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cyclothymia 101

Travelling whilst Cyclothymic

I had a disappearing comment on the blog today asking for advice or thoughts on long-term travelling/backpacking whilst cyclothymic™. I think it’s something I can offer some comments on, as I do have some experience.

I try and travel regularly: living in Europe (although I don’t get to be a proper European for much longer *weep*) gives me a huge number of cheap options for getting out there and seeing the world.  My two most recent trips were one trip for 12 days backpacking through 4 cities and 2 countries, and a 3 day trip to one city. 10 years ago, before I was diagnosed, I did a massive backpacking trip around the world for a little over 6 months. It’s this experience I’m mostly drawing on here.

In my 6 months of backpacking, there were exquisite moments, but there were also truly awful times.

I vividly remember sitting on a bed in some anonymous budget hotel in Montevideo. It was early afternoon and I’d been sleeping for about 14 hours. I was looking at the window and, for the first time, I had just the most visceral understanding of why they put locks on hotel windows/don’t let you open them. I sat and I wept. Then the phone rang, I stared at it for ages, trying to imagine who could be phoning me. I eventually decided to answer, in my halting Spanish. It was a friend I’d met a few days earlier and who I was travelling through the country with. She wanted to know if I’d like to go to McDonalds. I agreed, and met her in the hotel lobby 15 minutes later.

McDonalds didn’t cure me, of course, I was depressed for a lot longer than one lonely hour sitting on a bed. But it was a reprieve from myself, and that was all I needed to get through the rest of that day.

I hate Uruguay now – and it has nothing to do with the country or the people – only my truly terrible emotional state while I was there.

That isn’t really advice.  But it is an introduction to the possibilities of travelling.  You’re away from your support networks, you might be disconnected from online support too – although that’s less common now, but when I was travelling 10 years ago Wi-Fi was not really A Thing, and I didn’t take a mobile phone with me. You’re also less accountable – how long could you fall of the face of the planet for before someone noticed, compared to when you are at home?

Here are a few things to consider if you are considering travelling and have cyclothymia:

  1. Travelling is tiring and will disrupt your sleep patterns. For any flight more than 6 hours long, you need to schedule a day off immediately following landing/arriving to dedicate to sleep/sitting around/having a very low energy day.
  2. For long term travel you need to build routines into your stops. Can you get a part time job at a place which you plan to stay at for longer? Do you want to enrol on a language course for an hour or two each morning for a month? Is there a place you can go everywhere to give you a sense of familiarity (personally, and slightly shamefully, I’ve been to either Starbucks or McDonalds in every country I’ve been to – and I’ve been to a lot of countries). When I’m starting to get hypomanic, or depressed, that carbon-copy familiarity can help ground me a bit.
  3. What are your strategies for dealing with dangerously low mood (think me, on a bed, looking longingly at a window, in a shit hotel in Uruguay)? Will you be travelling with a friend or partner; do you have an international calling bundle on your mobile; is there someone who will accept a collect call at any time of day (time zones!) and can talk you down? Have you got travel insurance with an affordable excess, on which you fully disclosed your bipolar/cyclothymia? You’ll need that to access a consultation with a GP/short term medication/review of existing medication if you are already taking it. Similarly, if you are taking psychiatric medication, you’ll probably have to get repeat scripts whilst you travel – so you may need a psychiatrist’s letter, and to confirm your particular medication is available in the countries you are travelling to.
  4. Sleep! Sleep is so important to maintaining my mental health and sleeping in hostel dorms is pretty much the opposite of achieving good, quality sleep [case in point; my experience in Singapore is number 4 on this Buzzfeed list of strange-shit-that-happens-in-hostels]. It can be a good idea to both budget for and schedule time in private rooms or hotels. 2-3 nights uninterrupted sleep, especially if you have an en-suite and a TV so you can just hole up for a few days and reset, is about the best thing you can do to take care of yourself. I did this a few times whilst travelling and it was money well spent every single time. My more recent short-term travel is something I still plan around having one to two days recovery time when I get home.
  5. What are the hardest things for you about being either hypomanic or depressed? For me, it’s the nervous/anxious habits and fixations. I cannot cope with ‘dirt’ – real or imagined. Hygiene standards whilst backpacking can be pretty variable. Your fellow backpackers may have some fairly singular ideas about what constitutes appropriate bathroom etiquette, and don’t even get me started on kitchens. What strategies are you going to have to deal with that? If you don’t have funds to decamp to a mid to high range hotel at the first sign of trouble, you’re going to need to be more creative. I carried a thin blanket, and a few items of cutlery which I resorted to when I stopped trusting the cleanliness of bedding and self-catering facilities (I’m in a low mood period right now, and just thinking about using unfamiliar cutlery is making that dragon of anxiety rear up in my chest). I also, on my long trip, travelled with my-then-partner and she did sometimes take up the job of scoping out the cleanest bathroom or pre-washing cooking material. It helped that she tended toward obsessive cleaning in this respect and appreciated terror at ‘dirty’ things.
  6. Travel can be lonely. Don’t think for a minute that taking a laptop or tablet and staying up to date on social media is going to be a substitute for hanging out all evening with your oldest friend and putting the world to rights. There can also be a real pressure to be seen to be having a good time whilst travelling. I found it really hard to update friends (with whom I would normally discuss my mood) that I was experiencing depression whilst I was travelling. Because who could be unhappy whilst on a picture-perfect Brazilian beach, right? A good old fashioned paper journal where you honestly record how you’re feeling can help ‘get it out’ (I still have mine – it records the highs and the lows from my trip and I’m glad I have the honest account of it, as well as the edited snapshots of me smiling on beaches and in rainforests) You might also try and schedule regular Skype dates with close friends where you give yourself enough time, and privacy, to actually talk properly about your feelings. Finally, you might want to travel with a friend, or arrange to travel with other backpackers you meet for short (or long!) periods.

I can’t stress enough that making the decision to travel is not all about planning against the worst. From a cyclothymia point of view, I think there are a lot of positives to long-term travel.

Travel is good.  Personally, when cyclothymia gets oppressive or I start cycling too fast, a change of immediate surroundings helps ease that sense of crushing weight or inescapable thoughts. Travelling – especially backpacking – is about doing just that; being able to pick up and run.

I also find it really hard to be mad around people – when I’m feeling particularly mentalist and maybe having ‘strange’ reactions where I talk too much, or get distressed by certain noises, smells, or just get caught talking to myself – I’m mortified to have to see the people who witnessed it, again. The advantage of travelling is that when you’ve made a ‘bad’ [read: they’ve all clocked me as a mentalist] impression, you can just move on to your next stop and never see those people again. Problem solved!

Someone said to me, before I travelled, that your worst day travelling is still better than your best day at home.  I don’t know if I’d make quite such an extreme claim, but I do think it’s easier to keep your mood moving on when you are in the midst of a lot more activities, a lot more options, and a lot less rigid routines. Yes, you need to make choices and maybe put in place a few more protections/insurances than your ‘standard’ backpacker, but if you’re doing that in your daily life anyway, it’s not a particularly onerous task and has much bigger rewards.

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