A little insight

So, what is the difference between Mania and Depression in bipolar disorder? I’m glad you asked (even though you didn’t) because I want to educate you on this. 

1. Energy levels. When someone is depressed they literally sleep more because they are TIRED. Not mentally, but PHYSICALLY SLEEPY. This is a PHYSICAL issue, not a method of hiding from depression. When depressed I cannot drag myself out of bed until I’ve had at LEAST 10 hours of sleep. My movements are physically slower, and that alone is a sure sign that I am heading into depression. 

Conversely, when manic a person has seemingly LIMITLESS energy. We can’t get to sleep. We can’t stay asleep. When I’m manic I sleep five hours per night MAX. My movements are quick and decisive. I need to expend physical energy. 

2. Concentration and brain function is strongly affected. When I am depressed I am easily confused. I have to work extremely hard at grasping simple concepts. Nothing makes sense, and I feel like I am in a fog. 

Mania allows me to understand EVERYTHING with lightning speed and clarity. I come up with novel ideas and solutions to problems that no one else has considered. 

3. Decision making is strongly affected. My mood dictates my core feeling about any given decision. When I am depressed I feel completely incapable of being decisive. When weighing options, no single option seems preferable to any others. I see only the worst case scenario in every option, and I am prone to making those decisions based on external factors. I’m far more likely to make a decision based on the needs of the other person in the situation. 

When I am manic I am decisive, but my judgement is poor. I make my decisions based on idealism, foreseeing the best case scenario every time. I am keenly aware of my own needs and desires and am more likely to consider them in the equation. I also take more risks. I’m naturally a more cautious person, but when I’m manic I consider consequences less seriously. 

4. When I’m depressed, EVERYTHING MAKES ME CRY. Commercials, posts about homeless people, and the sadness of people that I love all make me even more depressed. I consider everyone else’s feelings over my own and to try to avoid that just makes me even more depressed. My empathy is on overdrive. Also, something that is exceptionally annoying to everyone around me happens. Everything that has ever made me sad comes to mind and makes me cry. To others, it seems like I’m actively LOOKING for things to be sad about. In reality my brain literally inundates me with things that make me sad. It is beyond my control, and no amount of positive thinking will change it. When I am depressed I am also prone to self pity, which is extraordinarily unattractive. 

When I am manic, the feelings of others are less relevant. I try to consider them, but my words and actions come so much more quickly that I don’t have the time to weigh them and their effects on others. I don’t even foresee or UNDERSTAND the responses to my words and actions. When people are upset by the things that I say and do I am very confused. I have far less empathy than I do when I am depressed or even “level”. 

5. Confidence. When I am depressed I am convinced that I am worthless; That my family and friends would be far better off without me in their lives, and they are just too nice to tell me how much of a burden I am. I am very vulnerable to suicidal ideation. That part is rare, but it happens. Fortunately I have this very vocal secondary voice that has always warned me that THIS IS A RED FLAG!!!!! I have always gotten help immediately when this happens. Not everyone has that voice though, and I think that it is mainly a result of growing up with my mother’s frequent struggles with suicidal thoughts. 

When I am manic I feel like I actually enhance the lives of those around me. That I am strong and capable, an asset to society, and that I am helpful to the people that I care about. Unfortunately this is ALSO on overdrive. I get cocky. I feel superior. It is EXTREMELY unattractive. 

Then there is the “Mixed State”, which I’ve touched on before, but this post is already a virtual book, so I’ll talk about that in depth another day. 

This is all very exhausting and, in spite of struggling with it all for literally 28 years now, I still don’t always recognize the symptoms at the onset of a mood change. I’ve gotten better at it, but it’s a constant struggle. Also, because I am “rapid cycling” (as opposed to those whose moods last for months at a time) my moods, along with aaaalll of these symptoms,  can make the complete cycle from depression to mania and then to “level” several times in one day. USUALLY the change will happen once every 24 hours, but sometimes it’s several times in one day and sometimes a mood will last for a week before it “flips” to the other. 

“Level” is the “goal”, although I don’t really think that it technically qualifies as a goal because (other than finding the proper medication/s) there is very little effort that can change these things. Some things that help include getting the proper amount of sleep (I sleep exactly 8 hours EVERY night), maintaining a tight schedule for taking my medications, tracking my moods, and being very self aware in terms of subtle mood shifts. Hyper-analytical, really. But NONE of these things, even when all executed perfectly, guarantees “level”. 

How does this all affect me when I AM “level”? The answer is: A LOT. I wonder which of these people is the real “me”. Am I empathetic and compassionate, or is the REAL me callous? Am I strong and capable, or am I a fraud who plays strong and capable on TV? Do I cry easily, or am I emotionless and cold? My answer, when I can see clearly (but not TOO clearly haha) is that I am an amalgam of these things. I am more prone to tears than the average person. I am kind and compassionate, with a tendency to put the needs of others ahead of my own. I still shortchange myself in terms of confidence, but I’m improving. I am strong, capable, and resilient. I am interesting, intelligent, and worthy of love and attention. I do not have all of the answers to life’s problems, but I give good advice (although I  rarely see how my OWN life would benefit from the same advice). I am a good problem solver, and thinking outside of the box is my specialty. I also struggle with confidence in my decision making skills, because I know that any decision that I make when level is likely to be changed when my mood plummets or elevates. I have to continually remind myself of the decisions that I’ve made and that I was level when I made them. 

“Level” has been coming more frequently in the past couple of years, thanks to an excellent doctor who truly listens to me and my symptoms (literally a first for me) and he is extremely intuitive in the tweaking of my medications (truly, he has an incredible gift). I also attribute my level periods to my diet. Cutting sugar out of my life has given me clarity that I have never had in my life. It was hard at first, but I don’t miss it often believe it or not. Drinking more water helps, which makes sense when you consider how much of the human brain is comprised of water and how much the proper electrical impulses in your brain rely on. Keeping a journal (in addition to my mood tracking app) helps me to see my thought processes more clearly at each stage as well. 

Stigma Doesn’t Die In The Dark

I want to talk about my recent medication issues, for anyone who cares. I hear a lot from people who tell me to stop taking meds because they are “poison”. Bipolar disorder is a genuine illness with physical AND emotional symptoms that OFTEN requires medication (depending on their severity). I would never tell someone with epilepsy that they should stop taking their meds, so why would anyone tell me to? 

Anyway, I’ve been working with my doctor to stop taking my antidepressant. I’ve been taking it for ten years and it has started making my moods unstable. Before I lost any weight I was taking 120mg of Cymbalta per day. As my weight decreased my dosage had to as well. That was the case with all of my meds. I was down to 40mg/day, when we decided to take me off completely. It’s a slow process of stepping down incrementally. At 10mg/day I began having dramatically increased irritability. Losing my patience over every little thing. Overwhelmed to the point of crying in the bathroom at work, several times per day, only to be absolutely fine ten minutes later. This went on for a week, and I tried deep breathing, meditation, calming music, CBD oil, and aromatherapy to manage the symptoms. Three days ago I decided to return to 20mg/day. This small tweak has made all of the difference. My moods have stabilized, and I can function again. 

I realize that there are reasons that people choose not to take medication for mental illness. When the symptoms are less severe, a person can choose to manage them themselves. I don’t think there is anything wrong with that. I envy those who have the choice, because I do not. I have spent time in a mental hospital due to being inadequately medicated. I do not want to ever have to do that again. I was raised by a woman who was unmedicated for most of my childhood, and I never want my son to be exposed to that. Back then, bipolar meds were experimental and she had few options. Had she had the medications available to her that I do now, my childhood would have been far different. She did the best she could because she loves me with all of her heart. I do the same for my son. I take my meds for the people who love and depend on me, and I refuse to apologize for that. 

On Being a “Good” person

You know, being a “good” person is subjective, but I think that I’m a pretty good person. I want to talk about that. People tell me that I’m a “good” person a lot. When they say it, they SEEM to be thinking that it is just my natural state. That I am inherently good, and always have been. This makes me think that many people don’t feel that it’s possible to be better than they are. This is flawed thinking. I often have to remind myself to do good things. I often have to take a moment and ask myself what action the person that I strive to be would take in any situation. I am so imperfect, as are we all. The ONLY thing that makes me a “good” person is the effort that I put forth to be one. Effort = everything. Do I fail? Hell yes I do. Over, and over, and fucking over. But keep trying. The more effort that you put into reminding yourself to do the right thing, the more easily it will come. Ask yourself who you want to be, and then do what that person would do. It is hard, although I make it sound simple. But try it. My mama always told me that the hardest thing is always the right thing to do, and she was pretty much right about that. 

A Mother's Love

When I was a teenager I saw the movie Stella. It is a movie in which Bette Midler plays a single mother who, having raised her daughter to her early teens, realizes that the girl would be better off with the opportunities that her father could provide. In a gut wrenching scene she basically tells her daughter that she doesn't want her around so that she will stay with her father, because that is what she knows in her heart is best for her. 

I didn't understand that movie at all when I saw it. I cried, but I didn't UNDERSTAND it. Not like I do now. There is truly nothing like being a parent. I'm not one of those people who thinks that everyone should have a child or that a person's life is incomplete without the experience. But it is a brain-altering thing, being a parent. And sometimes I am felled by the awe of it. The knowledge that, without hesitation, I would do ANYTHING for my son. I would lie, cheat, steal, kill, and/or die for him without question. The knowledge that although my happiness matters, it is directly tied to his. I couldn't choose my own happiness over his if the choice were given. 

Chasing Normal

It's exhausting. Sometimes it's excruciating.  It feels like fire in an enclosed room. The pressure builds, and eventually the air runs out and the fire extinguishes. The windows didn't break this time, but the interior is unsalvageable. The heat subsides and I can focus on things besides the pressure and the pain, but then comes the let-down. Despondency, followed by increasing dissatisfaction with everything about myself and my life. The things that feel so incredibly unjust in my world are suddenly at the forefront of my mind, and I am overtaken by the futility of railing against them. 

Some days I wake up and I feel cautiously optimistic. Like "Hey, I feel good. But not TOO good, because you know what THAT means... No, this is just good. Whew!" But then my mood improves, and it happens slooooowly but steadily. I laugh harder at things than I "should". I make impulse purchases. I want to DO things. I feel PRESSURE to DO things. I have to clean. I'm hit with a barrage of ideas and plans, along with the delusional belief that I CAN and WILL accomplish them. I have boundless hope for the future. SO MUCH self esteem. Everything is going to be OK. I'm going to be happy. But I'm not, because at this point I realize that I'm manic. The realization does nothing to change it though. Nothing does. It lasts until I sleep again, usually. 

In the morning I will be a wreck. I can't handle even the smallest problem. It's like a "mania-hangover". Sometimes finding an external problem to solve, one that does not affect me directly, helps me to take the focus off of the self pity. And there is a TON of self pity wrapped in a mania-hangover. I am watching myself from a distance, deconstructing in slow motion. I want to help me, this person who is failing so miserably at life. But I am a failure in that as well. 

It's a shitty game of chutes and ladders, and if I'm lucky I'll land on "level" for a while. A day, maybe an hour. Every now and then it will last a week, but that hasn't happened in years. I can't figure out the steps to the routine though, and that is what causes me the most trouble. It's like I'm in a synchronized swimming class where the moves change every time I feel like I'm catching on.

 

"Left arm, right leg, breathe. Just like last time!" 

"Wait...but last time we did left leg, right arm... no, that's not right."  

"Breathe! You aren't breathing! Everyone else is doing left foot, right armpit...just like last time! Why can't you do this?"

And now, well, I'm tired. I'm tired of writing and I'm tired of feeling. SO tired of micro-monitoring and micro-managing my moods when it seems to have very little effect on the outcome. The only thing that it really does is give me the chance to avoid situations in which I will make an idiot of myself. Knowing that I'm emotionally fragile helps me to avoid freak crying spells in public. Knowing that I'm heading toward mania helps me to avoid getting into situations where I could spend impulsively. Things like that. 

But here's the kicker. I CAN'T always tell. AND the moods have no definitive length. Ten minutes, two hours, a day, a week... and anything (or nothing at all) can flip the switch. And right now I just need the switch to flip to "off".

Red Pill/Blue Pill

I've been messing with...er..."tweaking" my meds. The more that I do this, the more clarity I acheive. The more clarity I acheive, the more that I realize just what a detriment psychiatric meds can be. What a sham the whole psychiatric and pharmaceutical industries have perpatrated, although (at least on the part of psychiatry) unintentionally, I believe.

I do not believe that I can function without meds entirely. Not within the society that I am foced to operate. But what if instead of developing psychiatric meds, which we give to every person who realizes that the reality of life is becoming increasingly awful, we developed and used therapuetic methods for dealing with that reality AND real outlets for changing that reality? What if the artists and the progressively minded folks weren't medicated to the gills and were given affordable access to therapy that helped them to DEAL with the shitty things that meds lull them into thinking they cannot change and instead allowed them TO change these things?

What Is So Bad About Feeling Good?

I read something recently in which someone wrote that he could comfortably talk all day about his bipolar depression, but that it was difficult to talk about mania. Suddenly I realized that because people with bipolar disorder DON'T talk about it as often (most likely because it is less understood by those without the disorder) most people wouldn't know a person experiencing mania if she/he were right in front of them. So I am going to break down mania for you in a way that you can, hopefully, relate to and understand. 

Imagine yourself, age 7, on Christmas morning. Take that feeling that you get when you see the piles of gifts beneath the branches of that gorgeous, twinkling tree. That feeling of infinite possibility for all things that are good. Now hold on to that, and add to it the feeling that you get when you look at the sky, out in the country where the light pollution is absent, and are in complete awe of the immensity of the universe. That feeling in your chest, that joy. Now put those two feelings on, and wear them (as an adult) for a while. A couple of hours, if you're lucky. Days, or weeks, straight if you aren't. 

Everything is amazing. Everything feels 1000% better than it usually does. Chocolate? Omg it is the best taste and feeling on the planet. Sex? HOLY SHIT you can't get enough. Orgasms are more intense, and your inhibition is practically nonexistent. You feel SO GOOD. You feel intelligent. Sexy, even. Your self esteem is through the roof. Money is no object, and the moment is meant to be lived in! God forbid you meet someone, for the first time, when you are manic, because they will instantly be impressed and think you have it 100% together. (Pro tip: Interviewing for a job when you are slightly manic works well for this reason.) 

Wait, what? Slightly manic? Oh yeah, there are varying degrees and various TYPES of mania. The mania that I just described is mine. 90% of my mania is euphoria and elevated self esteem, with very little danger to myself or others. I can overspend, and the quality of my driving suffers, but otherwise I'm mostly giddy and fun. You are, no doubt, wondering "what's so bad about feeling good?" Well, here's the thing: what goes up must come down. Also: an object in motion tends to stay in motion until acted upon by an outside force. And who knows what, or from where, that outside force will be. So one minute you are flying high, and certain that depression is behind you. Everything is infintely possible. The next minute you can't get out of bed. And I don't mean you don't feel like getting out of bed. I mean that your body aches, you can't talk to anyone without crying, and you feel like you haven't slept in days. DAYS. Doesn't matter if you slept 8 hours the night before, or 12, or 3. You're exhausted. You hit snooze 10 times before getting up for work, and you may not even know that you did. This is the crash, and it hits hard and fast. It doesn't give a crap whether you are at home cooking dinner, at work in an important meeting, grocery shopping alone or hanging out on vacation. You are suddenly and inexplicably incapable of blending in as a functioning member of society. 

For some people, mania is anxiety and extreme irritability. Anger, brought on in an instant. I think this type is less common, but that's just from talking to people that I know who experience mania. When it comes to bipolar episodes, more often than not, there is no discernible trigger. We each have our own mental list of the things that will DEFINTELY bring on our mania or depression, but there are far more unexpected episodes. And those lists? Carefully compiled over years of introspection and self-analyzation. People who function well in spite of bipolar disorder spend YEARS working, with and without therapists, to understand our own behaviors and triggers. We work very hard for the same things that the average person takes for granted. The average person doesn't have to wonder if what they are feeling today is genuine happiness or the beginning of a full blown manic episode. The average person doesn't have to monitor their every mood change in order to be aware, as quickly as possible, of things spiraling out of control. 

As hard as I feel I work to understand myself, my moods and my motives in life, I could not function without the medications that my psychiatrist prescribes. An antidepressant, a mood stabilizer, and an antipsychotic. They are not "magic" pills, but they ARE tools that enable me to live a relatively stable life. In that way they DO sometimes feel like a bit of magic. 

One more thing: Bipolar disorder is a preexisting condition. Before the Affordable Care Act (aka Obamacare) I was ineligible for insurance unless I obtained it through an employer who offered group insurance thst I could afford. If I lost my job I had a set amount of time by which I had to find new coverage through another employer offering group coverage that I could afford. If I lost access to affordable healthcare that covered my mental illness, my quality of life would decline dramatically. More devastatingly, so would Davis'. I can tell you now that I would not be the patient, loving, and egaged parent that I am now without my medication. 

By denying affordable insurance to people with preexisting conditions, insurers and our current administration will cause irreparable damage to the families of people who are struggling just to survive as it is. Please think about that before you support any changes to our health care laws that would limit coverage for preexisting conditions.