Daily Archives: August 4, 2015

10 Ways to Prevent Mania and Hypomania? You only Need One: Lithium or Another Mood Stabilizer

peachpeach

All the information below is great, but if you aren’t on Lithium, or if you cannot tolerate that, then another mood stabilizer, then you can practice these steps till the cows come home, but you most likely will not be able to avoid hypomania or full blown mania.

So take your Lithium or whichever mood stabilizer is right for you. Lithium is just the GOLD standard in Bipolar d/o treatment, therefore I keep talking about it. Take your medication and stay out of trouble. You can even practice all 10 or as many steps below as you like, that won’t hurt you. What will hurt is not taking your meds.

So, have I said “Take you meds, stay on your meds, don’t come off your meds!” And life will be peachy!

http://www.everydayhealth.com/columns/therese-borchard-sanity-break/ways-curb-mania-and-hypomania/

“10 Ways to Prevent Mania and Hypomania

Published Jul 1, 2015

Bipolar disorder is one of the most difficult illnesses to treat because by addressing the depression part of the illness, you can inadvertently trigger mania or hypomania. Even in Bipolar II, where the hypomania is less destabilizing than the often-psychotic manic episodes of Bipolar I, persons often experience from a debilitating depression that can’t be lifted by mood stabilizers and antipsychotics. Antidepressants, though, can cause a person with bipolar to cycle between hypomania and depression.

I have worked with psychiatrists who were too afraid of cycling to risk using antidepressants for bipolar patients. They put me strictly on mood stabilizers and antipsychotics. However, I did not get well. I stayed depressed, and all original thoughts in my brain vanished. My current psychiatrist knows that depression is my primary threat, not so much the hypomania, so she was able to pull me out of the depression with the right combination of antidepressants, but is vigilant for any signs of hypomania. Because I know how vulnerable I am to hypomania, I have learned several strategies to help me stay grounded. By making them part of my life, I have been able to take less lithium, my mood stabilizer, which ensures that I continue producing original thoughts and not get too medicated. Here are 10 tools I use to avert hypomania.

1. Practice Good Sleep Hygiene

Developing good sleep habits is by far the most potent tool for preventing mania and hypomania. There are a handful of studies documenting that sleep deprivation is associated with mania and hypomania. By going to bed at 10 every night and sleeping a good eight or nine hours, we have the power to stop rapid cycling and to reverse mania or hypomania. In a study published in Biological Psychiatry a rapid-cycling patient was asked to remain on bed rest in the dark for 14 hours each night (gradually reduced to 10 hours). Times of sleeping and waking were recorded with sleep logs, polygraphic recordings, and computer-based event recordings. His sleep and mood stabilized when he adhered to a regimen of long nightly periods of enforced bed rest in the dark. The abstract’s conclusion: “Fostered sleep and stabilizing its timing by scheduling regular nightly periods of enforced bed rest in the dark may help to prevent mania and rapid cycling in bipolar patients.”

Good sleep hygiene means you go to bed at the same time every night, ideally before 10:30 p.m. — not one night 2 a.m. and another night 7 p.m.; you sleep at least eight hours a night; and you wake at the same time in the morning. Since many folks with bipolar disorder havesleep disorders, a nighttime routine is often needed. For example, I shut down my computer at 8 p.m. and try not to check my emails or messages on my phone. Reading a disconcerting email at 9 p.m. will keep me up all night. It takes me a good two hours to calm down, so I get out the lavender oil around 8:30 p.m., pull out a real book (not an iBook), and begin to tell my body it needs to seriously chill out.

2. Limit Your Screen Time

CNN did a story a few years ago on iPads (or LCD screens) and sleep. Journalist John D. Sutter asked Phyllis Zee, MD, a neuroscience professor at Northwestern and director of the school’s Center for Sleep & Circadian Biology, if our gadgets can disturb sleep patterns and exacerbate insomnia. Dr. Zee said:

Potentially, yes, if you’re using [the iPad or a laptop] close to bedtime … that light can be sufficiently stimulating to the brain to make it more awake and delay your ability to sleep. And I think more importantly, it could also be sufficient to affect your circadian rhythm. This is the clock in your brain that determines when you sleep and when you wake up.

I absolutely know that to be true, because for awhile, I was reading iBooks for a half-hour before bed and staying awake until 2 a.m. My concern with LCD screens isn’t limited to bedtime. I know from people in my depression community that persons with bipolar disorder have to be careful with LCD screens at all times, as they can make the highly sensitive personhypomanic if the person doesn’t take a break from them. For me and for many fragile persons with bipolar, looking into an LCD screen for too long is like keeping your light therapy sunboxon all day. I made the mistake of firing up that baby from 9 p.m. to midnight right after I got it, and I did not sleep one iota the next day, and felt hypomanic all day long. Keep in mind that not only is the light stimulating, but so is all of the messages and tagging and poking — especially if you have as many social media handles as I do.

3. Avoid Certain People and Places

Most of us have a few people in our lives that appear as though they’ve downed three shots of espresso every time we see them. They are usually great fun and make us laugh. However, the hyperactivity isn’t what you need if you haven’t slept well in a few weeks and are trying to calm down your body and mind. Same goes with places. I don’t dare step foot inside the mall, for example, between Halloween and New Year’s. There is just too much stuff being forced in front of my face. I also hate Toys-R-Us. I still have nightmares about the time my husband pressed three dozen Tickle Me Elmos and the entire shelf began to shake.

4. Pay Attention to Your Body and Breathe Deeply

Before attending the mindfulness-based stress reduction (MBSR) program modeled after the one developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center, I did not pay attention to my body’s cues preceding a hypomanic episode. In fact, it was usually another person who would point out the embarrassing truth — like the time my editor wrote a letter to my doctor after I started publishing eight blogs a day thinking my traffic would go up. Now, though, when my heart races and I feel as though I have consumed eight cups of coffee, I know this is my opportunity to reverse my symptoms by doing lots of deep breathing exercises.

Of all the automatic functions of the body — cardiovascular, digestive, hormonal, glandular, immune — only the breath can be easily controlled voluntarily, explain Richard P. Brown, MD, and Patricia L. Gerbarg, MD, in their book The Healing Power of the Breath. They write:

By voluntarily changing the rate, depth, and pattern of breathing, we can change the messages being sent from the body’s respiratory system to the brain. In this way, breathing techniques provide a portal to the autonomic communication network through which we can, by changing our breathing patterns, send specific messages to the brain using the language of the body, a language the brain understands and to which it responds. Messages from the respiratory system have rapid, powerful effects on major brain centers involved in thought, emotion, and behavior.

5. Eliminate Caffeine

A good caffeine rush mimics hypomania. You feel more alive, more alert, like you could actually contribute something of worth to the world. That’s all fine and dandy except when you are teetering on the hypomanic edge. Caffeine can provide the ever-so-subtle push to the other side, especially if you aren’t sleeping well, which is when most people most crave caffeine. Stephen Cherniske, MS, calls caffeine “America’s number one drug” in his bookCaffeine Blues because of the withdrawal our body goes through three hours after we’ve drank a cup of coffee or a Diet Coke. Persons with bipolar are even more sensitive to amphetamine-like substances that raise dopamine levels, so the safest way to prevent hypomania is to eliminate the stuff altogether.

6. Exercise

My best workouts have been when I’m either on the verge of becoming hypomanic or when I am ticked off. My usual 10-minute mile goes down to an eight. I start passing people along my route, at the Naval Academy, feeling like Lynda Carter in her Wonder Woman getup. And my swim interval is consistent with the people who swam across the Chesapeake Bay in under two hours. The truth is I have averted many hypomanic episodes by working out until I collapse or at least become tired, which can take a few hours. Two years ago, the only way I was able to sleep was by swimming more than 300 laps a day. There are people for whom vigorous exercise triggers mania, but most experts report on the benefits of exercise for bipolar disorder.

7. Watch Your Sweets

There is a reason why ice cream, Swedish Fish, and animal crackers are comfort food for the bipolar person. The rush of insulin generated by those foods will calm those carbohydrate-craving brain pathways for a bit, until a crash in blood sugar has the person binging again on sweets. It’s a vicious cycle, one that can keep a bipolar person cycling indefinitely.

I will tell you a true story about sugar and bipolar. About 16 years ago, before I knew I wasallergic to sugar and that a high-carb diet was the worst thing I could do for my mental health, I would sometimes drink two bottles of Arizona Iced Tea and eat two or three chocolate-chip oatmeal bars for lunch. One day, there was a Horizon milk truck in front of our house with a large cow on the side. I started mooing at the cow. My new husband, behind me, was truly frightened by this and told me to lay off the Arizona Iced Teas and granola bars for awhile. I haven’t mooed at a truck since.

8. Be Careful With the Opposite Sex

I am all for good, healthy friendships between men and women. If you’re not bipolar. Consider me a prude, but I know how difficult it can be to be consistent with good boundaries if you are even the tiniest bit hypomanic. You sincerely didn’t mean for something you sent in an email to sound flirtatious — you were just being playful, like you are with your girlfriends. However, when you do get a reaction from a person of the opposite sex, something in the least bit flattering, that communication can ignite a rush that sends a signal throughout your entire body that you want more of the feel-good hormone it just experienced — dopamine, essentially. It’s even riskier if you have a history of substance abuse and bipolar — because your body will compromise any moral agreements you have signed off on prior to that email in order to get that damn rush again. If you’re not careful, this dangerous game will trigger a full blown manic episode. I have had the best intentions with 85-year-old men, and still, somehow, found myself in trouble. So for the time being, I’m sticking to female friendships.

9. Use a Shopping List

One of the most common manic behaviors is uncontrollable spending or shopping. Therefore, it is sometimes helpful for persons with bipolar disorder to make out a list beforehand of the items you absolutely need to buy — be it a grocery list, a Home Depot run, or a mission to get a your daughter’s friend a birthday gift. That way you won’t end up with 20 different kinds of paint swatches for the kitchen and living room you’ve decided to paint while you were at the store.

10. Allow Time to Decompress

This one is probably the second most important for me to prevent mania. I would say meditate, but that word produces too much expectation and pressure for me right now. Decompressing means after you finish something like a blog post or after you’ve forced yourself to be social for a few hours at a party that you didn’t want to attend, you allow yourselves 15 to 30 minutes to look at the ceiling fan in your bedroom and think about just that: the ceiling fan.

The case has been made that persons with bipolar disorder are creative and therefore need more chill time than the average person. Our brains are operating at a faster pace and more intensely than our non-bipolar friends for the periods of time where we must appear normal. So it is absolutely imperative that we allow some time where nothing is required — where we can drool, or lie in the grass, or doodle, or collapse in front of the front door. Although it seems as though these hours are unproductive, this activity will rebuild the gray matter of our brains and safeguard us from a manic episode.”


in which I watch a documentary and get sidetracked

Get some coffee, this’ll be a long post. Mine’s milk no sugar thanks. My mother used to say that she’d end up at Bellevue if we didn’t all behave Of course, she wanted to go to Bellevue where the world was safe, the grates familiar, the howling not unlike her stifled sobs. (from ‘Bellevue’ by […]

Today is my birthday

and in reflecting on my younger self and wondering how I have come so far.

Really excited about the future and today :)


Episode Of Doom

Ya know how there’s a certain number of factors that add up and they call it “the perfect storm”?

Yeah. That’s me right now, mid episode of doom. That spot where the depression drags me under the surface, the hormones surge and have me all but spewing pea soup and pissed about everything, and I’m too lethargic to do much more than watch paint dry.

Perfect storm. Perfect, my ass. I can handle depression. I can handle lethargy. I can manage pms. But when it all hits at once…Dark thoughts seep in, thoughts I reject yet still, the worm their way under my skin, whispering negative things, telling me I am doomed and I should just…

NOPE.

I’ve tried fighting this perfect storm, this episode of doom. I did dishes, I gathered all the paperwork so I can register Spook tomorrow for school, I’m trying to SNAP out of it.

Thus far all I am doing is snapping at every tiny thing. Not that my kid defying me and taking a bath, in cold water, fully clothed, while claiming to be washing a toy, is a tiny thing. But shit fell out of the freezer and I get this white hot rage and scream out curse words in strings like a chain link fence, I feel like nothing is going right, so defeated. Kitten is playing with my elbow, omg, rage bubbles not at the cat but at my own stupid brain for interpreting all these petty things as some personal affront.

It doesn’t change what is. I’m crampy, grumpy, bored yet lethargic, depressed without knowing why I feel buried alive, and my body is too tired to do much of anything as every piece of skin feels bruised and battered.  I can puke sunshine all over it, doesn’t change a damned thing.

I was doing okay for a few days. Not stellar but also not licking the bottom of snake bellies because my mood is so low. Leave it to the pms monster to come along and set off yet one more cycle of fucked upness. I can’t get my feet under me when for ten days a month I’m battling hormones and bipolar, then for 20 days I battle the bipolar, start to stand back up, then shark week mows my ass down all over again. Is it any wonder I feel like I am drowning and everything is dark?

I’m told to have the female parts yanked, be done with it. But that opens up the door to menopause and with my inability to take hormones, that’s just one more blessed hellride that will come in due time.

I have to accept that at this time, I am drowning, I am buried alive, I don’t want to do a damned thing but watch paint dry and chainsmoke. God, I feel like I got hit by a bus, even my forearms are aching. What have I done that was strenuous aside from carry in groceries? I don’t get all this random soreness in my body all the damned time, if this is age, I wish I’d have died before I hit 30. It’s all fucking downhill from there,apparently.

Hey, I warned you I was bitchy and venomous. Considering I can recognize this in myself means I’ve come a long way over the years. Once upon a time, I was pretty sure everyone else was the whole problem rather than me having a baseline dysfunction triggered by stupid.

I’m  wondering how much of this is also remnant of that stupid sleeping pill. Of course, the doctor would deny it and a million others who didn’t have the same experience would protest but…after the Latuda debacle…I believe what I experience. If this is the aftermath of Restoril…Fuck that with a barb wire dildo. Not like it even kept me down. Though the Benadryl sure kept my kid down for ten solid hours. Viva allergy season and its justifications.

I just wanna curl up in a grumpy little ball of grinding teeth and crampy tummy and alternate between staring off into space and swearing at every tiny asinine thing that for whatever reason triggers me and my horrormones and my ick-polar and whatever else fucked upness I have going on.

Blarrgh. There’s always a downside to being functional and I’d rather just never know up because the down is TOO MUCH SUCKAGE.

*We now return to your regularly scheduled programming that probably does not include pegacorns and giraffes but absolutely should*


Voting

So today we held party primaries to see who the nominees were for statewide and county offices.  THe most important election locally is for Superintendent of Education in the county I live in.  THe longtime office holder has finally stepped down after several ethics investigations that all mysteriously came out in his favor–so we have a chance to get someone honest in there who will maybe do what’s right instead of blowing with the prevailing political winds.  The schools are in dire need of systematic discipline and higher academic standards.  So that is what we are hoping for in this election.

I’ll run some more errands this afternoon–getting money out for school, getting gas, picking up some things at the grocery store.  So that is the rest of the agenda for today.  Nothing exciting–just a normal day.  I’m having more and more of those as days go by  Hopefully it will stay that way and I can continue to add in work and projects that mean something to me once I start school.

Hope everyone has a good week!


Happy 1st Birthday Bipolar1Blog!!!🎈🍵🎁🎂🎁🍵🎈

  


FOREVER PLEDGE

Originally posted on ON THE ROCKS:
He’s too late to beg for her forgiveness, the thunder rolled in and there’s no one to witness. The rain soaks his feathers and mats her hair, what used to be a formidable duo and an whimsical pair. He came back as a friend and enticed her to follow, the eyes of…

Sedatives, Sleep, Siri-ously?

I took my first Restoril (however it’s spelled) last night around 9:40 p.m. Then waited, fully expecting the floor to drop out from under me like all other sleeper meds cause. And waited. And waited. It took over an hour before it even slowed my brain down. Then longer before sleepiness became sleep. And BAM. I woke up before midnight. My head sort of hurt. I slept. I woke. I slept. I woke. Around 5 a.m. I woke and  my head was aching and I was still groggy but my mind was freaking out…So I took .25 Xanax and went back to sleep.

So not a coma med since it didn’t even touch the sleep/wake cycle. Also, not the pill of death because I don’t feel terrible right now. Little sluggish but I’m not a daywalker so that’s normal. Anyway…That’s the “morning after” portion of my sleeping pill experience.

One of Shade’s newborns died. So sick of burying dead cats. It’s sad but not a tear can be mustered. Thank you, psych meds. Crying 24-7 isn’t optimal but not being able to squeeze out a solitary tear when it’s appropriate..assfuckery.

I spoke to stepmonster on the phone last night about Spook’s school supplies. She filled me in on my brother’s appt with Dr B (my shrink.) They raised my brother’s mood stabilizer cos he’s still aggressive and anti social. I had the stupidity to say something to the extent of, “You remember how I used to be with ups and downs and I’m not like that anymore.”

Oh, Niki, Niki, Niki, so stupid when talking to family.

Her voice gets all tentative and she says, “Well, not as much but you do bite our heads off sometimes.”

Yeah, when I am pms-ing. Or you show up unannounced and expect me to stop what I am doing to fit your schedule. Or the car breaks down and dad screams at me like it’s my fault cars have problems. None of which is related to bipolar.

It took every fiber of my being not to go off on her. I am so fucking sick of having perfectly logical emotions like anger dismissed as some abnormality exclusive to bipolar disorder. I’m not in denial that often bipolar and depression distort things and cause reactions that are out of proportion to the situation. And to get this shit from her and my dad, who don’t know how to communicate except with loud voices, lots of swearing, constantly interrupting others, and talking over you…Yeah, my self control has been perfected and is immense.

Bipolar people are so brainwashed, we constantly apologize for perfectly normal feelings. That we’re invalidated to this extent makes me want use a nail gun like an Uzi and spray people down. People use our bipolar against us so no matter how logical our reaction, we are easily manipulated into thinking they’re right, we’re wrong ‘cos we don’t perceive things properly, and we end up apologizing and feeling guilty. Such a crock of shit. And women have it especially tough because of ya know, hormones and the age old man adae, “women are too emotional and hysterical.” Yes, because we can show emotion, we are totally irrational whereas you and your bottle it all up then blow up method is much more intelligent.

Just pissed me off, cos it happens all the time, especially with R. “Are you hormonal?” No, you’re just a dickhead who said something insensitive to piss me off. Logical.

I could even second guess myself on this whole rant. Surely, it’s just me being dramatic. Nope. Being manipulated into thinking you have less right to have feelings because your chemicals are imbalanced should piss me off.

On with the day. But not without this gem I found on youtube. It’s always fun to mock Siri, even when she’s trying to do the smart thing. (It’s like sixty seconds long, ffs, turn off your ADHD and watch it)

 

 


everything but the kitchen sink

While cheerfully (yes, cheerfully ffs) washing up this morning, it hit me. I’m hypomanic. You know how sometimes it’s hard to see what episode you’re in? As I stood there enjoying the warm water (ffs) and the clean crockery (ffs), I had a hypopiphany, which may or may not be accurate (fucknose, my bright hyporevelations are not to be trusted). Anyroad up, I worked out a bipolar episode diagnostic scale.

I imagine that people who are experiencing euthymia, coinciding with a sink full of dishes, react to the matter in a calm, prosaic way. They might groan a bit, but they just wash the dishes and then proceed with their lives. Something like this…

Euthymic – I’ll just do the dishes, brb.

image

Nope, but let me know if you locate a porpoise.

And then there’s the manic depressive experience…

Depressed – Oh god I need to wash the dishes. I can’t do it. I’m such a failure.
Anhedonic – Whatever.
Mixed episode – Fuck the fucking dishes, I resent housework grrrr.
Hypomanic – Yasss I wash the fuck outa those dishes quickquick.
Manic – What dishes, who cares? It’s time to partaaaaayyy!!
Psychotic – wow, talking dishes,

image

I walked the dogs extra far on the beach at sunrise, my laundry is hanging out in the sun, I was nice to the poison pygmy next door – I even gave her one of my baby guava trees. Ffs. I’m sitting down with a filter coffee, a smoke and my snuggly dog (fast asleep after running like a wild thing on the beach) and I’m chilling the hell out to avoid ascending to mania. So there’s that.

I think (hope) that the bipolar episode diagnostic scale™ might also be useful in working out where I crash/land/crash land after hypomania asap. Taking the BEDS™ (lol) notion a little further, the diagnostics might be more accurate if the condition of the crockery etc in and around the sink were factored in too. No wait, that’s bs, it’d just be:

image

Depressed – full sink.
Anhedonic – full sink.
Mixed episode – full sink.
Hypomanic – empty, shiny sink, or blahpolar rolling up her sleeves with a gleam in her eyes.
Manic – full sink.
Psychotic – wow, that is one chatty sink.

As far as my own personal manic depressive episodes go, the couch scale could be of some use (crap acronym though):

Depressed – miserable blahpolar under a blanket.
Anhedonic – seated zombie, with a thousand yard stare.
Mixed episode – blahpolar either sitting slightly forward with clenched fists, jaw and any other clenchable* body parts, or walking angrily along the beach, praying for a storm.
Hypomanic – blahpolar engaged in housework, gardening, walking etc.
Manic – empty couch, empty house and the subtle sound of dust settling.
Psychotic – wow, the couch can talk too.

Daww-happy-lovebird-takes-a-bath-in-the-kitchen-sink-ImgurI suspect that people in a euthymic state utilise couches, while people like me form relationships with them. I guess I interact unnecessarily emotionally with banal things. I guess my priorities are screwed. I guess being unconventional can be pretty cool, when it’s not causing agony. I guess.

Okay, I’m down a notch – the more I write, the more my headspace relaxes. I’m glad I’m not feeling that frayed edge focus thing anyway. And I suppose it’s just as well there aren’t any women around to ravish. I’m gonna stop writing before I raid the alphabet for cool acronyms and inventing more diagnostic tools. Ffs.

I even washed the ashtrays.

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*not a real word, probably a sign of the general logorrhoea, circumstantial and tangential speech and all their friends (below) that are very familiar to me.

Word salad. (Schizophasia) A jumble of words that are not apparently linked and may be hard to understand. Philosopher Noam Chomsky is well known for his studies in language and cognitive science; his famous grammatically correct example of word salad is “Colorless green ideas sleep furiously.”
Disorganization. Jumping from one idea to another without transition.
Neologism. Making up words that have no meaning to anyone but the speaker.
Echolalia. Repeating others’ words or phrases.
Flight of ideas: (in psychiatry) a continuous stream of talk in which the patient switches rapidly from one topic to another and each subject is incoherent and unrelated to the preceding one or is stimulated by some environmental circumstance. The condition is frequently a symptom of acute manic states and schizophrenia.
(Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier.)

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Depression/Bipolar Disorder makes you FAT!

Yeah – there is nothing like an over-sensationalized headline to grab the auld attention! But, despite my joviality, I am thoroughly depressed and completely rotund! Think Mrs. Clause corpulent and you probably have a good idea of what it is … Continue reading