Category Archives: self-hood and cyclothymia

Limitations

I grew up, like so many people my age, being told we could be anything, achieve anything if we only set our minds to it.

My parents are the result of post war baby boom. The world changed beyond recognition in their lifetime. They built me up to more than they ever imagined for themselves and they did it in good faith. They are a generation of optimists.

We, at the top end of the “millennial” generation, have come to terms with the idea we’re going to have lower social mobility than our parents. We’ve come to terms with the idea that we can enjoy avocado on toast but not ever get a mortgage.  We’re more educated but underemployed and living on temporary and zero hour contracts.

We get to do that collectively.

What I don’t get to do collectively, is come to terms with the other limitations I never expected. The limitations which no amount of work, witty think pieces, or economic change will alter.

Tonight this came, unexpectedly, into focus, when I watched a BBC 2 show called “Astronauts: Do You Have What it Takes?”

When I was a kid I wanted to either be an astronaut or a vet. My maths and biology was atrocious during my A Levels because I was a neurotic, mentalist wreck and busy taking lots of drugs so I never applied to any veterinary university programmes. But I know the route to being an astronaut can be much more circuitous, so I never really, truly let go of that dream. I’ve never pursued it, but it has lived as a pleasant daydream at the back of my head.

Cyclothymics in Space! is not a series we’re going to see anytime soon. Our unique talents don’t really tally.  What can I bring to the ISS? Moods which expand beyond self discipline, a tendency to paranoia, lingering trauma and grudges which primarily exist in the mind and not objective reality. Emotions which happen for no damn reason. Fluctuating energy levels, distrust, clouded reasoning, blurry recall, hyper sexuality.

These are antithetical to being an astronaut.

Lots of people are unsuited to being astronauts. People with physical disabilities, people with chronic physical health conditions, people with colour blindness, deaf people, blind people, claustrophobics…the list goes on and on.

But tonight it was realising I would be ruled out at the first personality and emotional evaluation test stage which made me feel utterly defeated.

We all want to be limitless. Our limits happen in different places and at different times. Sometimes it’s unexpected places we find them, places or things we didn’t even know we still had an emotional connection to (like being an astronaut) and that’s when it can really trip you up.

No mortgage, no stint on the ISS. I’ve got avocado on toast, what is the consolation prize for not being able to be an astronaut?

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On [non]therapeutic interventions and feelings of failure

I’m having something of a tough time at the moment.  I’m struggling with my work and as that is all I have in my life right now, that has an enormous knock on impact on my mood.

At about 3am last night (insomnia ho!) I was reflecting on my experience of CBT; why was it so useless to me?  I thought about a typical interaction I had in any of the 6 sessions at either of the three times I had CBT.  It would go something like this;

CBT Practioner: “So, what is difficult for you at the moment?”
Me: “I can’t sleep”
CBT P: “What stops you sleeping?”
M: “I feel tired, I go to bed, but as soon as the light is off my mind gets noisy and I can’t relax.”
CBT P: “What thoughts keep you awake?”
M: “That I’m a bad person. I think of all the bad things I’ve ever done and my stomach turns to a knot of anxiety and I go over and over and think about how people must think of me as a terrible, stupid, useless person”
CBT P: “Can you give me an example?”
M: [after some hesitation at saying these things aloud] “Yes. I phoned work the other day, my boss answered the phone. I said ‘hi, it’s me’ like I would to a friend, not a colleague, and she didn’t answer, so I immediately said “it’s [my name], it’s me.” And then we had our conversation”
CBT P: “So what makes you anxious about that?”
M: “I imagine she thinks I am an idiot, that I can’t even deal with a simple phone transaction properly. I embarrassed myself”
CBT P: “That one small thing?”
M: “Yes”
CBT P: “Do you think [your boss] thinks about that? Did she say anything? Has she indicated she thought it was odd?”
M: “No. I know that, logically, on the balance of probability, she doesn’t even remember it. I am sure even if she did, she wouldn’t care enough to keep thinking about it or make any conclusions about me. I’d be surprised if she even remembered it, it happened more than 6 months ago [insert time spans of up to 15 years in this for different things that keep me awake]”

And that is precisely the problem I have with CBT.  I can identify my thought processes as irrational, I can imagine the most likely and rational response other people have to all these imagined faux pas, I can even have confirmation from people that, no, they don’t hate me because I didn’t hold the door open for them 6 years ago that one time.  But I am perfectly capable of – skilled at, even – holding two pieces of contradictory information in my mind at once.  I can know, be 99.9% certain that people on the street aren’t talking about me, laughing at me, but I’ll still hurry home and slam the door closed behind me, heart pounding, because there are two parts of my brain – one sane, one insane.

Insane.  A strong word, but in it’s purest, most precise meaning, that can be the only description of the thoughts that drive my anxiety and unhappiness. It is apart from rationality, it is apart from reasoning, and thinking it out.  As I told the final CBT Practitioner I met (who was disillusioned with CBT too, and enabled me to voice my problems with it, for which I am grateful): “if I could think myself out of this, I would have done it already. I’ve been trying to think my way out of it since I was 14”.

He smiled and agreed, ‘yes, it has limitations’.

I can understand I am wrong, and still feel with every fibre of my being, the wrong thing to be true.  When I went private, very briefly, for therapy/counselling, I discussed this with the counsellor. She kept saying, with a bit of surprise, “it’s like there’s a split, you have a split in your thinking, two halves”.*

But I still feel like I failed at CBT and not the other way round.

Right now, for example, I am very unhappy and very demotivated. I’m not getting any work done and I’m angry with myself for that, and that anger isn’t translating into action.  I look at my life; I am financially set for the next 12 months, I have a nice home, enough food, enough clothes, I am doing the thing I supposedly love (PhD) and I’m doing it in one of my favourite cities in the world. I am unburdened by serious responsibility or serious health problems.  What on earth have I got to be depressed about? How dare I?!

And I know, of course, as everyone bleats and shares and reassures “depression isn’t about circumstance, it’s not about how great your life is, anyone can be depressed”.

But, as we established above, I am really good at holding two conflicting pieces of information in my mind at once.  I’d never judge a friend for saying they are depressed when I think that they have a good, or enviable life; I’d just offer support and love and help in anyway I could.  But me? I look at my life, all the opportunities I have, all the opportunities I am sitting in the middle of failing to take advantage of, failing to ‘grab the moment’, failing to do things people would give their eye teeth for that are sitting open to me and I cannot understand why I am not happy.

Why aren’t I living the wonderful life that is sitting open to me?

Why aren’t I happy with all the great things in front of me? Why can’t I think myself out of this?

And more than that, if I’m not happy now with what I have, and I pursue and attain the next list of things I think will make me happy, how can I ever be happy? There is no pot of gold at the end of the rainbow.  Just more “oh, it’s not this pile of things and people and opportunities I need to make me happy, it’s that pile of things and people and opportunities I need, I’ll go chase them”.

It’s unending.  It’s always going to be me saying “just a little further, then I’ll be happy”.

What I need is to be happy here. I have no idea how to do that.  I just know I should be already.

* I didn’t care much for this as a response because that’s diagnostic of schizophrenia, and no, my mind isn’t split – the two contradictory parts talk to each other – that’s the conversation which keeps me awake at night.  It’s also a really unhelpful comment – yes, I know it’s odd I can hold such polar opposite thoughts, how do I stop doing it?

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You Wouldn’t Like Me When I’m Angry

I’ve spent some time thinking about what my next blog post should be.  There is a more general piece on trigger/content warnings on online safe spaces brewing in my head but today it’s a much more personal ‘state-of-me’ post.

This blog has always been about my journey through a life with cyclothymia and right now that journey has come to a cross roads.  How do I proceed? What do I need?

The biggest issue in my mental health life right now is anger.  Anger has its uses, it gets me out the house, it makes me stand up for myself, it motivates me, and it keeps me from caving in on myself when things get tough.  But it also means I lash out at people around me, alienate them and isolate myself.  Anger means I never rest, never feel relaxed, always ready and waiting for the next fight.

Anger has, I’m coming to see, become a crutch.  It’s no longer an emotion which helps me – perhaps it never was although at one time I was sure it was all that kept me alive – it’s an emotion which is just burning me up from the inside and leaving me no energy or love to put out into the world.

I’m angry about a lot of things; I’m angry I have cyclothymia, I’m angry my brain can cripple me emotionally and physically with no warning.  I’m angry about the person cyclothymia has made me – insular, untrusting, nervous, exhausted.  I’m angry about the way I’m living my life – both the choices I made that brought me here, and the factors I never had control over that caused life to end up this way.  I’m angry about the way some very important people in my life behaved, I’m angry about the way I have behaved towards others.  I’m angry I keep getting knocked on my arse by a resurgence of bad, depressive feelings. I’m angry I can’t control it.  I’m angry about the crap treatment offered (or refused) to me by the NHS and I’m angry we have had 30+ years of governments who don’t care about mental health enough to put any meaningful investment into it.

This list of things I am angry about could go on and on, and I’m angry about that.

So what I need, now, urgently, is to find a way to deal with this anger and if not erase it from my day to day life then at least channel it into some more useful outlet than the current mute and impotent fury I carry around in my chest each day.

I need to find a way to get up each morning, face the world, and do my work that doesn’t depend on, function through, anger.  I feel like I’m pedalling furiously and standing still because so much of my energy goes into feeling angry but so little of it turns into anything productive.

And too much of my anger gets turned in on myself – why aren’t I better? Why don’t I do better? Why aren’t I the kind of friend, colleague, ally I would want? Why am I unable to make myself different? Why can’t I just shut up and get on with life? And then that anger turns into self-punishment, drinking too much, sleeping too little, denying myself a social life, refusing to plan for a different future.

It’s time to change.  This is a line in the sand.  I’m going to explore ways to let go of anger and ways to generate positive energy to put into the world and to motivate me to live.

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The Great Big Cyclothymia Q&A

This Q&A is almost entirely composed of search terms which have brought people to my blog.  I’m no expert, but over the years I like to think I’ve collected some instructive experiences and learnt, often from my mistakes, a few things which may, if not help others, then at least provide them with a perspective to consider as they continue researching these things.

How do you deal with a colleague who has cyclothymia?

I recommend dealing with a colleague who has cyclothymia in exactly the same way you deal with a colleague with curly hair.

If you would like to help a colleague who has cyclothymia then your first stop should be having a conversation with them about what they might need in the work place – it could be a friendly face, a regular coffee break or lunch-date with a colleague, it could be additional meetings with line managers to help flag up feelings of being overwhelmed or excessively stressed before they turn into massive problems.

If you have cyclothymia and you’re thinking about how to deal with this at work I recommend looking at the Mind website. They have extensive advice on being mentally healthy at work and the possible risks and benefits of ‘coming out’ at work about your mental health issues.  I personally have never disclosed a mental health problem to an employer, with mixed results.  The most negative experience was when I was a manager and my staff told me “you’re funny because you’re great to be around sometimes because you’re so enthusiastic and positive but sometimes you’re incredibly grumpy and it’s no fun working here then” which came as something of a surprise as I thought I was hiding my mood swings well.  If you’re considering disclosing your mental health status to an employer or colleagues remember that they probably already know something about you is cognitively….off.

Can you hold a job with cyclothymia?

This really isn’t a question with a definitive answer.  It depends on you, how well you are able to manage your moods, how you respond to stress, how much stress your job entails….Personally. I’ve found jobs which have a degree of flexibility – for example office work which has varied tasks to be completed in a month ranging from mindless data entry to complex accountancy work – to be one of the better positions I’ve held as I was able to set my own schedule for the day or week, and work around my capacity for concentration and originality at any given time.  Conversely, working in customer service, whilst tremendously easy when hypomanic, was excruciating and often-times disastrous when I was depressed.

Holding a job with cyclothymia, like any other mental health issue, is a question of how well you manage your symptoms, what degree of flexibility you need and can have, and how much you disclose to an employer and their response.

Is cyclothymia an excuse/reason for being rude?

It’s not an excuse, but it can often be a reason.

Both highs and lows bring their challenges for social interaction.  I talk over people when hypomanic and am curt with people when I am depressed.  I work hard to remind myself to think first and act and speak second.  But impulse control, as you likely know if you are reading this, can be a huge challenge when at the extremes of mood.

I always maintain that no matter what my mood, I am accountable for my actions – I apologise to friends and family I think I may have offended or upset as soon as I am able, and I try and let close friends know where my mood is so they can be prepared for some irrationality.  How well your friends tolerate your moods is down to a lot of factors – their patience and understanding, your willingness to be accountable for your actions, and sometimes, just dumb luck.

Should I tell my friends I have cyclothymia?

My close friends know, acquaintances and colleagues don’t.  As I say in the above point, having your friends understand why you may act erratically or very differently from one week to the next can help you maintain better relationships. Friends can also offer support and understanding when you really need it.

In the end, it’s up to you – what do you want to get out telling your friends? Do you want to help them understand you better? Do you want to ask them for support in some areas of your life? Do you want them to know that you understand their struggles with mental health because you have your own? All good reasons to share. If you want to tell your friends in order to get a carte blanche to treat them differently or to demand they alter their behaviour around you then you may want to think more deeply about how you relate to these people and what is reasonable, or unreasonable, to ask of people.

Does cyclothymia affect concentration?

Poor concentration is a symptom of depression.  Inability to focus on a task or subject for an extended amount of time is a symptom of mania and hypomania. So in summary? Yes.

Anecdotally, my concentration levels are one of the key ways I monitor my moods.  The moment my concentration drops significantly, I know I’m heading up or down.  We’re talking about something more significant than a tendency to procrastination, or that fidgety Friday feeling we all get; we’re talking staring at a page and reading the same sentence 6 times but taking nothing in. We’re talking abandoning one task to begin another because a better idea just occurred to you.  Lack of concentration, when it’s symptomatic of cyclothymia, describes just not being able to discipline or motivate yourself into acting in any other way than you are; it can mean doing a job is like wading through treacle so hard it is to make your mind process anything, or feeling like a butterfly on speed, flitting from one idea or job to the next without a pause in between, but completing nothing.

What are the habits or behaviours typical to cyclothymia?

I’ve written in various entries about some of the common experiences of cyclothymia, from hypomania, to anxious compulsions, to the suddenness of the onset of mood swings which is characteristic of cyclothymia.  I tag entries dealing with my experiences of specific symptoms of cyclothymia with ‘symptoms and habits’

To a degree, manifestations of cyclothymia are as unique as the sufferers, in other ways, there are a distinct list of symptoms which we all experience to a greater or lesser degree – some of which are also common to other mental health disorders.

Is my psychiatrist right about cyclothymia?

Short answer; yes.  Long answer; no.

Psychiatrists have a habit of telling people with cyclothymia that without treatment it will develop into bipolar II but this seems to be anecdotal and difficult to disentangle from people being re-diagnosed with Bipolar II after not responding to treatment for cyclothymia.  Psychiatrists, in my experience, also have a habit of insisting your life will be dramatically altered because of cyclothymia, and that you cannot successfully manage it alone – this may not be true, or it may.  There are so may variables in anybody’s life which make such pronouncements utterly meaningless.

Seek advice and information on cyclothymia from your GP, psychiatrist, from Mental Health charities or advisers, and speak to other sufferers.  Do not allow yourself to be pressured into decisions or treatments you feel uncomfortable with and feel empowered to ask for second opinions.  Psychiatrists do not have all the answers, they are not sooth sayers, they do not have a crystal ball.

I wrote a little on my experiences of following, and not following, a psychiatrists advice in my post ‘things I want you to know if you have cyclothymia

Can you manage cyclothymia without medication?

Perhaps.  I can.  Or rather I am trying.  Its a continual process and it depends heavily on your lifestyle, your job, your experiences of medication and your ability to maintain healthy routines.

I have written here, and here, about my attempts to manage cyclothymia without medication.  After a few years, it’s still currently the right choice for me; it may not always be the right choice for me and it may never be the right choice for you, but it is possible.

What medication can be used to manage cyclothymia?

I have taken a slew of anti-depressants and the last medications I was on were Seroquel and Mirtazipine which worked to an extent but ultimately I decided the benefits were outweighed by the side effects.

Wikipedia has a very brief list of the medications commonly used to treat cyclothymia as does the NHS choices website (scroll down for ‘How is it treated?’) For detailed information on a drug you have been prescribed I recommend asking your doctor or psychiatrist, and having a look on the Crazy Meds site which I have always found to be both frank and accurate.

How do you live with cyclothymia?

This is the question my entire blog is aimed at exploring.  There isn’t, I am confident, a single answer.  I’m finding careful use of some medications (anti anxiety and sleeping tablets), occasional short courses of talking therapy, healthy physical routines and habits, and being tolerant of my own fluctuating reserves of energy and resolve, all contribute to me feeling in control of my life with cyclothymia.

It’s not an easy road, but it is one that it is possible to walk, with time, and effort put into finding what does and doesn’t work for you – either alone or in conjunction with mental health professionals, and supportive friends and family.

And finally, a google search term I couldn’t turn into a question;

Cyclothymia and stupid people

Unfortunately, cyclothymia does not bestow you with the super power to avoid stupid people, or eradicate them from your life. Sorry.

Have you still got a question that needs answering? Do you want to add to or query any of these answers? Please drop me a line in the comments.

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Filed under cyclothymia 101, diagnosis, medication, self-hood and cyclothymia, symptoms and habits

Accentuating the positive

I’m conscious this blog could easily become a litany of misery – all the ways cyclothymia is ruining my life.  There’s a fairly clear reason for this – I don’t associate anything positive in my temperament with cyclothymia.  Is this fair?

I sometimes experience hypomania as rampant anxiety running through my tense, restless body, forcing me to think through every faux pas of my life in excruciating detail at double speed.  For this reason, I rarely speak about hypomania as an enjoyable experience.  That’s not the whole story though, as anyone with cyclothymia will attest.

Hypomania can also mean self confidence, sexual confidence, a real belief the future will be ok, the most wonderful sense of financial freedom (usually exhibited in spending sprees), high energy levels despite almost no sleep and often no inclination to eat meals, and a sense of creative inspiration manifested in becoming an engaging conversationalist and compelling writer.  I’ve redirected my life a few times on the strength of feeling sure everything will come up roses for me if I gamble on a series of long shots. The majority of the things I own were bought during spending sprees (although I do now find these spending sprees so inevitable I put off buying everything until the chemicals switch and not buying ALL THE THINGS becomes unthinkable)

The run up to a period of hypomania is one of my favourite times, the little niggles of life start to fade into the background, I start to crave social interaction, I begin to feel confident that my friends and colleagues really like me, I begin projects I’ve never found time for before, I laugh more, often at my own stories, but I also share my laughter easily with others.  I suddenly have enough energy to share – I have the emotional resources to give to friends, I have the energy to be everywhere and do everything.

God it feels good.

I was reflecting the other day on a question Stephen Fry put to interviewees on Secret Life of a Manic Depressive: if you could press a button and erase your mental health problem, would you? At the time, I recall, I cried watching that because my moods were out of control and I felt utterly lost. Yes, I would have pressed that button. My answer today is different. As I’ve said in other posts, the distinction between ‘me’ and cyclothymia is not immediately clear, so I don’t know what – or who – I’d lose if I pressed that imaginary button. But more than that, I don’t know I’d want to give up what I get from hypomania. Yes, sometimes I can’t think or write, but at other times I find I can look at things cock-eyed and in so doing see something I didn’t before – new inspiration on an old problem, like getting a fresh pair of eyes but it’s all in me. What would I have missed in my life if I didn’t spend one half expelling enormous amounts of energy maintaining ‘normal’ when I’m low, and the other half of my time throwing myself obsessively and totally into keeping myself occupied when I’m high?

Yes, cyclothymia can take a lot from you, but it still bestows some benefits in exchange. It can just be a matter of riding it out and grabbing at all the good points as they go flying past – although that’s easier to say when I’m not in the middle of a low.
 

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Love me, love my cyclothymia

A question that seems to linger in my mind, year after year, is ‘where do I end and my cyclothymia begin?’

I think it’s a question that plagues most people with mental health issues.  We understand so much of who we are as being about how we respond to things. Personality and emotions are so tied together, both in how we describe people and how we understand why we, or others, act.  And if, as this logical chain insists, if we are no more than a collection of symptoms then we are less of a person than a psychologically ‘typical’ person.

So I begin to stack things up in two piles; things I do because of cyclothymia and things I do because I’m me.  In the cyclothymia pile is shopping sprees – I hated shopping for most of my life and still do the majority of the time, but every now and again I pass like a whirlwind through the high street and online with an anxious, hypomanic glee.  In the ‘me’ pile is academia – I’ve always been bookish, I’ve always worked hard, thoroughly, even obsessively at school, sixth form and university.  Academia asks for a lot from you and offers little back (more on this another time, read this until then), it has to be passion or it’s nothing and often it punishes you with self doubt and uncertainty.  Back to the cyclothymia pile we’ve got ‘quick temper’.  Although is that where it belongs?

This is the thing about symptoms of psychological disorders, they so often cross over into what we think of as personality traits.  I remember having a furious temper all my life, so was that an early signal of cyclothymia or is that just the person I am?  This slippery slope analysis doesn’t stop there.  I try and list the things I love, am passionate about and wonder why I care about them.  Queer theory work in academia, Francis Bacon in art, Manic Street Preachers in music.

But the way I relate to these things is, inextricably, tied up with cyclothymia.  Queer theory can be difficult and complex and cross-disciplinary, when I’m hypomanic I enjoy the detail and complexity and run away with ideas about how to overhaul the discipline.  Francis Bacon’s work scares me when I’m both hypomanic and depressed, but in different ways, and I find I can never look away.  It’s as though the bodies he distorts are rearranged in the same way the whole world looks to me.  Manic Street Preachers offer me solace in sadness, they offer a point to become obsessive over when I am anxious, depressed, or having that very specific type of hypomania which makes the inside of my skull itch and I’m scared of everything and need to have one thing to cling to and be absorbed by.

I don’t know where cyclothymia ends and I begin.  I’m not sure it possible to disentangle the two.  It’s going to remain a topic I dwell on, not least of all because the spectre of all-consuming mental illness always looms, threatening to rob me of myself.  Does it matter?  Perhaps at the heart of my anxiety around this is the belief that cyclothymia is something bad.  And that leads me to ask if the way to release myself from the tangle of asking who I am and what cyclothymia has made me, is instead to embrace the different ways I look at the world, the different relationships I have with the things I care about because of the fluctuating chemicals in my brain.

I don’t subscribe to a belief that mental illness can offer a more accurate or inspired perception of the world, but perhaps it’s time I let go of the belief that cyclothymia is somehow holding me back from being me.  Me and cyclothymia are a package deal.  In order to love myself, I need to embrace everything that comes along in that tangled mess, and so does anyone else who I might meet – although that latter one might be harder to come by.

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