Seasonal

My moods have always cycled with the seasons. In the heat of the summer, I tend to have more manic and hypomanic episodes, and in the late fall and early winter I experience more depression and the symptoms that come with it. This year, it is the same.

I feel listless. I have no energy. I feel apathetic. Muted. Dulled. Flat.

I know this will pass, and my moods will continue to cycle throughout the year. And my mood isn't overwhelming me, or crushing me. It just makes me feel dulled. It's fairly manageable and under control.

I've been spending a lot of time thinking about my symptoms lately. Thinking about where my symptoms end, and where I begin. My symptoms, when my illness is under control, can be subtle at times. Drawing the line between "I'm feeling a little down right now" and "this is a symptom" can be difficult.

The thing I always go to when I am struggling to determine if something is "me" or a symptom, is to ask other people about my feelings. Considering the circumstances, are my feelings "normal" or are they bizarre? Sometimes it is hard for me to tell in the moment. Sometimes I know that they are irrational. Knowing doesn't change anything though, as far as how I feel.

That's the frustration I have about knowing when something is "normal" and when it is a symptom. IT DOESN'T CHANGE THE WAY I FEEL. Knowing that it isn't rational for me to be depressed and feel sad doesn't change the fact that I feel depressed and sad. And knowing, in those early stages, that it is depression doesn't mean that I can prevent my symptoms from worsening. Knowing only allows the rational part  of my brain to try to fight against it a little bit.

Ugghhh...

Having a mind that is dysfunctional is awful. Not knowing whether or not you can trust your thoughts and feelings. Never being sure if you are experiencing reality, if you are being rational. It leaves me feeling... I want to say "broken", but I'm desperately trying to stop calling myself that. I am "fixable", I may be in need of repair, but I can be fixed. There will always be cracks and imperfections. I am not beyond hope. I am not broken. Right?

I can't wait for the dull, dark days of late fall and early winter to be over. Once the days are sunny and the snow is white, I feel some relief. But these cloudy, dark, cold, miserable days with less day and more night....

Right now the clouds are dark and gray - nearly black - and they look heavy and low. I feel the same way. But I ask myself - is this normal? Do other people - normal people - feel the same way this time of year? Is this normal? Or is this a symptom? I'm not sure.

I tend to think that my mood this time of year is a mix of normal and symptom. I don't think most people are bright and cheerful on days like these. But I don't think it is normal to feel this low, either. I think it is not completely normal, but not purely symptom either.

I'm trying to stay positive. I try to act perky. I'm pretty sure I'm failing miserably most of the time. But it makes me feel a little lighter when I act like I'm more upbeat than I actually feel.

I can't wait for the bright sunny days of winter. The snow sparkling and glistening as it reflects and refracts the sun's rays. I know they will make me feel better. They always do.

Out of focus

Frustrated right now. My schizoaffective symptoms are well managed, after a few minor adjustments to how and when I take my meds. I feel stable, I feel good, I feel normal. I am functioning at 99% as far as those symptoms go.

Unfortunately, I can't say the same thing about my ADHD symptoms.

We recently tried adjusting the dosage of the stimulant I use, because I was experiencing a "crash" when it abruptly stopped working in the late afternoon. The lower dose makes the crash more tolerable, but does almost nothing for my focus and attention.

I have been doing a lot of reading and chatting in ADHD forums, and I came across a med I want to ask my doctor about at my next appointment. It lasts longer, it tapers off instead of the abrupt stop of my current med, and it is supposed to also improve mood and boost motivation. So the lingering depression I am experiencing could also be affected.

This lack of focus and the lingering depression, combined with the lessened motivation, means I am getting a lot less done. My blog entries are sporadic, my energy and motivation at home and at work are diminished, and I just feel less productive in general.

My other symptoms though are much improved. Last week I was still having some issues, almost always in the afternoon. We changed one of my meds a tiny bit. I take the same dose, but instead of taking it all at once, I take half in the morning and half at night. It seems to be keeping me more stable all day long.

I was taking the entire dose at night before, because when I took the whole dose in the morning, it left me feeling exhausted. Taking it at night though, had me feeling it fade the next afternoon. Taking it twice a day leveled me out, it seems.

There is also an extended release form of this med that is an option if this doesn't work as well as we hope, on the off chance that this lessening of symptoms is temporary.

I have been taking a very proactive approach the past few weeks when it comes to my medications and my treatment. I have decided that I want to be able to explain what I don't like about treatment and offer alternatives. I want to be educated about the options out there.

I'm feeling good. I wish I had more focus, but other than that, I feel really good. I'm optimistic that this will last a while. I have accepted that this probably won't be permanent, that the future may bring more adjustments, more changes. But I'm okay with that. I'm feeling good.

Pills

Uggghhh. I hate meds sometimes. They work, and I know that when I am unmedicated I am unable to function. But it gets so frustrating.

I am trying to decide right now how to tell what is a symptom and what is a side effect. I have felt flat and numbed for the past few weeks. Is it that I am depressed? Or is it that my meds are doing this to me? I'm not sure. The same goes for some of the anxiety and agitation I sometimes experience. It's frustrating.

I also have been looking for something to add to or replace my antipsychotic. It knocks me out, so I can only take it at night. But I can feel its effects fading and waning throughout the day, and feel less in control by the evening. Adding a small booster in the afternoon helps, but now I am taking naps all the time and feel tired all evening. I found an extended release medication that isn't supposed to have as much of a sedative effect, and is almost the same drug. I will be asking about it at my next appointment.

Then there's the dry mouth. Oh God. I can't take it sometimes. Drinking water doesn't really help. It makes it better for a couple minutes, maybe. I spend all day filling my bladder to try to relieve some of the dryness, so then the bathroom becomes a revolving door.

I am still having some mild symptoms, and am currently debating whether or not to ask my doctor to up any meds, because I already worry about their side effects.

Is the goal of this to END my symptoms, or just to make them tolerable? Right now, I'm at the point where they are tolerable 95% of the time, and I'm feeling stable. But do I ask for enough to make the symptoms of away for right now? And, if I do, how long will they be gone?

Meds are a pain in the ass. It feels like I take mountains of meds every day, but things still aren't perfect. Should they be? Am I expecting too much? Am I expecting to little?

I feel flat and numb right now. I'm hoping this passes. I'm hoping that this isn't my new normal. I'm hoping this a symptom, not a side effect.

Fixable

I am trying to change the way I think and talk about myself. Through therapy, I am learning to recognize the negative thinking patterns I have. It's tough to change. They are deeply ingrained in me. But I am trying.

One of the biggest things that I am working on in therapy is changing the way I see myself. I see myself as broken. Irreversibly damaged and defective. I see my inability, at times, to fight off symptoms as a sign of my own personal weakness. I have, I am realizing, unrealistic expectations for myself.

Broken. What does that mean? It implies that I am beyond repair. That I am not worth trying to fix. When something is broken, you toss it out. I struggle, I really struggle, to see myself as anything other than defective. My illness makes me feel powerless at times. I feel like I should be stronger, that my symptoms shouldn't impact my behavior. A part of me believes that I should be able to live my life without interruption, and that my inner struggles should never be obvious to others.

How can I expect these things of myself? Of course my illness is going to have an effect on my behavior! Of course my illness is not my fault, and of course succumbing to symptoms does not mean I am pathetic and weak. I am not broken. My therapist challenged me to come up with a different word, a different way of seeing myself.

The word I settled on was "fixable". It implies that something is wrong - there is an imperfection. But it also says that there is hope. Something fixable may never look perfect, it may always have some cracks or marks or visible imperfections. But it can still be useful, it can be repaired.

It's a struggle to change something so ingrained into my thinking patterns.

Another one of the things I am struggling with is how I think others see me, or will see me. I worry that I will be seen as weak by others. Seen as damaged, broken, fragile.

I don't know how others see me, and I can't control it even when I do know. But I will tell you what I don't want. I don't want to be seen as frail and weak. I don't want to be treated with extra care, handled with kid gloves. I am not some kind of cracked glass, ready to break at any moment, unable to handle a single tremor. I struggle enough with how I see myself - I don't want others to see me as more broken than I see myself!

I assume, too often, that if I share details, if I open up, if I am vulnerable - I worry that it will fundamentally change how others see me, and that it will always be in a detrimental way. I am so afraid that I will lose the respect of others, that I hesitate to ever completely open up.

I mentioned a couple weeks ago that I had been challenged to reach out to a friend and share things that I didn't usually share. I did that, and it went well. But I did it through text, where I wasn't as open and vulnerable. I worry about appearing weak. Often, when I explain my struggles and battles and pain, if I do it in person, I end up crying and sobbing. I hate feeling that vulnerable, and I assume that others will see me as even weaker because they see me as a blubbering mess, barely able to survive, failing to thrive. I assume they will see me as weak, and the thought of breaking down in front of them terrifies me.

I worry, all the time, that when I share my struggles, when I explainy symptoms in detail - I worry that I am burdening people. I worry that since there is nothing anyone can do to help, my sharing will only add stress to their lives. Nothing useful can come of it. This idea was challenged the other day, and so I shared some things with my wife. She immediately pointed out that I was wrong. There are things she can do. Maybe not right away every time, but she can learn what soothes me, what relieves stress when I am symptomatic. One of the examples she used was that if my paranoia was convincing me that I was being watched, she could get some more of the curtains we have in our bedroom that block outside light when they are closed. If that relieved my stress and anxiety, that is an option.

I never thought about it that way. I never thought that there was anything that anyone could do to help. I felt like it was my struggle, and mine alone. It was out of anyone else's control, so why burden them with the details of my pain and frustration? Why allow them into my madness? I never thought about the fact that there ARE things that can be done to alleviate symptoms, at least some of the time. Plus, knowing what my symptoms are and what they look like allows others to keep me safe and minimize risk. It can be one of the safeguards I have in place.

I am trying, really trying, to change the way I think and behave. It's hard. It's really hard.

My therapist gave me a paper about "automatic negative thoughts" with a list of different types of negative thinking patterns. It was like a checklist of my ways of thinking. It surprised me, honestly. I didn't realize how much of my thinking is negative.

Some of the things on that list;

• "All or nothing thinking" is seeing everyone and everything as black and white, good and bad. Imperfections are failure.
• "Always/never thinking" is seeing a pattern where there isn't one. If I failed today, its because I ALWAYS fail.
• "Guilt through should-statements" is focusing on how things SHOULD be, and seeing myself and others negatively if they fail to meet that standard.

Those are three of the twelve thinking patterns, and I have used at least ten of the twelve.

Here's where the problem turns back on itself. Understanding that I think irrationally, and use negative thoughts patterns, I become frustrated with myself. I then find myself beating myself up for not recognizing this earlier. It's a vicious cycle. Trying to change this way of thinking and finding a new way is difficult. Really difficult.

I am trying to change the way I think and behave. I am trying, really trying. But it's tough.

Acceptance

Symptoms may include the following:

-Delusions - having false, fixed beliefs
-Hallucinations, such as hearing voices
-Major depressed mood episodes
-Possible periods of manic mood or a sudden increase in energy and behavioral displays that are out of character
-Impaired occupational and social functioning
-Problems with cleanliness and physical appearance
-Paranoid thoughts and ideas
-Weight loss or gain
-Changes in sleeping patterns (sleeping very little or a lot)
-Agitation (excessive restlessness)
-Lack of energy
-Loss of interest in usual activities
-Feelings of worthlessness or hopelessness
-Guilt or self-blame
-Inability to think or concentrate
-Thoughts of death or suicide
-Increased and/or rapid talking
-Rapid or racing thoughts
-Little need for sleep
-Agitation
-Inflated self-esteem
-Distractibility
-Self-destructive or dangerous behavior (such as going on spending sprees, driving recklessly, or having unsafe sex)

That is a checklist of symptoms for schizoaffective disorder. You can see why it could be confused with bipolar disorder. The symptoms overlap quite a bit.

Schizoaffective disorder is basically a mix of bipolar disorder and schizophrenia. It presents differently in different cases. Some look predominantly bipolar, some predominantly schizophrenic.

Basically, my Schizoaffective Disorder is Bipolar on steroids. My psychotic symptoms are more severe, and they sometimes happen without changes in my mood. That is one of the key factors that led to my change in diagnosis - my psychosis and my moods are separate things. I can have mood changes without psychosis, and psychosis without changes in mood.

The change in diagnosis initially freaked me out. Hell, I'm still a little freaked out. Schizoaffective disorder is a more challenging illness. It means I will have to fight harder. My relapses may be more frequent. Treatment will be more difficult.

I am trying to accept this diagnosis. I am trying to be cool with it. I'm not 100% there.

It does explain some things. My change in dress over the past several years. I used to wear collared shirts most of the time, now I wear mostly the same t-shirts over and over again. I used to go to the doctor and to the dentist regularly. I just went back to the dentist after seven years, and I'm going to the doctor after three years without seeing him. It explains some of the changes in my hygiene, and appearance. It explains some of the sixty pounds I've put on in the past eight years. It explains my recent symptoms, my anxiety, my agitation.

Please be patient with me as I process this diagnosis, and work on accepting it. I'll be honest - I'm scared. I worry that one day, I will lose this fight. This new diagnosis makes me even more worried.

Send me good juju, send me some good vibes, pray and think and reach out. I'm struggling, and it takes a lot for me to admit that.

Confused

I'm not sure what to write today. My diagnosis was changed a few hours ago. My doctor changed my diagnosis from Bipolar Disorder Type II to Schizoaffective Disorder Bipolar Type.

I'm not sure how to feel about this. It's just a name. It doesn't affect my treatment, since what we are doing is working for me. It's just a name for my symptoms. Right?

So I am trying not to act like anything is different. I am trying to act like this changes nothing. But I feel like it does.

This diagnosis seems somehow more severe, less manageable. It makes me feel like my struggles will be more difficult.

I'm confused and frustrated right now. I am trying to process all of this.

Sorry for such a short post. And sorry that I've been so irregular with my posts. To my regular readers, I will try to get my thoughts together and write more tomorrow or Friday.

I'm feeling a little overwhelmed still. I know I shouldn't be so confused and frustrated over a name, but I am.

Depression

I have to be honest right now. The reason my posts have been so sporadic lately is that I have been going through some depression. It sucks. It's overwhelming some days.

I feel flat. I feel like I can't truly enjoy things. Life is bleak and miserable.

I have been able, so far, to trudge through it and force myself to go on, and not give up. But it's hard.

I have been going to work every day. I have been keeping and sticking to my plans.

It feels like I am having an argument with myself inside my own mind. One part of me knows that the right thing to do is to keep fighting against the depression. The other part of me just wants to give up, to succumb to the depression. Right now the fighter in me is winning.

I hate this illness. At least, though, I know that this is my illness. This despair and darkness is caused by a chemical imbalance, not by reality. The world is not really this bleak, it only looks that way because of my illness. But that doesn't stop me from feeling it. It only helps to lessen the symptoms of this depression.

So I'm sorry. I have been acting more withdrawn, less active, less motivated. My blog entries have been sparse. This will get better, and I will win yet another battle against my disease.

Being open

I have a lot of issues surrounding friendship and relationships and social norms. I know I do. I have discussed some of that in previous blog entries.

I have always struggled to understand why it is that I don't have more close friends. This week I figured out a piece of the problem.

In therapy earlier this week, I was talking about the fact that I have always been "a listener", but have never felt like I should be listened to. I wanted to comfort others, but was hesitant to seek comfort for myself.

This blog is the most open I have ever been about my life. The things I share are often deeply personal, and sometimes difficult to share. I have been pushing myself to be more open, and to share my experiences with others. Of course, there are things too personal to share in this format. They need to be shared in a different way.

Too often, the only way I have shared my personal struggles is by going to a therapist. My therapy appointments allow me to discuss my darkest, deepest thoughts and the difficulties I have, and the depths of despair I feel. Mostly, these things are related to my illness, but there are other things, too. I usually begin sobbing, and go through a mountain of tissues. I end up feeling vulnerable and scared.

That vulnerability is uncomfortable. I don't do that with anyone outside my therapist. And, as I am now realizing, that is terrible.

The type of relationships and friendships I have always felt like I couldn't have - those relationships require openness and honesty. They require at least some vulnerability. You can't expect a deeply personal friendship from someone when you never tell them about your thoughts and feelings.

So my therapist challenged me. I was supposed to find a friend and discuss with that person the things I don't usually share. I wanted to choose someone that I felt would respond in a way I could be comfortable with. Not too much huggy-feely stuff, but not judging either. I needed someone who I had shared at least some things with, but didn't want to go with someone who I knew shared my diagnosis - that would make it TOO easy.

So I picked someone, and said things that were not easy for me to say, even through text. I shared things about my life and my illness that were deeply personal and private. It was difficult. I was uncomfortable. But it was good.

I felt like a weight lifted. It felt good to finally share with a friend the things I went through that were so hard to talk about.

It's dumb, because I see all the time, when I am listening and offering support to others, that allowing someone to share their struggles allows them to come to peace with those struggles. I just wasn't willing to share my own personal demons.

I don't know what I expected. Did I think my friends would judge me and be cruel? Run away and never look back? Abandon me? I had so much fear and anxiety when I thought about sharing some of the worst of my symptoms, and asking to be able to reach out for help.

When I occasionally have reached out in the past in dealing with my struggles, I have always been selective and ONLY discussed things with people who I am 100% sure have experienced the same things themselves. I have been unwilling to share them with my other friends and my family, for various reasons.

I justify my unwillingness to share by convincing myself that there isn't anything anyone can do, so I should just struggle alone. Or I say that I will just worry them, and so I shouldn't tell them. I think that my issues are mine alone.

The problem with this is that it only adds to the loneliness that suffering and struggling bring. Especially the struggles brought on by my disorder.

I always tell my friends to reach out to me whenever they need help. Now I just need to follow my own advice.

Violence

A mass shooting, a high profile murder case, a bizarre crime - you'll hear them say it nearly every time. They will blame mental illness - most often bipolar disorder or schizophrenia.

I agree, the mentally ill should not have access to weapons, especially guns. But the reason I say that isn't that I fear the next mass shooting. Someone suffering from a mental illness is far more likely to harm THEMSELVES than anyone else. Suicide is a HUGE risk, and access to a gun is a risk not worth taking.

Of my two most prominent mental illnesses, bipolar disorder and ADHD, the one more closely associated with crime is not bipolar, it is actually the ADHD. ADHD is associated with lowered inhibitions, impulsive behavior, aggression, hostility, and loud and obnoxious behavior. That's a bad mix when impulses lead to criminal behavioral, and interactions with law enforcement may not go well. The mentally ill, meanwhile, are far more likely to be the victim than the perpetrator.

You hear it though. "This isn't about guns, it's about mental illness" becomes a mantra. But the widely held belief that mental illness is linked to violent crime just isn't true. High profile violent crimes have many precipitating factors, and to say that the ONLY problem is the mental health system is ignorant.

Are there mentally ill individuals who commit violent crimes? Yes. But only a very tiny percentage of the mentally ill are violent, and many of those who are violent commit crimes for reasons unrelated to their mental illness. Poverty, childhood trauma, and abusing drugs and alcohol are much more related to crime than bipolar disorder and schizophrenia are. Most criminals are not mentally ill, and most of the mentally ill are not likely to commit a crime.

A lot of the stigma surrounding bipolar disorder stems from the media's portrayal of the mentally ill. Many people with Bipolar Disorder are hesitant to talk about their illness out of fear. The worry - that people will judge you, fear you, lose any faith or trust in you - can be overwhelming.

I think about it sometimes. Do people see me as fragile? Do they think I am a ticking time bomb? Do they believe that it's only a matter of time until I become violent and out of control? Do they see me as only a "crazy person"?

I seriously hope not.

I am a father, a husband. I am a supportive friend, and a reliable coworker. I go to work, I come home, I go to my kid's school events, I hang out with my family and friends. I am many things. I don't want my illness to define me.

I started this blog to discuss my mental illness and share my struggles with others. I hope that this blog hasn't made people think of me as a poster child for "crazy" and nothing else.

The mentally ill aren't terrifying monsters. The mentally ill are just everyday people, trying to get through life the same as everybody else. We aren't ticking time bombs, ready to blow any second without warning. Yes, we have our struggles, and they may seen foreign and bizarre to "normal" people. Yes, we can feel unstable and unpredictable. But we are far more likely to hurt ourselves than to hurt others. We are far more likely to be a victim than to be the perpetrator.

It's not just the news, either. Crime shows and police procedurals often portray the mentally ill as violent and dangerous criminals. Movies and television buy into the same false beliefs, continuing the false correlation between violence and mental illness.

Please, if you see this just plain wrong belief in action, point out to others the untruths surrounding this belief. Challenge the stigma of mental illness. Change the way others see us, whenever and wherever you can.

Snowball effect

The great thing about being stable right now is that the positive things I do to stay stable start building on each other, and I have had some lifestyle changes.

I have always tried to do some simple activity and exercise every day. It gets hard when I am experiencing depression, but I always try. Now that I am stable, I find myself WANTING to get outside and do something. I have been taking the dogs for several walks a day, and taking longer walks at a faster pace. It feels good. I have even been talking about going back to exercising in a gym again.

I try to limit the amount of junk food I eat. When I'm depressed, I often want to binge eat. Excess sugar and caffeine can provide extra energy and worsen ADHD symptoms. Now that I am stable, I find myself watching what kind of food I eat even more, and eatibg healthier - and doing so is easier. I have spent some time this evening looking for new recipes to try, as I plan on reviving something we used to do - "Meatless Mondays". For several years, we made it a point to have a dinner meal that was vegetarian every Monday. Recently, I had lost interest in that. Stability brought me back to healthy habits.

I have always tried to force myself to have healthy sleep habits. Changes in sleep occur in both phases of bipolar, with depression increasing desire to sleep, and mania decreasing it. I find healthy sleeping habits easier to maintain right now. I have been going to bed at regular times, and I haven't been sleeping in excessively on my days off.

The great thing about these, and other, changes in my desire and ability to maintain these habits right now, is that these are all things I use to try to alleviate my symptoms when I am symptomatic. Doing them when I am this stable makes it that much easier to deal with the mild symptoms that have been presenting occasionally. Decreasing the frequency and severity of the symptoms that do occur means that I will still be maintaining my healthy habits. Again, maintaining those habits further minimizes symptoms.

This cycle starts to snowball, with good habits helping with symptoms, which helps with habits, which helps symptoms - it starts cycling and snowballing and growing.

This morning, I had some anxiety and depressive features, but found fighting it off, and getting up and moving, easier than it was the last time that I felt that way. The habits I have created to make myself move when my symptoms are crushing and suffocating me - they give me the ability to deal with these symptoms much more easily than I used to.

I am sure my symptoms will still appear here and there, in varying severity and frequency. But with my current habits, fighting off the milder ones won't drain me and take so much energy and effort.

I am feeling good. I have been feeling good for a couple weeks. I think the worst of this is over for now. It feels good to be back to "normal" again.