Hypomania is fun!

So it's 1:30am and I'm awake, wishing that Michael or someone was still up so I could chat with somebody. I've already exhausted a few avenues on the internet, and I'm currently reprogramming my phone. What does all this mean? I think I'm hypomanic. I'm not feeling like spending my money or traveling, but I can't sleep and I'm thinking about way too many things at once. And I'm smoking.

I'm taking my meds, though the dosage changes all the time. It just depends on what free dose the doctor has. The drug companies give him free samples and he gives them to me, so I've been on 15mg, 5mg, and now 10mg of the same stuff. He just gave me a big bag full of more today, so I should be fine for the summer while I'm away.

So what can I do about this? Is mania coming? I don't think so. I don't feel like it's going to get out of control. I feel like I'm just a little high, but not dangerously so. I think it will be good to get me through the summer. Oh! Wait! Look at me, displaying addict behavior. "I like this high. If I can just maintain it...."

So what do I really do? I think I'll split the 10mg and stay on a consistent 5mg for a while and see if that balances things out. It should even out within the week, and if I still can't sleep next week then I'll have to call the doc and see what to do. I've got to make sure I'm taking the best care of myself that I can!

I'm in: Stop Self Hate

There's a lovely lady on Twitter (VoiceinRecovery) who decided to start a new campaign to stop self hate. "Because I am ready. I want to prevent eating disorders, self hate, self harm, and radically work towards self love, respect," she says.

And how do you stop self hate? Well, it's the little things. It's all about the self care things you do everyday like eating right, but not obsessing over it. Exercising, but not too much. Everything in moderation. Just being comfortable with yourself. One of the things I've started doing is buying myself flowers. They brighten up my room and keep me happy. I always get different types so that I can have different colors and blooms.

Some things I can do to love myself a little more is forgive myself for gaining some weight. It's ok. I've been through a lot lately, and it's ok to have fallen a bit off track. It doesn't mean I'm a loser or hideous or anything. In fact, I'm probably at a healthier weight now. My body has settled. I need to be ok with it, even if it means buying bigger clothes.

So what can you do to love yourself a little more? Be a little less judgmental? Show yourself the kindness you would a friend.

Stop self hate.

Moderately abled

Here's something I found interesting: "Bipolar disorder is responsible for the loss of more disability-adjusted life-years than all forms of cancer or major neurologic conditions such as epilepsy and Alzheimer's disease, primarily because of its early onset and chronicity across the life span."

I know my mom hasn't worked in 14 years, and probably never will again, even though she's otherwise perfectly capable of working. Unfortunately, she gets really manic or paranoid and runs herself out of a job within 6 months. There seems to be a theme online, too, that the Twitterers and bloggers are all writers for a living. Is it because we bipolars don't play well with others? Are we hard to work with? Who knows, but we do have higher disability rates than others, apparently.

We're all crazy here

"The U.S. attracts people who believe they can achieve a better life," Schlager says. "They come to believe they can pick up and start again. It's a self-selected sample of people who are grandiose and impulsive. It takes a certain suspension of belief to actually believe you can come here and make it happen. Those are a significant percentage of people on the bipolar spectrum."

The U.S. has the highest bipolar rate out of 11 countries studied. Of course, countries with more stigma had lower rates, probably because of a reluctance to talk about it, but the researchers used the same criteria all across the board in one-on-one discussions with people.

So why is the U.S. so crazy? I like the theory above. The theory that it takes someone a little hypomanic to think they're going to succeed halfway across the world with no money and not knowing the language. Hell, I think I can make it in Austria all the time. Luckily, I won't move without a job. Homeless I will not be, no thanks. My mom does it sometimes, and I'm not interested.

Anyway, it's pretty neat to think of a country of individuals and adventurers as a bunch of bipolars, too. Apparently, we're all crazy here.

A gene discovered

Why does the news media not care? This is huge! They found a gene that may have something to do with bipolar disorder:

"Our results provide strong evidence that genetic variation in the gene NCAN is a common risk factor for bipolar disorder," concludes Dr. Cichon. "Further work is needed now to learn more about the biological processes that NCAN is involved in and how NCAN variants disturb neuronal processes in patients with bipolar disorder."

There's your genetic testing and all sorts of moral questions right there. Should we test for it? What does it mean? Does it effect treatments? Can they do specifically tailored treatments for the gene? If you present with symptoms and yet don't have the gene can you be diagnosed bipolar? If not, what are you?

So many questions, and they'll never be satisfactory answers, methinks.

This is so not me right now

I like this, from over at Beyond Blue: Hypomania usually takes a bad habit and multiplies it by, say 100.

Damn, girl, ain't that the truth. What bad habit do you have? Let's make it 100% worse! Like to snort blow? Let's do it sunrise to sundown! Like to sleep with people? How about 5 this week? One for every day, you know!

At least, that's what my mania looks like. It takes me to awesome places of danger and expense of health and sanity. My hypomania looks more like shopping and overextending myself, which is probably good for me (well, not my credit cards). I also like to sign up for marathons and book plane tickets. A strange mania, indeed.

So where am I right now? I'm pretty depressed. I can feel it lurking under the surface. I just want to sleep, but I'm not tired. I just want to eat, but I'm not hungry. I need to work out, but my body just feels like it's dragging when I do. And I am not enthusiastic about anything. I don't feel so hot.

We're doomed

Interesting article about the "epidemic" of mental illness in the U.S. Apparently, they think it's caused by the very meds used to treat us. Here, you read:

Prozac and other SSRI antidepressants block the reuptake of serotonin . In order to cope with this hindrance of normal function, the brain tones down its whole serotonergic system . Neurons both release less serotonin and down-regulate (or decrease) their number of serotonin receptors . The density of serotonin receptors in the brain may decrease by 50% or more . As part of this adaptation process, Hyman noted, there are also changes in intracellular signaling pathways and gene expression . After a few weeks, Hyman concluded, the patient's brain is functioning in a manner that is "qualitatively as well as quantitatively different from the normal state" (Hyman & Nestler, 1996, p . 161).

In short, psychiatric drugs induce a pathology.

Basically, the drugs tell your brain to quit with the serotonin production. I always wondered what exactly they were doing up there. It sounds like a not so hot thing, and my theory that once you take drugs you can't stop seems to go along with this article. Once your brain makes an adaptation like that, it relies on the drug. So if you go off drugs, like I did, you're screwed.

Life is a symphony

"A new study in Biological Psychiatry implicates a brain protein called Piccolo in the risk for inheriting bipolar disorder. In the orchestra of neuronal proteins, Piccolo is a member of a protein family that includes another protein called Bassoon. Piccolo is located at the endings of nerve cells, where it contributes to the ability of nerve cells to release their chemical messengers."

And the flute gives you schizophrenia. I suppose researchers ran out of abbreviations and started using common names. I would love to hear a discussion on all of this. I bet it's confusing as hell.

Anyway, finding a genetic protein involved in bipolar is a great start. Perhaps they'll be able to do testing eventually to see if people really have bipolar, and then maybe develop some drugs that target that protein. Or figure out why the ones we have work. Science is fascinating.

Abilify I love you

I'm still thinking about how I'm going to get the doc to keep me on Abilify. I mean, it's approved for adjunct therapy with lithium, so it's not like I'm off label. I wouldn't be taking it long-term when you're not supposed to; it's encouraged for people with bipolar 1, which I have apparently morphed into.

Morphed? You say? But Anne, you always had psychosis and severe depression with alternating psychotic mania. No, I didn't. I used to just get really depressed and occasionally I would get up and spend money and sleep with people. Party a lot. The depression has gotten deeper over the years, and the psychosis is new. I don't think I'm too bizarre on the outside, but my thoughts get really bad. So it's moved to bipolar I over the years.

And what's a good treatment for bipolar I symptoms? Abilify! Or it's cousins. But I've been through them. I mean, not Geodon, but Zyprexa (made me fat), Seroquel (puts me to sleep). Abilify really works. Ok, so I end up a little hypomanic, but I'll take the credit card debt over psychotic depression.

So how do I get him to keep me on it? I guess I just have to beg and plead. I'm sure he can get me into the patient assistance program, which should cut down the cost significantly. It really works for me, doc, really!

Back on bc?

I've always wondered what your menstrual cycle does to bipolar. Since I haven't been on birth control, I've been a lot more depressed.

Anyway, "premenstrual mood exacerbation may be a clinical marker predicting a worse presentation and course of bipolar disorder in reproductive-age women." In other words, yes, your menstrual cycle does have an effect on your moods. Kind of a duh, but in some women with bipolar it really has an effect. I think that might be me. I've been noticing in the past year that before my period I hit a point of depression, and after I get a little manic. I've noticed it's a monthly cycle up up and down, and it's tied in with my period. I know you wanted to know this.

I suppose I should go back on birth control and see if that does something.

The full monty

So there's a cool chat on Twitter that happens on Tuesday nights at 9pm (#mhsm). Tonight they were talking about disclosure; when and who to disclose to, what the repercussions are, etc.

I'm one big contradiction. Everyone in my life knows I'm bipolar. I tell people usually the first or second time I meet them. I like people to know up front, and I like to have the people around me educated about the illness. I find it easier to just be me and have people who can call me out on my behavior if it gets too one direction or the other. It's also good to have people in your corner when you're not a very good advocate for yourself. Saying, "I don't feel good." to someone who knows how bad you can really feel is easier than getting yourself to a doctor. So really, disclosure is totally selfish.

But hardly anyone knows I'm sober. Isn't that odd? It's not like I care if they know, but I do, sort of. I mean, everyone drinks, and everyone is used to me drinking heavily. It's part of my personality, like being bipolar is. So what happens to a me without alcohol? I'm just finding that out, and I'm not sure I know how to represent myself yet.

Strange, huh? That I should be ok with the debilitating illness and not with the minor alcoholism?

Separate worlds

"You are not your illness. It's just something you have that flares up every now and again. It's not you." - Julie

I need to learn how to separate me from the bipolar. I tend to think of myself always as ill first, and everything else second. But who am I without the illness? Well, I'm hella optimistic, I can tell you that. I'm in a spot right now where anyone would be depressed, and I'm ok. I really am. I'm confused, and a little torn, but I should be. It's natural to be up in the air about everything when everything is up in the air like it is. But I'm optimistic that it's all going to work out. Everything is going to be fine; better, even.

The horrible, suicidal depression I slipped into the other week isn't me, I have to remember that. It's not who I am, it's just a thing that happens. A flair up. It's like having psoriasis or some other disease where the symptoms present sometimes and you have to fix them with medications, and then they go away for a while. Going off meds always reminds me how much I need them. I mean, look at my posts. I'm suicidally depressed and yet questioning my diagnosis. Dumb. Makes me laugh at how delusional I can get, but scared, too. I need to keep myself on track. It's not ok to go off meds.

Bloated goat

Julie and I went over some of the characteristics of mania and depression again tonight. "Sounds like mania, a little, but you have some of the depressive qualities, too. Maybe it's the meds?" she said. I don't know. I've been feeling agitated since before I started on the meds. Thursday was my first panic, and I didn't start the new meds till Thursday at bed time.

So what is it? Do I have to put a label on how I feel? Can I just say I feel extremely agitated, irritable, ansty, unnerved, like everyone can see just how messed up I am. I feel like I can't stop eating no matter how much I don't want to eat any more. I feel bloated to incredible proportions. I just feel sick. By all accounts I sound and look just fine. "You actually look much better rested this week," said Julie. Probably the awesome catatonia I fall into at night on the Zyprexa.

I want off the lithium already. I don't want to go back to doing monthly blood work and being a bloated goat, eating everything in sight. Can't I just go back on the lamictal? It has a generic, right? I think it was still $100 at CVS. I need to price these things out. And what the hell is the Celexa doing? It's the antidepressant, and I suppose I'm not suicidal anymore, but that could be the Zyprexa. Jesus. If I can't tell and I'm with me all the time, how is the doc supposed to figure it out in 15 minutes?

Pick a feeling, any feeling

How am I feeling now, after a few days of the new meds? I don't know. I think I feel kind of flat. I haven't had a suicidal thought lately, and I've even stopped researching it. I lost interest. Isn't that funny? I lost interest, like it was some sort of neat path I could be researching. Bored? Hey, let's come up with ways to kill ourselves! Like a game that I just stopped wanting to play. How bizarre.

Do I feel better? What is better? Not being suicidal is better, I suppose, but what have I traded it for? I've traded it for the incredible urge to eat and the feeling that my stomach is being twisted into knots. I've traded it for the cold sweats and the urge to vomit, which comes in waves with the sweats. I've traded suicidal thoughts for physical pain. A good trade? You tell me.

Before, I was scared. I never knew when the thoughts were going to come. Everything was dangerous because everything can be used as a weapon. Now, I'm just getting fat, which makes me depressed, and my brain hurts. Physical pain for mental pain.

I know when I see Julie on Tuesday she's going to go through the list of depressed or manic characteristics to see where I am. But I wouldn't have any idea how to answer. I can only focus on my physical feelings right now. And maybe that's the trick of big pharma. The meds don't make you less manic or depressed, they just make you so physically sick that you can't even think about how mentally ill you feel. Smooth move.

Temper tantrum

"But I never move on from bipolar. It isn’t a thing. It’s everything. It’s sleep schedules and med schedules and bipolar symptoms and medication side-effects and moods and therapy and doctors and control every day of my life. There’s never a break. Not for a moment. I’m bipolar now. A minute from now. A day from now. A year from now. Always sick."

I felt bad the other day when I mentioned that I hate having the diagnosis of bipolar. It's a life-long, debilitating, deadly illness that no matter what kind of medicines I take or meditation I do is not going anywhere. It's a part of me: it's my personality.

I can never escape the fact that I'm bipolar and need to be on medication for the rest of my life. Sure, I can stop taking medication, but that's just letting the illness takeover.

Natasha Tracy(the woman who wrote this) also had a neat article on the worst things to say to someone with mental illness. Amazingly, people do say that stuff. My dad says that stuff all the time. Actually, I think he may have said all of those things to me at one point, which just ups the guilt you feel and makes you hide your symptoms. A hidden madness is more dangerous, I think. When people see you're crazy they tend to help. But when you hide everything no one can help you.

So no, it's not fair. It's not cool that I have to take medications that make me a zombie and disrupt my thought processes. It's not fair that I have to be careful of sharp objects. It's not fair that anything I do that's too much fun I worry is mania creeping up on me. It's not fair, damnit.

It's a zombie's life

"...Zyprexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert." Zombie.

Celexa also makes you tired and dizzy when you stand up. Zombie.

And lithium? "Be careful if you drive or do anything that requires you to be awake and alert." Zombie.

I've been sleeping since I got off work. I just came upstairs, laid down, and that was it. I woke up about 3 hours later and started gorging. Again, it's just little food, not meals, but it all adds up.

I don't want to be a lightheaded zombie who sleeps all day and, when awake, has trouble putting together responses to customers. I really should go out and do something, but I'm kind of afraid to drive. I could take the metro, but to wear? It's all a little overwhelming right now.

I feel like I could just lean over and fall right back asleep. I bet I could. I suppose I should cut myself some slack - it's only day 2 of meds - but I don't want this to become a pattern. And it's Saturday, for crying out loud. There's a lot to do out there in the world. I think.

Oh so heavy

I feel like my tongue is dead. A big, useless piece of flesh is resting on the bottom of my mouth between my teeth; just lying there in peace, content to be unresponsive. And the fuzz. Wool has started to grow between my ears. There's a giant cotton ball being fluffed to brain-sized dimensions and spread out like a blanket inside my head.

I couldn't think of the word receipt.

I slept through my alarm.

I'm starving, but I've already eaten. Actually, it's not hunger, it's the need to keep my mouth moving so it doesn't sew itself shut. Each moment I don't open it, the heavy my tongue feels. It's like I can't even open it. My jaw is heavy, too.

As I stand here at the computer, I get the feeling I may topple over. Just lean a little too far to one side and down I'll go, straight down like a tree that's been chopped. It's taking all the effort I have to stay standing - if I sit I know I'm going to curl up in the chair and sleep.

Day 2 of Zyprexa, lithium, and Celexa.

High functioning bipolar

I'm not feeling very articulate today, so don't mind my rambling. I was reading a great blog this morning and came across a post she did on being a high functioning bipolar person. She talks about just how much mental energy it takes to be "normal." To show up for work, pay your bills, walk the dog. It sucks the life out of you.

"So all the appearance of my functioning is paid for by utter decimation and exhaustion the rest of the time. I don’t have energy or brain space left to read, see friends, date or do pretty much anything else. The last thing I want to do is leave the house. I want to sleep. Forever. And ever."

It really takes a lot of mental energy just to act normal. I suppose that's why I sleep a lot: I use up everything I have just trying to be perky and appear sane. In my head, it's all swirling around. Sometimes my inner voice is screaming things at me, but I look perfectly normal on the outside.

When in doubt, ask!

Since my mind is so messed up right now, I thought I'd ask some people if they remembered times when I was manic, or depressed, outside of the horribly obvious - like suicide attempts.

"That time when you went home with the guy in the snowstorm was pretty manic." said Tanya. Yeah, I kinda disappeared for 3 days.

"You get all bug-eyed and physically ansty." Micheal said. "I guess it's hard for you to see it, but you get really agitated and obsessed."

Good stuff to remember. I think I'm ready for the doc tomorrow. I'm just hoping the inclimate weather doesn't get in my way.

A bipolar's daughter

I just sat down with my dad to try and think of some of my manic/depressive episodes. "Where did it start?" I wondered aloud. "Well, I think it was after mom got diagnosed. But what's funny is you would be in a bad mood and then I would take you out and you would be fine. It was always only around her."

It was always her. She was always the reason for my moods; she could bring me up or drag me way down. My dad would find me hiding in the closet cowering from her, or we would be 100s of miles away at the beach (and before the cell phone era, this was called disappearing). She would let me sleep in and skip school, or I would run away and hide in the woods. It was always her: my moods were in reaction to her.

So maybe she was diagnosed first, but I remember wanting to go to the psychiatrist when I was 14. I had already been a cutter for a long time, and I was starting to get really "crazy." I can't remember what that felt like, I just remember being worried about myself. Maybe I was really worried about her and just projecting? Maybe I was fine?

Maybe I AM fine. My suicide attempt came after a huge hormonal flux for my body, coupled with a huge amount of alcohol and a shitty life at the time. My next big episode happened when I was unemployed last time, and I tended that with food and copious amounts of alcohol. And this time? I'm unemployed, again, and my situation would make anyone depressed.

Really. Maybe it's all ok? Maybe it's situational? Maybe she's the one with the disorder and I've just got "symptoms" that show up in times of crisis?