Tag Archives: anxiety

5 Exercises for Falling Asleep

Falling asleep can be tough, even after attempts to remove all distractions. Sometimes I find myself too worried or anxious to fall asleep, other times it is like my mind just wont shut off.

Obviously living with bipolar disorder complicates things for me when it comes to sleep. In depressive phases I might feel like I can sleep for days, but there are times when I feel exhausted but can’t seem to fall asleep. Other times manic energy or a racing heartbeat makes it difficult to physically relax, not to mention hypomanic or manic flights of ideas that leave me constantly grabbing for a pen while I’m lying awake.

In these situations there are definitely times where I feel compelled to use a sleep aid and any number of attempts on my part to try to slow myself down to sleep seem to fail, however I can also have a difficult time falling asleep when I haven’t been bouncing up and down manically in my living room for 12 hours.

There have definitely been periods where I was prescribed sleep aids to take on a regular basis, and what I found was that it really screwed up my ability to fall asleep if I stopped taking them for any reason. The inevitable insomnia that followed triggered mania for me, and finding myself caught between being able to sleep but also having unwanted side effects or damaging my own ability to sleep wasn’t a fun place to end up.

These days I make the best effort I can to fall asleep before turning to a sleep aid, and over the past few years I have gathered a few exercises (some physical, some mental; all done while laying in bed) that have helped in my sleepy success.

Of course, there are many things that can be done to help increase our success rate for falling asleep like limiting screen time, increasing physical relaxation, and creating a routine around our sleep schedules. I find every little bit helps, and while it isn’t my intention to directly address these (or other) external strategies in this post it should be said that taking some time to bolster a healthy sleep routine can definitely get the ball rolling, and you may find that doing so may be all it takes to help you fall asleep.

These exercises are free, relatively easy, and can be done by anyone, not just folks with bipolar disorder, or anxiety, or depression. While I am not suggesting this can “cure” anything (and there are serious situations that require medical expertise) these five exercises have helped me become more successful at falling asleep naturally when I have been dealing with sore or stiff muscles, racing thoughts/flight of ideas, constant worry or obsessive thinking, physical symptoms of panic while in bed, and helped me relax when I generally just felt too alert to sleep. Some nights it takes a little extra energy to push myself into sleep past some of the physical side effects of my medications as well, and in those situations this list is my first line of defense.

1. Pointed Toe Exercise

This first exercise was especially helpful for me when I worked retail and spent several hours a day on my feet, but I used it just the other day when I had the flu and my legs were aching, keeping me from falling asleep and it was just as effective.

  • First I lie on my back and try to position my upper body to be as relaxed as possible.
  • Next I point my right toe down at the foot of the bed and then point it back toward myself. I repeat the pointed toe with the right foot ten times, and then do the same exercise with my left foot ten times.
  • Next I point both toes toward the foot of the bed at the same time, alternating between the pointed toe and toes pointed back up at me. I do this a total of ten times.
  • Finally (and this part is the most fun) I alternate which foot is pointed. If my right toe is pointed at the foot of the bed, my left foot is pointed up toward me, then they switch positions. Left foot pointed at the foot of the bed, right foot pointed up at me, kind of like using a paddleboat. I do this until each foot has been pointed at the foot of the bed ten times.
Usually by this time my muscles are stretched and much more relaxed, and my brain (that has been focusing on counting) is yawning and telling me, “dude, counting is boring. I’m going to sleep.” Sometimes I don’t even make it through the whole exercise before I am ready to fall asleep!
2. Clench & Relax
This is another exercise that is good for a tight/clenched/sore body, but the physical relaxation can be helpful anytime, really. I’ve seen several variations of this exercise but generally the idea is the same; systematically move through the body tightening and releasing different muscles as you go.
  • For this I lay on my back, and it doesn’t really matter how relaxed I am when I start (because end game relaxation is kind of the point here).
  • Starting with my feet, I flex my muscles in my feet and hold them rigid and count to five, taking a deep breath in as I count. When I breathe out I let go of the clenched muscles.
  • I continue up my body continuing this pattern with each area, flexing calves, hamstrings, hips, stomach, chest, shoulders, biceps, lower arms, hands, and then my neck. Finally I flex my face (I just scrunch it so the muscles are tight) and release.
One tip to maximize relaxation on this is to keep all areas of the body that have already been addressed as still as possible to maintain the relaxation. It can be eerie to feel like parts of my body have melted away to relaxation as I progress with the exercise, and that is part of the fun for me.
3. Fake it ’till You Make It
When I was a child I hated taking naps, so I devised a plan to lay perfectly still and pretend I was asleep to trick my mother into thinking I was napping. I remember laying on a couch at my grandma’s and considering what someone looks for to tell if a person is sleeping, and I tried to address every aspect I could think of. Wouldn’t you know it? I ended up falling asleep! I use this technique when I just generally feel too alert to sleep overall, as it covers some mental and physical strategies.
  • First I consider, “How do sleeping people lay?” and position myself in whatever is most comfortable for me that would recreate a deep slumber.
  • When people sleep they often appear or feel heavy and loose, not rigid, so I focus on making my body as heavy and loose as possible. I unclench my hands, sink into pillows, and let my shoulders sink downward.
  • The real trick, I find, is considering how sleeping people breathe. The breaths often aren’t too deep or too quick, but instead they are slow and moderately shallow. Focusing on trying to reproduce this kind of breathing is something that often uses all of my attention (which doesn’t make room for many other thoughts).
With this exercise I like to imagine what would happen if someone I knew came in the room and found me there. Would they think I was asleep? Typically, when the answer is yes, real sleep is right on the heels of my faux sleep.
4. Continental U.S. Map
I find this exercise the most useful if obsessive thoughts or constant worrying is getting in the way of falling asleep. Sometimes even if my regular thoughts are simply being too persistent I can use this to fall asleep as well. This exercise can be done in any position, all it takes is closing one’s eyes.
  • First I imagine there is a white line against the black background I see with my eyes closed.
  • Next I follow the line with my eyes as it creates an outline of the continental United States (moving clockwise). I allow my eyes to move as the line dips and curves around the great lakes and rises up over Maine, etc.
  • Depending on how persistent the thoughts are I might circle the country two or three times before going back to trying to sleep. If the obsessive or persistent thoughts happen again, I do the exercise again.

I know this exercise might sound ridiculously simple, but it has been super helpful for me. Weird, right?

5. Conjuring Observations

Ok, this one might be a little trickier but it is my favorite. I find it to be sort of emotionally soothing, beyond just helping me relax enough to sleep, and it is usually my first choice when I am experiencing physical feelings of panic in bed while trying to sleep.

  • This exercise requires me to unfocus my eyes. The best way I can describe it is that I close my eyes and first focus on an imaginary point (like the line in the US map in exercise 4), and then relax my eyes as though I am looking at a distant landscape of a mountain beyond tiny point. It can be helpful to make the distant thing I am looking at someplace familiar, a wooded trail I know, a beach I grew up by, or a room from my childhood.
  • Once my eyes are unfocused and I am looking at this “distant place” I occupy my mind by conjuring items or landmarks that I once observed of these places. Sort of like taking a big empty space and filling it with elements that I can remember. They can be as specific or general as I want. For example:
    • What were the location and types of trees in our old orchard?
    • What machines were at the arcade at the local drive in movie theater?
    • What was the floorplan of my childhood friend’s house?
    • What items could be found on the counter in my childhood home?
  • For this to be a nice experience and soothing (like soothing enough to make me fall asleep), there are some rules I employ, like:
    • I only choose places with positive or neutral associations. That doesn’t mean some places (like my beach) were never associated with anything negative, only that I have reached the point where I no longer feel a negative association with that location.
    • The details should be difficult enough to remember that it requires my entire focus (so it can’t be wandering around distracting me).
    • I never populate these spaces with living creatures, human or otherwise. I want to treat these spaces as tools and don’t want to lay around reliving memories that might produce an unexpected emotional response that might hinder my ability to sleep, not help it.

 

So what do these exercises have in common? It seems that each of them involves creating a relaxed atmosphere (physically or mentally) and occupying my mind in a challenging, but still relatively mundane task (like keeping track of how many times I’ve counted to ten). For me this is a combination that has made a recipe for success when it comes to coaxing myself to sleep.

Keep in mind that yes, like I mentioned, there are definitely still times I can’t calm my manic energy enough, or rebound from a midnight panic attack into a state of sleep, but I have been finding that with practice those moments seem to be getting farther apart. While I can’t guarantee these will work for you just because they work for me, I hope that considering what we are imagining or thinking, or how we are feeling right before bed is just as important for falling asleep as, say, having the right pillow.

There are numerous tips and tricks out there to help turn those sleepless nights into sleep-filled ones, and I encourage anyone and everyone who has had trouble falling asleep to do a little research and keep some tricks up their sleeve! There has certainly been no contest for me, more stable sleep is a constant requirement for a more stable emotional life and regaining the power to help myself fall asleep without the use of a sleep aid (at least, most of the time) has been paramount in helping me regain a feeling of control and peace in my life as well.

Stepping Stones; Stepping out of PTSD

Trigger Warning – my brand of PTSD came from situations involving sexual assault, and this post may contain loose details about that situation or other sexual topics regarding my recovery. Nothing super graphic though, don’t be gross.

Post traumatic stress disorder seemed to come into my life like a flood. One minute life seemed totally normal, and the next it began to deteriorate rapidly.

It was sort of like, if you could imagine, every time you bought a smoothy someone would walk up and take that smoothy away from you after a couple sips. After a while, you sort of just know to either avoid buying smoothies or, if you do buy one, only expect two sips. This is just the way things are, and because you haven’t known much else there are no real expectations otherwise.

Now imagine someone sits down with you and tells you that we live in a world where you could have (and you deserve) that entire effing smoothy. I mean, more than two sips. And that these people who have been taking this delicious fruity beverage away from you are a-holes who have done something profoundly inappropriate.

Well there’s shock. And anger. And definitely some horror associated with the fact that people can be so awful to one another, and that you’ve let this smoothy-snatching business go on for so long. There is guilt for not knowing things could have been different, and fear that this cycle is something that will never end.

But, maybe you feel a little empowered too. Like maybe now that you know this business about the smoothies you can buy one and enjoy the entire thing. You can break the cycle! So you go out, you buy a smoothy, and after two sips someone walks up, takes it, and walks away.

This time it feels different though, doesn’t it? This time you know you’ve been violated, that the other person is in the wrong, but maybe you just froze and didn’t know what else you could do to stop it. The anger is much bigger, much more difficult to contain. The fear becomes profound, because now you know that people seem cavalier about hurting you and that it can happen anywhere at any time. The shock leaves you frozen, bringing guilt because, somehow, you knew this would happen, didn’t you? Maybe the horror is so overwhelming you decide to pretend the whole thing never happened, just to put it all out of your mind, and ultimately blame yourself. After all, you really just can’t be trusted with a smoothy.

For me there was a series of moments like these that were like seeds being planted. I pushed the memories and my reactions down into the dirt as far as they would go, and once they were there I didn’t feel a need to address them because I thought I won. I thought I put them somewhere that was somehow equivalent to them not-existing, and if they didn’t exist I couldn’t be upset, right?

I admit, it is easy for me to look over this whole process when it is about a deliciously fruity blended beverage or something as seemingly harmless as seeds and connect the dots, but even now, years later, thinking about this process in terms of sexual assault there is a whole host of emotions that come up making it difficult for me to see through the fog that they create.

For several years I did a great job of putting the whole thing out of my mind and ignoring it. Then, after enough time had passed, those seeds that had been planted began to grow.

They broke through the soil and I suddenly began having panic attacks in crowded places. I became physically ill when someone, anyone, would touch me. I couldn’t leave the house without getting into arguments with people, so I didn’t leave the house. I felt powerless and depressed, but also angry and very afraid. Every time I closed my eyes I could sense someone standing next to me waiting for me to be vulnerable, like any moment I was happily unaware or in the shower or asleep.

The most infuriating part of this process for me was not being able to see how one person could get from the situation I was in to something better. My PTSD symptoms (mostly the anxiety and panic) were just as treatment resistant as my bipolar symptoms so I couldn’t rely on any anti-anxiety medications to help with the panic attacks and fear I was having. My doctors suggested deep breathing and reading boring case studies about PTSD, and while the deep breathing only really helped keep me from constantly screaming the reading seemed to trigger my symptoms over and over again.

Having said that, (spoiler alert) I am sitting here today really feeling like I have finally made a big dent in untangling myself from those awful PTSD plants and I found myself wondering just what I did to make it here. I thought that perhaps sharing what helped create a makeshift ladder for me might be useful to others in a similar situation, and while I am not suggesting you go out and do any of the things I am about to share I can honestly say they helped me, and all of these things were done with the consent of my healthcare team (including my therapist and psychiatrist).

For Anxiety and Panic Attacks

Basically I needed to desensitize myself to being around people and sort of re-learn that people (in general) aren’t trying to hurt me. The real trouble was that any time I was in a more crowded place (the bus, downtown, the grocery store) it would just trigger the panic attacks over and over again. Even at house parties of people I knew and loved I felt overwhelmed and would panic, so I entered into the realm of medical marijuana.

I realize this might not be a popular idea, but totally legal here in Washington State. Also, like many of the medications I have tried, it turned out there are some forms of cannabis that actually made my anxiety and panic symptoms worse, so the process of narrowing things down was a little frustrating. Thankfully, as someone with treatment resistant symptoms I have a lot of experience trying treatments that either aren’t effective or have some rough side effects so I already had a system for taking detailed notes on the effects I was experiencing.

I wont lie, I felt pretty weird about this idea at first. Growing up in a time where I was led to believe that the slightest proximity to any and every “drug” out there (D.A.R.E!!) would immediately make me an addict or banish me to hell or make me lose everything I loved made me initially totally recoil from the idea.  The legalization of medical cannabis only dampened this mindset slightly, but after speaking with three different psychiatrists and four separate therapists, all of whom who told me [given the nature of my treatment-resistant symptoms] I should proceed with anything I found that was helping, I felt a little more comfortable. Even so, it took some time for me to feel ok when other people were being judgmental about it but the fact that my doctors had my back (and heck, even my grandmother agreed) made me feel less squeamish about the whole thing.

Once I was able to pinpoint a couple strains that helped alleviate the anxiety and panic I was feeling (without sabotaging something else, like my mood for example) it was a matter of using it strategically (not all the time) to introduce me into settings where I might normally totally freak out, but because the cannabis removed the elements of anxiety and panic I was able to experience triggering situations in what felt like a non-threatening way.

Basically, cannabis allowed me to remember what it was like to be around people and feel safe, or at-ease, and after long enough it became the default setting for my brain again.

For Regaining a Sex Life

This has been very tricky, and while the cannabis was helpful enough to get me to the point of being able to be touched in general (like a back rub or foot massage) I had a big blinking red stop light in my brain around sex for a long time. Not super helpful, considering my PTSD symptoms didn’t actively show up until several years into a committed and safe relationship! Even though it had been years since I was in a place where I was in danger, once those seeds sprouted it didn’t matter.

I am sure it will sound a little funny, but the most helpful thing to removing fear and panic around sex for me was when I had surgery and my doctor told us we weren’t allowed to have sex. That’s right! Having even the possibility of having sex taken off the table made me feel more comfortable because then it wasn’t this awkward thing (or an obligation) I felt compelled to dodge constantly because I felt uncomfortable. Effectively we had to almost start our physical relationship over at square one (I recognize I am really lucky my boyfriend is the most patient person I’ve ever met) and in doing so we re-built the trust that I knew was there, but couldn’t feel because of my anxiety and panic.

For Fear and Paranoia

First I would say going to therapy and spending a lot of time talking about being assertive about boundaries helped me feel a bit more confident, but I was still really afraid that if something happened again I would freeze up and be unable to assert myself.

Something that really helped solidify a confidence in my ability to protect myself was taking a self-defense class with a friend at Fighting Chance Seattle. The staff was really knowledgeable and our male instructor made me feel very much at ease and did not require us to practice defensive moves with him, instead with anyone we felt comfortable with. Being able to connect a physical action to a feeling or desire to protect myself made me believe that if there was ever another situation I knew what to do and would be less likely to freeze in the moment. The class was only one day, but it really helped me feel like I was moving forward.

Another milestone was getting a tattoo that would act as a reminder that the fear I was feeling was coming from me, not from threats around me.

Over the last few years I have tried to keep my apartment feeling like a safe space for me. At first that meant coming home and looking behind every curtain and in every closet to be certain it was safe, but now that I have made some progress with my fear and paranoia I try to talk myself through the fear and visualize every detail of the apartment when it is dark to remind myself it is empty and safe. It is funny to me sometimes to think that my brain wants to imagine all kinds of horrors waiting for me when I close my eyes, but I spend a lot of time actively un-imagining them!

***

While I can’t sit here and say, “and that’s how I kicked PTSD in the face! It is gone forever!” Things have gotten significantly better.

I still get triggered from time to time, but I’ve got enough tools to keep myself from replanting that same seed over and over again. After taking that self-defense class I felt quite empowered when I was faced with a situation on a city bus, a creepy dude next to me put his hand on my leg.

Initially I started to freeze. I could feel myself starting to shut down as I had in the past, but somehow I managed to turn things around and do the total opposite of the cowering I felt like doing.

“Excuse me?!?” I yelled in his face and then stood abruptly, pushing past him to sit in another seat. He looked over at me and I scowled, shaking my finger at him. Even though my hands were shaking and my heart was racing I turned away to look out the window and my scowl turned into a faint smile.

I was free.

Travel; Mental Health Hurdles

This year my Grandma turned 80 years old, and to celebrate my family wants to host a camping trip in her honor. The reality of the situation though is that traveling anywhere (whether it is just heading downtown, upstate, across country, or across the globe) while living with a mental illness involves taking a bit more into consideration than the “where” and “when”.

Things got panicky last week when some crossed communication left me under the belief that my boyfriend and I would not be able to bring our own vehicle to the camp because of it’s affiliation with the military.

For anyone else, carpooling seems like the obvious answer, right? Well for me, living with bipolar disorder means knowing my triggers, and anytime I start to feel trapped in a strange place without an exit strategy (oh, say, like on a beautifully landscaped but guarded-by-armed-men sort of military recreation site – I have no affiliation with the military personally) I melt down. And I mean total manic/psychotic, you’ll-find-me-in-the-woods-later melt down. It is almost like a guarantee, and knowing myself well enough to know this would be an issue (after kicking countless ‘vacation’ situations in the balls while psychotic and trying to escape) left me in a bit of an odd position.

Of course, it isn’t unusual for me to try to push myself through things like this. Tell myself, “well, those other times are a fluke, and you will be totally fine this time.” I start to feel like I am making a big deal over nothing, and when friends or family who don’t have to make these kinds of considerations for themselves agree, I have a bad habit of walking into the same situation over and over again and reacting poorly on ‘repeat’.

Last week’s situation was a little more special because I went in to see both my therapist and my psychiatrist, and both immediately sided with the rational, more cautious part of me.

“Absolutely not,” they both said. “You’ve been triggered this way several times before, and you know that walking into a situation like this will be more of a strain than you are likely to handle.”

Keep in mind, my situation is really pretty singular in that my symptoms are not regulated by medication. My symptoms of bipolar disorder and anxiety are treatment resistant (they have not responded to any medications), so I am largely in a position to have to cope with them on my own. That is another big reason why it is important that I am familiar with my own triggers, because knowing what could put me in a dangerous position and either preparing myself for the outcome or avoiding the situation altogether are the best strategies I have for dealing with my symptoms on a regular basis.

I have found one of the biggest strategies that helps me when traveling or heading into a potentially stressful situation is knowing I can leave at any time. If I have an exit strategy, if I can leave the stressful environment before my irritability or mania becomes psychosis things are much more likely to go smoothly.

Even though my therapist and psychiatrist both agreed this trip would be detrimental for me, I couldn’t help but feel bad about needing to cancel. I mean, my granny is 80, and you can believe she has been talking about this for a month already.

The final decision I made was to go back and double check the policy that would keep me from having my escape route. I scoured websites and even eventually called the navy to help clarify their policies on bringing in civilian vehicles to their recreational sites. And -wouldn’t you know it? The entire situation was a communication error. We should be able to bring a vehicle to the site without a problem (so long as we have the proper documentation, yada yada yada).

Ultimately, the problem is no problem at all, but I am proud of myself for taking the steps I did (talking with my boyfriend, my therapist, my psychiatrist, and looking for a solution) before responding emotionally or making a final decision about going, or not, to this event.

Sometimes living with my current mental health situation can feel like I have to live in a small bubble to survive, and while the bubble feels safe it also shields me from many of the life experiences I want to have. That bubble doesn’t guarantee I wont become depressed, or manic, or psychotic, so I don’t feel like forgoing all manner of travel and personal growth that comes with it should be kept from me because doing so does not mean I will be able to live peacefully. I will have bipolar and anxiety outside the bubble, but I have it inside the bubble as well. For me, the trick is knowing what my absolute deal breakers are (like transportation) to keep me from moving from a “moody” travel situation to an emergency travel situation.

Of course, there is a lot that goes into it beyond that to prepare, things like

  • having my doctor’s information handy and with me at all times
  • bringing all medications, and extra in case of emergencies
  • making sure I will be in a position where I can eat regularly
  • making sure I will be in a position to have the best chance of sleeping fairly regularly
  • using coping skills to help counteract instabilities
  • maintaining an awareness of my current state
  • informing my fellow travelers how to best help in an emergency situation
  • and knowing when to pull the plug on the trip

to name a few.

Even though I have gotten over the transportation hurdle regarding this short trip, it is still a few months away. I have plenty of time to worry (heh) as more things come up, but I hope to smooth over as many of the rough edges as I can before I get there.

Depression Under the Radar

Like most people, when you hear the word depression you probably associate it with emotion. Sadness, perhaps, if you’ve never had it yourself. Despair, even, if that is something you’ve come face to face with. I know when I hear the word depression it is easy for my mind to make an association jumping straight to utter and complete hopelessness, or going a week without leaving the house, or even suicidality.

However, the truth of the matter is that depression has many symptoms associated with it that may not directly involve feeling sad or hopeless at all, and it is this odd grey area that I’ve found myself in lately.

Though I haven’t been having feelings of despair (profound or otherwise) I am definitely feeling exhausted all the time. I am more anxious than usual and having a hard time being in public places. I am less motivated and less interested in things, and I keep bouncing back and forth between wanting to eat everything I can get my hands on and not having an appetite at all.

But, despite all of these things, my first reaction when I saw my therapist last was to say things were going well. It wasn’t until she asked about my appetite and sleeping that I started noticing all of the other (emotionless?) symptoms of depression have been stacking up, but without that emotional sort of sinking feeling they’ve all latched onto me under the radar.

Once I noticed it I felt a little silly for not noticing it before. After all, I consider myself pretty experienced with depression’s escapades at this point and beyond that, there are plenty of times I have had symptoms of mania come on without the bliss or agitation I normally associate with it. Things like increased energy, impulsivity, lack of appetite and sleep, have been pretty easy for me to notice, but something like decreased energy could be any number of things from my immune system to stress to the weather. It isn’t until I can see all of those symptoms together that I am willing to start labeling them.

I guess I am hoping that since my stress level should (that’s the key word) be letting up in the next couple weeks I can simply play hostess and seat these other symptoms at a table while they wait for their friend emotion to arrive. If I’m lucky it’ll get stuck in traffic or be too sad to come to the party, and if not I will have my wait staff ready to do what needs to be done to keep things afloat.

Looking Back, Looking Forward

With the new year fast approaching I am excited to say that I will be starting 2016 with a new therapist and a new psychiatrist. I will also be continuing the DBT group I have been participating in for a couple months now which is great because so far I would say it has been helping me make a difference in my reactivity and emotional rumination.

Of course, it helps that Emotional Regulation was the first thing we covered because that is one of the more challenging things I have been facing. The funny thing is that now that I’ve got a few skills to help me see the big picture (instead of a pure emotional reaction) in situations it has been made clear that my other biggest challenge is communication and Interpersonal Relationships. That module of the group definitely can’t come soon enough!

That doesn’t mean I am miraculously cured, or that I am not continuing to lose my shit on a semi-regular basis. But… I may lose it for a shorter period of time, or only two or three times (instead of 12-16). Frankly I am willing to consider any and all progress progress.

Ultimately the way my perspective has been shifting around because of this class highlights an issue that I’ve known for a while but may not have given enough credit to. Stress makes a huge difference, in terms of the timing and magnitude of a lot of my emotional episodes. Stress is like… my death star. I might think it is a friendly moon at first but really it is a fully operational space station of mass destruction.

What does that mean, exactly? I am not sure, but I know I need to be addressing stress more aggressively (eh, not me being aggressive but more seriously) and not fail to recognize it or deal with it before all the firing sequences have been completed and it becomes a giant laser heading straight for me.

I can’t control the stress, but I am hoping that if I can recognize it early enough there will be time for me to react before the laser hits the fan.

Anyway, even with the intense illness and surgeries of 2015, spending summer in bed, and most of my plans being totally pulled out from under me this was somehow a better year than 2014. While 2014 was almost a year of being comical because of how many things could go wrong, 2015 was great because “at least it isn’t 2014.”

I don’t know if it was because I spent 2014 operating on a totally empty tank but this year it was like I could feel parts of my brain beginning to operate that hadn’t been used in ages. I can’t make a final word as to if I should be chalking that up to hypomania or simply 2014 acting as a hard-reset of my brain but it leaves me hopeful that in 2016 I might be able to dust off a few more parts and put them to good use again. We’ll see.

Ultimately, this year I learned that there is still a lot of improvement to be had in terms of the treatment of people with mental illness and mental health crisis. It bewildered me that so many people were willing to reach out and to respect my space when I was having surgery (for a physical problem), but the treatment I have received both just having a mental health problem or during a mental health crisis is wildly different. I am hoping that going forward I can learn and discern new or better ways to communicate this problem and what we can all do to help solve it.

In the mean time, however, I will wish you all a happy new year! Thanks for reading!

Biting Off More Than I Can Chew

One of the best pieces of advice I’ve ever gotten regarding my mental health is to only take on as much as I feel capable of taking on.

Sometimes when I am depressed that might mean considering something as simple as taking a shower to be a triumph, which can be hard for me because my productivity can feel equal to my worth – which isn’t true.

Lately I have been practicing not biting off more than I can chew, but it has been a really difficult idea to master. It seems like I can frequently plan on taking a small bite and somehow wind up mowing down the whole damn chocolate bar.

More Than I Can Chew

There are a lot of elements that can add to this phenomenon, things like stress and external pressure from obligations can make it hard to scale back the things I am taking on. Experiencing episodes in the manic end of the bipolar mood spectrum often make me feel invincible and like taking on 25 extra tasks is not only worthwhile but easy (which isn’t always true).

I know I can also make the process hard for myself because I am someone who generally feels more comfortable processing and planning what I need to do before I do it (without the impulsivity of mania, anyway!). Unexpected changes in the plan I’ve set for myself can cause me to shut down just to try to process them.

Much like eating a slice of pizza may only take a few minutes (less if you’re really hungry), suddenly finding yourself tackling an entire pizza by yourself will not only take a different strategy, but also significantly more time.

A Slice is Nice!

It isn’t uncommon for people to say that I am not always great at adjusting quickly in situations where my plans have been derailed, and part of that is because many times my plans have budgeted for what I currently feel capable and able to accomplish. Entering into a situation, no matter how simple, after working myself into a position of calm and confidence…

SO on Top of It

…only to find myself having to eat through an entire pizza instead of a single slice generally means facing some big emotional upheaval and panic beyond the simple act of trying to rapidly digest more new information that I feel I can handle.

ERM...

Though I am working on learning ways to absorb and adapt to new information more quickly, there are times where I am so focused on trying to get that whole pizza down that I lose track of the conversation we’re having, or where I am going, or I forget to have fun. This can create an awkward environment for everyone involved, and what’s worse is I can tell when I am doing it so I also feel very self-conscious.

 The holidays are a difficult time to try to keep things simple, with plans constantly changing it can be really rough trying to be prepared emotionally and conscientious about how much I am taking on at any given time. Being in a situation where I find myself choosing between pleasing the people I love and taking care of my [mental and/or physical] health usually feels unfair, but is an unfortunate reality that I am faced with on a regular basis.

Luckily the process seems much less daunting when my friends and family remember maintaining our relationships work best when they involve:

  • Being patient
  • Not taking my absence in any situation personally
  • Allowing me to prepare for stressful events or situations in advance, when possible
  • Discussion so we can be on the same page
  • Respecting my boundaries and personal space
  • Being open and discussing your needs too!

Ultimately creating and maintaining relationships without retaining an unnecessary sense of guilt or shame when I am having a difficult time has been a learning process, but surrounding myself with people who are capable of being  understanding when the most I might be able to handle is a single bite (as opposed to the whole meal) has made a huge difference!

Finding Psychosis in Unlikely Places

Lately things have been up, up, up! A rather profound and relatively welcome change from my typical morose malaise dragging down even the most cheerful of moments. Things seemed to be going perfectly well when I hit a bit of a speed bump last week and started noticing my slightly-elevated hypomania (and general stability) being peppered with hysteria riddled buckshot.

Right now in the DBT (Dialectical Behavioral Therapy) group I am in we are learning about a skill called check the facts which involves taking time out to look at the big picture and discern if my reaction to events (or if my interpretation) might be colored by unwise reasoning (like jumping to conclusions).

I felt like I had a pretty good grasp on the skill and practiced it multiple times before that speed bump I was talking about last week. In these periods of agitation and intense depression-laced moments (lasting a couple hours at a time) I could no longer find “the facts”. It seemed like my ability to step back was totally negated, adding fear and panic to my already disoriented state.

I have always had a hard time identifying psychosis when it is happening, or at least identifying it before it has altered my psyche in a profound way. Typically the only way I have been able to pinpoint it in the past was after the fact, faced with a trail of breadcrumbs leading in several opposing directions at once.

Granted, I have experienced a few situations where the psychosis I was experiencing was something that seemed pretty easy to point out at the time. The overwhelming need I had to live with gypsies and time I thought I had become a werewolf are definitely two examples, but both occurred many years ago. Since then things have changed, and the psychosis I experience now is almost exclusively tied to fear, not euphoria or grandeur.

The fears are almost always something that could happen. Typically not things that are likely, but possible in the realm of actual life events. My boss trying to undermine me at work was a pretty infamous episode I had, but this time it was a little closer to home and my fear revolved around my boyfriend and an impending doom of our relationship.

In my mind, my boyfriend was trying to push me away to the point where I would become fed up with him and break up. Though this is not even remotely based in reality I was certain it was happening (but only for 1-2 hours 3-4 times a day) and I became terrified to speak to him. Unfortunately not speaking to him only fed into the awkward feeling I was having, making the whole thing seem more real.

For me, psychosis is typically like a real asshole lawyer. It builds a case based on tiny clues that are generally considered meaningless in our everyday lives, and when there are big pieces missing to corroborate the story, it makes them up. I’ll often find myself with memories of saying or hearing things that never actually happened, despite feeling very much like they have.

Trying to reason with someone who isn’t playing by the rules (psychosis) became relatively meaningless in my experience this last week. I felt overwhelmed by mass confusion because trying to check the facts led to so many contradictory facts that I didn’t know who or what to believe.

And that’s when my boyfriend found me.

I tried to explain why I was upset (without knowing at that point that I was even experiencing psychosis). It didn’t seem like him to be vindictive or evil, after all our relationship had always been like a slow, lazy river as opposed to the Niagara Falls of my last relationship. I blamed him for a long list of things that apparently never happened, and when trying to express my confusion I suddenly started laughing. Yep. That’s when I figured it out, the contradictory breadcrumbs were coming from many different directions and were made of several individually delicious but totally different and clashing baked goods.

[insert emergency antipsychotic here]

Things have been fine since, and while these sorts of episodes always lead me to feeling rather embarrassed and apologetic I was very lucky that I had some help in pinpointing this situation early. Being able to celebrate my birthday over the weekend without any added psychosis was huge.

Corey reminded me that this sort of thing tends to crop up for me when I am starting to get stressed. It was a good reminder to pay attention this holiday season and do my best to remain relaxed. I never want to come off as being a “Scrooge” but finding a way to celebrate the holidays without totally losing control of myself can be a big challenge. High-five to my man for being smart and compassionate!

On a final note, I am in the market for a new psychiatrist. This last one has made some comments that were more harmful than helpful, so this week I hope to switch to the next doctor on deck. Stay tuned!