Monthly Archives: September 2011

Test is Complete!

Yay! I’m finally done with my test. It’s been a long time coming. Last semester has dragged on for a very long time due to surgery and a complete second meltdown. I wasn’t able to go to classes, so I missed a great deal there (which didn’t help my final grades). On top of it, the test hung over my head so badly that I had a hard time studying for it. Amazing how anxiety gets in the way of productivity.

Still, all said and done. Even with 2mg of Xanax in me and being barely able to walk, I still threw up and dry heaved later from the anxiety before hand. All morning I was twitching and couldn’t sit still. Now, after a cigarette to calm me down from post test anxiety, I feel so out of it that I can barely stop the spins. I have a love hate relationship with xanax for that reason. It’s great for getting the anxiety down to a manageable level of simply vomiting and general anxiety. But it sends me into a spiraling pit of out-of-it-ness that I can’t function very well unless I’m in a high stress environment. So on the one hand, I can barely walk right now in a straight line, but as soon as the test anxiety hits, I have so much adrenaline coursing through my body that I become almost normal. Granted, I still can’t think as straight as if I’m in a normal state, but it astounds me how much adrenaline still impacts me.

Still, everything is done and a weight is lifted from my shoulders. It’s just music and relaxation for the next 4 hours until the xanax wears off. And now I can truly focus on getting to my studies.

General/Test Anxiety and Organizing the Chaos

It’s that time again in the academic year for tests. And tomorrow I have a big one. I can barely stand it right now. My entire body feels like it has electricity flowing through it. Which is something that I feel that many people do not fully understand about anxiety in general. It is a physical problem as much as a psychological problem. Right now, just about 16 hours before the test, I have a plethora of physical symptoms. I feel like there’s electricity flowing through my muscles, leading them to feel like they’re ready to cramp up. I’m light headed and can’t think straight. I feel wobbly on my feet. I also feel sluggish at the same time ready to bolt at a given moment. It’s the fight or flight response that’s doing this to me. And I know that, but knowing is not sufficient to overcome it.

But I think I’ll write about it.

So I have physical symptoms, what do I do when I have these? I usually do a routine of breathing exercises and mindfulness techniques. The primary breathing technique is an old one. I inhale for five seconds, hold for five seconds, and then slowly blow it out. All the time to make sure that I’m breathing with my stomach and not my chest. This tends to help settle the feelings of light-headedness and is crucial to restoring proper CO2 levels in the body. Otherwise I start to inadvertently¬†hyperventilate and that’s what produces the feelings of wobbliness and light-headedness. It also helps calm my muscles down by the deep breathing relaxation that occurs. I feel less electric and am calmer in general.

Taking care of the physical symptoms is important in my book. Since anxiety is as much physical as it is mental, it’s important to tackle the physical symptoms. They are often also the easiest to take care of as well as the quickest to feed back into negative mental feelings. But the mental must also be taken care of.

For mental exercises I really just do a simple one of picturing a rock in a river. I try to imagine every last element of it. From the visual surroundings and how the water would flow around it, to the sounds, smells, and even how it would feel to touch the rock or be the rock. It’s a very simple exercise. The reason why it’s a rock in water is because it combines two very simple things to picture, something steady and something in motion. Visualizing this is not hard at all. Given common experiences it requires little brain effort to generate the image. In general, I find that meditative techniques work best when it is as simple as possible. One should not exert too much cognition in calming oneself down, one should just let it die down without effort. To just let it pass.

And then there’s blogging. Which is also good for stress. The act of examining oneself is another type of meditative technique and it works in a different way than the simple meditation. It works by distraction and organization. While the above two techniques allow one’s mind to rest and come back to neutral, blogging and writing causes the mind to refocus on something else. I find this to be incredibly helpful for stress of any sort. Writing things down allows the mind to organize itself again. Something that I feel that many meditative techniques lack. The act of organizing the thoughts gives a similar sense of peace that most meditative techniques do, but it also helps in other ways. When meditating, it can be very difficult to keep out the negative thoughts. At times it’s impossible to do so. This disrupts any sort of relaxation that might occur. It’s rather simple in fact, once I turn off the outside world by meditating, I open up myself to the screaming chaos of my internal world. And here the organizational nature of writing really asserts itself. It distracts one from the chaos, but it also imposes order. My mind rather likes order and finds it calming. So I write. No editing, no judgment, just writing as long as I need to, or as long as the anxiety lasts.

So I’m writing, and feeling better because of it. It could have been a journal entry, or in this case it came out a rambling blog post, but it still imposes just enough order to aid my mind in reasserting itself.

It’s Wednesday, Again

It’s wednesday, which means that in about an hour I need to see my professor about my thesis. Currently psyching myself up to walk the 50 feet to his office. Not exactly able to do it. I like sitting here in the comfortable lounge and simply reading. It’s safe here. Still I need to go in an see him. I’ve had a major break through, at least, I think so and one of the graduate students seems to think so. But I have no clue what to do with it. I simply don’t know what it means. What’s worse is that I’m currently awaiting an email back from Brandon Fitelson on where to go in the literature because my professor is rather fuzzy on it. So that’s eating me up.

I’ve noticed that even with my anxiety in check, I still obsess about things that I say. I’ve been constantly going over in my head everything that I sent to Brandon thinking what a idiot I must be for asking such a simple question. I can’t get it out of my head. I know that it’s just my brain playing head games with me, but I still can’t seem to stop. I do it with other things that I say around other people as well. The words that I used play back and forth in my head at night as I go over what other people must have interpreted them as. Usually I find myself believing that they must think that I’m an ass or something. I don’t know what to do about it beyond talking to myself, which oddly enough helps considerably. Still, wednesdays are definitely a wreck for me, I’m just waiting to pass out in the lounge from the xanax later on. Can’t eat very well on these days either. All I seem to be able to muster is drinking tea or coffee. At least I’m showing up. Last year I did my usual disappearing act. So kudos to me.

That’s about all, I can’t be very creative on these days. But that’s 1 day out of the week, so it’s fine. I can’t wait to see how I do in grad school where I have to defend a dissertation. Probably a lot of xanax will be involved. Still, I’m a lot better than last year where I went without medication. I’m more studious, slightly more outgoing, more relaxed, and more on top of things in general. Plus a little hypomania here and there helps a great deal. In those terms, I guess I have to give myself a pat on the back for being functional again. That’s a first in a very very long time.

Comorbid Migraines and Other Health Issues

Recently, I’ve begun to delve into the world of comorbid (two or more health issues arising in one individual) health issues and bipolar disorder. Starting in third grade, I had chronic migraines which left me bed ridden for 2 years of my early teens. Now I’ve started to learn that this is not entirely surprising given that I have bipolar disorder.

Psychiatric Times has a good article on the comorbidity. There’s substance abuse which is at 61% among BP1 and 48% among BP2 compared to the 10-20% of normal people. 1/3rd have something along cluster B diagnoses, which is borderline,¬†narcissistic, and antisocial personality traits. There’s also high rates of type 2 diabetes and migraines. And finally there’s ADHD.

What this reveals is that there is more to being bipolar than just having a mood disorder. Along with it comes a host of high probabilities of other debilitating conditions. In fact, the numbers are so high, that the National Comorbidity Survey has life long psychiatric conditions that are comorbid with bipolar set at 85%. And 65%, according to the Stanley Foundation Bipolar Treatment Outcome Network, have another axis 1 disorder, like anxiety. To me, these numbers present a scary reality, that bipolar is more than a mood disorder, it’s a host of medical problems.

But what’s even more interesting are the treatments that are proposed and used. They’re all bipolar meds. Whether it’s anticonvulsants or 2nd generation antipsychotics (like abilify or seroquel), what’s being used are essentially the same medications that one would use to treat the moods. So from a biological perspective, this raises interesting questions that I lack the answers to. But from a basic modeling perspective, it seems to point to something where maybe these physical problems are heavily entwined with the inner workings of the brain chemistry that is also the cause of bipolar disorder. If this is so, then it leads to a relatively hopeful outcome in the years to come. That there are multiple biological models that can all lead to understanding the relationship between mood disorders and other medical conditions. That is, learning more about bipolar disorder might help migraine sufferers, and vice versa.

On my end, thankfully I’ve had 1 migraine in the past year thanks to lamictal. In many ways it’s nice to take one less pill for something. I still have the whole GAD thing, and maybe ADD, but I’ll take the win with migraines. But I’ll end with questions, again. What comorbid life time illnesses do you have in addition to bipolar disorder?

Now Part of A Canvas Of The Minds

For all my readers, I’m now part of A Canvas Of The Minds, I just posted a piece about medication, so head on over and check out all their wonderful posts. Also be sure to check the blogs of the other members, there’s a wealth of good information over there, so check it out.

 

PS. Sorry about the shameless self promotion, but you really should check them out. It’s a wonderful collaboration that I’m thrilled to be a part of.

Attempting to Motivate Myself

I’m coming out of a depression. It lasted just a few days, but it was enough to interrupt a lot. Most of which were my studies. It’s amazing how in academics that 1-2 days off is enough to set one back by a fairly wide margin. It’s just more impetus to keep ahead of things and not put them off. Hence, my attempts at motivating myself.

I’ve discovered recently that there are two things that are necessary to keeping myself motivated. One of which is keeping things quiet, and the other is getting out of my house. I’ve been delinquent in both and as a result, I haven’t done a whole lot. But sitting here in the undergrad lounge, looking out on the lake and forest (the lounge is the greatest thing ever) I’ve been noticing why these two things get me going.

First is that being in a quiet area, my mind has really calmed down and the thoughts are slower. There’s almost more cohesion to myself when I’m in a quiet area. More simply, I feel like myself. It’s different from having lots of distractions. I can get distracted here, but having that quiet seems to do more for my inner self. I’ve noticed it in the mornings at my house, but now later in the day I feel even better. I guess the running theme of my discoveries is that quiet is really important for me, and might be really key to managing my moods.

Currently, the quiet really helps motivate me to write and do work. When I feel more cohesive, I seem to be able to plan and budget my time like a normal person would. I can think ahead of what I’m doing, lay out what needs to be done, and then get to work on it in an orderly fashion. But it wasn’t always like this. The quiet before hand really threw me off. The buzzing mental state got even worse where I was trying to take in all of my surroundings. I felt uncomfortable and out of place. But by desensitizing myself to the room, I’ve really grown to enjoy it.

The second thing is getting out of the house. The lounge is now my work area, I do work there and nothing but work. And over the past week I’ve become very good at associating it with that area. I don’t watch tv, I don’t read anything but what’s related to classes. I think that for students, this might be very helpful to form a direct link with a specific place. I’ve done it in the past with organizing my days around different geographic locations, where each spot is where I do different tasks. But here, I’ve really cemented it as my place to do work and to think. It’s kind of behaviorism at its best. Associate a locale with a specific behavior, reward oneself, repeat. But the important thing for getting myself into that mode is truly leaving the house. Something about being in a different place allows me to really condition myself to work in that area. I’ve tried doing it at my home, but it just doesn’t work.

So that’s it for my break. Nothing deep and amazing, but I’m getting myself to write every day even if I think it’s not that interesting. And for the record, I’m still counting this as work since it’s getting my writing juices going. So don’t go commenting on me not doing work while I’m in my work space.

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