Posts Tagged ‘depressive physical contractions’

My new psychiatrist recently said something that I have been saying for a while (which makes him look smarter to me :)): “Bipolar disorder is not a mood disorder, but an energy disorder.  We go through cycles of expansion and contraction.”  My central depressive symptom is a painful contraction, like each cell is in a vice.  Sometimes the mood change lags behind by a couple of days – once it never happened at all, just seven days of painful contraction …no sadness or discouragement or nasty self-talk, nuthin’.

So when I am depressed – contracted – like today, Mania-depression 8 (“definite physical contraction”) sometimes the best treatment is anything that helps me to extend.  Expansion may be too big a stretch, but if i can reach out, push out, lean into life – anything that can get me back out from being curled up into a little ball.

I woke up at 5:30 a.m.: not quite enough sleep, having gotten to bed at 11:30, but I knew I wasn’t going to get back to sleep, so I knew that what I needed to do was to extend – get up – but instead I contracted back into the bed, trying/pretending to be asleep and just making myself miserable.  Finally, at the last possible time, I extended by getting up and going to dance (Asheville Movement Collective ecstatic dancing – see the page at the top).  I had to really push to get there on time.

Then, on the dance floor, I was confronted with a big blank canvas for painting contraction or extension.  (Sometimes extending left me expanded, but it continues to feel useful to make the distinction.  Extending is the effort to push out of contraction.  Expansion is what happens when it works.)  Some of the time I pulled in on myself.  But some of the time I extended.  I extended my energy and my body – moving vigorously through the space.  I extended towards other dancers – moving in and out of their space, dancing around them.  This is more complex: that other dancer can respond in a variety of ways.  In one instance, she danced away sooner than I would have wished.  In another, I finally moved away because I couldn’t handle how open she seemed.

Sometimes I can't find anything to do but to contract; other times, with a lot of effort, I can extend out.

Sometimes I can’t find anything to do but to contract; other times, with a lot of effort, I can extend out.

Overall, I was very confronted with all my issues about moving towards other dancers – all my insecurities, my mental trips about “Do they want me?”  And today that felt very productive.  Whereas another I day I might have just said, “I’m depressed, I’m contracted and I’m having a terrible time”, today I said, “I’m confronting some of my trickiest interpersonal issues.”  That seemed workable, important, valuable.

After dance, I completed the second part of my extending commitment for the morning – going to church.  Over the last year, I have been doing a lot of pulling away from this community – which has at times past been very important to me.  Sometimes I have been critiquing the church, sometimes I have just said that I hate going there when I’m depressed.  Today I said, “This place pushes all my buttons around belonging.”  This is such a  more useful way to think about it.  It’s also a place where I like/care about/love a lot of people – and they feel this for me.  If it also stirs the pot, gets me to work on my key issues, why would I not want to be there?  When I’m up, I love being there.  When I’m down, it’s an opportunity to practice extending.


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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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This morning i woke up with painful physical contraction immediately present.  Some days it takes an hour or more to kick in, but today it was immediate: i had not even stirred when i knew that the pain was back.  And, whereas the affective side of my disease – discouragement, negative self-talk, etc. – sometimes does not immediately (or sometimes not at all) accompany the physical pain (brain pain), today that affective side of depression was also present immediately.  I was, from the moment i gained consciousness, immersed in very painful emotion and cruel self-talk about myself and my life.  And the deep cognitive component of my condition was also in full gear – i was mostly believing these painful, discouraging thoughts about who i am and about the state of my life.

All this was so painful that moving around in the bed at all made it worse.  (The pain in my brain radiated out to the rest of my body.)  So i did everything i could to stay still – and preferably drift back off to sleep, which i did on-and-off until about 9 a.m.

At about 9 a.m., i finally convinced myself that i needed to get up, even though i knew that this would make me feel worse – which it did.  My face went into a painful grimace and i was so contracted that breathing and walking were both difficult.  As i tried to move out of my bedroom and down the hall towards the kitchen, at a couple of points i had to lean against the wall to steady myself.  But i knew that, among other things, i needed to let my dog out, so i kept going.

Sometimes, when i have slept this late – and when Buddy has not spent the night outside, which is his preference in warm weather (last night rain was forecast, so i brought him in) – he immediately wants to go outside.  But other times he wants to cuddle first, and this was one of those mornings.

As i sat down next to him under the kitchen table (on the nice thick area rug there, one of his favorite places) and began to talk to him, I was immediately shocked by how sweet were the words that came out my mouth!  I couldn’t believe that this sweet talk was emanating from the same brain that had, up until this very moment, been totally castigating me.  The words were so melodious, so gentle and tender, that i wanted to make them and hear them just as long as i could.  As long as the sweet words kept coming,  i felt lots, lots better emotionally and even physically.  And Buddy was still in no hurry to get going.  The couple of times i pulled a bit back and asked him if he wanted to go out, he immediately extended a paw onto my leg or arm or chest in his classic gesture of “No, don’t stop yet.”

Finally, i felt an internal need to “get going and get some things done”, did fully pull back – and Buddy immediately got up and asked to be let out the back door.  As I did so, much (but not all) of the physical and affective pain came back.

I almost immediately got a business call, which kicked me into gear.  While i was on the call, i was (as so commonly is the case) distracted from the physical/emotional/cognitive pain – but it all came back almost immediately when i got off the phone.  The gentle rain that had been falling left off and i walked Buddy and our neighbor dog Lucy back up the hill.  I was still in a lot of pain.  (So many people encourage me to get out and walk when i’m in this state, not knowing that physical movement – at this stage of physical contraction and brain pain – makes it worse, causes the brain pain to radiate out into the rest of my body.)

When i am feeling better than today, I like to reserve this first walk of the day for keeping my mind mostly empty, where it can be receptive to creative or interesting thoughts.  (I carry a little spiral pad and often jot lots of notes for stuff i want to write.)  But this morning i almost immediately threw my brain in the direction of memorizing a poem, a mechanism that i regularly use to distract myself from all that is going on within me.  Sometimes that works really well, and this morning it worked pretty well.

I came back and received another business-related call, but this time from a colleague whom i know and very much like.  Again i functioned – and even felt – very well while i was on the call.  When the call ended, i was immediately back in physical pain – but much less affective or cognitive pain, because i like talking with this friend and liked a couple of the plans we had made.  And i was encouraged to see myself functioning, overall, so well – on a morning when i had not been sure that i would be able to function at all.

It’s now a couple of hours later.  I am functioning fine: not, yet, attempting any complicated mental tasks – just sitting here writing this note.  (And even typing fast and well – i just ran a spellcheck and had not left an uncorrected typo in the whole note!)  I’m in a lot of pain (brain and body contracted, face grimacing, breathing too deep hurts), but i’m functioning fine – and less discouraged, mostly liking myself ok, and feeling a lot of compassion for this guy who is hurting so badly.

I’m pretty happy to have come this far, on a day that started so much worse.

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It’s about 2 hours after i wrote that entry about my painful depressive contractions setting in – and now they’re gone!  This is completely unprecedented: the best i usually get away with is one day and the thing snaps, but it’s almost always 2-3 days minimum.  What happened?

The best thing i can pin it on is a long, delicious phone conversation i just had with a friend that i like tremendously, but with whom i have never had this kind of rich conversation.  Over about 60 minutes, we covered the waterfront: serious, very serious, gossip, light, funny.  I have been writing lately about loneliness – this was a tremendous antidote for that.  For my bipolar condition, the interaction between psychology and biochemistry is so complex and mysterious: maybe intervening in the biochemical “down”, right when it was starting, with such a powerful psychological upper was just what the doctor ordered!

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