or alternating back and forth between depression and mania specifically. The chart has also been great for seeing how the medications I have tried have effected me and since my symptoms are treatment resistant it has been really important to have this tool to convey the way many medications have triggered (or worsened) episodes for me (like during the past few months) instead of quelled them.

It has been encouraging too to see episodes that were initially big chunks of depression or hypomania become smaller fractured chunks. Even without a medication to stabilize me everything I’ve learned about how to cope with the mood swings themselves has helped me bounce back out of them at times instead of staying locked in. Even though there are times I find there is little I can do to shake my way out of an episode, the smaller daily mood swings are something I’ve learned to cope with somewhat more effectively.

Just something fun to share and maybe some inspiration for those of you living with mood swings (bipolar or unipolar too). Being able to quantify the periods I am having problems has made living with my illness much easier to accept and try to treat.

For more information on mood charting (including other charting methods and tips) you can read “why chart?” as well as a number of other posts from Chart Week like “Personalizing Mood Chart Rating Scales or  “What else can I chart?”

 

Redefining My Urges

Trigger Warning: topic includes some discussion on self-harm, suicidal, and homicidal urges.

Lately I’ve been trying to do a better job of understanding the urges I feel and how they fit with my symptoms. Living with treatment resistant bipolar disorder has meant that even though I find myself having the sorts of urges everyone else seems to (though as human beings we all seem quite reluctant to talk about urges) I also experience urges brought on by my illness. On top of that, my ability to respond to these urges can be quite compromised based on what my symptoms are doing as well… but let’s back up for a second.

Urges are impulses. Strong desires. They are those feelings inside of us that scream out to “just do it” in certain situations. Sometimes my urges come only in the form of a feeling like gravity taking over and I act on them without thinking, sometimes they’re accompanied with thoughts that can encourage or discourage following an urge.

To break it down, here’s an example of a relatively healthy urge I have. A simple craving.

Urge: make eggs.
Thought: I do like to eat eggs.
Action: made eggs.

You can substitute chocolate in for eggs, chocolate is good. Or you could substitute tea, in which case the urge and actions become blurrier for me because I have dietary restrictions. In that situation having a chai tea latte, for example, becomes something I shouldn’t do. I will get sick if I have dairy, so the urge has a negative consequence –it becomes unhealthy.

Urge: drink a chai tea!
Thought: holy yum batman, but this will make me sick (Reminder: I can’t have milk or caffeine).
Action: urge denied, drank juice.

Even though drinking a chai tea is unhealthy for me, there are times when I am run down or worn out where the negative consequences of drinking one sort of fade out. In that kind of situation I find my thoughts work against me.

Urge: for pumpkin spice’s sake, drink a chai tea!
Thought: It is fall, I do like chai, and even if I get disgustingly bloaty and gassy and can’t leave my house for two days I don’t have any plans anyway.
Action: 20 minutes of sweet, sweet chai tea action, 48 hours of intestinal horror.

Finally, there are those situations where thinking doesn’t even come into play (I swear, I have a point here). If someone put the chai tea in my hand and told me to drink it, the impulse becomes much easier to carry out.

Urge: drink this chai tea in your hand!
Action: yes, thanks.

Alright, so this seems perfectly reasonable to understand when I am thinking about something mundane but delicious, like breakfast… but these same scenarios are true for most types of urges I encounter. As human beings, we come up against a lot of kinds of urges, but the ones I want to look at more specifically are the negative urges, the ones that we know will have (or are likely to have) negative consequences. Things like lying, cheating, stealing, violence, sexual attraction to inappropriate parties, overeating, overuse of drugs or alcohol, self-harm, and suicide (to name just a few).

Most of the things I’ve listed are not things people talk openly about despite how commonly we find ourselves feeling urges to do negative things. I’m sure there are people who excel at shooting down these urges, but I don’t think it is very clear cut. If my chai tea was now an act of violence (let’s say slapping someone in the face who had done something inappropriate), even a totally rational person might not deny the urge after several drinks.

Urge: that bitch just threw a drink in your face! Slap her!
Thought: I’m the bigger person here… she looks ridiculous, I can let it lie.
Action: deny urge, stand around dripping.

(But after several drinks, or a bad day, or after something particularly offensive like groping your partner…)

Urge: oh no she didn’t, slap her!
Action: slapping.

I’d say that, more than anything else, is why I don’t drink anymore. My mind, for whatever reason, seems fully capable of jumping from urge to action without being intoxicated.

Anyway, last example. Living with treatment resistant bipolar disorder has often meant living with suicidal urges on a regular basis, and this is one aspect of my illness that I think people understand least. You see, these urges are something I can typically rationalize away.

Urge: you should kill yourself.
Thought: I might not feel good right now but I’ll bounce back. Plus that sounds like a lot of work. Plus what about my dog? Plus I think people might get upset.
Action: still alive, despite lack of chai tea lattes.

But, as I mentioned with my chai example above, if I find myself in a position where extreme stress or a particularly long depressive episode has eroded my ability to think clearly, the urge becomes harder to contradict.

Urge: you really should kill yourself.
Thought: you’ve been pushing that nonstop for months, and I’m sure there is a reason I have resisted that urge in the past even if I can’t quite remember it now. I’d better call someone.
Action: call my therapist, she acts as a rational brain for me when mine isn’t working.

Then there are situations that I call “level 3” suicidality, and that is when hospitalization becomes required because the urge has consumed any ability to contradict with thought.

Urge: kill yourself.
Action: jaywalk, check into the ER.

I know it isn’t a pretty topic, I’m sure that is why it goes unmentioned most of the time. Just the fact that I spent so many years not knowing where the urges I felt were coming from or that they did not mean immediate suicide, or violence, or self-harm, that I still had a choice as to whether I would act on them or not, was exceptionally confusing and wildly detrimental to my sense of self-worth. On top of that, not knowing what kind of situations (alcohol, mania/mixed episodes, high stress) led me to jump from an urge to an action without thinking made it really hard for me to stop acting on the urges I felt.

Being unable to separate the urges I felt from the totality of who I thought I was meant years of trying to punish myself for urges I could not control in an effort to curb them because I assumed that “getting better” meant not having those horrible feelings anymore. Besides, urges that provide harmful consequences are not generally seen as normal in our communities despite how often people experience them because the topic is typically taboo. Needless to say, when I was sixteen and experiencing psychosis with homicidal urges I immediately assumed I was a terrible person who probably didn’t deserve to live, given the fact that I wanted so desperately to hurt other people. Even though I worked hard to deny those urges I still felt wildly ashamed for having those urges in the first place.

I still catch myself sometimes, telling myself that the urges I feel to self-harm or commit suicide mean I am something less that others, that it doesn’t matter how many worms on the sidewalk I frantically save from being walked on because overall I’m a terrible person.

But that simply isn’t true. (And I’m sure the worms do appreciate it in their own way.)

I can’t judge myself based on the urges I feel because doing so is like judging an entire library because one book doesn’t seem to get shelved properly on a regular basis. To discredit the entire system and collection because of one book seems absurd, especially once I’ve learned that there are many creative solutions for where to keep that book in the catalog.

As I’ve gotten older I’ve started to understand that everyone feels urges and that urges are outside of our control. We might not all feel the same ones, but I’m sure we’ve all felt an urge now and again we have felt ashamed of. Being able to take a step back from that shame has meant feeling better about myself and even though I don’t expect those urges to go away anymore, I just try to focus on the way I view the urge and how I choose to act when it comes up.

…and if I slip up and drink a chai tea now and again, I’m only human.

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.

 

 

 

 

Inspiring Inspiration

Writer’s block. Drawing a blank. Creative stagnation. If you’re a creative person, you’ve probably felt it at one time or another. Working on a project or in a job that requires constant new ideas and drive to complete them often  sounds great until I realize just how much inspiration is required to keep up.

People have typically always considered me to be a very creative person and I feel lucky to have grown up with one parent gifted in fine arts and another who is a skilled musician. Both were constantly supporting my desire to be creative, even when I made a change from attending a typical university to go to art school.

I don’t remember feeling very hard pressed for inspiration as a kid or through school. Ideas seemed to come easily while making videos or sketching or writing (really bad) poetry, and it wasn’t until I found myself in a job as an adult that I really began to struggle with trying to balance having a job and being creative.

The funny thing is that I was working in design in the fashion industry and most people would probably consider the work of a fashion designer to be creative, right? I had trouble trying to align inspiration with the rigorous, fast-paced schedule of the companies I was working for and ultimately didn’t feel much creative fulfillment.

The more I worked, the more my creativity seemed to be totally tapped out. I wasn’t doing projects at home, not even drawing anymore, and the more depressed I felt the more frustrated I became. The constant pool of inspiration I had been able to draw from previously seemed completely gone and I couldn’t help but wonder why or where it had gone.

Increased creativity is often said to be connected to those with mental illness, though we still don’t quite know how or why. It doesn’t surprise me because living with bipolar disorder has allowed me to experience extreme mental states like mania and psychosis where it has felt as though I have ideas faster than I can recognize them. Many of these ideas seem to take root like small seeds that quickly grow on their own until they’ve created a jungle of fiction around me.

I know I am not the only one to have seen this jungle and said, “ah ha! That’s where the pool of inspiration must be!” In severe moments of frustration at not being able to produce things creatively at the rate at which I have wanted to I have found myself grabbing a machete and traipsing into that jungle like Ponce de Leon looking for the fountain of youth.

It can feel easy to believe that this is the one and only source of true inspiration when I am not used to having to work for it. After all, who would want to work for something they can get for free, right?

As I have gotten older I’ve come to believe that my mental illness isn’t the one and only source of inspiration. I’ve been able to create things while stable, even while depressed, so my idea that mania is a prerequisite for creativity has become somewhat antiquated.

What got me thinking about this topic was writing. I started this blog five years ago and, surprise surprise, I was in a pretty elevated state heading somewhere near mania at the time. I could sit down and write post after post, but as time wore on I found myself having to work for that inspiration that came so easily at first.

I had a goal to keep writing, and the biggest change I made was to shift my mindset from being someone who let creative ideas flow into me to someone who actively pursued things that interested me. Lo and behold, the more I scientific articles I read, the more people I talked to, the more blogs I read, the more I had to say.

I always wondered why people would say, “if you want to be a writer, read a lot of books.” The more I read and the more I write, the more true I find that statement to be. When it comes to my mind I’ve been ignorant about the fact that to get something out, to produce something, I need to take something in first.

Now that I recognize it, the concept makes perfect sense to me. When I was younger I drew inspiration from being in school. Constantly learning new things about history or art, talking to people and hearing new points of view; if you think about it school itself is a breeding ground for inspiration, I just didn’t know it at the time.

Beyond that, what is my mental illness but a constantly changing experience informing my senses in new ways all the time? In a sense, bipolar disorder has informed me emotionally the way reading has informed me in a literary way; it has been a platform for me to absorb something new without realizing it.

It seems totally reasonable that becoming more stable might make one feel less creative  when we consider how easy it can be to lean on the unprompted ideas sparked by mental illness for inspiration instead of taking up other hobbies or interests that might produce similar results.

Needless to say, I think it is really important to teach ourselves where to look for inspiration and how to capture it without having to rely on something that can otherwise be detrimental to our lives. I truly believe that creativity does not require an element of self-destruction. Sometimes it might take a little more effort to initiate that creativity with activities and engaging our senses, but imagine the things we can learn and pass on along the way!

Inspiration can come from anything, anywhere, any time. For me, finding it is about putting myself in a position to experience something new, whether that is experiencing something emotionally, visually, physically, or mentally, etc. Paying attention (being mindful) to what I am experiencing is key to getting something useful out of it, but I don’t go in with any expectations. Sometimes it takes me a few days to let something stew for inspiration to pop up, sometimes it happens right away. It is all about the mind making new connections.

Here are a few ideas for ways to help inspire inspiration:

  • Watch something new
    • Youtube
    • Movies
    • Television shows
    • Plays or musicals
    • Comedy
  • Listen to something new
    • Music
    • Audiobooks
    • Street noise
    • Sounds in nature/wildlife
  • Read something new
    • Books
    • Magazines
    • Blogs
    • Web Articles
  • Learn something new
    • take a class or workshop
    • Youtube how-to videos
    • watch how someone does their job
    • volunteer
  • Experience something new
    • Attend a sporting event
    • Meet new people
    • Join a club or group
    • Try out a gym
  • Be somewhere new
    • In nature
    • In the city
    • Travel
    • Take a new route home
  • Create something new
    • try a new hobby like pottery or knitting or photography
    • try a new medium like watercolor, charcoal, ink
    • allow yourself the freedom to make “mistakes”
    • try writing or drawing prompts
    • try a new genre for writing like mystery, romance, or non-fiction

One of the benefits of experiencing mental illness in my lifetime is that even in periods where I am stable, I am able to draw on that experience. Sometimes, like with this blog for example, I might not be having an episode and there is no intense emotion to fuel a subject for my writing. I’ve come to actually enjoy those periods because it allows me to write about my mental health in a different way, I can shift my perspective to think about topics like creativity when I might normally be too engaged with feeling depressed or manic to consider them.

Ultimately I’ve reached the point where I am happy to be learning how to inspire inspiration for myself without having to rely on my own unpredictable behavior. The most helpful elements for me have involved making an effort to step outside my comfort zone (and be open minded about it) and chasing what interests me. While it is true that “chasing what interests me” might be making my boyfriend a little crazy right now (because what interests me is South Korean pop music videos) there is little substitute for the feeling of feeling a new idea take root and watching it grow.

Back in the (Rx) Saddle Again

Living with treatment resistant bipolar disorder can be really frustrating, not just for me but also for those around me. With symptoms that have responded atypically (either worsening or not resolving and accompanied by outrageous side effects) to the traditional route of pharmaceuticals normally used to treat bipolar disorder I have to shift all of my focus onto using skills to help keep me calm and rational.

Even doing everything I have encountered; things like meditation, dialectical behavioral therapy skills, living openly about my illness and asking for help when I can, paying close attention to my diet, sleep, and exercise, -that bipolar spark in my brain remains elusive and unchecked. Under the right conditions, my big mood shifts can happen in whatever direction they choose and I find myself along for the ride.

Lately I’ve been seeing that frustration growing in my healthcare team. In the last two months I’ve been taking a significant shift into depression, enough that both my therapist and new psychiatrist (of about 6 months) have become edgy. My therapist let slip that, “well you would think something should be helping by now!” and my psychiatrist sat, horror-stricken, when I replied to her question about what we should do about my depression with, “well the past few years nothing has worked so we typically watch and wait, requiring hospitalization as necessary until the episode ends.”

Unacceptable!

Maybe so, but it is my life. As much as I dislike being subject to frequent mood swings and psychosis I have reached the point of feeling some form of acceptance over my situation. I can’t throw a fit (though sometimes I do) every time a new treatment option doesn’t go my way, but the slightly pissy attitudes of my healthcare team the past few weeks has initiated something of a domino effect kicking people into gear.

On one hand, it feels nice to know that my psychiatrist feels inspired to do everything she can to try to help me. On the other, after a constant barrage of negative outcomes from medication after medication the past few years I am pretty familiar with how it can feel to be a guinea pig. I’m not saying I am opposed to new options, quite the opposite. I want to keep trying, I want to move toward a life that is stable and more functional, I just need to find a balance where I can do that and not have to be pulled along in the wake of each drug that’s had a negative effect without being able to take a break. When psychiatrists take me on it can be easy for them to look at me as a sort of challenge and they feel eager to throw everything at me they can think of right away without giving me time to recover. It has tended to make me both more physically and mentally sick while this is occurring, so it is important that I can balance pursuing new treatment options and living some of the life I am working to improve.

After how hard it was cycling through medications the last go around (2010-2015) I have been floating around using my cognitive skills and sitting tight taking Lithium that isn’t helping. I have actually been doing better without the barrage of new drugs constantly eroding my mental and physical health, so I have just kind of been waiting for the right doctor, or something new to come on the market, or for things to get rough enough to push me back into feeling willing to roll the dice again.

I wouldn’t normally consider my current state of depression severe enough to make me desperate enough to move back into that place of uncertainty, but last week my boyfriend was gone for 8 days and I was really concerned about being home alone that whole time and having the added stress of taking care of our sick dog on my own.

My new psychiatrist is focusing on making tiny changes in medications (hoping that my big reactions to regular doses might be mitigated by tiny doses) and trying things that have a low chance for making my overall health worse.

We started with a huge increase in my fish oil consumption, up to 2400 mg daily of highly concentrated oil (with a bunch of other specific properties I can’t quite recall). I couldn’t tell if it was helping while my boyfriend was out of town, but I didn’t feel worse, so for depression that was causing me to steadily deteriorate that may have been enough to give me a more level playing field last week.

If the fish oil was helping keep me from sliding further into depression, the plan went to hell a little bit when my boyfriend came home from his trip with a broken shoulder. The immediate jump in stress level left me plummeting and I was frantic this week trying to take care of him, and the sick dog, AND me.

I found myself in a situation where I can’t really afford to be screaming at my neighbors or paranoid out of my mind at the grocery store so I called my psychiatrist and agreed to try an antidepressant again.

I tried Zoloft a few years ago in a similar situation and was manic within a couple days. My boyfriend found me feeling high out of my mind in our apartment jumping around uncontrollably and he thankfully had the frame of mind to point out to me that I was acting a little strange.

Naturally, the idea of taking an antidepressant isn’t one I’m too keen on (I’ve had several mixed or manic reactions over the years to them) but I find my psychiatrist’s theory about trying the tiniest little bit to be intriguing, mostly because I’ve had the same thought myself and anytime I’ve brought it up to a doctor before (or my sensitivities to medications) they always just prescribed a regular dose anyway.

Yesterday I tried 1/8 the dosage of Zoloft as I did the first time around. 12.5 mg, half of a 25 mg pill that is so small I keep losing them. I was able to sleep (which is a good sign) so I expect to keep this up and see if anything happens.

In the meantime I’ll be here doing the best I can.