On Bipolar, Ever-Evolving
I have, as is my habit, been fighting a depression that wins a little ground each day. My strategy, generally speaking, is to put a brave face on it in hopes that nobody will notice, and then, when I can no longer manage that, to beat a hasty retreat into the nearest isolated cave, emerging only to dance.
I’ve decided to pop the rest of this behind a cut, both because of strong language (“He said a-hole, Mom!*”) and because of subject matter that maybe could be a little on the triggery side for those of us currently wrestling mood disorders.
My Brain Hates Me Right Now, And Maybe If I Write About It, It Will Shut Up
As you may have gathered from Friday evening’s post, I am wrestling with insomnia. Possibly also a touch of dysphoric mania on-ramp action. It’s par for the course (onset of winter, hormones being wacky, somewhat stressed out), familiar enough, but still difficult.
In a comment on my earlier post, Cabrogal referred to that state in which your mind is still blazingly awake and alert but insomnia has begun to make your body tired. I can relate: that’s where I am tonight. I felt tired at 9:30 PM and crawled into bed. Despite many efforts to sleep, I’m still awake.
When I close my eyes, my mind whirls away at 3,000,000 miles per hour: musical compositions (which arrive with regularity at the onset of mania) playing themselves at various tempi (often inappropriate ones), sometimes elaborating themselves into staggering crab-canons that wheeze and clatter along like seige engines. Hard and bad thoughts intermittently surface. I try to just acknowledge them and let them go, but they persist. None of this feels like a conscious process; in fact, the music leaves little room for intentional thought.
When I’m just having difficulty falling asleep (read: almost every night), I tell myself stories. Apparently, my stories are very boring, because often they do the job. (Okay, so actually I think they just distract me from the horrid life-long anxiety about being unable to fall asleep — another trait El Roberto and I share)
When my brain won’t stop musicking, I often can’t tell myself stories. I can’t “hear” them (more like see/feel/smell/hear them) over the din of my mental calliope hammering out my setting of Psalm 137, which is actually a lovely piece of music, but not like this.
It’s almost 3:30. If a miracle occurs and I get to sleep soon, I should be okay in ballet class. I don’t want to keep missing class. I don’t want this to be my new reality, always sliding away from the thing I love the most (after Denis, anyway).
Touching Back on a Point About Bipolar
Recently, another blogger linked to my post, “Bipolar As Unexpected Gift?”
I haven’t read the linked post yet; I’m not in a great place for dealing with controversy (of which there may not be any).
That said, there are a couple of points that I think are really missed in my post — for a couple of reasons.
First, I didn’t invest a great deal of clarity in them, because the post in question was never meant to be anything but a reflection on a very surprising experience of mine (that of finding that there were good outcomes in my life — especially my marriage — that stem from the effects of Bipolar disorder on my decisions and experiences).
Second, the title is unfortunately close to the kind of thing that apparently gets out there a lot — happy-clappy New Age bull about accepting and making the most of mental illness or whatever cross one bears in life; seeing it as a gift and not as a tragedy.
I wasn’t aware of those articles when I wrote my post.
Anyway, the points in question are these:
First, when I used the word “as” in the title, I didn’t mean “as only” — quite the opposite. I had been struggling with a lot of bitterness; a lot of pain about the things Bipolar had taken from me. I can’t remember now what led me to realize that there were also things it had given to me. So the word “as” in the title doesn’t mean “as this and nothing else.” Not at all. It means “as this, surprisingly enough, along with all the other stuff it is.”
Western culture likes things to be black and white, either or: thus, if any one of us points out a way in which Bipolar has been beneficial, there are many outside the Bipolar community who will choose to see only that. “If it can ever be good, it can’t be bad, right?”
But that’s not how life works. Sometimes an ocean of bad manages to bring along with it a teaspoon of good. No, the good doesn’t invalidate the bad — not by any means. But neither does the bad invalidate the good — and hanging on to the good is one of my survival strategies.
Which brings me to the second point I rather failed to address back then: in this battle, there’s no One True Way. My experience with Bipolar Disorder is, by necessity, different from yours, and yours from mine. What works for me might not work for you.
So when I comment on the surprising experience of finding that there are good things in my life that wouldn’t have been without Bipolar Disorder, know that I don’t expect you to feel the same, or judge you in any way for however you do feel (okay, full honesty: if you regard your Bipolar Disorder as an unequivocal good and insist that others should do the same, I’m going to at very least shoot you a long, stern, professorial look with bristly eyebrows — feel how you feel, but don’t tell other people how they should feel; that is so not cool).
So there you have it.
I don’t see Bipolar as only or even as mostly a gift, and however you see your Bipolar, I honor that, too.
Some Days, Bipolar Wins*
Monday was kind of, in many ways, one of those days for me. Yesterday was also kind of one of those days, though it was exacerbated by the fact that I couldn’t sleep on Monday night, took a sleeping pill at 3 AM, and woke up … um, kinda late.
Today started out feeling like a Bipolar Wins kind of day: I woke up at 8 AM, said, “F*** a bunch of life right now,” and went back to sleep, which is uncharacteristic.
Later (at 9:30, when it was too late to leave on time), I woke up again and berated myself about how I could have and should have gone to Wednesday class, and how I am never going to accomplish anything I am trying to accomplish because I’m apparently constitutionally incapable of being consistent, &c.
And then I read for a while (because that’s one of the things I can do even when I’m depressed) and then I got out of bed and took a bath and read in the bath for a while (because that’s another thing I can do even when I’m depressed) and then I decided to shove myself out the door and finish up the yard work that we started working on this weekend.
That felt like a small victory. When you’re really, really depressed, you can’t even shove yourself out the door. Sometimes, you can’t even shove yourself out of bed.
Anyway, while I was out there in the yard, chopping and bundling bits of the trees that Denis cut down because they were growing too close to the house and feeling sorry for or maybe about myself, something occurred to me:
Some days, Bipolar Wins, and that just kind of how it is, and that’s okay.
Right now, my goals feel a billion miles away. I’m not making it to ballet class on the schedule I “should” be. I’m only writing intermittently (but, on the other hand, wow, have I made some progress in the past month). I’m only sort of on top of the housework, which I guess is progress, actually?
A lot of the time, I wake up and think, “What’s the point?”
A lot of the time, I don’t want to go out into the world because my social persona is so, so very far from who I am right now.
A lot of the time, I’m frustrated by my own lack of forward momentum — or, well, of continuous forward momentum. Like, when I have moment, OMG, do I have momentum … but then when it goes away, it’s gone. For a while.
And then I have these moments of clarity and insight, these moments in which I understand that this is who I am, when I remember that trying to fight my own nature isn’t going to really solve the problem.
I can beat myself about the head with a stick all I want, but it isn’t really going to accomplish anything.
So often, resources written by people without Bipolar treat these moments of clarity as if they should, like, magically solve the problem — and I think that’s because, for a lot of non-Bipolar folks, they do.
Like, often, if you can identify and begin to understand a problem you’re experiencing, you can begin to solve it — but Bipolar Affective Disorder kind of doesn’t work that way.
This is where all that psychobabble about acceptance comes in handy (if not easily, because our minds like to resist things like that, and I think BPD affects cognition in ways that only increase that resistance).
I think that, in the past, I’ve seen acceptance as a synonym for “giving in” — that I’ve seen it as the equivalent of telling someone who’s just had an amputation at the knee, “You can forget about running marathons.”
Yeah, well — it turns out that amputees can run marathons if they darned well please, thank you very much.
I am trying to learn to accept that BPD makes me inconsistent; makes me constitutionally unable to really be consistent in the way that I might have been if I didn’t have BPD, or maybe if medication was a more workable option for me — while also remembering that the inconsistency inherent in my existence doesn’t mean I’ll never do the things I’ve set out to do.
What it does mean is that I’m good at getting back up when I fall down (you guys, I have had a ton of practice at getting back up when I fall down).
What it does mean is that it takes me longer to reach my goals, maybe, than it would take someone else. My Original Life Plan was School => High School => College/University => Write some books and who knows what else?**
It didn’t actually work out quite that way. It was more like:
School => Mental Breakdown => Psychiatric Hospital => Psychiatric Hospital High School => Non-Residential Psychiatric Hospital High School => Arts Magnet High School => Win A Bunch of Scholarships and Walk Away Anyway Because I Just Couldn’t Even => Wander Around In A Haze For A While => Pick Up A Few Community College Credits => Moar Wandering => Computer Networking Certification => Work At One Job I Loved (Playing With Horses And Getting Paid For It!) => Move Another 79 Times => Work At a Few Jobs I Mostly Either Didn’t Like or Hated => University => Well, Here I am.
I’m actually kind of in a better spot than I’ve ever been, in one regard: I have something more closely resembling a long-term vision of What I Want To Do When (If Ever) I Grow Up. Dance-Movement Therapy! Writing! Baking Bread! Ballet! Choreography! Art! Maybe a PhD in Neuroscience! Definitely Travel!
The thing is, it’s probably going to take me longer to get there (wherever There is) than I want it to … and the road might look a lot different than I think it’s going to look.
The hard thing is knowing that, in the darker places, I won’t remember this.
Maybe I should make it into a poster and stick it on the wall, like one of those affirmation things.
Come to think of it, maybe I should make a bunch of those, because (even though I know they work for a lot of people, and I am total not judging) they make me feel really silly, which makes me laugh, and anything that does that is worth keeping in your anti-depression arsenal.
The long and short of that is that accepting the limitations that come with Bipolar disorder means, for me, being willing to countenance the fact that I’m going to have to take different routes than I thought I would; that I’m probably going to have to arrange my work and creative life differently than I expected to (not, to be fair, like I ever had much of a set of expectations about having a traditional work life; that hasn’t really been one of my major goals, to be honest).
The overall output of my creative spark might be smaller in volume than it otherwise would have been. That doesn’t mean it will be less significant (though it feels weird to think of myself as someone whose creative work will harbor any significance at all in the world — but that’s a topic for another time, as I always seem to be saying).
Meanwhile, I need to stop panicking when I fail to make it to class for a week or two. That is the nature of the beast, and it doesn’t mean I’m not eventually going to absorb all the stuff I need to learn. Over the course of ten years, it doesn’t even mean it’s going to take all that much longer (if anything, sometimes I come back from one of these unexpected Mental Health Breaks and discover that something I was struggling with has magically sorted itself in the gap).
I’m not sure how to wind this all up. To some degree, it’s just a reminder to myself; just me thinking out loud, as it were, in this 21st-century-specific way we have of thinking out loud now.
To some degree, there’s something that feels New and Important about these thoughts — not in the sense that they’re New and Important in a universal way, because, like, All of Buddhism has had this down for centuries. It’s just that I feel like I understand this stuff in a way I haven’t really understood it before, which I guess is what Life and Adulting and stuff are all about.
It’s all leaves of the lotus or layers of the onion, depending on whether you prefer boating or cooking, I guess.
So there you have it. Ten years from now, as long as I keep dancing, I will be ten years better at dancing than I am now; ten years from now, as long as I keep existing, I will have ten years’ more experience and wisdom under my belt — and that will be the case even though I am going to take breaks, and fall on my butt, and generally be a screw-up sometimes because that’s how I am; that’s how my Bipolar is.
So there you go.
Some days, bipolar wins — but usually, in short, it’s not the end of the world.
A Little Lift
As you may have already determined* based on the sheer number of posts I’ve made in the past few days, my mood appears to be creeping up a bit at last. As usual, I’m trying to approach this uptick with caution, so as not to, like, scare it away (or burn out my synapses, or exhaust myself, or overcook my brain, or whichever analogy you like).
The timing is interesting. The whole intersex thing, in my case, means my hormones do interesting (and sometimes horrible) things on what has evolved into a fairly predictable cycle. I would, in fact, rather expect this to be the part of said cycle that makes me (and everyone in a 20-meter radius) miserable. That said, I am not complaining. Complaining about catching this lift is like complaining about catching a taxi in Times Square at 2 AM (I think? Oddly, though I have spent a fair bit of time in the Big Apple, I have never been to Times Square, let alone at 2 AM).
Of course, it’s possible (to belabor my metaphor) that this lift which appears to be driven by a sedate little old lady driver is in fact under the command of the Little Old Lady From Pasadena (Go, Granny; Go, Granny; Go, Granny; Go!). As those of us whose carpool parents were huge Beach Boys fans may recall, “…she drives real fast and she drives real hard.”
So while I am not complaining right now, I reserve the right to complain at a later date.
Speaking of dates!
I love dates. The fruit, I mean. A while ago I bought a 2-pound tub of deglet noor dates at ValuMarket (which, though it sounds like a Quick-E-Mart kind of operation, is in fact an awesome little local grocery chain; the one in my neighborhood is decidedly international in flavor).
At the time (this was several months ago; the dates in question suggest that I use them by 30 June, 2016, so we’re good), I was in the midst of an upswing and not shopping all that carefully and failed to notice that the dates in question are processed with glucose. So now I have all these sugar-coated dates lying around, waiting for a purpose in life … or, well, un-life, I suppose, since the purpose of the sugar is to preserve the dates, which are not living, and perhaps could be considered undead**?
Since I am not really into consuming oceans of refined sugar (regarding which: dates are pretty sugary to begin with, but you eat them whole, fiber and all; it’s the added sugar that’s kind of not my thing), I have been working my way through the dates a little at a time. Last week, I added some to my batch-o-muffins. This morning, I said “screw it” and ate four of them (a portion is about eight) with breakfast.
So, to make a short story unnecessarily long, I’m thinking that the next time I have people over, I am going to make an enormous, enormous date-oriented cake or something in an effort to reduce my household Zombie Date population. I am also thinking I could probably soften them in water (which might also coax some of the added sugar off the dates), chop them up, and make them into bike/ballet fuel of some kind (and then freeze the extras).
If any of you have any recipe suggestions, let me know.
In the future, of course, I shall purchase my dates more carefully.
I make no promises about the duration of this uptick, but I plan to relax and enjoy it while I can.
In other news, our finances are more or less sorted at this point, and I was able to purchase a RAM upgrade for my laptop. Said RAM arrived last night; I dropped it in (which was an incredibly frustrating process; getting the RAM seated correctly in this machine is a huge PITA) and my lappy, unsurprisingly, is like a whole new machine.
I really should’ve done this ages ago.
On Wednesday, B. and I were chatting during the quick break between barre about how we’d both lost so much ground to injury this year (she with a stress-fractured foot; I with my calf and then my toe). I was like, “Can you believe we were doing brisees last year?”
Anyway, that’s kind of a theme for me, right now. In some ways — mood-wise, ballet-wise — I’m sitting at the bottom of a long climb back to where I want to be.
Fortunately, as a cyclist, the ability and willingness to climb ridiculous hills was and remains one of my strengths, and I feel like maybe I can translate that over to the rest of my life.
That doesn’t mean I’m going to climb this particular set of hills quickly. Just that I know myself well enough to recognize that I’m probably going to make it (even though I’m in that weird place, right now, where you’re rational enough to know that the voice in your head that constantly yammers on like, “You’ve squandered your potential and will never amount to anything now!” is a crazy voice, but not yet in a place where you can make it STFU).
Anyway. So I’m gaining ground more slowly than I would like, but I’m gaining ground.
I guess I can pop in another bike-racing analogy, here: one time, Timothy and I raced Death March while both of us were recovering from various winter illnesses, including some kind of gut thing that was going around. In short, neither of us had been able to eat like a normal person for several days, and we were what a long-ago Arnold Schwartzenegger might have termed “weak little girly-men,” and we did nothing fast, least of all climbing … but climb we did, and (as evidenced by the fact that I am sitting here in my living room, writing this post), we lived to ride another day (in fact, the next year we came back and roundly spanked half the field, although we were in turn roundly spanked by the other half).
Sometimes it sucked, and sometimes we walked our bikes, but at the end of the day, we kept going and eventually made it back to the ranch without having to ride in the Broom Wagon.
So, anyway. I’m not all there yet, but I’m not ready to wait for the broom wagon, either.
As such, here are some plans for upcoming posts, with no particular timeline in mind (though next week would be nice):
- Two Cooking With ADHD posts:
- What To Do With 10 Pounds of Chicken Leg Quarters (Because They’re On Sale)
- How To Make Bread And
- One hopes, a string of Ballet Class Notes, as my foot can definitely handle at least 3 classes per week at this point if I don’t jump too much.
- Maybe a post about writing? I am doing that still.
In other news, I am rocking along in Homemaker Mode and actually rather better at it than I used to be.
This is comforting.
Some of it, of course, is the Miracle of Modern Medicine (go, Adderall!), but some of it is simply a function of the fact that, amazingly, I do appear to be able to learn.
I’m hoping my friend Robert (Hi, Robert!) will be able to come visit before we head out to the desert; maybe when he does I’ll ask him to collaborate on a Cooking With ADHD Video Post, since we have two different flavors of ADHD and we might find different things helpful.
Oh, and I just read Ellen Kushner’s Swordspoint, and I highly recommend it (if Regency-era romping bisexual sword-wieldy people sound like your cup of tea).
That’s it for now.
Maybe if I ever manage to get Cooking with ADHD rolling, I’ll expand it into a guide for the ADDle-pated Homemaker. Goodness knows I could use one!
Onward and Upward, By Fits, Starts, and Degrees
Sometimes, recovering from a bad episode of this depressive bipolar crap seems a bit like doing the hokey-pokey.
You put your left foot in, you put your left foot out, you put your left foot in, and then you go back to bed because frankly you’ve had enough for today and you’d really rather try again tomorrow, thank you very much.
I tend to make optimistic prognostications about my ability in moments that I’m feeling a bit more “up” than I have been (read: moments when I’ve taken my meds and downed something with a bit of caffeine in it, of late).
Later, when things shift back towards really deep end of the spectrum, I tend to sit there kicking myself about making said optimistic prognostications (which I tend to do publicly, because, in short, I never freaking learn, I guess?).
Right now, I’m somewhere between those two states: not at that point where I’m like, “I am going to do All This Stuff soon,” but not at that point where I’m like, “Yeah, I’m a waste of oxygen and I should really stop thinking I’m ever going to do anything.”
Instead, I’m in this spot where I’m able to see that the optimistic part of me that makes bold plans is okay, and the horribly depressed part of me that gets really angry when I fail to complete those plans is also okay, and that can be what they are, and it is, in its own way, okay.
Not always happy, not always fun, not always even remotely anything like pleasant: but valid, allowed. The human experience is rich with contradictions; with complications.
Today I did not even remotely attempt to get out of bed early enough to get to morning class. A part of me is really pissed about that — the same part that’s forever saying things like This is why you never amount to anything; you’re better than that; this is what makes the difference between people who succeed in ballet and people like you.
Another part of me recognizes that you have to work with what you’ve got. What I’ve got right now is hard to work with (though, on the other hand, I’m writing a fair bit, so there’s that).
I did begin my Great Office Rehab Project — or at least some of it (some of it will have to wait ’til I can buy some paint and some fabric). Denis brought in the replacement desk, so I set it up, installed the office air conditioner, and then became insanely, furiously frustrated because there are still Too Many Things In This Room.
The difficulty is that some of the things need to stay, but they need to live in or on other things that aren’t in here yet, and I don’t want to bring those other things in until the things on or in which the first set of things resides are out of the way, but I can’t get them out of the way without bringing in the things to put the things in…
My brain makes everything a thousand times harder than it has to be when I’m depressed (not like ADHD helps any of this, but depression makes it worse; when I’m manic, OTOH, I can organize anything to within an inch of its life, as long as something else doesn’t distr— SQUIRREL!).
So today I went to see my therapist (and rode my bike a lot, because I figured actually getting some exercise would solve one of the problems contributing to the severity of this depression — lack of exercise).
Tomorrow, maybe I’ll bring in the things into which I need to transfer the other things, so the things in which the things now reside can go wherever it is they’re going.
Maybe I won’t.
I’m not making any bold statements right now. We’ll see.
Perhaps that should be my motto for the time being: “We’ll see.”
Ultimately, it’s not like we can ever say for certainty what we’ll be doing at any given moment, anyway. Control is an illusion, and it seems especially illusory when you live with a mental illness that really rather prevents you being able to make long-term forecasts about your emotional weather.
If I have my head together well enough, my foot should hold up to at very least Essentials on Friday. I might give Intermediate class a try.
I do feel like I need to get back on top of ballet. I have missed so much. I don’t suppose I can do anything about that (water under the bridge, etc.), but I can work on putting the pieces in place to prevent it from becoming an established pattern.
Just going to class is one of those pieces — ballet is such an effective preventative and remedy; it seems to take the teeth out of my depressions when I can keep dancing.
This particular depression, though, has been a perfect storm of ballet-interrupting foot injury, stress, hormonal disruptions (blargh), lack of externally-imposed structure in my life, general lack of exercise, and the destabilizing effect of summer itself.
Anyway, that’s it for now.
More soon, maybe?
Back … ish.
(That wasn’t actually intended to be a play on the title of the TV series Black-ish, though that seems to be a fairly thoughtful sitcom, as sitcoms go, from the tiny bits I’ve seen of it.)
So I’m back on my meds (huzzah!) as of this afternoon and, as such, improving in terms of overall function … which is good, because the drain in our kitchen sink chose tonight to explode, and I would have had a flat-out meltdown about that if it had happened yesterday. Fortunately, I married McGayver, who can fix that kind of thing.
I’m doing the job applications thing and it’s going well — had an interview this morning for a position that sounds like pretty much a lock (unless I’ve been convicted in absentia for some kind of crime I committed in my sleep?), though it turns out there are no seasonal positions open ’til September. I could have started next weekish as a permanent employee, but it wouldn’t be terribly convenient for the company, as I’d have to run off for two solid weeks for Burning Man.
Unless I find something that’s really relevant to my studies and/or sounds really compelling, I’ll probably take that job in the fall. It sounds like a good fit for what I want right now — an active, rather than a sedentary, workplace; decent pay; hours that mesh nicely with ballet. Shouldn’t hurt the fitness bit, either.
I’ll need to finally get an actual driver’s license, since the job in question may potentially involve actually driving, but that’s in the plans anyway.
I’m still working for Denis’ Burning Man project and feeling ever-more-useful in that regard. Tonight I set us up with a G+ page, even though I still feel kind of iffy about social media as a marketing platform. For this project, though, since it’s primarily a do-gooder collectivist kind of gig, I don’t really mind 🙂
On Glassdoor this morning, I spotted a listing for a web developer with some knowledge of WordPress and Drupal, as well as some command of your general web languages (HTML, PHP, CSS). I’m kind of kicking around the idea of applying for that. The upside is that the pay would very likely be pretty nice; the downside, of course, is that most development jobs are desk jobs, and I’m not really super into that whole idea. Been there, done that, decided it wasn’t for me.
Our finances are on the mend. Since it took about two solid years of complete and utter miscommunication to blow them up, it’ll probably take a few months to get them 100% back on track. Until then, we’ll be wearing our dance belts a little tighter* 😉
My toe is healing. I’m still on the fence about Saturday class. Tomorrow’s out; it’s definitely not ready for Intermediate, and Essentials is cancelled tomorrow. I was able to ride the bike a bit today without driving the toe crazy, but I’d rather let it really heal before I try to push it.
I’ve noticed that Fusion Fitness Dance is back on the calendar, so maybe I’ll give that a whirl at some point, too. That depends on the finances, though. If we’re going to be tight enough that I can only do class two or three times per week for the next while, I don’t want to add a non-technique class.
I guess I’m also going to try not to spring back too quickly from this depression. I tend to decide that “feeling somewhat better = feeling 100% better,” then overtax myself and crash even harder. I hope maybe I’ve learned that lesson by now.
I’ve also learned that, while I now know that there is not, in fact, a famous band called Holland Oats, Harlan Oats, or Haulin’ Oats, I still don’t really know from 80s music. Did you know that “Danger Zone” was a Kenny Loggins song? I sure didn’t until just now. Thanks, Amazon Prime Music.
So that’s it for tonight.
Stay out of the Danger Zone.
You know, unless that’s where you want to be, in which case, carry on.
Life: Yet Another Momentary Lapse of Reason
As a whole, I’m doing better the past few months than I have in, like, ever.
The past four days have been an exception: I had been waking up a bit down in the dumps, but as a general rule it was wearing off once I got going; on Friday, however, the feeling kind of stuck with me.
Yesterday seems to have been the zenith — perhaps it would make more sense to say nadir — of this particular depression. I suppose the fact that I just plain wasn’t feeling well complicated things.
Today, I’m feeling a bit better on both the physical and mental fronts. Still not all there, but at least more or less functional. Apparently, the sleeping-for-fourteen-hours bit and the wheezing bit were only tangentially related: one was the result of depressolepsy; the other of my asthma deciding that it hadn’t said “hi” in a while and should probably remind me it’s around, or something like that.
A lot of this is complicated by the fact that I’m out of medication and currently unable to refill my prescription for stupid and ridiculous reasons (read: our finances remain complicated, for the moment). The medication I take doesn’t treat depression, nor is it properly a mood stabilizer (sidebar: I almost typed “mood sanitizer,” FFS, though come to think of it that might be rather apropos) but it does go a long way towards keeping my mood on a fairly even keel.
Today I am back to the strategy of basically distracting myself by doing things that I don’t find horribly onerous, like making bread and maybe washing the sheets (thanks to the cat’s decision to sleep right next to my face; apparently, he thought I needed cuddles: to be fair, he was correct, but I like cat cuddles better when the cat in question keeps his dander at waist level or below).
I am feeling depressed in part, by the way, because of our financial straits. Situational depression is definitely a thing, and it’s a thing that is very much a problem for me, since my brain likes to perseverate on emotional states. Way to go, brain.
Coming up with a plan to get out of our current straits is hampered by the fact that being depressed makes me much, much less rational, which also makes me do things like weigh myself three times in one day (and discover that my assumptions about the relationship between time of day and weight were, if not baseless, at least a bit off-base: I weighed less at 12:00 than I did at 8:45, go figure).
In other news, I am biting my lip and letting my stupid toe heal, so doing Brienne’s class tomorrow is a non-option. I dreamed about going to aerials class, but that will have to wait ’til we get ourselves unmired, financially speaking.
I missed Claire’s final class because my toe was really quite seriously painful on Saturday morning; apparently, I was still supposed to be wrapping it before walking around on it all week. Le sigh. I may be able to go back to class on Saturday; I may not. We’ll see.
So that’s that for now. Nothing philosophical or balletic to contribute to the Internets today.
PS: Derp, half the point of posting at all right now was to link a recipe that I tried last night.
So, without further ado, here’s a link to last night’s really delightfully-easy fried rice:
Treatment: A Series About What I’m Doing And Why
This title should really come with a long caveat: I’ve taken meds for both ADHD and bipolar in the past, so what I’m talking about here, in part, is why my treatment approach prioritizes the medical management of ADHD over the medical management of bipolar.
I initially meant to just write a post about my treatment protocol; about what I’ve chosen to do (for now) and why. When I started writing, I realized that this is going to have to be a series.
It seems like a good idea to begin with an explanation of what, exactly, I am doing treatment-wise.
I believe deeply in the power of complementary medicine: that is, harnessing both medical (including evidence-based naturopathics) and non-medical treatments.
The difficulty with complementary medicine is that it’s not easy — or, rather, it involves the investment of research and time.
By its nature, a sound complementary approach must be carefully designed to suit the needs and circumstances of any individual patient. Many doctors and patients are hard-pressed to find the time to do that; moreover, not all of us are in positions that allow us to.
It also really helps, as a patient, to have (or to be able to acquire) the background in scientifically-sound research practices that makes it possible to tell a sound study (and, thus, pretty reliable data) from an unsound one.
This, by the way, is one area in which I am eternally impressed with the overall community of mental health patients — perhaps because our conditions are still stigmatized and still, in many cases, under-researched and under-publicized, we tend to be very proactive about doing our homework. Likewise, those of us with solid academic research backgrounds tend to act as advocates and guides for those of us who don’t have as much experience, and I think that’s awesome.
In that same vein, though, complementary medicine tends to require a lot of participation from each individual patient.
It’s not a great solution for someone who just wants or needs to take a pill (or a few pills) and forget about it.
Historically, I’ve been kind of judgmental about that — but the reality is that, for a lot of people, being able to just take a pill (or even a handful of pills) is what is most workable.
Each of us has the right to do what’s most workable, and it isn’t fair for me to make judgments about what makes things workable or not workable for other people (unless they ask me to, and give me information from which to make sound inferences, and so forth!). Ultimately, it’s all about quality of life. If the medication-first approach is less onerous and provides better quality of life, that’s absolutely the right way to go!
What works best for me — that is, what strikes the best balance between usability, disease-management, and quality of life — isn’t going to be the same as what works best for someone else. That’s okay.
That’s one of the cool things about human beings: we’re all different. Sure, sometimes it makes life complicated, but it also makes life interesting.
Likewise, especially where bipolar is concerned, mood-stabilizing meds are an essential first-line therapy for a great, great many people.
Moreover, as with some antipsychotics in the treatment of schizophrenia, mood-stabilizing drugs (a class in which I’m including, for this discussion, both classic mood-stabilizers and also atypical antipsychotics) can prevent some of the brain changes associated with the disease and decrease the long-term likelihood of dementia.
This is something that Denis and I discussed very seriously when we were deciding how to manage things from a medical angle. The research that could determine whether other therapeutic approaches prevent this stuff hasn’t really been done yet. That’s a risk that, for now, I’m going to have to take (to be fair, it’s a reasonable one: there is absolutely no history of dementia in my family, even in the folks who had bipolar or bipolar-like symptoms).
I have had very serious problems with mood-stabilizing drugs in the past, which I’ll outline in my next post — problems which make taking them more debilitating than not taking them.
For me, mood-stabilizing drugs amount to a non-cure that’s worse than the disease, though if it ever gets back to a point at which it’s use them or die, I have given Denis the power to make that call for me (since, by that point, I wouldn’t be in any position to make that kind of decision for myself).
Moreover, they haven’t worked very well for me, and the side-effects (loss of equilibrium, loss of dexterity, tremors, and mental fog, in particular) kept me from doing the things that do work.
Thus, for me, the goal is to avoid mood stabilizers for as long as possible, which means (if I want to keep my brain in one piece) doing a metric crap-ton of research and using every other tool I can lay hands (or toes) on to keep it together … and still accepting that a day may well come on which I will have to go back to taking mood stabilizers anyway.
Each approach comes with benefits and challenges: more medication-focused approaches tend to bring more side-effects into the picture, while a less-medication intensive complementary approach involves a lot of effort, a lot of management, and no small amount of risk. For me, the drawbacks of the more medication-focused approach (debilitating side-effects) outweigh those of the less-medication-intensive approach (a heightened risk level; reduced day-to-day stability).
As an adult in a stable, mostly financially-secure relationship with no children, the risk is something I can afford.
I might feel differently about it if there were kids — especially small children — in the picture.
I grew up with a father whose volatile mood swings were so terrifying to me that, at one point, I opted not to participate in overnight visits for several years. To be fair, his alcoholism greatly exacerbated the problem. After he stopped drinking (and started using mindfulness and other tools to manage his moods), my Dad became someone I enjoyed being around — but little kids, especially, need predictable worlds to live in, worlds in which actions and consequences are linked in ways that make sense as frequently as possible.
I know that, even with my relatively-successful treatment model, there are still moments that the chain of reasonable reactions breaks. I may not be inclined to become abusive towards people or anything, but it’s still scary to be a kid and have no idea why your parent is foaming at the mouth in the general direction of the refrigerator. Likewise, it’s scary to be a kid whose parent goes from cucumber-cool to stark-raving-furious with no apparent transition time. That’s a thing I’m working on, but some of it’s the result of brain chemistry. Mood-stabilizing drugs could combat that tendency.
I might also feel differently about it if I had to be the primary breadwinner: if, tomorrow, Denis developed some kind of illness that prevented him from practicing, I wouldn’t be able to be as selective about the work I do and so forth, which would in turn expose me to many more destabilizing forces and stressors that I currently avoid through lifestyle management. Mood stabilizers might become pretty important in that sort of situation.
So what, you might wonder, does my particular complementary approach look like?
First, I do take fish oil as a mild mood stabilizer, an approach that has seen empirical support in academic research settings. It does seem to help in my case. It’s not perfect, but it’s a good compromise.
Second, I take the generic form of Adderall IR (the immediate-release version), which both helps to manage the executive-function function problems that come with my ADHD and actually, very much to my surprise, helps keep my moods on a much more even keel.
…So much so, in fact, that I’d really like to do some research into the question of whether other people with both rapid-cycling Bipolar I and the “predominantly-hyperactive type” subset of ADHD experience similar effects (I’m also curious about the biochemical differences between those of us with predominantly-hyperactive ADHD and those with the predominantly-attentive flavor).
I really didn’t expect that effect. Adderall is a psychostimulant, and psychostimulants are absolutely capable of precipitating mania in people with bipolar disorder (I have certainly experienced that effect with caffeine). When I started taking it, I was entirely prepared to have to stop for exactly that reason; likewise, my doctor started me out on a pretty low dose to avoid that eventuality.
However, for me, Adderall’s IR formulation behaves in a really interesting way: it both keeps my mood more level (in short, prevents emotional perseveration) during its effective period and makes me freaking tired as all heck when it wears off.
I have a literally lifelong history of insomnia — I slept little as an infant; in preschool, my pediatrician decided that I should be prevented from napping (not that I was sleeping during nap time anyway) in hopes that I would sleep at night; all through childhood and adolescence, I rarely fell asleep before 2 AM; etc. I still find the notion that my 7-year-old nephew just turns off like a light at bedtime absolutely incomprehensible.
The only reliable solution to my insomnia, historically, has been sheer physical exhaustion — which is pretty hard for me to achieve (and was essentially impossible to achieve when I had a desk job). It’s also a diminishing goal post: the more you exercise, the more exercise it takes to achieve exhaustion.
Adderall, bizarrely enough, does the job nicely. It wears off, and I feel tired — often, tired enough to get to sleep at an hour that resembles the hour preferred by the vast majority of my fellow humans. Considering that my brain, left to its own devices, wants to sleep from 2 AM – 10 AM or from 3 AM to 11 AM, that’s no small accomplishment.
Sleep, in turn, is critical to preventing mania for me (this is why any of the extended-release ADHD meds are off the table for me, as far as I’m concerned: fortunately, the generic form of Adderall IR is about the cheapest option going).
For me, sleep deprivation tends to lead very quickly into mania (this is true for most people with bipolar disorder). The less I sleep, the more hyperactive and manic I become, until suddenly I’ve been awake for nine days (yes, seriously, that’s my record) and I think I can conquer the universe, or whatever.
Thus, something that keeps my moods a bit more level during the day and actually allows me to sleep goes a long, long way towards preventing the largest peaks and valleys.
Denis says he does still notice fluctuations in my mood, but their amplitude is significantly smaller. I tend not to notice my upswings (except for the really black ones; dysphoric, agitated mania is very, very hard to miss), so I can’t really speak to that, but I do find that my depressions are less severe and less persistent: my brain just plain doesn’t get “stuck” in low spots as easily.
Likewise, the ability to get more done in the day and just keep my crap together a bit better (the ultimate goal of ADHD meds for most of us who take them) reduces stress, which in turn reduces emotional instability. Stress is huge destabilizing factor for me.
Third, I exercise. A lot.
“A lot,” for me, doesn’t generally mean thirty minutes a day, five days a week. I’m talking about hours every week — a typical Wednesday morning involves a thirty minute bike ride, a ninety minute ballet class, and another sixty-minute bike ride. I also spend much of my time on my feet, doing stuff, when I’m at home. I do all this stuff because I like doing it. I am happiest when I’m moving.
“Exercising a lot” used to mean just riding the bike a lot (like, upwards of two hours a day, in addition to the time I spent running errands and commuting), but I learned a couple of summers back that too much “just riding the bike a lot” can lead to waaaaaay too much sun exposure, which can lead to dizzying manias followed by really, really black depressions.
Now I dance. Getting back into ballet has been immensely helpful. I still get a ton of exercise, but the amount of sun exposure is controllable.
I don’t think ballet by itself would manage my mood, but I think it is, to an extent, the key piece in the whole puzzle — or, if you will, the lubricant in the machine.
Without dancing, the system doesn’t exactly break down right away. For a while, it chugs (and then creaks) along — and then, eventually, it fails.
Fourth, and perhaps most importantly: I am in a position that lets me make choices that in turn allow me to avoid stressors which precipitate episodes of mood destabilization.
This is a privilege. I am absolutely aware of that. It shouldn’t be one, but it is.
I wish every single person living with serious mental illness had the same privilege, because it makes a world of difference for me.
There are entire career paths that I look at and just say, “Nope, that flavor of stress is a huge trigger; not worth it.” Likewise, I’m in a position to consider the relative flexibility of various career paths.
Almost as importantly, I can say no to social invitations when I’m in a spot where the excess stimulation might send me up-spiraling, and I don’t feel obligated to take on social obligations that might get in the way of taking care of myself during difficult periods.
Likewise, it is, ultimately, the real crux of my whole system. It’s the reason that I hesitate to tell anyone else, “You should try what I’m doing!”
I am only able to do this because I’m lucky.
I get that.
Fifth, I pay attention to how things I put in my body affect my mood, and I try to respond accordingly.
Bipolar disorder is a disease of emotional regulation in the brain. The brain has trouble sticking with a nice, stable, basic mood; meanwhile, it all too easily gets stuck in low or high spots. When it’s going up, it doesn’t know how to stop until it hits some critical threshold; then it tends to crash all the way back to the abyssal depths.
The things we eat and drink can help or hinder the brain’s efforts to regulate itself.
Alcohol, for example, is a central nervous system (CNS) depressant. It may make you feel giddy and happy when you’re using it (then again, it may not), but from a biochemical perspective, it’s the opposite of a stimulant.
Under normal conditions, I can have a drink or two without worrying too much about it — but that’s it. Any more upsets the balance of my biochemical apple cart — and it can take days or weeks for my brain to recover its equilibrium; days or weeks in which I experience hellish depression. For me, it’s not worth it.
Caffeine, meanwhile, is a CNS stimulant.
It’s one I seem to have a beastly time processing, as well: an Adderall IR tablet taken between noon and 2 PM will wear off and leave me ready to sleep by 10 or 11 PM; not so much a Diet Coke or a cup of coffee.
Between sleep disruption and stimulant effects, more than a little caffeine quickly begets mania — and it seems that there’s a threshold beyond which there’s no backing down, for me. Up to a point, the conflagration can still be prevented; beyond that point, the flames are going to engulf the entire house before they die back.
Needless to say, I try to manage my intake of both caffeine and alcohol pretty carefully. The alcohol part isn’t hard — Denis and I are barely even social drinkers. Most of the things I do socially (ballet, cycling, creative stuff) don’t usually involve alcohol.
I say “usually” because our longest bike rides often end with a celebratory beer, and some of the more casual ones begin with a celebratory beer — but on rides that begin with a beer, more than one or two isn’t an option anyway. I wouldn’t be able to ride after that.
The caffeine part, historically, has been harder, because caffeine is so ubiquitous.
If you’re out for lunch, for example, and you want a drink that has flavor but not sugar, your options are generally iced tea or diet cola, both of which come with a fairly sizeable caffeine hit. Likewise, for me, the impact of one delicious cup of coffee is disproportionately strong relative to that of one delicious post-ride beer.
When possible, at restaurants, I order plain soda water with a twist of lime or lemon (at home, we drink mostly decaffeinated tea, plain soda water, or just plain water).
There are some foods with which I like plain, still water; beyond that, though, I simply accept that sometimes I’m going to drink some unsweetened iced tea or diet coke, and I try to plan accordingly. (Sugared beverages — including 100% juices, which are still basically liquid sugar — tend to screw with my blood sugar levels, so I avoid them almost all the time. The exception is the rare bottle of Mexican Coke during a lunch break on a long — like 50 miles or longer — bike ride.)
Beyond that, I just eat what I like — so a lot of fresh vegetables, raw spinach, raw cabbage, carrots, quinoa, all the tomatoes, eggs, and so forth, but also smoked white turkey hot dogs (which I prefer to regular ones), chorizo, pizza, and a little ice cream here and there. When I get a rare chocolate craving, I go for it; likewise, when I’m craving salt, I go find something salty — my body wastes salt, so in my case I’m usually craving it because I actually do need it.
For some people, certain foods screw with brain chemistry; beyond the blood-sugar issues that lead me to mostly avoid high-GI foods, I’m fairly lucky in that department. I do count calories, but more often than not it’s to make sure I’m eating enough.
Sixth, my half-baked mindfulness practice.
Like most people with ADHD, I am not a master of meditation. I am pretty good, though, at living in the present moment (this may be the sole benefit of living in Golden Retriever Time: while I’m capable of worrying about the future and obsessing about the past, I can’t while I’m doing anything else, especially anything physical), and the ability to think about my thinking that Adderall has afforded me has allowed me to reflect on what I’m thinking and feeling in ways that I haven’t been able to until now.
That’s a pretty cool development.
Adderall allows me to monitor my moods in ways I haven’t been able to in the past, which lets me check in with Denis about them when I think things are getting out of whack. That, in turn, means we can take action to try to mitigate any manic fires before they get out of control and to use whatever means are necessary to haul me out of a depression before it gets too deep.
Adderall also facilitates both those processes.
Initially, I felt weird about this “Adderall-as-mindfulness-tool” thing: specifically, it kind of felt like cheating. Then I realized that it basically boils down to the fact that, for most people, learning mindfulness is kind of like seeing over a fence that’s just at eye-height; it isn’t automatic, but it can be done with a bit of effort (and a little releve!). Me? I’m standing in a hole. Sometimes I can jump and get a glimpse over the fence, but that’s it. Adderall gets me to ground level. I still have to make the effort once I’m there.
I can’t claim any formal daily meditation practice, but I use mindfulness techniques frequently in daily life, and they help.
Seventh, I try not to be too obsessive about rules.
There are a few that I know don’t offer much leeway: sleep, for example. I really do have to be pretty rigid about sleep.
Beyond that: if I screw up, if things go off the rails … well, that’s part of life. I grew up riding horses, and we accepted falling off sometimes as part of the deal. That didn’t mean that we didn’t work to become the best riders we could, and to hone our abilities to reduce the likelihood of falling off — but it’s a thing that happens.
I build wiggle room into my diet.
I accept that sometimes I’m going to forget to take my Adderall.
I recognize that once in a while I’ll bang my toe coming off the lyra and have to take a few days off from ballet and cycling.
I understand that sometimes I’m going to overdo it being a social butterfly and sometimes I’m going to avoid the entire human race for far too long when I shouldn’t.
I accept that I really actually like diet cola and sometimes I’m going to drink it; I accept that I really actually like beer (hello, Koshihikari Echigo Rice Lager), and sometimes I’m going to drink that, too. I accept that I like the occasional glass of wine with dinner (though not at home; we don’t drink enough to make buying bottles worthwhile).
I accept that my current treatment modality may be only for now; that somewhere down the road, mood-stabilizing drugs may become necessary.
I’m not sure what I’ll do if that happens: like I said before, I don’t take them now because my quality of life with them was worse than it is without. I hope that I could adapt; that I could learn to live with them, but I don’t honestly know.
I accept that, too. It’s uncomfortable, but being upset about it isn’t going to change anything. Sometimes reality is uncomfortable, and while often we can do something about that, sometimes we can’t.
I accept that this current equanimity is a result of the fact that I’m experiencing the longest period of relative (though still bumpy) euthymia I’ve ever experienced, and that I will feel differently at times.
One Last Note
I realize this probably all sounds like a lot of effort. If it was a program that was being prescribed to me, at least, I would think that it did!
In truth, though, this approach mostly takes advantage of my own basic nature; the rest has been implemented a little at a time.
It’s kind of like counting calories: it sounds onerous, but that’s not how I experience it at all. It’s just a habit, a thing that I do. If you’d told me, five years ago, “You’re going to try to note down every single calorie you eat for the next five years,” I would almost certainly have mentally kicked you in the shins. Taken as a whole, that task sounds impossibly huge. Taken in itty-bitty pieces, though, it’s amazingly doable: “Present doughnut, only doughnut.”
Likewise, sometimes I forget, but the fact that I can see that as no big deal and just get back to it when I think of it really helps.
In some ways, the fact that my system of treatment has a number of different parts is a good thing for someone like me. It’s more flexible: when, inevitably, I forget to do one piece on a given day, the rest keeps on going pretty smoothly. I have to either forget one piece for several days in a row or forget several pieces all at once for things to fall apart completely.
Excepting exercise, no one part of this system really requires sustained effort — and exercise is a kind of effort I enjoy. If “sitting behind a desk for 8 continuous hours per day” was part of the system, it probably wouldn’t work as well for me.
Now that I’m pretty familiar with my own individual stress tolerances, stress-related decisions are fairly momentary. My last few semesters in school, I made a lot of decisions based on that premise: can I handle these three classes together? What if I add this one? What if I also do this other thing? The consequences of those decisions may have taken months to unfold, but the decisions themselves were momentary.
If you told me, “YOU CAN NEVER HAVE CAFFEINE AGAIN!” I might actually cry. Well, probably not, but I’d definitely give you a swift mental kick in the shins, and then I’d sulk. Not so much because I love caffeine so much (I can take it or leave it), but because never is a difficult word (and also because you’re not the boss of me, nyah, and you’re not so big :P). On the other hand, on any given day, at any given present moment, choosing not to drink coffee or cola or whatever is no big deal.
I don’t think about not drinking Diet Coke forever; I just think about what I’m drinking right now.
Obviously, that sort of thing is harder where actual physiological addictions are concerned (which is another reason I’m careful with caffeine — I have had to wrestle a serious caffeine addiction a couple of times already; not looking forward to doing that again). For me, in that department, an ounce of Keep That Stuff Away From Me is worth a pound of Betty Ford. It just helps not to think of it as, “I’m not doing this ever.” Because “ever” is a really freaking long time.
Anyway, so that’s the basics. Sorry this is so ridiculously long. I have a lot more thoughts about this topic, and I could keep on writing for hours (growing less and less coherent with each keystroke), but I think this about gets it down.
Next time (whenever that is, because Golden Retriever Time), I’ll write more specifically about my choices with regard to meds.
My experiences with mood-stabilizing drugs have been, in a word, awful. There are a lot of ways in which they interfere with critical parts of my well-being; likewise, there are ways in which they interfere with critical parts of my treatment plan — and they don’t work terribly well for me.
Some thoughts about why things might work for me; maybe also some thoughts about why the things that work for me might not actually work for everyone.