Tuesday, September 29, 2015

Community

Now that I am stable again, I feel like I should DO something with my experiences. I know that I have used this blog to help people understand my illness, but I want something more.

I have been trying to find something. Today I started something where I am actively making a difference. I started following a few forums like this one where people are looking for help and support in dealing with symptoms and managing their illness, and started responding and offering help to people.

I have used my experiences to help people before, but it has always been people I knew, not strangers. I am finding this to be not only helpful for others, but helpful for myself as well. I had similar experiences with my friends. Offering support helped us both. It reinforces the things I know, and offered perspective on our symptoms and thoughts and behaviors. Talking about it is good for everyone involved.

I have decided to use my illness as a tool to help others.

This got me thinking. I dropped out of college back before my diagnosis, with a couple years under my belt. I am now seriously considering returning to school and obtaining certification in psychology and mental health. I want to use my experiences to help others on their path to stability and wellness.

I want to make sure I am stable and ready before I commit to school, so it would be spring before I was prepared and sure enough of my stability to enroll in classes.

Until then, I will make certain to help where I can, and offer whatever support I can give. I am enjoying my stability. It has been steadily improving still, and my symptoms have been presenting less and less each day. I think we are right where we need to be, my body just needs to get these levels steady within itself.

Thank you to everyone who has offered support during my worst moments these past few months. It means the world to me. And if anyone needs me for support, I am here for you.

Sunday, September 27, 2015

Not okay with okay

Lately I have been feeling okay. Any symptoms I have experienced passed quickly, my anxiety and agitation have been minimal. A big source of anxiety for me had actually been my other symptoms. A moment like the one I had yesterday, when I briefly believed that Satan was telling me to hurt myself, would have caused me a lot of panic and anxiety a few weeks ago. Now, I accept it and move on, noting it in my list of symptoms I experience.

Today I realized that this bothers me. It sounds strange to say, but I am not okay with being okay with my symptoms.

I was contemplating my symptoms and my recent breaks with reality, and my calm acceptance of them. Since when is hearing a demon from the pits of hell just another day? I get it, this isn't real, its a symptom. I guess that the way I am handling it is, in some ways, a healthy approach. I know that, but it just feels wrong. Calmly writing in a notebook "Heard Satan telling me to [x,y,z] tonight" - I shouldn't be okay with that, should I?

I am probably wrong in the way I am thinking about this. I am probably only creating unnecessary anxiety and agitation and panic. I am probably being irrational.

I just feel like not FIGHTING against this - just calmly letting it pass - it just feels so WRONG.

I am probably wrong about all of this, but I feel like I am doing this all wrong.

It seems all backward. I do what the experts say is the healthy approach, and I feel like everything in me is rejecting it. I feel like I am not FIGHTING. I feel like observing, watching and accepting these symptoms and letting them pass - I feel like this makes me somehow weak. I am probably wrong.

That's the thing about therapy, and education - learning a different way to deal with things just feels so WRONG at first. Changing my approach and thought processes and behaviors - it's seems impossible sometimes.

I feel like I should be freaking out about some of these things. Feeling and hearing things that aren't there, sensing a presence, and my mind's belief that these things represented reality - even just for a moment - I feel like that should be freaking me out.

I worry that maybe this calm is a side effect of my meds. Perhaps my emotions are dulled, and I am not panicked because I can't feel anything that strongly.

I worry that my acceptance is a symptom of my illness. Am I now so crazy that I am accepting these things as a part of my normal life? Is this part of my sickness? The progression of my disease?

I hope that this calm, this acceptance - I hope that this is just me learning a new strategy and a healthy way of dealing with things, an effect strengthened by the med changes.

My mind is torn, confused, and uncertain. I am not sure if I am okay with being okay with all of this.

My mind's rejection of my now calmer approach then creates another layer of thoughts. Why am I rejecting this healthy way of dealing with my symptoms? Am I rejecting it because I am not truly well enough to change my thoughts and behaviors? Is my rejection of the right way a sign that I am not strong enough to do this, to heal, to cope, to manage?

This is the unhealthy way of thinking my therapist was talking about. The thoughts keep coming back to the same thing. The same idea.

"When I am symptom free, it is because I am strong. When I experience symptoms, it is because I am weak."

That is seriously where my mind takes me again and again. Hearing a voice makes me feel weak. Having a panic attack about it makes me feel weak. Calmly accepting it makes me feel weak. Questioning either approach makes me feel weak. Questioning my questioning makes me feel weak.

I know, in my head, that this illness is not my fault. My symptoms are not my fault. My disturbed thoughts and behaviors are not my fault. Sure, I can learn strategies and coping skills to handle my symptoms and minimize the negative effects they might have. But I can't stop symptoms from happening. I know all of this in my head. I do.

But in my heart, I don't buy it. There HAS TO be a reason that this illness sometimes runs my life. This disease must have a cause. There must be something.

I always turn it into blaming myself. A part of me knows that I am wrong. A part of me knows that this is not my fault. But I still find myself directing the blame inward.

This is the thing about mental illness and the unhealthy thoughts that accompany it. Even when my rational mind knows that the way I am thinking is wrong, it doesn't stop me from thinking that way. It's not like my brain just stops whatever crazy thing it is doing and reverts back to sanity. Knowing something is crazy and that my mind is disturbed doesn't stop the disruptions and the crazed thoughts. Knowing that what I am experiencing is not reality doesn't change the fact that it feels so fucking real.

It's tough to explain to someone who has never been there.

My depression isn't sadness. It's a soul-crushing darkness, an obsession with death and dying. It's apathy and nihilism - I want to set the world on fire just to watch it burn. It's believing that I am worthless, that everything is worthless. Nothing matters. Nothing, nothing. It's believing that of the sun were to explode tomorrow, and turn this world to ashes - that would be an improvement.

My manic episodes aren't sunshine and rainbows. It's a nuclear weapon. Energy, energy, energy. So much energy. But it's not skipping through fields of flowers kind of energy. Oh sure, it might start out that way. A childlike wonder, a puppy's exuberance, joy and giddiness. But it changes, and soon it's throw shit around, hit something, and break something type of energy. It's anger and rage and destruction and mayhem. It's hedonism and anarchism. I crave money, power, sex, and every sin and vice. And the rage. So much rage. It overwhelms me.

I hear things, feel things, and believe things that are disturbing. Magical, mystical things. Dark and evil things. I have been to the edge, I have seen the darkness. I have contemplated or attempted suicide multiple times. I have gotten as far as writing a suicide note on three separate occasions. I have heard what I believed to be angels, gods, demons and satan. I have felt their presence, the warmth of the breath on my ear. I have seen the veil lift, and suddenly felt in communion with all of nature, with all of the universe.

No matter how much I know that these things are symptoms of a disease. No matter how many times I remind myself that these things I am experiencing are the result of chemical misfirings in my brain. No matter how many times I remind myself that this isn't my fault, that sometimes, these things are entirely out of my control. That's not how it FEELS. No matter how wrong I know that feeling is, it's tough to shake. When your mind can trick you into hearing devils, convincing you to blame yourself is pretty easy.

I am trying to remember to not fall into this endless cycle of negative thinking. This circle of self blame. I am trying.

I feel okay. And I am trying to feel okay with feeling okay.

Saturday, September 26, 2015

Religious fervor

I think I can understand why mental illness historically was seen by primitive societies as demonic possession. I understand why the mentally ill have often felt like they were talking directly to God, or hearing Satan. I understand the gods, magic and mysticism. I get it.

My delusions and psychoses often have religious overtones, and I am not of a religious nature. I get how a religious or superstitious mind could buy into the ideas that these episodes bring into my mind.

The most common "religious" experience I feel is more animistic than anything. I am one with nature. I can feel and hear trees and plants breathing and shifting and growing. I can communicate with animals and plants and the sun and the Earth. I have written poems about this in the past.

"A Mystic's Prayer"

I believe
the Earth is
my Mother
the stars
my Father
I believe that
the beast is
my brother
the grass
my sister
I believe god
is present
in all places
all peoples
all times
I believe that
the soul is
the home of the sacred
that god is
not a person
but all people
I believe
I
have been here
before.

That poem is one way I have expressed my feelings and thoughts during these moments of religious fervor.

Another type of religious experience I have experienced in my symptoms is believing that a mystical "other" or some kind of higher power is either making everything go my way, or trying to ruin my life and everything in it. I may even believe I hear the voice of God or Satan directing me to do things.

These moments frustrate me, because, afterward, I now that they aren't real. But in the moment, in the moment they feel so REAL.

I get it. I get the urge to explain these thoughts and feelings in animistic and religious ways. Gods in the sky, in the trees, in the waters. I get it. I have lived this.

Today I had a moment. A moment of delusion that had a religious theme. It made me think of all the other times I felt this way. Similar things I had experienced.

I remember the emotion, the elation, the ecstasy. I remember the poetry I used to describe these feelings.

I am a mushfish
a fishstar
a starwish
I am a green
brackish
salt water
wishfish
I am a fishroom
a mushdream
a dreamroom
half lucid
half breathing
sexmagic
wishroom
I am a fishwish
a mushwish
a dreamfish
a dance round the fire
with this voodoo shroomfish
I am a starfish
a mushroom, a dreamwish
I am the heartbeat in you
I'm the mushfish

These thoughts. These holy and hellish moments. God and Satan come to life. They can be stressful. In the moment they are so real. But afterward, they just seem foolish.

I get it. I understand the urge to create the forest spirits, the gods of winds and water. I understand the urge, the thoughts, the ideas. I get it.

These religious delusions are probably one of my more common symptoms. They frustrate me so much, I think, because I am naturally such a skeptic and search for logic and reason. These moments of supernatural paranoia and religious fervor frustrate me.

This is one of the things that starts to make me feel weak and foolish. I feel ridiculous for believing them, even for a moment. It just seems like I should know better.

I am trying to accept that this is something I will have to deal with sometimes, and that I can't expects all of my symptoms to disappear forever. I am really trying.

I have been feeling stable. I am functioning at what I would say is 95% normal. I have moments of irrational beliefs and delusions and paranoia, but mostly I feel good. I am trying to accept the 5%. The mild, short episodes and moments of abnormal thoughts and behaviors.

I really do get it. Devils, gods, spirits. I know how it feels to be a mystic, caught in a moment of communion with an indescribable otherness. I know the manic, powerful feeling of touching some part of the Earth, the sun and moon, the stars and the universe. I get it. These primitive urges and feelings are intense. I feel overwhelmed with joy and beauty and ecstasy in the brighter moments. I feel paralyzed with fear and unholy terror in the darker moments.

Today I felt a presence, a whispering voice, a darkness. I believed for a moment that something powerful and evil was influencing me. I had dark thoughts, and believed that the presence was putting them into my mind. It lasted just a couple of minutes. But after it passed, I felt ridiculous. I know that these things are chemicals in my brain, creating feelings and ideas and confusion and delusion.

I know that these things aren't real. It just frustrates me that I even believe them for a second. I know that my guilt and judgement of the delusion and confusion that happens to me is unwarranted. I know that I need to work on it. I'm trying to catch myself. But old habits are hard to break.

Friday, September 25, 2015

Psychoeducation

So I have been reading about the concept of psychoeducation, which refers to a patient gaining insight and understanding of their illness by being informed and educated about that illness. I have been doing this on my own for several years, and didn't realize if was a legitimate treatment approach for bipolar disorder and psychoses. I wanted to discuss the benefits I have experienced by learning about and educating myself regarding my illness.

One of the first benefits is a greater understanding of what my symptoms look like. There are things that I wouldn't have thought of as symptoms without education on the subject. Especially in the early parts of an episode, I may have milder symptoms that I would brush aside if I was not vigilant and aware that they are early warning signs of an episode.

Especially during a manic episode, it can be hard to recognize symptoms for what they are. The early stages of a manic episode feel GOOD. Elevated mood, a grandiose self-esteem, hyperactivity and increased energy and drive. How can that be bad? Knowing how my illness works, I can often recognize what is happening in the very early stages and use safeguards to limit the damage my symptoms can cause. I know that when I start making more plans than I can reasonably fulfill, when I feel unusually energetic, when I feel more talkative than usual - I know that these are symptoms.

My depressive episodes, too, can be caught early when I know more about them and what they look and feel like. Catching both mania and depression early means that I can better manage symptoms. Which brings us to the next benefit of understanding my illness.

Nearly all the coping skills, strategies and safeguards I have in place came from reading about bipolar disorder and the things that worked for others in managing their illness. Education offers a range of approaches, and I tried many of the options and strategies I read about, and kept the ones that were effective. Education allows me to understand what I can do, what therapy can help me to do, and how my therapy and medication help me manage my symptoms. Which is the next benefit.

Psychoeducation has meant that I read about the medications I take, their effects, how they work, any potential side effects, and their method of action. Knowing what my meds do and how they help me makes me it easier to take my meds and less likely to skip a dose or go off of them. Bipolar disorder puts one at a greater risk of noncompliance with medication, and education helps. Plus, knowing what more severe symptoms look like and knowing that experiencing an episode makes future episodes more likely, I am more likely to remain on my meds.

There is a concept in both seizure disorders and  bipolar disorder that is called "kindling". Some research suggests that each seizure/mood disturbance involves misfiring in the brain, and that everytime the misfire occurs, the brain learns the pattern, and it becomes easier for the brain to misfire in the same way again. The brain becomes more sensitive to triggers and stressors with each episode. The episodes become more frequent and more intense with each episode. The idea is that each successive episode adds kindling to the fire and progresses the illness. That is one reason meds make sense to me. Preventing or minimizing episodes means that the pathways and patterns that cause then aren't as deeply embedded in my mind. Staying on meds helps me prevent and minimize episodes. Knowing that makes my choice clear.

The last thing I wanted to mention is that education has increased my awareness of triggers and stressors, and the best ways to avoid them. I learned that getting enough sleep and some moderate exercise helps me manage symptoms. I learned that over stimualting and high adrenaline activities can trigger mania. Spending too much time alone or sleeping a lot can trigger depression. Certain events, activities and even certain people can trigger symptoms. I know that sometimes, if I am having any signs of symptoms, I should avoid those things if possible.

Education has given me greater insight into my illness. If you are struggling with a mental illness, I encourage you to do the same thing.

Thursday, September 24, 2015

Me, myself and I

Today someone commented to me that I hadn't been "acting like myself" lately. It made me pause and think. What is "myself"?

I have been struggling with mood disturbances, personality changes and abnormal behavior since I was in junior high school. At this point, I'm not even sure what normal behavior looks or feels like. I just don't know.

It bothers me. Is the calmer, mellower version the "real me"? Or am I the energetic, hyper, manic one?

Am I somewhere in between, or just nowhere in particular.

It created a sort of crisis in my mind.

Sometimes over-thinking things does that. Thinking too much about something that seems trivial can send me down a rabbit hole - a slow descent into a strange madness.

I snapped out of the strange thoughts, the de-realization and separation from reality. I focused. I think I am okay right now.

That brings me to the other thing I realized today. I sometimes have a hard time admitting that I am struggling. I thought of this because I was thinking about the way I felt before I got my meds worked out again, and the fact that I was going to work when I probably should have been staying home.

I realize now how stupid that is. Going to work when I am not well is a terrible idea. There are limits to what I can do sometimes. I need to recognize my limitations and stay safe and let myself take a break if I really need it. Honestly, a couple days off at the beginning of my issues may have been better for me than trying to work while it was going on, and then ending up in a real crisis.

So, I need to take breaks and accept my limitations.

Finally, the last thing I have learned over the past few days is how important routine is to managing my symptoms. If my expectations for the day veer off and take an unexpected turn, it throws me off and can leave me feeling restless, agitated and frustrated.  I experienced this a couple times this week.

Something as simple as a change of plans can cause me to have mild symptoms. It's frustrating. I find myself going back to the negative thinking. "What an idiot I am. How weak. Such a tiny thing can upset me  that much? How pathetic!" I am fighting against this pattern of thinking. It's going to take a lot of work to break that habit.

So, anyways. Sorry I haven't written in a couple days. I've just been in a funk because of the changes in my routine and the unexpected crap I've been dealing with. I'm getting back on track, and feeling better tonight. I'll keep everyone posted over the next couple weeks, and I'll be going back to regular posts now. Peace and love to you all.

Monday, September 21, 2015

A Gift?

I am involved in some online support groups for people who have bipolar disorder, and I see the same question asked repeatedly in many of the forums. "If there was a magic button you could press that would erase your Bipolar Disorder, would you press the button?"

As shocking as you might think it, I usually find that people usually respond with a "No". People living with pain, confusion, and serious and debilitating symptoms - and they don't want it to go away? That may seem bizzare to you. But I get it.

I have been considering the question myself. Would I press the button? No.

I have been thinking about my illness a lot, and trying to see if in a different light. I have changed my view on many things regarding my illness over the past few days. Yesterday I wrote about a change that had happened about how I feel about my diagnosis. Today I wanted to write about the change in how I view my illness as a whole.

I have come to see my own personal experiences as a gift. Let me explain.

During periods of hypomania, I am creative, imaginative and filled with energy. I have learned to harness that drive and focus to complete what would usually be quite daunting projects quickly and thoroughly in a short period of time. I have use the creative and imaginative aspects to write poetry and short stories. I draw, I create, I complete crafts quickly and easily, and enjoy giving my projects out as gifts. Yes, there are aspects of hypomania that I have to rein in, but I have learned to do exactly that.
Without my Bipolar Disorder, I would miss that creative and energetic aspect of myself.

I guess part of the change in how I see my disorder has to do with my realization that I have so many ways of dealing with my illness and have functioned at such a high level throughout most of my symptoms. Many people aren't capable of that. I am not here to judge people who struggle to maintain control more than I personally struggle. It's just that, apparently, because my expectations of myself are so high, I have created good plans and safeguards, and have many effective coping strategies. I had never realized how many people struggled to create plans and then follow through with them. I see this ability as a gift, and as a personal strength.

Another thing that changed my view about my own illness is the discussions I have started. People talk to me in person, or read my blog, and the discussion opens up. I start hearing about other's struggles, and have been able to point people in the right direction to receive treatment for their own mental health needs. I hear stories of family and friends, and the feeling of hopelessness that loved ones feel when they don't know how to help. I can offer my own experiences as an example, and offer suggestions and advice on how to learn how to help during a crisis. I hear people say that they didn't know much about Bipolar Disorder or other mental health issues, and that my words have opened a window, and started a discussion, and engaged them in a topic they previously know almost nothing about. I hear supportive words and encouragement, too. That helps in my own healing process.

I have been thinking about my own personal expectations, and my resolve to function and live an active, "normal" life, and the inner strength that requires. I have changed my view on things because of all these things.

If I didn't have this illness, if I wasn't open and honest about my own personal struggles - how would that change things? Would the people I have helped still be struggling on their own? Would I have a stack of notebooks and journals filled with stories and poetry? The people who have a new understanding of the illness that disrupts the lives of the people they love - would they remain confused and feeling powerless? My passions and interests - would those be dulled?

Don't get me wrong - there are plenty of things about my illness that I do not enjoy, and that are painful. But that doesn't mean that I would get rid of it, even if I could. I see the change I have initiated in my small corner of the world, and it makes the pain worth it.

I guess I have come to see myself almost like an athlete. I will experience discomfort, pain, and exhaustion in the game of life. But the game is a good game, and I am out here, helping out the group of people that count on me, and that I count on as well. My friends and my family and I - we are the team and the fans all rolled into one. Rooting for each other, offering support and assistance, and cheering each other on. I am staying in the game, and all the pain will be worth it to me, as long as everyone has a good game and enjoys themselves, and I contributed something to the game. I am strong. I am winning.

Sunday, September 20, 2015

Diagnosis

So, over the past couple months, while my symptoms have been more severe, I often have wondered about my diagnosis. Do these new symptoms mean my diagnosis will change? Do I have something more debilitating? What is this disease? What is wrong with me? I've spent some time today thinking about these questions.

First of all, a little bit of detail about my meds.

1. Antidepressant: I take a medication that is used to treat depression, anxiety, panic disorders, social phobias, obsessive-compulsive disorder, PTSD, and the depressive features of bipolar disorder, schizoaffective disorder, and schizophrenia. It is in the class of drugs known as SSRI's, a common class of antidepressant and anti-anxiety medications.

2. Mood stabilizer: This medication is used to treat epilepsy and other seizure disorders, migraines, and to stabilize moods in depression, bipolar disorder and schizoaffective disorder. It is actually classified as an anticonvulsant, and was originally developed to treat seizure disorders, and its mood stabilizing properties were discovered later. Many anticonvulsant  medications also stabilize mood, actually.

3. Antipsychotic: the particular medication I use as an antipsychotic is used for psychotic episodes in depression, bipolar disorder, schizoaffective disorder, and schizophrenia. It is also used to help those with autism or dementia better control irritability, aggression and/or violent outbursts. It is considered an "atypical antipsychotic", one class of antipsychotic medications, the other being "typical antipsychotics".

4. ADHD (stimulant): I use a psychostimulant medication to treat and manage my attention deficit and hyperactivity disorder. Treatment of ADD and ADHD is the primary use of this medication, although it can be prescribed for weight loss, narcolepsy, or treatment-resistant depressive features in depression or bipolar disorder

5. ADHD (non-stimulant): I take a medication that is considered an "NRI", a class of drugs used to treat a wide range of psychiatric disorders. The drug I am prescribed is used to treat ADHD, anxiety, depression, smoking cessation, eating disorders, and bedwetting - among other uses. I am using it in combination with a psychostimulant because on their own, neither ADHD medication is enough, and each has side effects I don't like. Together, they work much more effectively and the side effects seem to cancel each other out.

Why did I go into all this detail about my meds? Because each and every one of them is used in the treatment of a wide range of medical and psychiatric conditions. They are effective for more than one diagnosis.

So what does this mean for me? Today, I decided that it doesn't matter. I have an illness, and the medications I am using are effective at treating my  symptoms, and help me better manage flare-ups. What does it matter what the name of my illness is? It very well could be something other than Bipolar Disorder type 2. It could be type 1, it could be schizoaffective disorder, it could be something else entirely. Maybe I have an anxiety disorder, or a panic disorder. Maybe some of my intrusive thoughts are from a Disorder on the OCD spectrum. Does it really matter? The meds I am taking? They work. They are used for many things, and whatever you want to call my illness, this treatment works.

Saturday, September 19, 2015

Safeguards and Skills

I mentioned that my therapist said I had many effective safeguards and skills in place to manage my illness. I said I would explain some of them in greater detail. Here you go.

1. Spending: my wife and I have learned to recognize the early signs of a hypomanic or manic episode. These episodes often feature an urge to buy things and spend money. We have an agreement that when symptoms begin to appear and I am likely to make poor decisions about money, I have limited access to cash, and all of my credit cards are taken out of my wallet. This prevents me from spending insane amounts of money. This plan was put into place after I put our banks account balance in the negative several times, including the time that our balance was $1000 overdrawn.

2. Meds: one of the most common features of bipolar disorder is difficulty taking medications regularly. This also can be a feature of ADHD, as remembering to do things can be difficult when you are always distracted. To manage my medications and make sure I take them as prescribed, the first thing I do is set a week's worth of medication up in a "med minder" - those plastic med cases separated by day and time. I have a system, and I double check that all my meds are where they should be for the week. I then make sure I have alarms set. I set an alarm to take meds at each designated time, and if I know I am not going to be home at that time, I set a reminder to take the med with me. I also try to associate each time with a task, so I have a natural cue to remind me as well. For example, I currently use breakfast, leaving work, and my late-night snack as natural cues for my med times, and try to always do them at the same time.

3. Sleep: another common problem during both mania and depression is change in sleep patterns, and also disturbances. During mania, I can't sleep, and during depression, I don't want to do anything else. I have been forcing myself to remain in bed for at least seven hours when I am not able to sleep. I will not allow myself to get up, to read, or play on my phone until the seven hours are up. I toss and turn and try to rest for that time. During depression, I do the opposite. I try to limit my sleep, and go to bed and get up at reasonable hours. That can be a real struggle, but I make a real effort.

4. Social/Activities: when I am depressed, I don't want to do anything but sit home and mope. When I am manic, I want to do EXCITING, EXHILARATING things. I have a rule in place. If I have plans made to do something - I keep them. I don't stay home. I don't cancel then to do something more exciting. I keep my plans. My wife knows that this is what I want, and reminds me and pushes me to fight the urge to cancel plans, and we have a pretty good success rate.

5. Normal Functioning: sometimes I don't feel "normal" when I am experiencing symptoms, and may struggle or worry about my actions and behaviors around others. I have learned over the years to mask and hide mild symptoms. I never thought of this as a "skill" until my therapist talked to me about it. Acting "normal" and happy when I am depressed sometimes actually lifts my mood, at least temporarily. Trying to remain calm and in control may soothe me during mania or anxiety or frustration. Trying to not give in to my impulses and urges, and trying to behave normally, even if it is the complete opposite of my impulses, can help me maintain some control.

6. Breaks: sometimes, the only thing that can help is time alone to just deal with my symptoms and ride them out. I have learned to take regular breaks when I need them. I take breaks when I BEGIN to experience the symptoms, rather than waiting until they are nearly uncontrollable. Setting aside time to just sit and be calm and quiet and alone is really important and vital to managing my symptoms.

7. Directing Symptoms: my wife and I learned quickly that my symptoms during a hypomanic episode or mild manic episode can actually be useful. I have learned to direct the increased focus, drive and energy into productive things. I once painted nearly every room of the house in under a week. Directing symptoms into productive outlets allows me to deal with them in a healthy way. Many of the features of hypomania and mild manic episodes can be directed into useful and productive things, rather than acting in impulsive and destructive ways.

These are some of the things I use to manage my symptoms, and I try to use them regularly. I have the support of my wife when I need reminders to keep doing the things that keep my illness better under control. I stay on track.

Until I started listing off the things I do to keep my illness in check, I never really thought of these as "skills". I thought they were something that EVERYONE with my illness learned to do. I didn't give myself enough credit, apparently.

I hope these things give you some idea of how much Bipolar Disorder effects nearly everything I do, and the habits and behaviors I need to practice to maintain anything near stability.

These are some of the skills I already use. I will build on them. I am sure I will learn additional skills and strategies down the road.

It feels good to recognize that these are skills, and that my ability to maintain them is a sign that, even in my darkest hours, I try to remain at a high level of functioning. The reason I am so hard on myself sometimes is that I feel like these things aren't ENOUGH. I get frustrated with my symptoms. I get frustrated with myself, for allowing them to have any control over me. I am working on changing that destructive way of thinking. It will be a process, but I have confidence that I can do it.

Friday, September 18, 2015

Breakthrough

I feel like I made a breakthrough today. It involved me sobbing in my therapist's office, but it was something I really needed. It was therapeutic and healing.

I went in to my therapist today thinking I knew what the conversation would be. I wanted to talk about what I wanted out of therapy. I had thought about it and assumed that the area I needed to work on was coping with anxiety and frustration. I really thought that was my weak spot. I was wrong.

When I arrived at my appointment I told her what I had been thinking about. She challenged me. Why do I want these coping skills? What do I want out of this? Where do I want to be?

In my responses, I quickly realized that my problem was not what I thought it was. My therapist was the one to initially point it out, but once she did I realized how right she was.

The real problem? How I see myself and my illness.

You have probably seen me refer to Bipolar Disorder as a disease and I have said that you can't CHOOSE to be Bipolar anymore than you can choose to be diabetic, as an example of challenging the stigma around mental illness. Today I had that analogy thrown back at me.

Yes, a diabetic doesn't choose diabetes, and they can't think themselves well. But you know what else? They can't be cured. They will always live with symptoms. And sometimes, even if they are doing a good job of managing their symptoms, they still have bad days, and may have lower or higher blood sugar than expected based on past experience. They have to constantly monitor their symptoms, their illness, their diet.

I have been talking like I will get to 100%. Like I expect myself to be strong enough to overcome this disease. Why? Because, when I experience symptoms, and feel powerless, and have a lack of control... I feel weak. I blame myself for succumbing to my illness, for buying into my delusions, my fears, my bizarre thoughts, ideas and actions. Every misstep, I see as my own failure.

When it was pointed out to me, I started hearing the way I talk about my illness, about myself, and my symptoms and experiences. I expect so much of myself. I aim high, perhaps too high sometimes. I see myself as broken, defective.

This latest destructive pattern of thinking began the other day at the pharmacy. The girl at the counter had my meds ready, and had to reach under the counter for a bigger bag than the standard pharmacy bag. It hit me. All these bottles, all these pills - and still I am not healed. I still struggle. This much help, and I am still "defective". Still "broken". It hit me like a ton of bricks.

My struggles suddenly overwhelmed me, not because they were present, but because I still even had them. How broken am I?

As I talked about this with my therapist, she kept stopping me, and pointing out how much I was judging myself, how much blame I was putting on myself.

She asked again about my coping skills, and the safeguards I had in place for managing my illness. As I talked about them, I realized how many good choices, skills and strategies I already have used to manage and cope.

So what was a looking for? It dawned on me. I want to be symptom free. I want to be in control at all times.

That's when it hit me. I started crying. Why? Why do I do this to myself? Even as I tried to explain that I was realizing how destructive my thought process was, I continued to talk badly about my own thoughts, feelings and behaviors. I struggled to speak objectively about my own feelings.

I can't seem to think about my symptoms and my illness without passing a judgement on myself. I see my illness as making me weak. I'm not strong enough. There must be a way to be symptom free forever, right? Wrong.

In this blog, I usually talk a good game. But I struggle. I say "this is happening to me, this isn't me, this is my illness". But I don't put that into practice, not really.

Even now, as I describe these feelings and thoughts, I am passing judgement on myself in my mind. How ridiculous. How stupid. Why would I think that this illness is in any way my own fault? Why do I get angry at myself when I am having symptoms, and an no longer in control. What an idiot I am! And the cycle continues.

This is what we will be working on in therapy. This will be our focus. Changing these thought patterns, this unhealthy, destructive view of myself. And talking about how I see my illness, and how I view the fact that I am living with it, and my experiences with it.

Today was the first day that I said all of these feelings aloud, in a single conversation, and actually listened to my own words objectively. It was eye opening, to say the least. It made me cry, and I felt overwhelmed. But it was healing, too. I feel better, and now am catching my own thoughts and habits.

Talking about all the skills I already have made me think that I might do a post just about that in the near future. I wasn't giving myself enough credit when it comes to the strategies and safeguards I already have in place.

I feel exhausted, and drained. But it's a good feeling. It is cathartic.

Thursday, September 17, 2015

Frustration

Today was my first day back at work. I had signed up to work a double shift today, and didn't back out of it, so I worked a fourteen-hour shift. It was a long day.

I had some frustration today about money, and my finances. Between overspending during manic episodes and actual desperate times dealing with unexpected bills, we have credit card debt. Thanks to the way I drive when I am manic, we have brake issues on the car. Since I was off of work while I adjusted to my new meds, I lost a lot of overtime, and we had been counting on the money from the overtime to start catching up. It got brought up tonight, and I started to get frustrated, and I nearly snapped.

I can feel it just beneath the surface. Depression, and that pathetic pity-party aspect that usually flares up. I guess I have some of that, since I am whining right now. I can feel the self-destructive tendencies, and the hopelessness, bubbling up.

Right now, the meds are holding the symptoms at bay. That is the level I have been functioning at. Feeling the start of the symptoms, but not falling into them.

I am trying to keep steady. To use what has been working to keep me calm and stable. So far, it has been very successful.

I feel good still. This level of frustration would have put me in a dark place just a few weeks ago. I am able to deal with it in a healthy way right now.

This is what I want. To be able to live a normal life, with normal problems and normal issues, and handle things in a normal way. I know that "normal" people have bad days, minor breakdowns and ugly moments. I know that I will have that, too. I just don't want those things to send me spiralling out of control. I don't want to fall victim to the chemicals in my own mind as they go haywire and my brain malfunctions. I want to feel normal. To have normal problems, normal bad days, and deal with them in a normal way.

Today, I was really close. I was really close to slipping and falling. But I kept my footing. I stayed in control. And it felt good.

I think I am finally getting there. I think we have things figured out. I think that this is nearly the end of this particular pause in my life.

I'm frustrated right now. For real, normal reasons. And I feel like I am dealing with it in a normal way. I went for a walk outside, came back in and ate some chocolate, and looked for something to distract me for a little while until I was feeling more rational and reasonable. If that isn't normal, I don't know what is.

Today I was frustrated. And it felt good.

Wednesday, September 16, 2015

Adjustments

So I saw my doctor today, and I requested a few adjustments. The doctor listened to me, and one of the first things she said was "I'm reading [the other doctor]'s notes, and what he is describing and what I am seeing...WOW. Things are really getting better."

Because I was able to articulate what I was experiencing in great detail, and my reactions to different meds at varying times and in varying doses, my doctor pretty much agreed with me on everything I talked about regarding med adjustments. All of the changes I requested? I was given every one of them.

All of the adjustments were minor, but they were based on my experiences. For example, my antipsychotic knocks me out, so I take it just before bed. But that means I can feel it fading just after dinner, and that is when my symptoms tend to flare up. So she added a very small dose for me to take at 3 pm.

I am very happy with the meds and with the small adjustments that were made. I got a small dose of the stimulant back to perk me up and help with focus, the other ADHD med got adjusted a little to help even more with focus, and I got a small antipsychotic pill to take at 3pm.

I will still be going to therapy for a while, because I will still have symptoms here and there at times, and need some coping skills to remain in a good place. I have already added some things to my coping strategies.

One thing I have started doing is forcing myself to  lay in bed for at least 7 hours. If I wake up after 3 or 4 hours, it's a sign that I am experiencing some manic symptoms. Getting out of bed and allowing the symptoms to control me is not healthy. So I have been forcing myself to lay there, trying to relax. I have also been attempting to force myself to not sleep TOO MUCH, which can be a symptom of depression. Setting alarms, going to bed at a decent hour, and getting into a habitual bedtime routine will help me cope.

Another thing I have been doing is taking breaks when I need them. I used to use smoking as a tool to escape. Since I quit smoking, I need to recognize when I need to take a step back, and maybe go sit on the porch and play a game on my phone for a few minutes. My therapist reminded me to do this both at home and at work. Take a break, take a breath, and step back for a moment.

So I would have to say that today was a very good day. Symptoms are minimal. My meds got some minor adjustments to minimize the symptoms that I am having. And already, I am learning more coping skills.

Tuesday, September 15, 2015

90%

I have no motivation lately. My energy has been sapped. I'm not sure if this is because I am off of the one med or if this is a symptom. I just have no desire to remain active. No inner drive. I don't want to do anything.

This is potentially a real problem. One of the most basic coping skills I use is staying busy, engaging in some kind of activity, no matter how simple. Being idle only makes things worse most of the time.

I have been trying to force myself to do things, even if I don't feel like it. I have to stay in control, and this is one way I can stay in control.

In times like this, I miss the energy and focus and drive associated with a manic episode. As long as I don't experience severe symptoms, I'm okay with mild mania. The world is more fun, I am driven and engaged, life is fantastic. I wish for that right now.

The problem is, that mild mania can lead to more serious symptoms. I may become hedonistic and selfish. I may suffer a psychotic break. I may become delusional or paranoid. That, I definitely don't miss.

I have, however, been having fewer and fewer symptoms, and am feeling pretty stable. I see my doctor tomorrow, and am going to ask to return to work. The new med has been mostly good for me. It just saps my energy. I will also be asking about returning to a combination of meds, as I had experienced fewer symptoms, but with energy and motivation.

I also have been missing what I call my "attaboy". You know that part of your brain that makes you feel rewarded and happy when you do a good job? Like a pat on the back? Like someone saying "attaboy!". That's missing. I feel dulled, numbed.

I am hoping that my doctor and I can figure out the right mix of meds for me tomorrow. Treatment with meds is kind of a trial and error thing. What works for me, may not work for someone else. So they try different things and different combinations, using what has worked for similar symptoms in other people, adjusting as needed. It can be frustrating.

At this point, I know we are close to the right mix. This is nearly normal. This is functioning at 90%. Some days, it's closer to 95%. A few weeks ago, I would have said I was functioning at less than 50% normal.

It has been over a week since I had a major breakdown, or a major episode. Psychosis has been occurring less and less. I had a momentary lapse this morning, but it lasted maybe 5 or 10 minutes at most. I was briefly convinced that there were people outside, talking about me, and that no one else could hear them because they wanted everyone to think that I was crazy. I realized that I WAS crazy and moved on after a few minutes.

I have learned to "snap out of it" fairly quickly. I hope to make it even easier and faster in the next few weeks, with help from my therapist. I am feeling a little bit better every day. More able to function. More normal. I am getting there. I am winning.

Sunday, September 13, 2015

Paranoid

Today, I have been experiencing brief moments of paranoia and delusions. They have been coming on like a flash, and then disappearing just as rapidly.

Earlier today, we were parked outside a store, and a small, frail looking elderly man, leaning on his cane, walked by the van. I locked the doors, because for a moment, I was worried that he might be a deadly assassin in disguise, hired to hunt me down and destroy me. (Don't worry - he wasn't a deadly assassin!)

This thought, and others like it, seemed real for a moment, and then it was gone. It was over within a minute or so. The panic, the paranoia, the delusion - they rush in, and then rush back out.

I have been handling it fairly well. Especially considering that I just quit smoking and this is only day #2 of no cigarettes. Several times, I have had the persistent thought that I should just give in and have a cigarette. I have successfully fought those urges off each time. I am finding other ways to cope, to keep me distracted and busy.

It is good to see my symptoms retreat like this. Yes, they are present, but they aren't interfering with my daily living. I could tolerate this, quite honestly. Moments of madness, but stable and aware of what is happening as it happens.

I know that, for someone who has never lived with these symptoms, it must sound bizarre to hear someone say that they would be happy with some mild paranoid delusions, and maybe some voices here and there. But honestly, once you have had the terrifying, psychotic, hellish, nightmare moments, your definition of "normal" and "well" shifts.

I see the improvements in my symptoms. I recognize my symptoms for what they are. I know that I am stabilizing, and will achieve some level of normalcy soon, sooner even than I had hoped.

My depression has lessened. My mood improved. I am using positive thinking to keep myself from slipping into a dark state of mind. Just the fact that I feel so in control impresses me. My weakest moments now, are better than my strongest moments of just a few weeks back.

I was re-reading some of the things that I had written over the past couple months, and I could see the slow, steady improvement. Yes, there have been setbacks. Yes, there have been declines between some of the improvements. But the overall trend has been improvement.

I am hopeful.

Saturday, September 12, 2015

First session

So yesterday afternoon, I went back to my therapist after spending five years stable and with no regular therapy sessions. I had a one-hour appointment, and I poured my heart out to her. I talked about every symptom, every thought, every mood that I have experienced in the past couple months. I went over everything I had done to manage them, everything I had attempted to calm myself, to keep myself from spiraling out of control.

It felt good to have an hour where someone was just listening, affirming, and guiding me. She let me know that many of the tools that she would normally teach someone in my shoes, I already possessed to some degree. She made me feel like I was doing better than I thought.

I have had moments of frustration and hopelessness in this fight. I have had days where I feel defeated and helpless. But I always get back up. I have given my family and my friends tools to help me, and insights on my symptoms. I have told my wife that it is never a good idea to let me languish at home, and cancel my obligations. I have allowed her to push me, assisting me in staying active when I feel like I am falling apart and unwanted.

As I went over everything, it registered how many tools I actually already have. I hadn't really processed that until yesterday. I hadn't realized how many weapons I bring to the fight against the madness.

I left feeling hopeful. Feeling lifted up. I am not the sobbing, pathetic mess, crouched in the corner - a victim to my disease - that I imagine myself to be sometimes. I am a fighter. It felt good knowing that many people would have already given up. I am strong. I continue to struggle, instead of falling into a downward spiral of madness and disease.

I feel like I have a second wind in this fight. Knowing that I have been more successful than expected considering the severity of my symptoms, I feel stronger. Knowing that I have dealt with symptoms in appropriate ways, and already possess many of the necessary tools to continue fighting, I feel empowered. I am a fighter, as I have said before. And I am winning more battles than I thought.

I guess the biggest lesson I learned from my session yesterday is that I am truly blessed. I have friends and family who support me. I have a job where my coworkers and supervisor are understanding. I have many people I can lean on when things get really bad. I am a lucky guy. And I don't give myself enough credit, that's the other big thing I learned. I am handling things well, all things considered. I thought I was failing more than winning, but it seems that is not the case.

I go back for another session next week. After that, it will probably be every two weeks. It feels good knowing that there is someone who will just listen to me rant and give me good advice, while being objective. Yes, I know, she gets paid to do this. But that doesn't really matter. That's the great thing about therapy. This isn't your friend, this isn't your family. That sense of being a burden is gone. This person is paid to listen to your problems and help you solve them and provide you with tools to better handle them. That is your relationship. And it's a very effective way of dealing with some of these symptoms.

I feel better today. Talking through some of my stuff that has been uncomfortable to talk about was therapeutic. Talking to someone who has seen this before, and has helped others through this, felt liberating.

I feel more positive. I feel stronger. I feel more able to continue this fight.

Friday, September 11, 2015

Numb

I feel numb. Numbed and exhausted. I feel myself slipping.

Yesterday I didn't write. I didn't have the energy to write. I didn't have the interest. I felt numb.

I don't like this. I don't like this at all.

This is an aspect of my illness that is painful for me. The aching, the numbness, the apathy. I want to care, to have passion. I want to have joy, and happiness. I fight against the dulling, numbing symptoms. But even my fighting instinct is dulled.

I think this is one of the most difficult things to fight against. Normally, I rage against my symptoms, fighting and struggling to maintain control. In these moments, though, of apathy, my fight seems futile, my senses are dulled, my world is heavy and covered in dense fog.

This isn't the dark, feel, crushing depression that leaves me fearful and terrified. This is numbness, apathy. This is a lack of fear, of interest, of joy. I have no dread, no panic.

I want to feel normal again. I want to have sadness and joy and fear and elation. I want to feel. This numbness is heavy and hazy. I can't see through it. I can't feel.

I see my therapist this afternoon. I am hoping that returning to therapy helps me process these symptoms better. Helps me cope better. I want to get through this and be on the other side. I am so tired of this, it is exhausting to struggle against it.

Wednesday, September 9, 2015

Hangover

So today was the day. I took my last dose of my stimulant yesterday, as my doctor wanted me to try the new med in combination, and the new med on its own to see how I react. It feels pretty terrible.

Most of the meds I take have a side effect of drowsiness or lethargy. The stimulant cut through that drowsiness and sedation. I didn't realize until now how much. I feel exhausted and hungover.

I take a fairly large doses of antipsychotic meds at night, and they knock me out. Usually, in the morning, I still feel a little lethargic, but then when the stimulant kicks in, it goes away. It's still here, and its nearly time for dinner.

I had mentioned how effective the combination of the stimulant and the non-stimulant had been. I am now entirely convinced that I need to advocate for that as a permanent treatment.

I am afraid that this sedation will send me into a depressive state. That can definitely happen.

That is the thing about Bipolar Disorder. A lot of the mood changes have no cause. But sometimes something does trigger an episode.

For example, a lack of sleep, instead of making me tired, may make me alert and trigger a manic episode to some degree. Something bad happening can trigger either mania or depression. Low activity and apathy can trigger depression.

I try to monitor my behavior, because it can cause an endless cycle of cycling through moods, thoughts and behaviors that worsen my symptoms. This exhaustion, lethargy and apathy may trigger depression.

I see my doctor next week. Because I'm going back to therapy, I temporarily have to see a different doctor, but I have seen her before and she is a familiar face. I will have to hold out until then, as long as it doesn't get worse.

It's a good thing, honestly, that I am not working this week. I don't feel like I could do it. I have no motivation. No energy. No drive. Absolutely none. I just want to lay down.

My first appointment with my therapist, who I have also seen before, is on Friday. I am looking forward to that appointment. It will help me to cope better with my struggles and concerns.

I might not be as active as I usually am over the next week or so. Please bear with me. I have told my wife to drag me around and make me so the things I have planned, because staying at home and doing nothing would only increase the likelihood of this triggering an episode of depression. If I look like a mopey zoo lion, I'm sorry.

I really don't know what is worse, borderline mania, or borderline depression. They can both be nightmares. As long as it stays borderline, though, I can manage.

Tuesday, September 8, 2015

[untitled]

As a kid, I wasn't exactly what you would call social. I hung around mostly with a few kids from my parent's church, and I had known most of them for nearly my entire life. I went to a church-run school, and my classmates all went to church with me. At home, if I wasn't playing with my sisters (I'm the only boy, and have four sisters), I was in my room, reading a book. I didn't really make any new friends. I just hung out with my school/church friends when they were around.

When I was in 5th grade, the church and school I had attended all my life closed, and I rarely, if ever, saw the children I had grown up with. Some of them had moved away, and seeing them would have been difficult. My parents homeschooled me and my sisters that first year, so it was just us and my mom for my 6th grade year.

In 7th grade, I started a new school. It was still a church-run school, but I didn't know anyone there. I was, to put it mildly, awkward. The first year or two, I don't know that I would say I had any friends. There were a few kids I talked to in class, but mostly I was the awkward kid who sat by himself at lunch.

Sometime during junior high, though I didn't realize it at the time, my illness struck for the first time. Junior high was when I made my first suicide attempt. I took a couple bottles of pills from the medicine cabinet and took every pill. Tylenol, ibuprofen and a couple Sudafed were, obviously, barely enough to make me sick to my stomach. But I was in a bad place, and it was a genuine, although ignorant, attempt.

Then the pendulum shifted, and I went into a mild hypomania. I remember the rush. I would talk to everyone in my class, and in other classes. I would joke, I discovered how to make people laugh. I didn't know what was happening at the time, but it felt wonderful. My social awkwardness seemed to have disappeared. I was a new man (it was 8th and 9th grade, so I would have called myself a "man", because teenagers are dumb).

My moods, thoughts, and behaviors shifted back and forth, with some periods of "normal" mood in between. The cycles tended to be significantly longer than they are now. During a depressive episode, my mom recognized that something was wrong, and took me to see a professional. I was given an antidepressant, and assigned to a therapist.

I took the meds for a while. But they started to make me hostile, angry, irritable and mean. I refused to take them anymore, so I just quit going. After stopping the meds, my mom saw that the depression wasn't returning, so let me stay off of them. I know now that the reason I had that reaction to the meds was because of my illness. Individuals with Bipolar Disorder, when they are given only an antidepressant, tend to respond badly, and my behavior was a fairly typical reaction for someone with my illness.

My mood continued to fluctuate throughout high school. I would feel euphoric and social for a while, and withdrawn and sullen for a while. I'm not sure what others thought of my behavior, but in my mind, this was just the way it was. I didn't know that this was abnormal. I didn't have a standard to compare it to. I just knew that when I was younger, I had struggled to make ANY friends, and that when I got into high school SOMETIMES it was easier.

My senior year, I switched schools again. I left behind the friends I had FINALLY made, and spent my last year of high school in a public school. Again, there were ups and downs, and I did end up making some friends, although, I know, looking back on it now, that they must have thought I was strange.

My senior year, a lot of crap happened. It wasn't a good year, by any measure. I won't get into specifics, but I will say that the stuff would have sent a person without a mental illness into a dark place. I spiraled out of control. I started faking illnesses, so that I didn't have to go to school. I contemplated suicide. I came close to another attempt. I managed to make it through, but by the skin of my teeth.

The summer after I graduated, I went into what I now know was a mixed episode. I started picking awful fights with my dad, just to piss him off. It got so ugly that he kicked me out. I don't blame him. I was an asshole. I lived briefly with my grandmother. That period still bothers me, because I was mean and nasty to her, too. I moved out of there after a few months. I started to drink, experimented with drugs. I was reckless, I started and quit jobs. I was in college, and was regularly skipping classes, and almost never turning in homework. I lost a lot of chances in those years. I managed to meet and make a few good friends, but I screwed up a lot of things.

I hopped around from place to place, never living with the same people in the same place for very long. I performed poorly at work. My behavior with romantic interests was ridiculous, as I would start a relationship, end it, and then want to go back. Anyone who put up with me was a saint. I made friends, and then just dropped them, never returning their calls. I was awful.

Another depression hit, and I went back for help. Again, they gave me an antidepressant, and again I reacted the same way. That's the problem with Bipolar Disorder. When we describe our suffering, a lot of times we don't describe the manic episodes at first. They don't seem like a problem. I didn't realize that the extreme good moods were a symptom. They were a reprieve from the depression.

Even my marriage was probably due to my illness. I love my wife, and I would have ended up with her regardless, but I asked her to marry me, and insisted that we have the ceremony three days later. She said okay, though. At that point, I don't think she realized that there was something wrong either. She just saw it as my being impulsive. That impulsiveness had been part of me for nearly the entire time she had known me, as we met in junior high. She didn't realize it was my illness.

Shortly after we got married, I went back for help. The darkness was back. Again, the antidepressant made me unbearable. Again I went off of it, and went into mania. I cycled back and forth for a few more years.

In 2009, I had the deepest, darkest moment of my life. I had a well thought out plan, and was on my way to commit suicide. I was alone in the house, I wrote a note, and left. Instead of going where I planned on committing suicide, though, I went to the hospital. I had a brief moment of clarity and realized I needed help.

That was when I was hospitalized, and put under observation. It was then that I was finally properly diagnosed. In the hospital, I was given a fast-acting antidepressant and antianxiety medication, and after a day or two, I went into a manic episode. I was giddy and euphoric, laughing and running through the halls, when just a few days earlier I had been suicidal. The doctor diagnosed with me with Bipolar Disorder, and that is also when I got the ADHD diagnosis.

I was tempted, at first, to go off the meds again. But I knew, now that I had a mood stabilizer, that this would probably be different. It took a while to feel it, but it was completely different.

Those meds worked. I felt like I could function. A funny thing happened. Both my socially awkward and my overly-friendly episodes leveled out. I think that was the hardest thing to deal with prior to effective treatment. I struggled SO MUCH with even the most basic social interactions. I could be pushy, overbearing and obnoxious when manic. I was sullen and miserable when depressed. In mania, I made friends quickly and easily, and talked to everyone - but I had so much DRAMA that few could handle it for very long. In depressive episodes, I dropped off the face of the Earth. I ignored phone calls, refused to go hang out with people, and was just a miserable person.

Once I leveled out and got onto an even keel, thanks to treatment, I found that I could make and keep friends much more easily. I was comfortable in social situations. I could hang out, make new friends, and get along with people in general. It made it easier for me to handle difficult situations, and tolerate people that before treatment would have been unbearable. Life was just easier.

Reading my old journals, my struggles with my social life come up again and again. It caused me so much pain. The extreme moods and behaviors drove many people away. Why wouldn't it? They just thought I was an awful person. I didn't know what was happening either. I thought it was all my fault. I thought I was broken, and a hopeless case. I thought I would always be a pariah.

That was a big source of the panic and anxiety I felt when I began to have severe symptoms again. Even though I know that this is a temporary setback, and that I will be stable again sometime soon, the fear of losing the ability to function and interact with people overwhelmed me. That was, in large part, why I told everyone about my illness, and why I started this blog.

I don't want to lose control of my behavior and do or say something that causes anyone pain and drives them away. I was finally functioning. I don't want to lose my friends, distance myself from my family, or lose anyone during my moments of madness. Sharing my struggles, I hope, will allow them to grant me some leniency.

I know that my mental illness, this disorder that can cause such a drastic change in my moods and behaviors, can be traumatic for those around me. When I am symptomatic, if I can't keep it in check, I can be hard to handle. I can be rude, inconsiderate, and condescending. I can be hostile and aggressive. I will sometimes talk over other people, interrupt their conversation, and act like my thoughts and ideas are more important than theirs. I can be sullen, distant, and unbearable. I am hopeful that explaining my illness, its symptoms, and how it affects my behavior has allowed people to see my behavior in a different light.

That is my greatest hope for this blog. I want it to cause people to see someone like me behaving in an unusual way and instead of thinking "He's being an asshole!", I am trying to help them think "Oh, he's not well. Let me see if I can help him." If even one person changes the way they think, I will consider my pain, my suffering and my illness completely worth the struggle. Fostering compassion and understanding, and ending stigma, is the whole point of this blog. It's why I am writing.

I hope that my words have started something, a change in people's way of seeing others. I hope I have created a window into what the pain of mental illness feels like. I hope that I have helped people be more open with others about their own struggles. That would be success to me.

To my friends and family, I just want to say thank you. For your understanding, compassion and endless support. I am leveling out, and am feeling 90% normal again. This battle is nearly won. But, there will mostly likely be another battle ahead someday. That one, too, will be won. I hope that you will continue to stand with me. I hope that my blog has made standing at my side easier.

Monday, September 7, 2015

Let's do the time warp again...

So, the world is super slow today. Not really, but it seems so to me. Time seems warped, bent. I am set to a different speed than everyone else. The world is out of sync.

Altered perception of time is a feature of Bipolar Disorder. Not everyone experiences it in the exact same way, but from what I have read, it is fairly common.

In episodes of hypomania and mania, everything around me feels like it is moving in slow-motion. It feels like I am in a revved-up racecar, stuck in 5 mph traffic.

"Come on! Move, people! Put the pedal to the metal! I have nowhere in particular to be, but I damn well am going to go 90 mph to get there!"

It is almost painful. It is maddening. Have you ever been in a hurry to leave, and someone is trying to keep you there to tell you an inane story in great detail, as slowly as they can, and you just want to scream "Get to the damn point, already!"? Now imagine that people speaking at a normal pace, briefly saying two sentences to you - imagine THAT was as infuriating as Mr. Never-gets-to-the-point.

That's how I feel right now. It makes focusing on anything very difficult. I feel like everything is much slower than I would like it to be. I feel frustrated and angry that things seem to be taking HOURS, and then I check the clock. Oops, it's been about five minutes.

Depressive episodes are the opposite. When I am depressed, I feel like the world is rushing past me. I am practically standing still. Shuffling along at 5 mph down the freeway, watching the cars pass by me at lightning speed.

"How do people manage? How do people move at that rapid pace?" That is what time feels like in states of depression.

Having an altered state of time in my manic and depressive episodes actually does have a silver lining. It is one of the first symptoms I notice when an episode begins. When I become aware of it, I become aware of other symptoms. It is an early warning sign.
Right now I feel like I am still in control of this. That has pretty much been where I am at this week. Some occasional symptoms, but never so severe that I feel like I am no longer in control of my thoughts and behaviors. It's a positive sign, an improvement. I was feeling powerless and panicked not that long ago.

My thoughts are racing. My mind wants to do five thousand things at the same time.

Part of my own issues with the manic speed and time warp is that I also have ADHD. The inability to focus and stay on task associated with the ADHD only compounds the problem. That "Hey! Look! A squirrel!" aspect that is so often a defining characteristic of ADHD is suddenly overwhelming, because my mind is on maximum overdrive, operating at supersonic speeds.

Right now I have four apps running on my phone, and I keep switching back and forth from one to another. It is keeping my mind at ease.

Days like these are why I am going back to a therapist. I have some coping skills, and they work sometimes. But I could really use some more tools, and the ones I have, well, they could use some strengthening. Reading a guide or self-help pamphlet just isn't cutting it right now. A therapist will be able to help me build these skills, these tools.

I am trying to be still. To force myself to focus and live in the moment. When it becomes more insistent, I do something simple like switch briefly to another task and then return to what I was doing. It has, so far, kept it reined in.

One of the most helpful things I have been doing when nothing else is working is just completely stopping for a moment whatever I am doing, closing my eyes, and taking a few slow and deep breaths. I try to just observe my mind for a moment. Recognize what is happening, knowing that this is happening TO me, it is not FROM me. It has been extremely effective.

I know that this is just a symptom, it will pass. That knowledge comforts me. A few weeks ago, I would have felt completely overwhelmed. I would have lost control, however briefly. My thoughts and behaviors are still mine, just moving faster, at a manic speed. No bizarre thoughts, paranoid delusions, or psychosis. Just me, but in overdrive.

It feels good to be in control.

Sunday, September 6, 2015

What madness is this?

So, I have mentioned things briefly before about delusions, paranoia and other forms of psychosis, but I wanted to share a little more specifics today. I am feeling good, so all of the following things make as little sense to me as they probably do to you. But in the moment, while I am experiencing these symptoms, they seem 100% real to me.

So what exactly is psychosis, what does "psychotic" mean? Basically, psychosis is a "break from reality" that causes changes in behavior, mood and personality. Let's go over a few specific types of psychosis.

The most common type of psychosis is delusions. Delusions are ideas and beliefs that I hold despite other's objections or proof that I am wrong. Delusions may include an inflated unrealistic self-esteem, they may carry religious themes, themes of persecution, among others. My delusions often have religious, superstitious and animistic themes. I may belief that I can communicate with nature, that I can feel grass growing, understand the songs of the birds. I may believe that I hold special powers of perception. I often begin to believe that I need to perform certain rituals or carry certain things with me to bring me luck and ensure that nothing bad happens. If I don't do these things, and something bad DOES happen, I blame myself. For example, I believed that a flat tire was my fault because I wasn't carrying my "good luck" cards. Those good luck cards are a pile of tarot cards, each folded in half. At the time, I believed that if I shuffled them every fifteen minutes, nothing bad would happen to us. I was late with a shuffle, and blamed myself for a flat tire.

Another form of psychosis is hallucinations. I have never had severe hallucinations. I have had a few minor ones though. Sometimes I see what I call "electric rain". It looks like droplets of light and electricity falling to the Earth around me. I also sometimes hear voices. They have always been whispering, unintelligible voices, hiding in the shadows or around the corners. Sometimes, I become convinced that they are real, and start talking about the "shadow men".

Next, there is paranoia and pronia. Paranoia is believing that someone is trying to harm you, whether a specific person, the whole world, or god himself. Pronia is the flip side of that. Pronia is believing that the world and god and everyone is helping you, that they are making good things happen. In paranoid moments, I am being followed, people are talking about me. In moments of pronia, an open parking spot near the entrance is obviously reserved for me by the very hand of God.

There is also a type of psychosis referred to broadly as "thought disorders". This is any problem with communication and thinking. For example, I may go off on a tangent that seems completely unrelated to the current topic. I may stop speaking mid-sentence and have no idea what I was talking about. I may seem to confuse word meanings. For example, the following train of thought is one I often use as an example. I was talking about my "racing thoughts", and went on a tangent about car accidents, and then started talking about racism and bigotry. In just a few sentences, I became confused with what type of "race" we were talking about.

The last form of psychosis I sometimes experience is changes in "social cognition". Social cognition refers to my ability to respond to social cues, to interact with others in meaningful and appropriate ways. It can lead to behavior that could he interpreted as rude, inconsiderate, distant, or "cold" and insensitive. I may interrupt others and act as if I don't care about their opinions. I may say things that seem like I don't care about anyone, and that all others are somehow inferior to me (especially in moments of delusion).

Sometimes, these symptoms and episodes overlap. I may have more than one form of psychosis simultaneously. Sometimes, I am aware enough to somewhat hide my symptoms, but they can be quite persistent and at times they become more apparent.

These symptoms, obviously, can cause changes in my behavior and my ability to function normally. A couple weeks ago, trying to keep them under control was causing me massive panic attacks. Sometimes I get worried about these symptoms, because they may make me irritable, irrational or even aggressive. I may lash out in anger, and be hostile and rude, even yelling, at my friends and family. Other times, I can be detached and apathetic. Things that normally interest me, that I enjoy, even things I am usually passionate about - I may be completely uninterested and unable to enjoy them.

My symptoms have been much less severe over the past couple weeks, but things can still get weird sometimes. I am hoping that with a little more adjustments in treatment and some more coping strategies provided by a therapist, that I will be feeling even better.

If you see me acting strangely, please bear with me for right now. I am trying, really trying, to approach something closer to normal.

Saturday, September 5, 2015

The good, the bad and the ugly

Meds are complicated. I have taken quite a few over the years, and every med I have tried comes with its own desired effects, side effects, and unique experiences. Some of the side effects are good. Some are neutral. Some are unbearable. Let's briefly talk about some side effects.

Right now, every med I am taking causes "dry mouth", which can be just awful. It gets unbearable some days. No amount of water seems to help. Eating anything like a cracker feels like chewing on sand. It can get pretty terrible.

Another side effect that is common is a change in appetite. I once tried a med that made me gain about 30 pounds over the course of four months. I made my doctor try something else. Right now, I just started taking a med that is doing the exact opposite. At times, I have no appetite, and will sometimes skip meals, or eat tiny portions at meals.

I also have taken meds that cause odd movements and/or tics. Right now, I sometimes experience this. On the meds I am on now, when it happens, it is the worst late at night and first thing in the morning. I just feel like I need to move. Drumming my fingers or a pencil on the table, pacing, tapping my foot on the floor. If I try to force myself to stop this energy and movement, and just be still, I feel twitchy, and people say I am making odd facial expressions or tics.

Another side effect of some meds is changes in my smoking habit. I have taken meds that make me smoke like a fiend. My new med makes me not want to smoke at all for most of the day.

Some meds act as "downers", others as "uppers". They may change your energy levels and mood - sometimes in the opposite way you would think. An antidepressant may make you tired and apathetic, a med to treat manic episodes might increase your energy and drive. Sometimes they seem unrelated. A med to treat ADHD may also decrease anxiety and panic.

Some meds keep you awake, and others make you tired and sleepy. I take a med right now that I can't function on when I first take it. I take it one hour before bed, quite literally. Once I have taken it, I know I have one hour before I fall asleep, wherever I am. If I want to sleep in my bed, I better make it there before the hour is up. One of my morning meds has the opposite effect. For 8-12 hours after I take it, I couldn't fall asleep if I tried.

Some meds act different ways when you take different meds with them. For example, a med may cause an increase in weight when taken with one med, and a decrease when taken with another. A med can change your mood one way when taken with A, and completely different when taken with B.

A lot of findings the right combo of meds is a mix of guesswork and trial and error. It can be frustrating at time.

Meds, though, are worth it. They are 100% worth it.

Friday, September 4, 2015

All the world's a stage...

My symptoms are bleeding through a little. Just a little. And one of the symptoms is new to me. Fantastic. I experienced it a few times so far today, and I was able to "snap out of it" after a few minutes each time it happened. I think part of the reason I am not stopping it sooner is that it is so new to me. Once I become aware of it, and fight it, it goes away. I will try to explain.

You know how, in television shows and movies, sometimes they will pan back to show the whole scene? It feels like that happens. I feel like everything zooms away from me, and suddenly it feels like everything around me is on TV, and is not reality. "This is all just actors, on sets, playing characters. This isn't real." That is what it feels like.

It freaks me out. Thankfully, I am not having severe panic or anxiety attacks when I realize what is happening to me. That was what was happening last week. Whenever I realized I was experiencing something that wasn't real or true, something in me panicked. My heart raced, my chest tightened, my entire body started to tremor. That was awful. This week, my symptoms have been causing me much less anxiety.

I made a decision. My doctor was weaning me off of the one med and onto another, and I am just about done with the old med. Initially, I felt good enough on the combo that I was going to ask to continue on the combo. Now, I am not so sure.

The med that he is taking me off of is a stimulant used to treat ADHD. The reason he wanted to take me off it is that, sometimes, stimulants make psychotic episodes worse, in both frequency and severity. He hoped that switching to a non-stimulant would help. I wasn't sure if I wanted to stop, because the med had really helped me focus and concentrate. After these recent symptoms, I am not so sure. If the week I take only the new med goes well, maybe I won't ask my doctor to consider my taking both meds.

Thankfully, I still have enough control over my symptoms that I can return to reality quickly when these symptoms occur. I am still doing much better than I was.

The feeling that my friends and family aren't real, and are just actors on a stage - it freaks me out. Everything around me feels alien and unreal. In the moment, it feels true. But when I realize what is happening, and snap out of it, it feels terrible. I feel a sense of guilt. The people I love and care about, they suddenly were, in a sense, forgotten. It's almost like I feel as if I didn't know them personally, I knew the characters they portray on TV.

This is new to me. The worry that I will lose control, that my illness will tighten its grip on me, has returned a little. The fear that I will spiral out of control, that I will lose touch with reality and not find my way back, is a real fear again. Not a panicked, overwhelming fear, but a sense of dread in the back of my mind.

I know that the end is in sight. I am nearing the finish line. My symptoms are lessening. I am feeling more in control. I just don't want to stumble. I don't want to fall. I don't want to slide back into that panicked, paranoid, delusional state I was in.

I remain mostly optimistic. I am still able to easily fight off my symptoms when they occur.

But I can feel the mania, the madness. It is just below the surface, fighting to get through. My monsters aren't under the bed, they are inside of me. I can sense the symptoms, boiling and burping and bubbling inside me, trying to gain control, trying to reach the surface and break through. But I am holding them off. I am fighting. And so far, I am winning.

It comes and goes, ebbs and flows, waxes and wanes. The symptoms grow stronger, then weaken. They flare, and then fade. And I am fighting. I am a warrior. And I will win. I will hold out until the end.

Thursday, September 3, 2015

The Levee

Today, I actually had a good sign. I believe that I am nearing the right dosage of meds, and I'm approaching stability. I felt the levee hold.

When I am stable, I feel little to no symptoms. But here, when I am approaching stability, it feels like there is a pressure, an urge. There is something happening in my mind. The storm comes, the floodwaters rise, and I feel the surge of chemicals that want to spiral me into madness. But the levee holds. It means I am not in a place where the symptoms are completely absent, but I am able to easily hold them at bay. Able to fend them off with minimal effort. The storm comes, but the levee holds.

This affirms my positive outlook, my optimism. This gives me hope for the immediate future.

Actually, I think I would be okay, even, with this. I would love to be symptom-free, but this is acceptable. If this is where I stay, I could handle it.

I know that, without meds, today I would be agitated, hostile, and aggressive. I would be paranoid, maybe even delusional. I can feel it in the back of my mind, pushing and straining to get through. There are a few cracks, a few leaks. It's not perfect. But I can easily keep in control. When I get frustrated, I can take a step back and calm myself. When I feel anxious, I can breathe and talk myself down. The storm rages, but the levee holds.

This feels good. Knowing that my symptoms are starting to fade, to wane. The madness isn't in control, I am. At least for today. In this moment, I feel strong. I am a fighter, a warrior - and I am winning. I can feel it.

At times, the storm seems weaker, barely present. But even at its strongest, I am able to hold it off.

I felt yesterday as if this madness would erode my strength. I feared I wouldn't hold out. I would fail. Most of that fear is gone.

Don't get me wrong, I still have some worry, some anxiety. I still wonder how long this will last. But this strength gives me hope. I am aware of what is happening in my mind, I feel the disease pulsing and pushing. But I am in control.

I even know that, right now, some of the ways I am expressing my thoughts and feelings are because of the leaks, the tiny cracks. The mania is trying to push through. I feel its energy, its madness. I recognize it, and am accepting its presence in my writing and thinking, without fear that I will completely lose control. It feels like I am in the other side of the floods and the raging storm, and, while my shoes and clothes might be wet, I am not underwater. The levee holds.

I feel like this, for now, is nearly over. The storm will break soon. The floodwaters will recede. And the levee will continue to hold.

I accept that this whole thing will probably happen again. I will once again have to fight, to struggle. I will feel like I am drowning again one day. But, I also have hope. Hope that, if and when this happens again, it will be temporary. It will be, not an end, but a pause.

How long will this last? Your guess is as good as mine. A few months? A year? Maybe even, like last time, five or six years. Who knows?

Yesterday, the uncertainty was getting to me. But, after a full night's sleep and some more thinking, I was able to come to more of a peace with it. This disease and its symptoms will sometimes be out of my complete control. In the future, I may once again need adjustments, new meds, changes in meds. I may need to be in and out of behavioral counseling and therapy. I might even need to return to inpatient care, and spend some time in the hospital. All that is possible, but none are certain.

Worrying and ruminating won't help. Of course, that's easier to say than to practice. But I know it is the truth. Worry is a destructive force, eroding my strength in this fight. When I catch myself worrying, I try to stop myself.

I feel better, more optimistic. The storm is raging, but the levee holds.

Wednesday, September 2, 2015

My Question

I have to be honest. For the past several hours, I have had a nagging, persistent fear in the back of my mind. I have felt REALLY good the past few days. Better then I have felt in a while. But.....

I have felt like this - this hope, this optimism - I have felt like this on more than one occasion in the past month or so. I have raved about how great I feel, about my struggle coming to an end. I have waxed poetic about the cessation of my symptoms. And then comes the downward spiral.

I am concerned. Will this end the same way? Is this just a brief respite? I am worried. Have I been overly optimistic?

I still feel good. I still feel calm. But for how long?

How long will this last? How long will I feel well? A few more days? A week? A month? I have no idea.

I was fairly stable for six years. SIX YEARS!!! And then it was over. I spiraled out of control. I haven't seemed to regain my footing for more than a few days since then.

I worry quietly, trying to keep these thoughts suppressed. I can't completely get over them, though. I can't shut them out completely. I mean, yeah, worrying isn't going to do anything productive, but aren't my concerns valid? Aren't my fears legitimate? Don't I have good reasons to worry?

I am trying to remain hopeful. I am struggling to stay optimistic. I am fighting against my fear and worry.

It's difficult, though. How do you get over your fears when what you fear is YOUR OWN MIND?

Again, this is just me being honest. I am trying to level with everyone.

I just want this to stop. I keep fighting, and struggling, and trying to regain control. But I am terrified that I will come to the end of my rope, and just let my symptoms consume me, like I did before the meds. Let my illness run rampant through my life. I don't want that. But I worry. What if I get exhausted, and just give up?

The madness is kept at bay right now, and my worries aren't causing me to feel panicked. But is this the meds? Or is it just the ebb and flow of my symptoms? The natural waxing and waning of my disease?

I am afraid. Afraid of my own mind. It sounds almost silly to say it aloud. "I'm afraid of myself, and my own mind." It just sounds crazy, ridiculous. But it is my greatest fear.

I wish that the "power of positive thinking" bullshit worked. I wish that I could just think myself well. I wish there were a cure for my diseased mind.

I wish I knew, right now, the answer to my question. "How long will I feel well?"