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Posts Tagged ‘Bipolar biochemistry’

There was a time when I had no awareness of when I was getting manic – I just knew that I felt good, so bring it on!  Over time, I have become sensitized to more and more subtle cues that I am “getting high” – and I know that it has lots of risks.  Mania has some genuine gifts – as does depression – but the more ungrounded you get, the more risk of errors in judgement (spending too much money, starting unrealistic projects, etc.), interpersonal damage and the inevitable crash.  So grounding is key: how to keep your feet on the ground when the adrenaline starts to surge.

When you've been really low, all you want to do is to come up. Keeping your feet on the ground is both a skillset and a discipline.

When you’ve been really low, all you want to do is to come up. Keeping your feet on the ground is both a skill set and a discipline.

There are many strategies for grounding, from sitting and walking meditation to gardening.  I’ve tried lots of them, with more or less success.  Some, like walking/swimming/dancing, psychotherapy and talking with my friends are just part of how I regularly operate.

But I’ve got a new one: getting sick!  A couple of weeks ago, I came out of about two weeks of being down and started to come up.  Day 1 of being not depressed looked pretty balanced – call it a 6 (Peaceful State) on my Mania-Depression Scale.  But knowing the way my energy state tends to swing, I was watchful.  Then on Day 2, two things happened: I started to tip into mania (call it a 5, “slightly expanded”) and I came down with a cold.  And getting sick grounded me!  It turned out to be a nasty cold, which went on for ten days, getting worse for the first seven or so.  My up cycle lasted about eight of those ten days.

During those eight days, I frequently said to friends things like: “I physically feel like crap, but I’m not manic.  I’m not depressed and I clearly have tipped into the up end of the continuum.  My spirits are good, but I’m not speedy.  All in all, getting sick has not been a bad trade-off. ”

It felt great to not be emotionally down, but being physically down kept me from getting high - which itself felt pretty good.

It felt great to not be emotionally down, but being physically down kept me from getting high – which itself felt pretty good.

What’s the takeaway from this?  “Don’t try this at home?”  My current lesson from it is: Life is always working on me.  It’s trying to get me balanced.  It will use whatever strategies it can to teach me how to stay grounded when I am high and how to pull myself up to the surface when I am low.  I don’t want to use getting sick as a regular strategy for dealing with mania, but with a little luck I have integrated some subtle balancing capacity – or moved the needle a degree or two.  I’ll keep getting opportunities to practice grounding myself and hopefully I’ll have some muscle memory of what it was like here to be not depressed, but not high.

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It’s been a complex day – a day where I have inhabited a complex healing state.  You can read more about my concept of complex healing states in the page (tab) at the top of the blog, but in short they are states where up and down co-exist.  Today I started out depressed (have been for over a week): I had a very hard time getting out of bed and wasted an hour trying to be asleep – getting up an hour later than the 7 a.m. when I like to start my day.  This left me in a foul mood.  My biochemistry has not left that zone.  My mood is still down.  I’m liable to wake up tomorrow in as bad a mood as I was this morning.

But several things have gone on to make my day more complex – things that would not usually happen when I’m down.

  • I spent an hour on the phone with my friend Byron.  We do this every week, splitting the time and giving each other very good listening.  This often lifts my mood, but mostly did not today.  What was exceptional for me was that, as I laid out my fairly ambitious work agenda for the afternoon, I committed myself – more than achieving my goals – to loving myself as I did my work.
On one call, I committed to loving myself regardless of accomplishments. On the next call I practiced it.

On one call, I committed to loving myself regardless of accomplishments. On the next call I practiced it.

  • My afternoon did not go as I planned.  A friend who has been in a florid manic state called shortly after I got off the phone with Byron and kept me tied up for almost an hour. And I felt very unsuccessful in my attempts to ground her.  When I got off the phone, I spent another hour digging up resources for her (she’s in another state) and sending her a couple of long emails.  This threw my agenda way off – and somehow another hour evaporated.  But I told myself that all this is part of being a resource for people with bipolar disorder – and was not off my mission.  And I genuinely care about this person.  I was not accomplishing my original goals, but I was accomplishing my higher goal – I was loving myself.
  • I went for two good walks.  Now that’s something that I’m capable of doing when I’m down, though I have been doing it much less since my dog died four weeks ago.  That’s also been part of me not getting up in the morning: “What’s there to get up for?”  Going for the walks was nonetheless not so unusual.

    What was unusual was this: I genuinely appreciated the afternoon sky.  Granted it was pretty remarkably beautiful.  But when I’m as depressed as I have been today, I don’t appreciate beauty.  I don’t enjoy music – even music that in a better mood I totally rock with.  I don’t like visual art – museums and galleries are a waste of time.  And I don’t appreciate nature – even great skies.  But today I did.  I bet it had something to do with my earlier commitment to love myself and then loving myself right in the middle of my goals for the afternoon falling apart.

Appreciating a beautiful sky may seem like a no-brainer, but when you are depressed this kind of beauty can feel like one more assault: "I'm so messed up that I can't even appreciate this."

Appreciating a beautiful sky may seem like a no-brainer, but when you are depressed this kind of beauty can feel like one more assault: “I’m so messed up that I can’t even appreciate this.”

So a base of depressed, but several things that don’t usually happen when I’m depressed.  I’ve created a new rating on my Mania-Depression Scale (page at the top of the blog) to reflect this kind of state: 6 CHS (Complex Healing State). Six is right in the middle of this 11-point scale.  I call a regular 6 “Peaceful”.  I don’t call it “Balanced”, because a 6 CHS – which definitely is not peaceful – is also a kind of balance, holding within it light and dark, up and down.

I believe that this state is powerfully healing – maybe even more so than a “Peaceful” state.  It is the place where up and down learn from each other, stop warring against each other.  It works to reduce the wild fluctuation of up and down, because the two poles are not polarizing – they are integrating.

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I maintain that our healing through bipolar disorder happens not as much from mood stability (which is a manifestation of the healing, not a cause), from finding a happy medium between the ups and downs, as from bipolar integration – getting the two poles to integrate with each other, to communicate, to mix it up, so that we can harvest the gifts of each state.  Last week for several days I inhabited a complex healing state – in which i was in some ways clearly down, yet also encouraged about my writing.  And when I’m encouraged about my writing, I’m encouraged about my life.  So it was not as much fun a being up, but in some ways I believe more healing.  Then over the weekend, i came up out of being down, had a couple of days that I seemed simply, wonderfully balanced and a couple other days that I was clearly running high.  I crashed again Monday night – partly from having gotten high and missed sleep, partly from having used caffeine, sugar, and way too much other sweeteners.

So since Monday night I’ve been pretty down – and, however, once more I’ve been inhabiting these creative complex healing states.  Last week the mixture came from being encouraged about my writing.  This week some of that has been present, but there have also been some other elements that have complicated the depression.  Tuesday i was in a state that was pure biochemical, physical contraction, physically down without any affective down – no discouragement, no negative self-talk.  I’ve had this happen before.  Frequently in the past, my first day of being down was like this.  It was only later that the negative affect kicked in.  Once, about four years ago, I went through a whole 7-day downswing that was like this – never did negative affect kick in.  This to me is both testimony to the biochemical nature of so much of my depression and also testimony that the core of depression, at least for me, is not mood change but physical contraction – with the mood change being a result and an aftermath to that..

One kind of balance is a state where you are neither depressed nor manic - but another is one where some down elements and some up elements balance each other out.

One kind of balance is a state where you are neither depressed nor manic – but another is one where some down elements and some up elements balance each other out.

Wednesday i was clearly down – prone to some self-critical, nihilistic voices in the morning. But the thing that was wonderfully mixed was that, as I spent a day at my desk attending to business affairs (emails, etc.), I was content – even pleased – with some relatively modest accomplishments.  On a down day, where I would usually be critical of everything i did, I took some small bits of progress and felt happy about them.

Yesterday, i was definitely, clearly down – and yet made a decision to do some very forward-looking things. Yes, it was my birthday and that helped to make the day special, helped me to be more committed to making it a good day.  But I did – I focused on my vision for the new year.  I did some good writing for this blog (yesterday’s post and one to come tomorrow).  It was a fertile, mixed day..

Today, I started the day very clearly down – ruminating, criticizing every little step.  And I’ve taken a stance against this ruminating self-criticism.  I’ll make this into a separate post.

So more up and down together.  I call them complex healing states.  You could also call them complex feeling states – which is just as good as a description.  My friend Tony Godwin referred to the phenomenon as partly down, but also bringing some tenderness to it – which is a wonderful description.

Part of the mixture in the separate days has included some encouragement on a down day.  And the very presence of these mixed days is encouraging.  It’s not as much fun as being up – but it is, for me, a sign that deeper healing is happening.

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Today Is my birthday.  I have been spending some significant time elaborating a vision for myself for the next year – itself a very positive act on a day on which, in spite of it being my birthday, I am relatively depressed.  I actually started out today more like a manic depression 9 (very contracted), but this visioning activity – and going to a very good Overeaters Anonymous meeting – have moved me to my current 8 rating (definite physical contraction).  And I again today sit in a complex healing state – with that definite physical contraction cohabiting with some positive internal elements. Very significant parts of that vision for my next year have to do with my recovery from bipolar disorder and my vision for this blog.  I’ll write about my personal healing today and about my vision for the blog in a later post.

A friend of mine is making me a gluten-free, sugar-free (agave) flourless chocolate cake for my birthday - and I know it will be scrumptious.

A friend of mine is making me a gluten-free, sugar-free (agave) flourless chocolate cake for my birthday – and I know it will be scrumptious.

First, my recovery.  My vision includes:

  • I don’t have a vision of complete recovery from bipolar disorder.  This could disappoint or upset some of my colleagues who write and teach about bipolar disorder.  Unless some new medication comes down the pike that controls the oscillation of my states from manic to depressed, my vision of healing includes that i heal through bipolar disorder rather than from it – that it is the walk I need to walk, a disease I need to manage, even if I some day get off of all meds.
  • I spend more time in what I’m calling complex healing states – states where elements of up and down coexist together, where the polarization of my manic and depressed states gets a chance to heal because the two parts of myself get a chance to know and influence each other.
  • My prevailing state shifts gradually more towards the peaceful state (md 6) on my manic depression scale.  I spend less time on the more extreme levels – further from the balanced 6 – and more time right on it.  This is supported and facilitated by all the elements that support my healing – from psychotherapy to Overeaters Anonymous, the 12 Steps and wrestling with the concept of a higher power to ecstatic dancing and all kinds of other relationships and resources that are detailed elsewhere in this blog.
Balance - the elusive state that for me is the Grail for people with bipolar disorder.

Balance – the elusive state that for me is the Grail for people with bipolar disorder.

  • Because of this healing, I am able to negotiate with my psychiatrist and to manage successfully a gradual decrease in my psychotropic meds.  I hold out the possibility that eventually I will be off them altogether, but I don’t see anything like that happening in the next year.  I don’t think it’s in the cards for everybody with bipolar disorder to get off of or even reduce their meds, but it is part of my personal vision.
  • Last night I attended my first meeting of Magnetic Minds (http://magneticminds.weebly.com/), the Asheville chapter of the national group Depression and Bipolar Support Alliance (http://www.dbsalliance.org).  I liked it and intend to go back.  I visualize that this group will support my own healing, that I will be able to offer helpful support, inspiration and information to other members (partly by offering them this blog), and that the group will deepen my understanding of bipolar disorder and the impact it has on those who deal with it.
  • Writing (this blog and my memoir) supports my in my own healing through bipolar disorder.
  • This year – partly based on this blog and my memoir – I begin to do some public speaking and teaching on the topic -some volunteer through NAMI (National Alliance for Mental Illness) and progressively more for pay.  This supports me in my own healing.
  • I will continue my own reading on bipolar disorder, especially books and blogs by others with the disease, but also including scholarly and professional writing.  This will both give me more to share on the blog and support my own healing.

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My weekend held a series of errors in judgment, which comprised poor self-care around my bipolar disorder – and were set in motion by a slip around my food addiction.

I have known for some time that peanut butter is a problem food for me, a food that I am prone to eating compulsively – and sometimes outright bingeing on.  I have written about this twice in this blog.  But I recently gave up gluten, when about the fourth person suggested this might help with depression.  I actually took her advice to also get off dairy, a commitment on which I have since reneged.  Bread and cheese have been such staples in my diet that I rationalized that I needed to add peanut butter – a quick and easy source of protein – back into my diet.  What was I thinking?  How much evidence do I need that it is a problem food for me?  How great is my capacity for denial?

So I took a jar of peanut butter with me on a weekend trip to see my son, daughter-in-law, and new grandbaby.  I love my son madly – and I know that he loves me deeply, but our relationship can sometimes get tricky – so it’s extra important that I take good care of myself when I go there, do everything I can to stay centered and grounded.  If you’re already smelling trouble here, you’re right

After taking the peanut butter on the trip, my second error in judgment happened at Starbucks Saturday morning.  I had some time to kill before the kids wanted me to come over (on the weekend, when the baby goes down for her first nap they nap also), so I took my laptop to the wireless internet at Starbucks.  Probably even going there was an error in judgment.  I don’t drink coffee – I know that, as someone who is trying to manage his moods, caffeine is a really bad substance for me.  And i don’t even do decaf – it has always seemed like a lame substitute for the real stuff.  I also (aside from periodic slips or extended lapses) don’t do sugar, which is also problematic for someone trying to mange their mood.  I tell myself that other sweeteners with a lower glycemic index (how fast they metabolize in the body) are not a problem.  But it’s hard to make a case that the 7 packs of honey it took to get my bitter grande decaf sweet enough for me was completely harmless.  But i did it – actually it not once crossed my conscious mind that this was an awful lot of sweet stuff.  More denial.

Honey probably is relatively harmless compared with sugar - and I'm not ready to take it out of my diet - but 7 packs of honey is a lot of sweetener.

Honey probably is relatively harmless compared with sugar – and I’m not ready to take it out of my diet – but 7 packs of honey is a lot of sweetener.

We had a great day.  That night, the chicken took a long time to cook and we ate pretty late.  I ate kind of a lot (it was very good) – right up to the edge of overeating, or maybe a little over.  I was very full.  Then, since it was already pretty late, I went back to my hotel room.  The beginnings of my trouble back there was my Zing bar.  I know that those energy bars are very sweet, but I somehow had managed to convince myself that it made sense to buy one – after previously swearing off them – at the gym, after a swim earlier in the week.  The blueberries I had had for dessert at my son’s house were really very good, and I was already quite full – but there was this candy bar calling to me, so I ate it.

My Zing  bar was sweetened with agave and did have protein, but it was awful sweet - for me it was a candy bar.

My Zing bar was sweetened with agave and did have protein, but it was awful sweet – for me it was a candy bar.

I guess that just opened the flood gates, because for some reason I then got into the peanut butter – really into it.  I was still eating it as I walked it down the hotel hall to find a garbage can to dump it in.  That night my stomach tossed around all night and I didn’t sleep well – and woke up early.

The next morning it was back to the Starbucks for internet – and another grande decaf, with another 7 packages of honey.  My son and daughter-in-law know a lot about my struggles with mood and I had over the weekend recruited their judgment about whether I was cycling high, which I had been concerned about on Thursday.  We all kept agreeing that I seemed pretty level.  But that morning  (or almost noon, the appointed time to arrive at their house) I observed to my son, “Wow, I’m pretty chatty today.  It does seem like I’m cycling kind of high.  I think it’s the lack of sleep.”  (The honey still didn’t cross my mind.)

A little while later, I had a tense encounter with my son.  Perhaps the most telltale sign that I was revving high was that I made very little of it, and –  when my time to leave came before the tension had been fully dispersed – I gave it no thought the rest of the day.  This even though the next day it seemed pretty significant, enough so that I want to make a point of apologizing to him.  Carrying some unconscious tension from this certainly did not help my growing mania.

When I left for the 7-hour drive home at 2 p.m, the genuine caffeinated coffee that I had at Starbucks was not an impulse move.  I had told them of my plan.  When they offered to make me some coffee, I said, “No, if I’m going to break down and have real coffee, I want it to be Starbucks.”  And still, as I was announcing this decision, I at no point thought this was maybe a bad idea.  Let me state it again: I don’t do caffeine.  It had been many months – maybe a year – since I had had any.  I was already describing myself as cycling high.  What was I thinking?

Here’s where I think my food addict – with all the denial that goes with that – intersects with poor management of my moods.  I had, during the last week, been outlining a blog post on strategies for staying grounded – lots of very positive ideas, which I was actively practicing and which are very valuable, and which I am still going to write up.  But I may need to add some don’ts: If you want to get good sleep to keep from cycling high, don’t overeat before going to bed.  Don’t consume 7 packs of honey.  Don’t have caffeine.

So I went to Starbucks and – thinking I was being very disciplined – had only half caffeine in my 16 oz grande.  The French Roast bold blend in my half-caf part (my request) made the coffee even more bitter than the decaf had been earlier that morning, so 7 packs of honey didn’t get it sweet enough.  Rather than go back and ask for two more packs of honey, I grabbed two packs of “Raw” sugar.  Let me say it again – I don’t do sugar.  It had been several weeks since I had had any.  And still it did not cross my mind that I was making a mistake – let alone being flat-out out of control.  What was I thinking?

For someone who hasn't had caffeine for a year, 8 oz. of French Roast is a lot of caffeine.  Then there's the honey and the sugar - and I'm trying to stay grounded?  Sometimes mania has a mind of its own.

For someone who hasn’t had caffeine for a year, 8 oz. of French Roast is a lot of caffeine. Then there’s the honey and the sugar – and I’m trying to stay grounded? Sometimes mania has a mind of its own.

The trip home was uneventful.  I never identified myself as revving high, though looking back some  signs were there.  That night I actually slept well and long (7 hours).  The next morning, I did identify myself as revving a little high..  By mid-day I had a bad case of stomach cramps.  All afternoon I went back and forth as to whether I was manic or sliding towards depression.  (Being bipolar, it’s so easy to obsess over the signs – which way is my mood heading?)  By late evening, I had chills and fever, stomach cramps – and I was depressed.  Was I getting sick?  Maybe, but I think it was the over-eating, the lack of sleep, the honey and coffee and sugar – and mania.  Crashing from all of that can explain a lot – and gets me out of denial.

I had stomach cramps all night and didn’t sleep well.  Today I have stomach cramps, feel lousy – like the flu – and am depressed.  Maybe it’s the flu, but there’s no real learning in all of that.  The real learning for me is to keep working my Overeaters Anonymous program and to remember some absolute basics for self-care around my moods: no overeating before bed, no sugar, no big doses of “innocent” sweeteners, no caffeine.  All my positive, pro-active strategies for staying grounded are wonderful, but if I don’t mind the basics they don’t have a chance.

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I’m going to give it a manic-depression rating of 6 (in balance) for now, but I’m watching it.  Since Monday, I have been saying that I’m inhabiting a very fruitful mixed state – in some ways still clearly down, but also encouraged about my writing, which leads me to be encouraged about my life in general.  Today is the first day that I am clearly not down.  This was especially apparent walking the dog in the woods, rocking to Ani DiFranco on Spotify on my phone.  When I’m down, I don’t respond to music – it mostly irritates me.  All through my recent down stretch (9 days clearly down, then those 3 mixed), music didn’t work for me – though honestly I didn’t try it during the last 3 days.  But today I was really rocking.

Am I in balance? Or on my way from too down to too up?  Breathe and watch - and trust.

Am I in balance? Or on my way from too down to too up? Breathe and watch – and trust.

I don’t want to be an alarmist – I want to be able to enjoy just feeling good.  I am definitely revving kind of high, but that could be just the pressure I am feeling to get a lot of things done today before I leave early tomorrow for a weekend trip to see my son and new grandbaby in Louisville, KY (about which I am excited – and want to be excited).  I have had way too much mania over the last few months.  The Lithium I started two weeks ago is supposed to help me keep my feet on the ground – but I may not have been taking it long enough or may not be on the right dose.  (I took a blood test a few days ago that’s supposed to tell them if it’s the right dose for me, but I haven’t heard anything back from my psychiatrist.)

So meanwhile, just to be on the safe side, I’m practicing all the tools I’ve learned over the years for grounding myself.  I don’t have time to write all that up right now, but expect a post on it next week.  But one thing I know that i absolutely need to do is to slow down, every which way I can – and get a good night’s sleep tonight.  I’ll be away from the computer for a few days, but will give you an update next week.

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Up and down together is good news!

I’m inhabiting a mixed state today.  There’s lot of evidence that I’m still down (for the last ten days – today I’m calling myself a mania-depression 8, “Definite physical contraction”): on the conference call I was on this morning, my responses were really flat; my unconscious is still trying to generate the “This is all bullshit” mantra (though i have new tools to wrestle with this – which I will describe in a different post).  So it’s clear to me that my biochemistry has not shifted – I’m still down.

When I’m up, I’m very keen about this blog.  I believe that it has lots of value to offer – to mental health professionals and other helpers, to family and friends of people with bipolar disorder, but especially to my brothers and sisters who also suffer with this condition.  I picture that writing these mostly autobiographical posts will spill over into finishing my memoir, which is largely about bipolar disorder – and that this will then also reach and help people.  And I picture more books – why not? I have the professional credentials and the lived experience.  And finally I picture public speaking on the topic.  Again, why not?  I’m a terrific public speaker and get tremendous satisfaction from it.  All this will spill from the baby steps of writing this blog, day by day.

When I’m down, as I have been, I’m usually discouraged about my writing.  This blog seems useless.  “What do I have to say to anybody else about bipolar disorder when my own condition is still so out of control?”  And if my blog is worthless, the whole scenario of books and public speaking falls apart.

Today I’m clearly down.  Yet I’m encouraged.  Yesterday I had three separate encouraging experiences around my blog.  I had two days earlier sent the link to this blog to an associate who is very centrally positioned in the local mental health community.  I got her reply email yesterday morning, in which she raved about the blog up one side and down the other.  Then the piece of stand-up comedy that I performed at church yesterday (see yesterday’s post “A piece of manic comedy”), which in my down state I thought was badly written and would not reach people, did reach them – in spades.  More affirmation about my writer’s voice.  Then, in the evening, I wrote that blog post i just referenced – and couldn’t resist the assessment that it’s a good piece of writing and one that has a lot to say about bipolar disorder, that it could be useful to many people concerned about bipolar disorder, especially my cohort with the disorder.  My carryover from all this today is that I’m more believing in my writing voice, in this blog – and in all the other elements of a positive future that I see spilling from this blog.

So today I’m down – and encouraged.  My take on bipolar disorder is that the target is not so much mood stability as what I call bipolar integrity.  The problem is that these two states, mania and depression, operate so separate from each other – they polarize. We are like two different people that have no crossover, that don’t talk with each other.  Each side has gifts to offer, but those gifts don’t come to fruition as long as we are so split down the middle.  We need to integrate those two parts.

The da Vinci Vitruvian Man represents for me an image of wholeness, of integration.

The da Vinci Vitruvian Man represents for me an image of wholeness, of integration.

Today my up state and my down state are co-existing.  I’ve got flat responses and self-destructive rumination – along with encouragement about my writing and my future.  I’m not having fun – my mood is not up.  I would not say that I am happy even.  It makes me realize how attached I am to my up state, even with all its negative implications (ungrounded, out of control, creating the crash that comes after).  But I’m not discouraged.  So I have elements of my up state, but am not really up.  And I have elements of my down state, but I’m not really down.  I would not say that I’m in balance, because when I’m there I don’t have the elements of suffering that I have today.

Yet this is fundamentally encouraging.  The integration that I see as central to my healing is happening.  Part of me wants to try to leverage the good elements, to pull hard to get out of or away from the down elements – to get myself feeling good.  But another, i think wiser part, is saying, “Soak in this state.  Appreciate, relish this state.  Out of this mixed state will come the integration that is the key to your positive future.”

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