Monthly Archives: April 2012
I can’t really remember which one. I know that I’ve seen it, but it doesn’t deal with aliens. Instead it’s more of a character piece and about the dangers of space travel. Probably something like the Moriarty episode in The Next Generation. It’s one where the computer isn’t operating quite right. It works, then it doesn’t. Online, offline. Functional, then non-functioning.
That’s how my brain is operating right now. It works, then doesn’t work. It’s a good sign that I’m going to go into something big, mood wise, but it hasn’t figured out which way to go yet. I remember being told not to push for a mania, but sometimes, like this, pushing is what needs to be done in order to keep it from backtracking into a depression.
I also tried another post, something deeper than the daily life of your truly. It was about having children while bipolar. But I just couldn’t get it to work with my mind fluttering. The ideas didn’t flow right and I couldn’t wrap my head around the subject. That was after I started it. Before I began the post, my brain was on full alert and ready to take on anything. Now, it’s fizzling and nonoperational. Frustrating? Yes. But it’s a good sign, if I keep my stimulation and cognitive faculties working, I can push this into a hypomania. If I don’t, then like the crew on the enterprise, things will go south quickly.
The fluttering is another one of my many possible mood states. For a long time I thought it was rapid cycling, but shifts are cognitive while my mood state remains the same, a sort of eerie discomfort and inability to settle down. Months ago, I gave up on the bipolar continuum between mania and depression for reasons like the above fluttering mood. It’s a mood state, but it doesn’t fit anything along the spectrum. I’m not up or down or between. Around that same time I read some of Kay Jamison’s work, and she too doesn’t like bipolar continuum. So I dropped it all together. Why? Because there are more than two mood states that I move between and mania and depression can occur simultaneously.
Some of my moods are, manic, hypomanic, up, down, slightly depressed, and depressed. But there are more. There’s fluttering, like I’m in now. It’s where my brain feels almost hypomanic for short bursts and then seems to burn itself out leaving me with that eerie feeling of something is about to happen but I don’t know what. There’s agitated, not agitated depression or mania, just pissed off at everything from the moment I wake up. Also, there is more than a single mixed state. I can be in a dysphoric mania, where all my manic energy is self destructive. I can be in a doomsayer mixed state, where I think all is going to hell but I’m creative and have a good deal of positive self image. And I can also be in aesthetic mixed states where I find everything beautiful and often need to cut or claw at myself to find relief from the experience. The question that Kay Jamison asks is that if there is a continuum, then in the middle should be normal, not mixed. And some of these don’t even look like mania or depression, such as my aesthetic states.
Those are just the ones that I remember off the top of my head. I know that I’ve had more, but the point is that they don’t fall on the continuum. It’s not 2 parts depression to one part mania. They’re independent mood states that go along with bipolar disorder. Reducing these down to the spectrum would be like reducing emotions down to various degrees of happiness and sadness. One could do it, but it seems to impoverish life for the sake of simplicity. And like mixed states, it doesn’t seem to capture bittersweetness.
I’m only speculating here, but I wonder whether the continuum is used because it makes things understandable and communicable for people without bipolar disorder. One can imagine mania and depression to some degree (though I wonder just how well mania can be understood by those who haven’t experienced it), so things between these two are just a mixture of the two elements, as Jamison seems to hint at (but I won’t say that she endorses it). And this makes perfect sense in some respects because the different “mixed” states that I have are hard to communicate without a lot of explanation. It’s easier to just lump them all together as being “mixed” rather than assigning them names and figuring out the map of bipolar emotions.
But that’s an injustice to the reality of these different mood states. They aren’t all the same to me. I have to adjust my behaviors and interactions according to very distinct mood states that I have. They are not “mixed” to me, they have specific names and effects. It makes me wonder whether this idea of “heightened” and “depressed” categorization is worthwhile as a biological model. However, I do think that it is useful in the short run for zeroing in on some of the elements of bipolar disorder. I just wonder how long it should be kept around. Instead, I’d like to see if it were possible to map the various idiosyncratic moods to find patterns and determine whether people who are bipolar experience a different mood set all together from the general population and whether that mood set extends beyond mania and depression.
So I’m proposing to you to think about how many different mood states you really have. And how many of them really reduce down to the basic mania-depression spectrum? Or are they rather distinct moods that keep coming up in your life and you can assign a name to them?
I originally wanted to get back into doing a research piece on vitamins and their role in treating or maintaining bipolar disorder (or other disorders). So I did my usual PubMED route and started looking. To my surprise, there isn’t really anything out there from a credible source. There are no Lancet publications, or New England Journal of Medicine articles that remotely show any benefit from taking supplements on mood stabilization. There is, at best, a little of back and forth on fish oil, but nothing to really break through the barriers and land in a major publication. Why do I start out like this? Saying that there isn’t any major findings? Especially when there must have been studies conducted. It’s that this points to a gap in the literature. One that is there because there is nothing found worthy of attention. I put some faith in these journals that they are looking for the best articles, and if someone were to find something cheaper and more readily available than lithium to help mental illness, that would make the headlines of Nature. It would be a brilliant break through in treatment and also some understanding of bipolar disorder. After all, a study connecting urban living to increased rates of mental illness made it into Nature. I’m sure that the surprise effects of vitamin D3 would warrant something. I start off with this because there just isn’t a whole lot of evidence that says that vitamins are cure alls or significant.
But I still take them. I have my B-complex, my multivitamin, and I take 2000IUs of D3 everyday. And it is perfectly reasonable to take them.
For starters, I was told by my previous psychiatrist that I ought to take a B vitamin. This isn’t because I’m bipolar, it’s because lamictal, according to him, can lower certain B vitamins. And I have noticed that when I do not take it, I feel a little off, mentally speaking. Not enough to make me dysfunctional or destabilized. Instead, I’m just not at my A game. This could also be because B vitamins help boost metabolism and processing of food. Or it could even be a placebo, but either way, it does help. I’ll take a placebo effect if it’s cheap enough.
The other two I take because of general health. There is a vast distance between being specifically helpful to being bipolar, and to helping general health which then helps promote better moods. So I take a mulitvitamin simply because I might not get all the essential nutrients in the course of my daily eating habits. I eat as well as I can, but I have many bad days where I don’t get everything I need out of laziness or apathy. I don’t believe that there is harm in taking a pill to help, and I stress help not replace normal means, get all the basic minerals and vitamins that I need.
And finally D3. I haven’t done much research into the kook fest that happens over this one. I’ve only come across it on message boards where people claim that it cures depression, bipolar disorder, and a host of other things. All one needs to do is take massive doses of it and voila, you’re cured. If I was feeling brave and not easily enraged, I’d dredge up the people peddling this idea. But after reading about all the ways that women are having protections removed around the country, I’m not in the mood to deal with much more nonsense. Additionally, D3 (and all D vitamins) can cause kidney stones in high doses. So unless you’re chugging 2 gallons of water a day, like me, you might be in for a painful surprise after your D experiment. Still, I take it. Why? Because I live in Wisconsin where it can get frigid cold after 80 degree weather and I don’t get out nearly as much as I should.
As such, I take a really basic approach to vitamins, it’s in terms of health. Based on my habits, I know that in slumps I’ll need to supplement nutrients, and that B vitamins help with metabolism, and D is just because I live in the north and even when the sun is out, it can be hard to tan it has so little oomph this time of year. Together, they help improve my overall health, and that might make a difference in some way. But as for having any direct connection in helping mental illness, there really isn’t anything that’s made a splash. And in the mean time, I try to eat healthy and get a few fruits and vegetables in there as well. Good health depends on more than a pill or two, but they can’t hurt for when we’re not taking good care of ourselves.
During my time of rest, I’ve settled on a British show called Spooks, also known as MI-5 here. MI-5 is a British institution that can be thought of as a combination of the FBI and NSA. And it’s a sister institution to MI-6, which is like our CIA. Anyways, it follows government agents on infiltrations of groups threatening the security of Britain. I’ve also finished a Masterpiece Theatre production called The Last Enemy, which is about a big brother style government spying and collecting data on every British citizen. I’m addicted to both shows. They’re well written and quite fascinating. It’s also rather like The Wire. It’s all about information collection and paying attention to detail. And it’s starting to infect the way I think about things.
On my way to pick up my refill of meds, I noticed two very interesting things. First is that I was paying attention to everything. Seeing what’s in people’s plastic bags, how they shift, what bus is picking up at certain points (I have a phone app for that). On the short walk, I absorbed all sorts of information. Were they right or left handed, did they smoke, were they regulars on the capital square, work there, eat there. I took longer than normal because I sat down to smoke to watch people move about. I did it without thinking about it. I just did it.
It was rather nice actually, the world was very vivid and had lots of information to absorb. Information is like a drug for me. When I have lots of information to absorb, and I’m in just the right mindset, I consume it. It makes me happy and warm.
The second thing I noticed when I got home. While I was in a better mood, it occurred to me that I really did all this without thinking about it. With just about a day of suggestion, I very easily adopted certain habits, thought patterns, and behaviors. In fact, it wasn’t even suggestion, it was just a series of television shows about surveillance. I don’t know if it’s a bipolar thing, or a psychosis thing, or maybe it’s the drugs, but I’m far more susceptible to ideas now than I’ve been before.
And I’ve always been susceptible to ideas, especially when I’m manic. I’ll get some ideas stuck in my head and they just grow and grow into delusional ideas. It’s rather like I never grew up. Little children do the same thing with their ideas and playing make believe. So, I don’t know whether it is just me, or if it’s common to other manic depressives, or if I’m becoming manic and highly susceptive to suggestion. In light of my ignorance, I’m just throwing it out there to see if other people also get caught up in ideas very easily.
But it’s not the worst thing in the world. It’s eccentric at best, never fully growing up. It also makes life rather fun, seeing the world through different eyes wholeheartedly and without even trying. Really, it makes the world rather interesting at times, to see things differently. The trick is to not get caught up in the game too much. When ideas start to get too out of control, it’s good to take a step back and ask whether you have any evidence to support the claim, whether alternative explanations are available, and in the end ask whether you really know. It’s a common CBT trick to do this with all sorts of ideas and helps undermine delusions. I use it to undermine my paranoia all the time. It’s better than mindfulness in my experience. And this time around, it kept me from thinking I’m a spy.
It’s been slowly dawning on me. I haven’t kept up on readings for the graduate seminar that I’m sitting in on. And I haven’t been that active in working on my book for the past few weeks. Some of it is related to moods, but it really hit me today. I’m burnt out.
I’ve had massive changes to my daily regimin but I’ve also had a host of things to grapple with. I’ve had severe back injuries, evictions, psychotic episodes, hospitalization for depression. And I’ve been struggling with school the entire time it went on.
I felt the first pull of it last summer, where I just couldn’t complete what needed to be done. I just barely eked out any productivity. Then, after the stress of being drugged up to my ears after my first psychotic episode, I went into a depressive episode that could have ended very badly. And now, I’m just exhausted.
Being burnt out literally just means that I have no energy left to do major productive things. With some hypomanic pushes, I can get some stuff done. But in my day to day life, I just don’t have the strength to keep moving. I’ve noticed that I want the world to just stop for a month. No responsibilities, no cares, no nothing. I just want to sit under the stars every night and relax. I want to have a week to myself where I just wander aimlessly through hills and read when I want to. And I ultimately want to just dissolve into the background.
I’ve been fighting this feeling for a long time. It’s in my nature to want to be productive. Being productive makes me rather happy. But being productive means that I must not only push, but that I have a deadline set up. So then I get frustrated when I don’t accomplish what I want to do in the time that I set out for it.
It’s rather like being depressed, but without feeling so self destructive. It’s just a need to fade away for a while and rest without having pressing obligations swarming around. It’s amazing really, the number of obligations that we have. We have them in terms of housing, school or work (or both), we have social obligations, we even have obligations to keep the house tidy. It’s like a swarm of bees, all ready to sting you if you move the wrong direction to swat at them.
But today, I’m just going to relax. I’m going to focus on enjoying things and not thinking about the larger picture. It can wait. And I’ve also come to wonder just how much this constant feeling of stress has kept my moods fluctuating. By now, they should have settled down a bit into a regular rhythm, but they won’t. It’s erratic in terms of the changes. So something is the matter, and I’m going to guess that it’s the fact that I’m rather undone. I don’t have that cohesive sense of being anymore, and instead I’m just grasping at things as they come along. It’s time to try and rebuild myself. I’m not sure how, but I think that part of that is letting go of the image I have of myself being a fully functional individual at this point. The constant image of that functional ideal drives me mad, so today I’m letting it go for a while. Hopefully, I’ll get the strength to build a new, more accurate one in the meantime.
I’m in an “almost there” mania right now. I’m not manic by any means, but I’m creeping in on one. I have several ideas that I want to do, biking, studying, writing, and camping with my telescope. I want to do them all, right now. Just set off and do something. But I lack that impulsivity that comes with any sort of mania. As a result, I have many things I want to do, and can’t get around to doing any of them. It’s all so close though. I can almost taste the heights that my mind could soar to if only I could push a little bit.
Part of this is definitely the side effects of the drugs that I’m on. Be it the lithium, the zyprexa, or the klonopin, one or all of them are pushing me down. It’s an odd reality to feel yourself not transitioning in anyway. In depressive periods, I call this a purgatory of moods. But that’s where I don’t feel much of anything. I’m in no mood state. Here, I’m trending into a mood state, but being resisted, heavily. Which is a good thing as my girlfriend pointed out. It keeps me sane. I’m still eccentric, but I’m very sane on these drugs. Which is a good thing over all, to be sane, but it doesn’t feel as good as being manic.
And that allure of being manic is something that I discussed with my psychologist. On these drugs, they don’t stop you from becoming manic. If I really wanted to. I could drink a six pack and load up on 2 pots of coffee and trigger the whole thing. I’d be completely gone and ready to take on the world for weeks. And in these states that I’m in right now, the need to push is so tempting. It’s like having a marvelous drug dangled in front of you and all you need is a little push in the right direction to get there. You don’t have to find some dealer, or shady access, or risk chemicals. Just a little alcohol and caffeine and I could fly as high as I wanted. It’s something I did naturally, before being medicated. I’d use those things to make me feel better and push my moods around as I wanted to. It’s almost a benefit that comes with being bipolar, while we are a slave to our mood swings, at the same time, we can push our moods around in ways that normal people cannot imagine.
Yet, as much as I want to push, I’m not going to. I’m resisting. One of the ways that I find useful is talking to my girlfriend about the things that I want to do, and have her organize it and tell me what I should do. As strange as it sounds, I cannot do that on my own. I need someone to tell me and process for me. And I’ll keep my klonopin going, even though I desperately want to end it and let my mania take hold. Instead, I’m going biking. And I’ll bike until I collapse. I’m shooting for 50 miles today. And after biking, I’ll feel relaxed and rested and ready to tackle something else. In the past, when I was slightly manic to manic, I would just bike my brains out and it felt wonderful. So I’m trying that again today. And hopefully, it’ll alleviate some of the desire to push the boundaries of what my meds can do.
This August I’ll be moving in with a second roommate. She’s a very nice person and we lived together at the co-op for a while before. I believe that she’s vaguely aware of my mental health, but since the last time that I saw her, it’s become more pronounced. My mood swings are much more apparent and I have psychotic episodes. And there lies the question, just how much should I tell her and what sort of responsibilities should be forced on her? I’ll explain more of what I mean by these two things.
I have no problems with telling her the details of my current health. I’ve gotten used to the idea that I need to inform some people of the goings on in my head so that they don’t take everything I do seriously. Personally, I think that it would be a very good idea to tell her so that she doesn’t take my irritable moods seriously. I’m fairly good at controlling them with medication, but that’s never 100%, it only takes off the edge. In that sense, I’m in favor of informing her of some of the details just so she doesn’t get caught up in my bizarre swings and why I can seem like several different people in the same day. So in that sense, I think that informing her about my mood swings would be very good.
But then there’s the other aspect that she doesn’t know about, my psychotic episodes. To the best of our knowledge, they’re under control, so there is less of a need to inform her. Still, they might erupt out of nowhere and she should know what could happen. It could also make an episode far less frightening if she knows what is going on and that this is almost “normal” for me. The hesitation that I have with this is that psychotic episodes are perceived by and large differently than extreme moods. Even though I find that psychotic episodes are no more scary than something like a dysphoric mania. In fact, I’d rather have a psychotic episode than a dysphoric mania as my psychotic episodes seem comparatively kind and complacent. But back to the point, revealing the psychotic side of myself might make things uncomfortable in our friendship.
The other aspect to this is something that is sadly obvious but never talked about. It’s that living with someone new means that I’ll force a certain set of responsibilities on my new roommate. It isn’t that much, but little things, like having my psychiatrist’s phone number on file in case something goes wrong. Telling me to take some of my medications if I’m starting to act out of character. For instance, if I’m becoming very manic and becoming very bothersome, it does us both good to tell me to take my klonopin. But things get more iffy with psychotic episodes. I need to take certain medications but not twice (as I seem to try to do). It’s also a great responsibility to deal with someone completely delusional for the 2 hours until the medication works. There are other things that need to be done as well. Keeping me away from all medications and knives, and possibly ledges (we’ll be on a second floor), are some of the things that just need to be done when I’m in those moods.
In all fairness and likelihood, I’d like to be told by my roommate if she had such circumstances, so I’ll tell her. It would be much worse if the event would arise that I did have a psychotic episode and she was unprepared for it. And I don’t need to reveal every last detail of it. I need only tell her that I can become delusional and hallucinate, and that I’m safe to be around as far as is known. The only danger that is present is me taking my pills twice or cutting myself early on. And that my medication takes care of the problem very quickly. And as for the manias and depressions, if I start to seem hyper and irritable, tell me and I’ll take some medication. And if I’m depressed and things need to be done, just give me one task to do so I don’t get overwhelmed and get nothing done.