Category Archives: Variables

The Stress Variable

Has you doctor ever told you, “well, just avoid stress,” as a solution to one of your medical problems?

I have. It is the most infuriating thing ever. In our day & age, is it possible to avoid stress when stressors are attached to:

  • Technology, when we can be reached at any moment of the day due to cell phones
  • Jobs that “follow us home” due to technology or demanding fields
  • Health problems and seeking health care
  • Family, who can be supportive at times but stressful at others
  • Money, which for those with very little of it, can be the king of all stressors
  • Events, like holidays or planning a vacation

And really, the list could continue, couldn’t it? I feel like the list of things that stress me out is infinite, but ultimately there are a handful of things that each person could probably pinpoint as the most stressful for them.

For me the issue of insurance is one that I can’t even talk about for very long without getting completely enraged. Few things have upset me as much as the health insurance game, especially since I don’t consider my health a game. Red stress alert, indeed!

Chances are, if you have bipolar disorder you are more susceptible to stress than the average joe. Stress can act as a huge trigger, and cause even the best of us to have sudden meltdowns.

What we don’t normally think about, though is that stress can sometimes be used for good. I know, blasphemy, right? But here are a couple things stress has done for me:

  • Sometimes stress, like a specific event coming up, can help motivate me to complete tasks or projects that hadn’t gotten done. If someone is coming over, for example, I can be motivated to clean my apartment when I wouldn’t have bothered if it remained going unseen.
  • Having a job can be stressful, but that it can also help one feel a sense of “purpose”. Sometimes I need a little stress as a reminder that I’m still around for a reason, and that I’m living my life.
  • Stress helps me stay organized. If I feel like I’ve got more floating around in my head than I can easily keep track of, I’m force to create lists. These sorts of organizational skills often improve my life greatly.
  • I’m sure this sounds corny, but I’m also able to truly appreciate those moments without stress after knowing what stressful moments feel like.
  • Stress can also inspire me to make goals, even if they’re short term goals like, “get through stressful situation, x.” Goals then inspire me to achieve, and when I achieve I gain self-confidence.

“Great,” you might say, “that’s all well and good but it doesn’t take care of the negative aspects of stress.” Right. I have a few tricks of how to potentially prevent or alleviate stress as well:

  • Have a “no call” policy after a specific time of day. For me, I usually stop answering calls or texts around 8pm if I’m at home to help distance myself from the drama of what’s going on out in the world and focus on relaxing and getting ready to sleep. I also don’t take my cell phone in the bedroom, so if a random drunk friend calls at 3 in the morning my sleep is not disrupted.
  • Focus on sleep.This might sound like a no-brainer, but when I’m ultra stressed that is when I need the most sleep. That can also be when I have the most trouble sleeping, so practicing good sleep hygiene and even relying on a sleep aid can be a necessary evil at times, to keep from having that stress induced breakdown.
  • Use relaxation techniques to help curb the effects. With bipolar disorder, big stress tends to stick with us a lot longer than most other people, so getting a single massage may not be the answer here. BUT, if my arsenal is loaded with many relaxation techniques and I actually use them regularly, I’m much less likely to breakdown.
  • Take a mental health day off from work. No, seriously, you’re allowed. Sometimes I let things at home pile up if I’m working too much, and having all of those looming tasks really stresses me out. By taking a day off to take care of those things I’m actively improving my mental health by eliminating that stress!
  • Talk about it. Talk about what is causing stress to your friends, family, or therapist. Usually when I begin talking things out, I can rationalize the situation better which helps me think it through. Sometimes someone like a therapist will have great perspective on the situation too, and may be able to offer up more coping mechanisms.
  • Try not to take on too much at once. This is especially hard for me, I take on too much when I am feeling really good and then when I begin to become stressed I can’t handle the load I’ve created for myself. Being careful and choosy about what I take on has (so far) been hugely successful in helping prevent stress. It’s ok to say no to things, and sometimes even smarter to do so.
  • Do your research! In the instance of my big stressor: health insurance, I’ve found creative ways to work around that stress. Some hospitals offer charity care for those with low incomes, and there are even “scholarship” type funds that one can apply for to help cover the cost of necessary health care. Also, many pharmaceutical companies offer free or reduced cost drugs which can really help when you’re in a pinch. Talk to your psychiatrist if you’re interested.
  • Stick to a budget. If money is hard for you, try making a budget. Honestly I always feel a little better knowing exactly where my money is going, and creating a budget can open up the possibility of saving more in the long run.
  • Try not to rely on just one person to shoulder the burden in times of stress. What I mean is, if I always talk to Jed when I’m stressed out, and then Jed starts to stress me out, what do I do? Or if Jed starts to get stressed out by me, what does he do? It can feel natural to have that one “go-to” person to talk to but by having a network (even if they’re online or people you call) you’re less likely to both get burned out by someone or burn the other person out. Friends and family can get overwhelmed sometimes too. Another reason I suggest a therapist!

Preventing stress has made a huge difference in the state of my health, and I realized yesterday that all three of my hospitalizations were due to extreme stress. Sometimes I forget that bipolar disorder is something I seem to handle ok as long as I’m not dealing for too much stress for too long, and that has been a great thing to realize. Obviously stress will come up in my life, it is inevitable, but finding creative ways to keep it at bay has been enormously helpful.

The Relaxation Variable

Did you miss out on my External Variable posts so far? Check out the link at the top of this page for more information!

So far I’ve talked about sleep and diet, up next is relaxation.

Relaxation has been a huge tool for me when it comes to managing my moods. I’m sure some of that has to do with the fact that I have a co-morbid anxiety disorder, but a large part of it has to do with the fact that stress can trigger bipolar episodes.

Relaxation is the number one tool I have for combating stress, and the concept is simple.

When things begin to escalate, take the time to stop, and then do something relaxing.

Unfortunately, doing things that are relaxing are the easy part, actually becomming relaxed can be much more difficult.

The first step in employing this tool is to make a list of things that relax you. This could be as simple as lighting candles, or could be something bigger like going to the beach. Everyone is different, so it might be that the things that relax you are different than what relaxes someone else.

Does jumping around listening to death-metal make you feel relaxed? It does for some people, and that’s why the list is important. This way you’ll know what, exactly, is in your arsenal as far as tools for relaxation.

Here’s an example of some of the things I do:

  • Taking a bath
  • Spending time in a sauna
  • Going to the movies
  • Dancing
  • Getting a massage
  • Baking
  • Yoga
  • Playing with my dog
  • Listening to Frank Sinatra
  • Grocery shopping (I know that one is kind of weird, but it works for me)
  • Meeting up with a friend for sushi
  • Meditation
  • Hiking
  • Writing
  • Cleaning
  • Drawing
  • Reading
  • Organizing anything

And the list goes on and on. It is helpful to identify as many things as possible, because if I need to help myself relax at 11pm I probably wont go grocery shopping (but it happens sometimes). Also, I might not feel like doing anything creative, like drawing, because that inspiration can come and go. The more options you have, the more likely you’ll have a series of things that you’ll be able to utilize at the moment you need them.

Also, my relaxation needs while hypomanic are significantly different than my needs while becoming depressed. While hypomanic, running on a treadmill might feel relaxing. While depressed, you couldn’t pay me enough to get on a treadmill!

Step two is being able to identify when to use your relaxation tools, which tends to be the more difficult part. I would suggest two things:

  1. Schedule time every day for the purpose of relaxation. This will help serve as a reminder to do relaxing activities, because it can be easy to forget -especially when things are particularly stressful.
  2. React to stressful situations or feelings with relaxing activities as well.

Obviously if you’re feeling stressed, that would be a great indicator to do a relaxing activity. Personally, because of the anxiety disorder I have, I feel stressed about 80% of the time (or more), so I’ve learned to ignore the portion of my brain that tells me I’m on red alert. If the check engine light is always on, how do you know when to check the engine?

I try to counteract stress in the event of the following occurring:

Noticing physical indicators:

  • Clenched jaw
  • Hunched posture
  • Sore or stiff neck
  • Tension headaches
  • Nausea, in some cases

In accompaniment of stressful situations, before or after:

  • General planned stressful situations, like seeing a doctor or having a driving test
  • Stressful social situations, planned or not
  • Particularly harsh work days, or immediately following if something negative happens at work
  • Being physically sick, like having the flu or a migraine
  • Immediately following unforeseen bad news, like getting outrageous bills in the mail, having fun plans suddenly canceled, or even finding out someone close to you has fallen ill

Noticing shifts in mood:

  • A sudden feeling of depression or anger that occurs without warning (and possibly without “reason”)
  • Verbally lashing out at others
  • When feelings of isolation occur
  • Even sudden hypomanic mood changes, as they can transform when stress continues to contribute to them

Sometimes I think of my body as a child I have to babysit, and if I keep forcing it to run around without any relaxation, it’ll turn on me. If that kid doesn’t get nap-time, there will be cranky wailing and it’ll inevitably throw a fit in the middle of the mall.

I know, too, that it really takes me a while to adjust when things change suddenly or stressful situations happen. I’ve witnessed firsthand (as have some of my prior co-workers) that I’m unable to jump back in to situations after a lady yells at me at the cash register for 10 minutes. I need that extra time to react, relax, and get things working again before I can move on.

And finally, don’t be disappointed if doing one relaxing activity doesn’t relax you entirely, that i, unfortunately, normal. You may require many activities to feel the effects of relaxation, which is why I suggest having a scheduled time to work on this every day. For me, relaxation has been cumulative. To some extent it can be built up, and when it is built up we can deal with stress on a less explosive scale.

Anyway, whatever your situation, bipolar or not, medicated or not, it doesn’t matter. I would very highly suggest making sure your body gets the relaxation it needs to function properly. You just might find that those situations that used to set off spiraling episodes can be curbed somewhat if we give our bodies breaks from the inordinate amount of stress we are all under on a daily basis.

The Diet Variable

First of all, I hate the word “diet”. For me that word conjures up images of people practically starving themselves while eating minuscule portions to lose weight. For the record I just want to make it clear that that isn’t what I’m talking about here.

What we ingest can have an effect on both our physical bodies and our minds, so I usually try to address what I’m consuming when looking at the external variables that are having an effect on my mood.

That said, this is a hugely touchy subject for a lot of people. I’ve never had an eating disorder in the traditional sense, but I have had periods in my life where I could not afford to eat. Obviously not knowing where my next meal was coming from put an incredible strain on me mentally and I’ve had to work very hard to combat some of the effects that has had on my psyche.

I don’t know if you’ve seen the show Surivor, but usually after 40 days without substantial food the contestants return to every day life to find that they have become overly possessive of food. They take extra food and hide it, almost without meaning to, and they can’t stop eating (even when their weight surpasses what it was when they began the show). Their minds have been wired into survival mode, and even when they return to normal life it takes a long time for them to return to having a casual (rather than overbearing) attitude toward food.

My own experience has been similar.

Each person has an individual attitude toward food and have had different experiences (good and bad) surrounding food. I don’t want to encourage any obsessive food monitoring of any kind because from my own experience, even having to monitor my food intake for medical reasons when I was being tested for a food allergy caused me so much stress that my mood was significantly worse than usual.

Today my only suggestion is to just be aware of how different things you ingest effect you.

Awareness goes a long way, and once I became conscious of how certain foods/beverages were effecting me I found that I avoided some things immediately without even trying. Other things, like caffeine, I indulge in every once in a while (heck, I live in Seattle!) even though I know it doesn’t always have a great effect on me.

I know some people who swear that vegetarian or vegan or gluten free diets help manage their symptoms, but like I said… I found that I had the opposite reaction.

Some things to consider exploring their effects:

  • Monosodium Glutamate (MSG) – though not used as widely anymore it can still be found in some seasoning salts, canned soups, Asian food, and more. It is a pretty easy thing to check for and many Asian restaurants will put signs up now to signify if they do not use MSG in their food. Some people have allergic reactions to MSG without realizing it, so this is a good one to be aware of.
  • Sodium (salt) – too much sodium has been linked to several health problems (including some heart problems) and I’ve found most of the really intense amounts of sodium in processed foods like hot dogs, frozen pizza, and velveta cheese (to name a few). If I eat some of a frozen pizza my fingers will be so swollen the next morning I can hardly bend them. Yep, that’s the sodium causing water retention. If you are going to change the amount of sodium you ingest and you take Lithium, please consult your doctor. Sodium intake directly effects the amount of lithium absorbed by your body.
  • Sugar – who doesn’t love Kool-aid, right? I’m not usually that into sugar, but it is good to pay attention to this one because of those fun sugar highs, followed by the drop in energy (and potentially mood) when the sugar has worn off.
  • High Fructose Corn Syrup – at the very least, this one has a similar effect to sugar. There are several studies going on around HFCS though regarding how it is processed, as some people believe it may be doing more damage to people’s health. I feel like this is a hard one to avoid, because it can be found in anything from soda to condiments (like ketchup). I’ve noticed a lot of cereals and breads now that boast to be free of HFCS, which is nice if you’re trying to avoid it.
  • Caffeine – another culprit of the “crash” when the caffeine wears off, and as I mentioned in Variables: An Introducion I have experienced having hypomanic episodes triggered by caffeine. This may not be something that requires complete elimination from the daily routine but some people choose to. Like I said, I live in Seattle (which may as well be heralded as the caffeine capitol of the US) so it is common for social activities to be centralized around coffee. For the most part, as long as I consume the caffeine before noon I will be ok for the rest of the day.
  • Alcohol – again, I have no business telling people how to live their lives, but it might be beneficial to have a general idea of how alcohol effects you (if you intend to partake). I’ve heard from some that alcohol has triggered mania for them but for me it usually triggers depression. I can usually have a glass of wine or a beer, but for me anything more than that might wreak havoc on my mood. The effects of alcohol are very unpredictable for me.

There are plenty of other things to think about but, like I said, I am not trying to encourage any intense obsessive food monitoring.

Comfort Foods and Baking Beware!

There are periods when I am depressed where the only thing I want to eat is noodles with butter and Parmesan cheese. Seriously, I can go for days without eating anything else, and it isn’t hard to come to the conclusion that I’m not eating anything near a well balanced diet. It can be extremely difficult not to gravitate toward comfort foods while in the throes of depression. Really, all I can say on that is that my boyfriend has played a pivotal role in prompting me to switch out one of those bowls of noodles for a salad every once in a while. The only thing that has helped deter me from comfort foods is the attention of another person.

Likewise I am a big fan of baking, and whether I’m baking while manic or baking while depressed there’s suddenly an awful lot of sugary (but delicious) treats everywhere.

Do I need to eat 6 loaves of zucchini bread? No. Maybe one. I’ve found it is helpful to have a group of people that I can anticipate giving a portion of these treats to. Sharing with co-workers, friends, family, clubs, and my support group means less unhealthy food around for me to eat and less sugar for me to rattle my mood with. Also, others usually really enjoy getting a baked treat!

8pm is about the time that the sugar cravings kick in for me. It only takes a moment before I’m tearing the apartment apart looking for sugar, chocolate being on the top of the list.

My latest tricks to combat the 8pm sugar monster is to make sugar free candy readily available to myself (so I still get some of the sweet flavor without the sugar), or when that doesn’t do it I also keep a bag of chocolate chips in the apartment. I usually only need a few chocolate chips to feel satisfied enough to quit the sugar hunt. In the event that I need something more filling I have been having frosted mini wheat cereal. It does have sugar, but it also has 26% of my daily fiber requirement so I feel a lot less guilty about eating it.

Ideally, my ultimate goal is to be able to consider both nutrition and what will satisfy my craving instead of grabbing the first thing that sounds good and consuming it. It may take a while… but I’m working on it!

The Sleep Variable

Sleep as a Stabilizer

Sleep is one of the first thing I address when it comes to attempting to manipulate any external variables in an attempt to stabilize myself. Obviously it isn’t any sort of instant cure for any problem but I have never once had getting more sleep when I wasn’t sleeping backfire on my mood (I would know, I keep charts!). Trying to manipulate oneself to sleep less while oversleeping is a tad more risky, but more often than not when I fail in that category it isn’t my mood that suffers, I just continue to sleep too much. For me, many larger mood swings can be offset by adding or tweaking the sleep variable. In addition, having a solid, set sleep schedule can largely help keep my mood more even in general.

Though having a set sleep schedule is best idea I can think of for myself, it has been very difficult for me to execute. Having a job with an irregular schedule can wreak havoc on regular sleep habits, and events requiring one to stay up a little later or wake up a little earlier are a fact of life. Though sleep regulation has been a difficult thing for me to work on, the more attention I pay to it the more it pays off.

Sleep as an Emergency Reset Button

Pretty much any time I am in the sort of mood where lights are flashing and sirens are going off, any intensely uncomfortable or dangerous mood, sleep is my number one answer. If I can go to sleep and get a good 10-12 hour chunk of sleep it acts as a reset button. For sudden episodes this technique acts as my sort of emergency reboot.

Shut down the ol’ brain, ‘boot her back up.

From what I understand, many psychiatrists prescribe drugs for this very situation and sleeping is usually the immediate course of action advised upon getting an emergency phone call (as long as hospitalization is not immediately required). It seems extremely unlikely (because I couldn’t say for sure if it is impossible) that anyone who is sleeping will carry out a suicide attempt, right? In that regard I think sleeping in an emergency situation is one of the safest things you can do.

My boyfriend has witnessed enough at this point to know when to grasp me by the shoulders and say, “hon, go to bed.” It has been invaluable to have someone around to remind me of that because usually when I need it the most I am too emotionally distraught to recognize it.

Offsetting Too Little Sleep

Even when I am having a euphoric mood with no need for sleep, 9 times out of 10 things will start to escalate and I will begin losing control after two or three sleepless, energetic nights. Ideas suddenly become that much more grandiose, my desire to curb the mood will begin to fail, and soon I can rationalize even the most irrational thoughts. It is important for me to bring myself down before the whole thing gets blown out of proportion, and that is a situation where sleep becomes my number one ally.

With little or no desire to sleep in this phase it can be incredibly overwhelming trying to sleep after one realizes they somehow can’t.

I’ve compiled a list of things that one might use to get to sleep in those situations, and there are some nights where I have to use several in one night to get to sleep.

  • Taking a nice hot bath or shower
  • Receiving a relaxing massage
  • Physical touch (a nice cuddle) with another warm body (human or pet)
  • Deep breathing and/or meditation
  • Aromatherapy – lavender, chamomile, and sage are supposedly soothing for falling asleep
  • Stretching – it sounds simple, but can help with physical discomfort and relaxation
  • Drinking a warm (decaf) beverage
  • Reading a book – now, this can backfire if the book is too interesting, it’ll just keep you awake. I try to use books with more difficult vocabulary or more complex writing styles, that way I have to really slow down while I read, which usually helps. Anything a bit more taxing than what you’re used to reading is ideal.
  • Watching a movie – this works for some people, again it depends on the movie. I know it isn’t a bad movie or anything but for some reason any time I put on 3:10 to Yuma I fall asleep within the first ten minutes. Those sorts of movies are great to have in your arsenal. I shy away from anything too “triumphant” (aka anything scored by John Williams). Also, beware of televisions without a “sleep” feature that turn themselves off after a specific amount of time, without that you might wake up after listening to the dvd menu music/dialog for three hours straight while sleeping which totally puts me in a funk.
  • Listening to music – I had a specific mix tape at one point dedicated to making me fall asleep, mostly instrumental sorts of music (Sigur Ros, Explosions in the Sky, movie scores)
  • Listening to white noise/ambient noise – great with an ipod or iphone, stick in your headphones and go!
  • Listening to binaural waves – I would highly suggest the Mindwave app for ipod/iphone. This uses sound waves at different frequencies to stimulate different parts of the brain, again just stick in your headphones and go!
  • Medical cannabis is something that some people swear by as a sleep aid, though currently only legal in a few states.
  • And if all else fails, that’s usually about the time I take a sleep-aid (Ambien would be an example).

Personally it is very important to me that I don’t rely too much on sleep aids because I have already experienced what pharmaceutical dependence is like and it is not a pretty thing. Also Ambien caused me to have extremely intense hallucinations once, so again, I try to use these only as a last resort but sometimes a last resort is necessary.

Offsetting Too Much Sleep

It tends to be more difficult for me to cut back oversleeping when I am depressed vs. inducing sleep while hypomanic. Even so, I have noticed that it helps to have a set amount of time dedicated to being conscious while I’m depressed instead of allowing myself to sleep the day away.

  • Fresh air – it doesn’t have to be as much as going outside (which can seem daunting while depressed) but if you can that’s great. If not, just opening a window can help get rid of groggy sleepiness.
  • Eating healthier – again, sounds like a task when I’m depressed, all I want to do is eat comfort food that puts me into a food coma! Eating a salad instead of continuous mac n’ cheese is helpful for me every once in a while.
  • Performing repetitive tasks – nothing huge, but if I am to knit or play solitaire while being a couch potato I am much more likely to make it though that movie or tv show without napping.
  • Exercise – exercise is proven to increase energy, even though it usually feels to me that it is initially sapping all the energy I have at the time. Yoga is great for being energizing without requiring much energy to perform.
  • Making plans – I try to make plans at times I know I shouldn’t be sleeping (like the mid afternoon) so I am occupied during that time and can’t sleep.
  • Caffeine – I usually avoid this but when I’m depressed I’ll allow myself a cup of tea. Some people can handle caffeine fine but it can trigger hypomania for me.
  • Having a pet – kind of like making plans, but this is more of a permanent solution. I have to be up at certain times to take out my dog, so having that repetitive daily commitment helps keep me up. Also having to take her outside means I get fresh air as well, two birds with one stone!
  • Turn on a lamp – supposedly dim lighting can add to fatigue, so the more light, the better
  • Do a puzzle – personally I love puzzles, and not just the fluffy kitty cat jigsaw puzzles either. Doing a crossword, sudoku, watching Jeopardy, anything to keep my mind working (even a little) will likely keep me awake too.

Like I said, I really think it is much more difficult to offset too much sleep because usually when I need to my motivation is gone entirely.

How Much?

I guess everyone is different, as far as how much sleep is a good amount for each person. I need a little more than the average person. It usually takes me 10-12 hours to feel rested so I try to avoid napping, sleeping an hour or two at a time tends to leave me more cranky than refreshed. After particularly strenuous activities or after having gone a long time without the comfort of my own bed I tend to need 14-18 hours of sleep to recover.

Most people seem to have a pretty good grasp on how much sleep they need (or like) to get to function properly but if you don’t all it takes it a little experimentation to find out. Once I figured out the tricks for my own body, sleep has become the number one external variable I manipulate to improve my mood.

Variables: an introduction

After having a horrible time with my first antidepressant (fluvoxamine or “Luvox”) and experiencing rapid cycling between ungodly low depression and mania with psychotic symptoms which resulted in my first hospitalization (somehow only for the depression portion), then having to experience the withdrawal of being casually cut off of that medication cold turkey and locked in a room crying, shaking, and vomiting uncontrollably for hours… well, ever since then I haven’t been too keen on the idea of pharmaceutical medication. I can’t help but feel that I experienced what easily borders on torture, and it is very important to me that I do not ever have an experience like that again.

Needless to say, I have spent the vast majority of my life un-medicated. I don’t think things have been terrible, but they have been hard, and the thought of becoming medicated at some point popped back up on my radar as being something I wouldn’t entirely reject, but our healthcare system has made it almost impossible for me to explore that option.

Within the last year I had the opportunity to give things another go, but I’ve been shot down almost every step of the way by a lack of availability of doctors, lack of funds to buy overpriced pharmaceuticals, and living in a body with an extreme sensitivity to all 10 drugs I’ve tried within the last year, except one. For some reason lithium is the only thing that my body can stand, and I have been having almost the opposite reaction as the other drugs; at 900mg there is barely any lithium absorbed into my bloodstream. Even taking that much I haven’t been able to come close to having a “therapeutic amount” absorbed (aka, the amount when it is supposedly having a noticeable effect on your brain).

Please specifically take note that I am in no way trying to discredit the medications within the realm of modern medicine, I’m simply stating that my personal experience with them has been taxing, to say the least.

Living un-medicated has left me making my fair share of bipolar blunders, but through experimentation and experience I’ve devised a few systems for helping myself cope. It is important to me at this point to feel like I am doing everything I can to help myself.

My general philosophy involves tweaking different variables in my life to help push my mood one way or another. Honestly, it is an extremely exhausting process and it isn’t exactly fool proof, but it does help me.

There are a lot of variables that can help influence my mood. The things I would put in this category are things that may have the ability to have a negative influence on my mood (which I might include in my list of triggers -or things that are likely to trigger an episode, something I will write more about later) but are what I consider “variables” because I can change them in different ways to help level out my mood.

  1. Sleep
  2. Diet
  3. Relaxation
  4. Stress
  5. Communication
  6. Creativity
  7. Contact
  8. Exercise
  9. Medicine
  10. Environment

I am planning on exploring each of these variables further individually, however I want to have a breif description here:

1. Sleep – exactly what it sounds like, sleep regulation as both a stabilizing tool and a “reset” button.

2. Diet – people say, “you are what you eat” and most people agree that the more healthily they eat, the better they feel.

3. Relaxation – to me, relaxation and stress have a real yin/yang sort of relationship.

4. Stress – this is a tricky category, but finding creative ways to remove stress/stressors is very helpful.

5. Communication – the main reason I love therapy, verbalization helps slow and organize the thought process.

6. Creativity – another tool I use to help slow and organize the thought process.

7. Contact – anything from being in the same room as another person to physical contact.

8. Exercise – another of those “obvious” sounding ones but more difficult to actually follow through with.

9. Medicine – you are probably thinking “but didn’t you say un-medicated?” Yes, but there are many types of medicine, anything from dietary supplements to more alternative medicines.

10. Environment – our surroundings can make a huge impact on our mood, positive or negative.


Like I said, I am planning on going into each topic in detail beginning tomorrow with topic #1: Sleep.


Please note: In my experience it seems that most people with bipolar disorder ask a lot of personal questions about different medications and if I have tried specific ones when they hear about my bad luck with these drugs. Please refrain from doing so at this time, not because I don’t value your opinion, but simply because the frustration I feel about this topic makes it very difficult for me to talk about. I may drag out the ol’ laundry list at another time, but please leave it be for now. Thank you!

Follow the bouncing (exercise) ball!

I was just taking Luna (my dog) out for a walk when I started thinking about exercise.

Exercise is important for everyone but, looking back, bipolar disorder has really had an effect on the role exercise has played in my life.

For example, when I am depressed it is extremely difficult to do anything, let alone take on the daunting task of exercising. Near the end of the depressed episode I just had I started doing yoga to try and make up for my lack of motivation to exercise. I found that yoga is a fun, energizing, and strangely relaxing way to exercise that I hadn’t tried before. Even doing yoga exercises that weren’t particularly challenging, I could only maintain a level of concentration and strength to complete about 30 minutes or so while depressed. But hey, every little bit helps right?

Today my thoughts were geared more toward the combination of exercise and mania. I was thinking back trying to discern if and when I experienced manic episodes as a child or adolescent, and looking at my exercise habits at different periods in my life is a way I’ve found of getting a grasp on when these episodes occurred.

When I am experiencing mania I generally have an overwhelming amount of energy. A tingling, pulsing feeling almost like a hum invigorates my entire body and it is extremely difficult and uncomfortable to sit still. In my teens I had no real idea what the feeling meant, just that when I was experiencing it I needed to exercise intensely to feel any sort of relief.

Through my late teens I spent an extraordinary amount of time hiking with Chloe, the yellow lab you can see here on the left. Chloe was an excellent hiking partner, and really any amount of energy I was willing to expel she would match it.

You can also see Violet in the photo (the pug on the right), my family had three other dogs besides Chloe -three pugs (which included Violet). Violet was willing to go on walks for a while (the other two pugs were much too lazy for longer walks) but in her middle age gave in to being a wiggly, wrinkly home body.

Really, the two dogs in the photo here do a pretty good job of representing my manic episodes and my depressed episodes. Chloe the lab was great for big, energetic bursts, while Violet was an excellent cuddler, able to meet my gloomier, couch potato needs. Unfortunately, both dogs passed away of (extreme) old age in 2010.

It was also lucky in some ways to have grown up where I did.

Our house was a mile at most from an incredible state park, and half a mile from the beach. Some days Chloe and I would leave the house like a bullet from a gun and hike 8-10 miles before heading home. Eight intense miles of uninterrupted hiking was usually what it took to feel a shard of relaxation and some degree of resignation in my body.

Needless to say, I was in pretty good shape at the time!

I’ve heard similar stories from some of the bipolar acquaintances I’ve made, stories about biking 40 miles without realizing it just to relieve the overwhelming urge to “go”, or people going for a run only to realize that they’ve somehow run all the way to the next town or city over without tiring.

Like many of the traits that coincide with bipolar mania, I’ve found this extreme energy both to be a blessing and a curse. On one hand there are times when I am able to complete physical feats I am not able to accomplish otherwise, like hiking 10 miles without breaking a sweat. As long as I am exercising in some way, the hum of energy inside of my body feels amazing, and coupled with the endorphins of a long work-out I can wind up having a great exercise high while getting fit!

That said, there’s definitely a darker downside. Both from what I’ve experienced and what others I’ve spoken to have told me there doesn’t appear to be any way to attach this energy to a specific time of day. If and when it occurs it does so seemingly at random, and it is incredibly inconvenient for it to happen at, say, 2 o’clock in the morning. That may not seem like such a bad thing, but when it happens and the need for exercise is so completely overwhelming that one can’t sit or stand still (let alone sleep) it can be very dangerous. Depending on where you live, it may not be safe to be biking down the road at night or jogging down the streets if you’re in the city. Doing so might result in being mistaken for a prostitute (true story, though I don’t know any prostitutes that wear sweatpants) or much, much worse.

Most of my life I’ve considered gyms to be totally ridiculous, because why run inside when you could just run outdoors? For the sake of this situation though I’d highly recommend a treadmill or stationary bike, even one of those big red exercise balls -whatever it takes to be able to expel that energy in a safe environment.

Plus, it’s really frustrating to have jogged your way to the next town over and have the energy burst dissipate. Trying to figure out how to get home in that situation makes having access to some exercise equipment at home or at a nearby gym priceless.