Living Bipolar (4 page)

Exercise in my life today is crucial. It provides me with stress relief, and working out is form of meditation. I listen to music and zone out. I find that most of the time when I workout, I am in the moment, and working out is a great mental break for me. I have a lot of nervous energy and working out provides an outlet for me. Working improves my mood and self-esteem, and usually it helps me sleep a lot better.

EXERCISE

Doing physical exercise is highly advisable for a person suffering from Bipolar disorder, but we must bear in mind that sports are highly stimulating, so it is best to practice sports during euthymia and still better, during a depressive phase even though one does not feel like it. On the other hand, it is inadvisable to do sports during a hypomanic or manic phase or if we suspect we are going into decompensation of this type.

Remember:

In these cases, physical activity is a
natural antidepressant
, but it may make hypomanic or manic symptoms worse.

-Francesc and Vieta 2006: 187

Being good to myself is one of the most important lessons I have learned. Some days can be so overwhelming with intense emotions that I don't know what to do. When these days occur I've learned to be good to myself. I try to channel this energy through working out, prayer and meditation, journaling, helping other people, talking to other people, drinking chamomile tea, taking a hot bath, naps, listening to music, and sometimes getting quiet and watching a movie helps. And when none of these things work to alleviate my mood I simply focus on getting through the day.

Slowing down myself is another important tool I've learned. My mind is always racing and my body operates at a fast level. However, my mind is frequently moving way too fast and I get frustrated because life doesn't operate that way, or I will think of a million things I want to do in the morning for the day, and then because I'm thinking of so many things I lose focus of what I need to do and I end up getting nothing accomplished. During these times I will say to myself slow down, slow down, slow down. One thing at a time.

It's important for me to make a list of things to accomplish for the day and scratch them off as I accomplish them. But I must be careful of how many items I put on the list, because if I over load myself I will become very anxious and then nothing will get accomplished.

Having a strong support group is critical, and talking to others brings a new perspective in my life. However, finding support from others is not an easy task because most people aren't able to relate to the illness. If I start talking to a casual acquaintance about having suicidal thoughts, or paranoid fantasies, they probably not know what to do and then they might not want to be around me. Even having conversations with my family can be challenging because they might get scared, concerned, and possibly overreact to how I’m feeling. Today, I have a select group of friends I can turn to for support, and a lot of times I will tell them I just need them to listen. I also have a few Bipolar friends who I can tell anything that's going on with me and they understand exactly what I’m going through because they go through the same things.

MAINTENACNE AND TREATMENT OPTIONS

One of the most important long-term goals of therapy in patients with Bipolar disorder is to prevent the recurrence of additional mood episodes. Since approximately 90 percent of patients who experience a manic episode will have recurrent episodes, it is important not only to treat the initial manic/hypomanic or major depressive episode but also to prevent subclinical or clinical relapses. Maintenance therapy is intended to achieve this objective. Mood stabilizer therapy is the mainstay of maintenance therapy for patients with bipolar disorder.

-Keck and Suppes 2005: 10-1

I am working with my doctor on this journey. It takes both the patient and the doctor for a successful recovery. The more I've learned to communicate accurately with my doctor the better things have gotten. The same is true for my relationship with my therapist. Communication with my doctor works best when I talk about my thinking and behavior, what life struggles I've had, how I’m sleeping, if I can’t function in my day to day life, if my thinking is abnormal, and if I've had any physical problems such as muscle spasms, rapid heart rate, nausea, trouble going to the bathroom, etc.

I have learned communication requires action on my part. I must journal and take notes in between doctors’ visits to provide my doctor, and for myself, an accurate picture. In communicating with my doctor I've learned to keep track of certain events, such as suicidal thinking, problems sleeping, problems concentrating, anxiety, or problems I'm having with relationships, whether personal or professional. When I get depressed and I hit a wall emotionally I try to figure out what life event triggered the depression. Additionally, I've learned that I must tell my psychiatrist any physical problems I've had, and I must get his permission before taking any type of vitamin, or over the counter medication, to make sure it doesn't interact with the medications I'm taking. For instance when I take Sudafed my body breaks out in a rash and my skin turns bright red and feels like I've been horribly burned by the sun.

But one of the most important lessons I've learned is to do homework on the illness and research medications for myself. Most of this homework has come from talking to other Bipolar people and learning through their experience what has worked for them. I then take what they've done, research the medication myself (websites such as WebMD are great) and then I discuss this with my doctor to see what he thinks. When it comes to me taking medication I don’t have to settle for feeling bad or suffering in my life. I can work with my doctor to find the right combination of medication that will work to live a full, productive, and happy life.

Relationships are hard. We wouldn’t be human if we didn’t have relationship problems. But when you are Bipolar relationships seem to be especially challenging. My mood state causes changes in the way other people treat me.

When I am feeling good, that is, when I feel like myself, I am happy, friendly, outgoing and I have few problems in getting along with others. But when I am depressed I am distant, cold, withdrawn and very sensitive. In fact, I am sensitive to the point to where the slightest comment can hurt me. When I am depressed and “sensitive” and I get my feelings hurt, I get angry, frustrated and I experience such strong negative emotions that can result in me to creating a situation where I want nothing to do with the individual who hurt me and my feelings.

Intimate relationships are an entirely different issue. When I feel good I am affectionate. But when I am depressed I don’t communicate well, I have trouble making decisions, and for the most part I don’t want to be alive.

The characteristics I experience when I am depressed affect the woman I am intimate with. When I am depressed my mood and my way of being brings confusion, frustration, and resentment in the other person. Then, the other person I am in a relationship with takes my actions personally and they think they have done something wrong to have me act the way I am acting.

I remember seeing a woman once who had no exposure with a Bipolar person, and therefore, she had no education about the illness. Although I would try my best to explain to her what happens with me when I go through my changes in mood, she was still unprepared for these mood changes. Even though I told her when I was feeling depressed and down -- and therefore gave her reasons for my change in behavior -- what I failed to prepare for is she still has feelings.

Although I thought I had done my part by communicating with her my depression, I failed to realize that when I am in a relationship it’s not all about me, whether I’m depressed or not. When I am depressed I am still responsible for my actions, and I am still responsible for how I treat other people.

Relationships take work and more work. In the past, I have ended relationships when I have gotten depressed. Instead of taking the time to work through difficulties and explain my situation, and learn solutions with my moods with the other person, I’ve taken the easy way out and I have just quit the relationship. But after so many failed relationships in my life I have come to a new awareness, where my old way of thinking and living no longer serves me.

Today I take responsibility and action on changing how I treat other people whether I feel good or bad. Part of taking action in this area requires communicating with others where I’m at that day. This requires me being aware of my actions when I’m depressed, as so far, as to not step on the toes of the others around me or rub other people the wrong way. But it takes work, more work, action and more action.

I have a mood disorder which affects my perception and I see things in black and white. I also minimize and maximize events in my life. Thus, clarity in my life is crucial when my thinking and perception is off. Bipolar people are blessed in so many ways. We really are. It’s important for me to focus on what I have in my life -- not what I do not have. The easy road in life is to point out every little detail which is lacking. The abundance in life comes from being thankful for all the gifts I already possess. No matter how bad things may get at times, I know if I just hang in there life will get better. And as soon as things get better I enjoy the good things life has to offer. Life is beautiful when I see life as beautiful.

I have a strong faith in God, and deep down I believe He has been involved in my entire recovery process. Despite my strong faith there have been periods in my life where I have doubted and cursed God for my condition. I have questioned myself as to why God would create a person to have the illness. When I am in the hell of the illness it’s hard to accept God is there with me and it’s hard to accept that God will heal me. But my experience is God is there working in my recovery whether I choose to believe it or not.

Today I have faith in the process, and I recognize God is in the process. God is
G
ood
O
rderly
D
irection. I trust and believe, that no matter what, things in my life will improve if I follow the direction of recovery as outlined in this book.

My life today is good. I can live with the illness, and more importantly, I’m learning how to work with my illness. I have limitations and I accept that. Even though I have limitations I still have choices in my life. The fact is that even when I’m depressed, even when things are terrible -- I know I will get through it. That’s been my experience. Life still happens no matter what I do. The best thing I can do is learn to work with my illness and work with what hand life deals.

It’s easy to fall into self-pity, and fall into the trap that I am all alone. But this is not factual. Everyone has good days. Everyone has bad days. Everyone feels happy and everyone feels sad. The bottom line is everyone feels and everyone has experiences just like me. Therefore, I am determined to overcome any mood, or set back I experience with the Bipolar illness.

Today, I accept I have the choice to be active in my recovery, or to stand still, and not get better. Recovery for me is something I do every day, no matter what situation or mood I am in. In the past, I did not have any tools in dealing with the Bipolar illness, and consequently, my life was complete chaos. However, today I work on living one day at a time.

Now you are given the same choice:

To take an active role in your recovery and get better, or to continue the same old routine living in chaos.

Which path will you take?

This book is meant to be suggestive only. We are by no means the sole authority on how to recover with the Bipolar illness, yet we realize this book is an important first step.

Interview with Psychiatrist Dr. Joseph Mavica

Interview with Dr. Mavica

What else can Bipolar people do to help themselves, aside from taking medication?

There are a few things you can do. But we should probably start with psycho-education. Psycho-education would be knowing as much as you can about the disorder, and what that disorder is for you and for each individual. Now there are many manifestations of Bipolar disorder -- we’ve got the textbook diagnosis of Bipolar disorder, but there are many different colors of that depending on the person’s personality, and if they’ve had substance abuse problems, depending on if there are other problems, such as, anxiety, obsessive compulsive disorder. So all these things color the individual’s type of Bipolar disorder.

Once you understand your illness though:
How does it manifest itself? What are the first signs of the illness?
I think those are important things.
Is there a decreased need for sleep? Or is there some sleep disruption? What’s the cycling pattern? Do you go from a depressed phase to a manic phase? How long are you in a normal phase before you might switch -- how rapidly do you switch? Does the weather or the climate affect you? Is there a seasonal pattern? Is it more apt for you to get depressed in the wintertime or more in the summer time? Is there some specific pattern you know about with your illness?

Knowing this information just takes time. It takes charting the mood. It takes maybe reading about Bipolar disorder, educating yourself as much as you can; talking with your doctor as freely as possible.

Are there any books you are thinking of that people can educate themselves with?

An Unquiet Mind:
A
M
emoir of Moods and Madness
by Kay Jamison is a very good reference. This autobiography considering her stature in the mental health field, and also her recollection of her mood problems is significant. Really, any of the celebrity biographies are good sources. If you really want to get esoteric you can read the “Bible:”
Manic Depressive Illness
by Fred Goodwin and Kay Jamison. But really I think just the experiential world of anybody that has gone through it; any book that talks to that, you will see the differences.

Some of the actors and actresses we know that have the illness you would never know by seeing their work. They are in the acting field, they are artistic, and you never think of them as being Bipolar or having a psychiatric illness. Those are the good places to start. There are also support groups. Through the internet you get a lot of information. There is NAMI: The National Alliance for Mental Illness. These are all good sources to learn from.
The more you know about your illness
, I think that’s the first thing you can do for yourself aside from taking appropriate medication.