Category Archives: symptoms and habits

Stress Intolerance

A few months ago I saw an ad in the local hospital for a bipolar support group.  It said “having bipolar is like being allergic to stress”.  That’s about the most accurate description I’ve seen, I think.

I haven’t posted much on here in the last few months because I have been finishing up my doctoral thesis, then I took a holiday (my first in 5 years) and now I’m working on job applications.  It has been, in every sense, an exceptionally stressful few months.

It is perhaps curious, then, that it is only in the last week, a month and a half after I submitted my thesis, a month since I got back from a lovely holiday, and a week after I got a job application in, that the crushing anxiety, panic and low mood has really set in.

Whilst bipolar is an ‘allergy’ to stress, the reaction is often delayed and it can be hard to deal with that.  Immediately after submitting my thesis I braced myself for a downswing, cleared my diary and prepared to meltdown.  But it didn’t come. ‘Perhaps it’s not going to!’ I thought. ‘I’ll just get on with preparing for my holiday!’.  In the first couple of days of my holiday, whilst I was in Zagreb, I began to feel the black edging into the edges of my thinking – ‘ah! here it is! Best take myself off somewhere quiet to mope’.  But again, it never really came through – I travelled south in Croatia to Split and the sun was out and my troubles seemed to lift. ‘Maybe I really am cured!’ I thought.  ‘Perhaps the secret cure for cyclothymia is writing 80,000 words followed by sunshine!’

There was a nagging sense, deep inside me, that all that was happening was that the holiday was delaying the inevitable.  That low, that allergic reaction, was just waiting for me, biding it’s time.

Buoyed along by a busy schedule and post-holiday glow (literal and metaphorical, managed to get a lovely tan in 7 days in the sun), the week following my holiday was pretty solid.  But, little by little, I began to slow down. Waking later, sleeping longer, heating up meals from the freezer instead of creating culinary masterpieces from scratch.  It was coming.  Having terrible dreams, waking up sweating and gasping for breath.  The first signs of the inevitable reaction – the mental health equivalent of itchy skin, fuzzy tongue, sneezing.

And so, we come to today. Woke up, after another night of terrible dreams. barely able to walk in a straight line (anyone else experience low swing as significant impairment in physical-coordination?) Ate breakfast.  Fell asleep again for 2 hours.  Stumbled about for a few hours, tried to boost mood with music, ended up crying to Vivaldi, of all things.  Tried to work – read the same sentence of an article 4 times in a row before giving up.  Tried to sew – took me three times as long as normal to do a small section, abandoned. Considered visiting family, decided it wasn’t worth risk of an argument. Digestive system, which has been merrily melting down in response to stress since May, reaching it’s peak in pain.

Do I feel stressed? No. Do I have any urgent jobs, bills, or commitments? No. The peak stress is gone.  There are, of course, still various tasks and events on the horizon which will be challenging and likely stressful, but nothing in the immediate future. This is cyclothymia.  This is what stress does.  It goes in, gets absorbed, and then, when there’s nothing pressing, when there is time, it’s released throughout your mind and body, disrupting all the vital systems, leaving you on your knees amidst apparent calm.

I’m falling to pieces in a house well stocked with food, bills paid, jobs done.  I’m struggling to sleep in a large bed when I don’t have an alarm set for the morning and I couldn’t tell you the name of the thing that is worrying me half to death.

For people with bipolar spectrum conditions, stress is so like an allergen.  It’s a constant presence in life, ebbing and flowing with the season and the location. And it is almost impossible to protect yourself from – it sneaks into your world, leaking through the cracks in whatever plans you make or precautions you take.

Right now, it feels like the UK is in meltdown.  As the government and new Prime Minister push ahead on the disastrous Brexit plan, the main opposition party is in disarray and entirely incapable of coordinating a strenuous response to the inevitable public funding cuts, Brexit, and the terrifying rise in hate crime and hate speech.  This is stressful.  And, along with the undefined worries which already plague me, I can feel my mind absorbing it all, quietly storing it away, ready to top up my anxiety at any moment.

Sometimes it feels like cyclothymia disqualifies you from living in the world at all.

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Sleep

I am obsessed with sleep.

How much did I get last night? What’s my average this week? This month? How many times did I wake up last night? What arrangement of pillows gives me the best sleep? Did I sleep too much? Do I have a real headache or have I slept too much/too little? I could go on and on.

Sleep – too much or too little – both reflects my current mental state, and dictates it.  When I’m on a fairly steady keel I find I sleep a solid 8 hours, usually waking once, invariably waking groggy (I’ve never been a morning person) but rested.  Running into, and during, a depressive period I sleep terribly but frequently – upwards of 10 hours at night and often napping during the day – and walk around in a fog of exhaustion and anxiety.  During manic periods I sleep little, sometimes as few as 3 or 4 hours a night

I have a sleep tracker on my phone and have been coveting a fit-bit ever since I learnt they too track your sleep. Right now my sleep tracker tells a sad story – more than a week of sleep below my ‘ideal’ 8.5 hour line punctuated by 1 night of 11 hour sleep followed by an especially miserable 5.5 hours.  The mood cost of this? Anxiety, exhaustion, slow thinking, poor attention span and a niggling feeling the world is about to fall down.  Am I sleeping badly because I’m in a low or am I in a low because I’m sleeping badly?

There is quite a bit out there in internet-land about the importance of good sleep patterns if you have bipolar [spectrum] disorder.  A few online sources suggest that lack of quality sleep can trigger a manic period.  I’m not sure my own experience corroborates that and one might also question presumption of cause and effect implied in that conclusion (i.e. does sleep deprivation trigger a [hypo]manic episode or is the first sign of a hypomanic episode reduced need for sleep?). As I say above, I find lack of sleep corresponds with the beginning of a depressive period (although again, is it lack of sleep, or is it that I don’t sleep much because I’m hypomanic and then I, inevitably, have a depressive period?).

What I have found, conclusively, is that maintaining a reasonable sleep pattern and getting enough sleep (8 hours) each night is the best method I have available to maintain a stable mood.  I usually make it to about 3 weeks feeling ‘normal’ if work/life stress is average and I get a regular, uninterrupted, 8 hours.  It’s not much, it’s the time I live for though. The time I think least about whether I am happy or sad and, therefore, the time I am happiest.

Right now, I’m under quite a bit of pressure at work and over the last month have spent more time sleeping on friend’s floors, hostel beds, hotel room beds and buses than I have in my own bed.  It’s getting to the point where I’m fantasising about a week where I don’t have to set an alarm for any time before 11am (because, my brain is still out to get me and if I don’t set any alarm at all I sleep for 12 hours) and wondering if I’m setting any new records in surviving sleep deprivation without actually being technically sleep deprived (7 hours sleep on average the last 2 weeks)

Identifying how important decent sleep is to my mood is more than half the battle, I’m sure of that.  What is harder to deal with is what my obsession with sleep means for social and romantic life.

Ever fallen into bed with a new lover, then checked the clock as you finish and realise you needed to be asleep an hour ago? Then immediately ruled out anything else by turning over and concentrating on going to sleep? Ever left parties early, not because you had an exceptionally early morning or important shit to do the next day, but because you didn’t want to ruin the rest of your week with one disrupted night’s sleep? Ever refused a friend a place to stay because one night with someone else in the room means sleeplessness, and sleeplessness means a lost week?…And on and on it goes.

I love sleep.  I really do.  I love getting into bed, burrowing down, hitting ‘sleep’ on my phone.  I love waking up but not needing to go anywhere and just lazing in the in-between-haze of asleep and awake.  I just don’t love needing that more than almost anything else in my day if I want to be functional, coherent, and, most of all, sane.  I’d love just the odd late night without consequences.  Just a few sneaky early mornings without feeling like I have bugs crawling under my skin or that my brain is going to vibrate out of my skull.  And I do wish I wasn’t so obsessed by everything to do with sleep, because I think it’s a dead giveaway that I’m nuts when I meet someone new and my entire life is quickly revealed to be dedicated to a Good Night’s Sleep. It’s surprisingly hard to make an obsession with sleep – something we all, quite clearly, do – seem normal.

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You’ve Got that Manic Feeling

I’m back on the roller-coaster.  Or rather, I never got off the roller-coaster and right now I’m cranking back up to the top.

I felt it coming, as usual.  Over the last week I’ve had groggy morning brain which evaporates in the shower and leaves me with LOADS OF FUCKING ENERGY.  Today and yesterday I’ve barely slept – or rather, I’ve slept for the usual amount of time except for the second 4 hours I sleep lightly, waking frequently, drifting in and out of trippy dreams.

And there’s the anxiety.  That’s the other clue.

Skin crawling, brain itching, restless body anxiety. Tick tick tick tick….can’t sit still, can’t rest, can’t focus, can’t calm down.  This is shaping up to be a period of unpleasant mania.  It was perhaps inevitable because my last couple of hypomanic periods have been relatively mild and largely positive.

Last night I mentally composed an entry for here about dealing with anxiety; dealing with the oncoming wave of hypomania.  I was going to recommend my two preferred activities; sewing and swimming.  The former is repetitive, time consuming, and mind-numbing, the latter burns off loads of nervous energy in a really productive way that is energising in a ‘natural’ way rather than a hypomanic way.  Today I’ve been sewing for 5 hours, went swimming for an hour this morning, and I’ve cleaned the flat top to bottom. Unfortunately like almost all of my ‘coping’ strategies, when I get to the extreme end of high and low, they just don’t cut it.

I’m a little angry with myself this evening; hypomanic confidence has assured me that I didn’t need to work on a piece of work  which is due on Tuesday. I’m battling my brain over this even now; the little voice of rationalism is saying: “but it really would have been good to spend just an hour on it to assess how much additional work is needed tomorrow” whilst the booming voice of hypomania confidently shouts it down: “if we get in at 10am tomorrow that’s an hour to work on it before 11am meeting. 12-1pm planning Tuesday’s seminar and then the rest of the afternoon to work on Tuesday’s piece of work. Really, we needn’t have even worked on it yesterday. In fact, maybe we don’t even need to get in for 10am, we can definitely just wing it on Tuesday, now how about a nice triple vodka and orange?”

I’ve got a glass in my hand.  I think the comforting, friendly, fun voice of hypomania might have won this round.  It usually does.

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New Year, New You?

I’ve been weighing up a New Year post in my mind for a couple of weeks now.  In all honesty there are two big things that have stopped me.  Firstly, I’ve been feeling pretty good for some of the last month or so and, as I’ve written about before, when I feel good I’m always sure I’m not going to be unwell again and I certainly don’t want to think about the possibility I could be.  Secondly, I’m more inclined to reflect on the last 12 months, and look ahead to the next, on my birthday.  There are lots of positives to this: it means you begin every ‘year’ by having a party about how awesome you are for being alive; it means (as my birthday is in September) it happens during my favourite time of year – lovely lovely autumn and even if my annual review makes me sad I get to revel in the crisp fresh air of autumn; and it means I’m not influenced by the resolutions and triumphs of those around me.

A lot of people talk about how Christmas is a really difficult time for many people, and I’m not going to argue with that.  I personally find Christmas quite easy – your proverbial man-on-the-street tends to be more polite and charitable around Christmas, most things on tv are about the strength and qualities of the human spirit, and there’s lots of good food.  New Year on the other hand? Everything on tv is telling me I need to Be Better, Lose Weight, Shape Up.  The proverbial man-on-the-street is angry, hungover, skint, and filled with rage at the dying of the light (aka Winter Nights).  There’s very little good food, and often a lingering sense of indigestion.  And everyone else seems motivated and resolved to make themselves over, no matter how fleeting their resolve might be.

New Year, and January in general, are a hard, long, self-hating slog.

Naturally, I’m not one to abstain from the spirit of the season so I’ve committed to a schedule of self hatred, despair, and introversion.

I jest.  Well…I exaggerate slightly in an attempt to wrench comedy from my current low mood.

So I’ve decided to make January into my own personal mental health review month.  What went well last year? How I am going to make this year better?

Last year was punctuated by one of my 3-5 yearly major lows.  In 2014 this took the form of an almighty argument with a friend which turned into an almighty argument with my family which turned into an almighty throwing-stuff-in-a-bag-and-running-away-and-not-telling-anyone-where-I-was.  Not one of my finer moments.  It did, despite it’s car-crash execution, achieve what I needed at that time which was a release of the tension, anxiety and sense of being trapped which had been building for months.

When you are on a tight budget – which I permanently am – it can be hard to give yourself what you need.  Especially if the thing you need (and it always seems to be) is a break from your everyday life and a brief period of self-care and self-indulgence.  Self care.  That’s a phrase that sticks with me – sounds too much like ‘woo’, too new age, too indulgent.  And, as perhaps I will one day write about – the working class chip on my shoulder doesn’t stand for any of that woolly, wussy shit.

But this is what my 2015 needs; more time, more acknowledgement I can’t keep pushing and pushing myself and hope that the crushing anxiety and exploding stress in my chest will simply dissipate of its own volition.  It won’t.  In 2015 I need to take more time to refresh myself, give my brain some breathing space, and allow myself to break a little so that I don’t break absolutely.

Will I be able to do that? Well that’s another reason my 2015 is currently driven by sadness and a shunning of human company (haven’t spoken with anyone since Tuesday, oops?).  2015 is provisionally the year I intend to submit my thesis and to achieve that I do need to drive myself.  I’m not, and never have been, tolerant of anything other than perfection in myself and this will be a year that instinct is tested to breaking point.  Working out how to balance the need to push myself to my limit to produce the very best thesis I can at the very highest level I have ever worked and the very real need to hold my sanity together is going to be my biggest challenge this year.  I think it begins with taking time off and being kinder to myself.  I’ll have to see if I can learn how to do that.

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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

As in thesis, so in life….or something.

This blog has been rather neglected the last couple of months; not for lack of ideas, plenty of topics have flashed through my mind but somehow, I haven’t managed to put fingers to keyboard.

I’ve spent much of the last two months being blocked on writing a particular section of my thesis.  Last week I decided to put that section aside and begin revising another section.  Suddenly words flowed again and I began to believe it would be possible to physically turn out enough words, if not sufficient quality of words, to complete my PhD in the next 12 months.  As in thesis so, it seems, in life; I decided to delete my facebook and twitter accounts this weekend (temporarily, most likely) and found I had more hours in my day and lo! The flat is clean, my admin for my job is up to date, and I’m sticking to my daily writing goals.  Which brings us to the blog; I find I have time to think and write and construct a blog post.

I’ve actually had a steady period of mood for about a month now and kept noticing it, and silently celebrating, before returning to whatever I was doing when the thought occurred to me.

These last few weeks I’ve been getting angrier and angrier.  Tiny things began aggravating me, I snapped at everyone for everything they said. I watched myself doing this, watched myself getting angry but didn’t feel I had any power to stop myself – my mouth was running ahead of my head.  I expected this to turn into a depressive period, somehow, it hasn’t.

The last few days I’ve had terrible nights’ sleep, punctuating by frequent waking, feverish vivid dreams, and exhaustion come the morning.  I’m full of ideas but unable to settle on any one activity for more than 45 minutes. I’m still angry.  But I’m also periodically floored by acute moments, minutes, hours, of profound despair.  I think everyone hates me and am convinced everyone is talking about me behind my back/the moment I leave the room. The brain gremlins are chatting to me, recounting every stupid decision I’ve ever made and social faux pas, real or imagined, and assuring me I’m an ass.

It feels like I’ve been emotionally blocked in the same way I was blocked with my thesis writing and now I’m able to write everything I need to – blog, thesis, teaching feedback, teaching coursework – I’m also able to experience all my usual range of emotions, except, much like the writing, they are happening all at once.  Angry, sad, inspired, social, paranoid, exhilarated, manic, disjointed.

It’s a lot. It’s not bad…but it’s not good either. It’s just sort of…everything.

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Self Medicating and Being Healthy

One of the hardest things to work out when you are trying to manage your own moods is how to deal with bleak lows or unending highs.  As I chose to manage my cyclothymia without medication, I am continually evaluating and questioning the coping strategies I choose.

I made the decision, after a year on prescription medications for cyclothymia (and even longer on anti-depressants and anti-anxiety medications) to manage my moods without medication, excepting the occasional prescription sleeping tablet, and, a few years ago, a short course in anti-anxiety meds. My GP supports me in this and is happy to prescribe medications when I express a need for a little more support.  It’s not for everyone, but it’s the choice I made based on who I am, what I know about myself, and how I live.  Due to the frequency with which cyclothymia is misdiagnosed as unipolar depression, or undiagnosed, many sufferers turn to drugs and alcohol to manage their mood swings.  Some sources suggest as many as 10% of cyclothymia sufferers also have a substance abuse problem (we won’t speculate now on cause and effect) and the list of symptoms here, includes habitual use of drugs and alcohol to self-medicate.  I am conscious that those two pieces of information seem to suggest that un[prescription]medicated, any alcohol or drug use by people with cyclothymia can be judged to be an attempt to self medicate the mood swings.  It may also suggest, that simply not knowing what is ‘wrong’ – pre-diagnosis – means people with cyclothymia feel despairing and out of control, and turn to alcohol and drugs as both a comfort and a cure.  Can simply being aware of the tendency to self medicate be enough to turn alcohol use into a less damaging or unhealthy practice?

Before I was diagnosed with cyclothymia, whilst on an unending merry-go round of highs and lows, I drank everything I could get my hands on and turned back to the oblivion of drugs which I had previously only sought out when I was a teenager.  In the longer term, I came to think of that as a very happy period where nothing seemed off limits and everything was entertaining, but also one which exacerbated my loss of equilibrium. You introduce the artificial highs and lows of drugs and drunk/sober cycles and, inevitably, you are going to push the ‘natural’ rhythm of cyclothymic moods up a gear.

For this reason, I try and avoid excessive alcohol intake (the last hangover I had turned into a two day stretch of dreadful hangover blues, not cool) and I don’t touch drugs at all any more.  However, it really isn’t as easy as deciding not to drink for the good of your health, there are always complicating factors.

The trouble with managing a mood disorder is that you can practice healthy routines all you like – good sleep pattern, regular exercise, days off from socialising and work scheduled in, regular meals, tactics for coping with everyday stress – but when you sit down of an evening, flick through a few pages online, or in a magazine, and a low hits you, completely out of the blue, like a blow to the chest, there are few responses which squash those brain gremlins as efficiently and speedily as a big glass of vodka.  Conversely, when I’m feeling great on a hypomanic high, I tend to conclude I needn’t be too cautious about my alcohol intake because, obviously, I’m impervious to harm, and have more than once ended up a gibbering, mixed-mood, weeping, manic mess as brain chemicals and half a bottle of vodka fight it out.

I’m also not confident in saying “self medicating is bad” because, like so many other coping strategies – be they healthy or ‘unhealthy’ – it answers a need.  How do you deal with the low that comes swooping from nowhere and smashes into your chest? How else do you bring yourself down for long enough to sleep? How do you remove the emotional block that sometimes grows up after a long period of anxiety or instability and open the flood gates to tears and rage and raw emotion? I’ve found ways to deal with a lot of things, but the only way I know to deal with these things is, still, to drink.

Is it healthiest to use a bad coping strategy occasionally if overall you maintain a better balance, or is it best to espouse all unhealthy responses to unpredictable and ultimately unmanageable mood oscillations? I really, truly don’t know.

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Cured

I regularly experience something I believe is common to all mental illness. When I’m stable for longer than a week or two, I become convinced I’m cured.  Or, even more often, that there was nothing wrong to begin with.

Just last week I was thinking about how I should probably wrap this blog up, since I’d been stable for the best part of 6 weeks and clearly never had cyclothymia to begin with.  In fact, I said to myself, I probably did more harm than good talking about my supposed experiences of an illness I never had.

Until today.

The brain gremlins are back. I nipped into town this morning to pick a couple of things up and, I planned, to go to a coffee shop and finish a book I’d been reading. On the way into town I crossed the road against the lights (i.e. at a pedestrian crossing, I crossed on the red man) and I had to start running halfway across because a bus I hadn’t spotted was coming my way, fast. A woman waiting to cross on the side of the road I was heading for screamed at me; “IDIOT!”  I strode away, my big sunglasses hiding the fact I immediately started tearing up. I collapsed in on myself.  Everything came crashing down.

I got through the rest of my brief shopping trip by not meeting the eye of anyone, thanking cashiers profusely without looking up from my wallet, keeping sunglasses on to cover my just-about-to-cry eyes.

I got home, closed the curtains on the day, crawled into a ball on the sofa and watched Breakfast at Tiffany’s, my go-to Mean Reds movie (for obvious reasons).  I sat there, numbed, watching and watching.  My hands didn’t stop shaking for 3 hours.

After a few of hours at home I decided I needed a bottle of wine to make it through the evening and nipped out to the shop round the corner.  On the way home a woman was walking towards me with a little dog in her arms.  I smiled at the dog, as I always do when I see animals heading my way, and she saw me looking.  As we drew level her face broke into a smile and she said a cheerful “hi!” to me.  I couldn’t lift my eyes to her face, I rearranged my face as fast as I could to form the word ‘hi’.  But my face didn’t get there fast enough and the word died in my throat.

I got home.  Back to a shaking mess by the time I got in the door.  Started descending into a panic attack. Why? Because a beautiful woman with a dog had said hey to me, and I didn’t reply, so she must think I’m nuts, she must think I’m a weirdo, and actually, wasn’t she one of my neighbours? Oh god if she was one of my neighbours she probably already suspected I’m crazy, and now she’ll be sure, and she’ll talk to her flatmates about that weird girl upstairs, and oh god why didn’t I say hi? Why didn’t I meet her gaze with a friendly smile?

No, not cured.  The brain gremlins were just sleeping.

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Filed under cyclothymia 101, symptoms and habits

Head above water

I’ve been struggling to turn any of the drafts sitting in my WordPress dash into posts in the last few weeks.  I’m super low on energy just now and have spent the last week and a bit shunning most day-to-day social interactions and doing what I can to conserve the energy I have.  I know that this is a herald of a down-swing, how severe that down-swing is depends – I’ve found over the last few years – on how rested I am.  Until it reveals itself I’m living, fairly happily, as a hermit.

Today I went swimming, it’s one of the few things I do no matter where my mood is, and universally makes me feel better.  When my head is under the water and my whole body is working to propel me forward, my mind goes quiet.  I was struggling today and felt as though I was a car revving in neutral – no matter how hard I pushed I just couldn’t seem to generate my usual speed and ease in the pool. I think perhaps I’m carrying a virus and it’s wiped out my (physical) energy reserves.  I felt heavy, almost as though I couldn’t float.  Which reminded me of an opinion I held as a child.

I could never understood how people who could not swim, drowned.  For me, floating is second nature; I can’t remember a time I couldn’t float. I relax my muscles, let go, and I float the surface of the pool.  I recall asking my mother why non-swimmers didn’t simply relax and wait to float.  Of course, drowning – and floating – are rather more complex than that, but it did get me thinking about the commonly used metaphor of struggling with mental health issues as being like drowning.

Right now I’m rationing out my social life, pushing myself to meet up with friends at least once a week even though all I want to do is stay home and listen to music.  It’s a bit like trying to take big lungfuls of air when sinking below the waterline is an inevitability.   I recognise these last gasps of air will sustain me when I simply cannot socialise, but taking them hurts; my lungs are already beginning to burn, my muscles ache, I want to let go and let my head dip below the water’s surface.

As you drop below the surface of a pool, sounds become muffled, the water presses in around you, your body is suspended – neither floating nor drowning.  Just hanging between the surface and the bottom.

Cyclothymia can be like that.

Part of the world and yet separate.  Seeing the same landscape as everyone around you but through a lens which distorts and refracts.  Hanging between sane and crazy, floating and drowning.  Half-welcoming the silence and calm that comes as you dip below the surface, half fearing it because after a few moments – or days – luxuriating in that silence your lungs begin to burn and feel like they will burst, the surface feels too far away to reach before you let go of your breath and suck down a lungful of water…

But I’m not drowning quite yet.  At the moment I’m floating on the surface, sculling along with my ears below the waterline, only conscious of the water lapping against my cheeks, sounds coming to me distant and echoing…calm, quiet, alone.

 

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Filed under extended metaphors, symptoms and habits

Builder of Routines

A common symptom of both down swings and up swings for me, is anxiety.  And with anxiety, come compulsions.

Let me be clear, I don’t have Obsessive Compulsive Disorder, nor am I ignorant enough to suggest I’m ‘a little bit OCD’, I’m not.  What I do experience, is an urge to fulfil certain behaviours during times of high stress and/or anxiety.  These compulsions, these habits or routines, are crutches I fall on.  They are as comforting and as irrational as a child’s security blanket.

I’ve mentioned before, briefly, that I am a Manic Street Preachers fan.  The most recently released album included a track called ‘Builder of Routines’ which articulates the feelings I have around the routines, or compulsions I sometimes feel (You can listen to the track here).  In order to talk about how this mood takes me, and the experience of being gripped by compulsions, I’m going to work through some key sections of that song.

I have sealed myself in /Laminated all of my skin/Sellotaped my world in bits/I must embrace paralysis
I go into a closed loop, no new experiences or sensations in – the very idea petrifies me – but so doing closes off the world to me. Everything outside my front door is overwhelming, too much noise.  But working within the closed loop, closed system, robs me of any creativity or originality. I become paralysed as I repeat the same actions and activities over and over.

Builders of routines/It makes me safe and clean
Everything calms down when I start going through a routine. Cleaning the kitchen, picking pieces of fluff from the floor, remaking the bed, brushing my teeth in a particular order with rinsing/spitting/brushing, listening to the same song again and again until I get it right…I can’t even articulate that last one properly.  I have to go through it, singing, or running through the lyrics, again and again until I get it right. Or I practice conversations – how will I introduce a funny anecdote? What is every possible response I could get? How will I reply? How will I pronounce each word?  Over and over, running through every scenario, past present future.

It doesn’t make me safe and clean, as such though, because the execution of the routine is never perfect. But trying, doing it over and over, silences the frantic parts of my mind for a few minutes at a time. And a few minutes silence can be worth every agonising moment of precise action.

It crucifies parts of me/But never seems to make me bleed
There’s a numbing quality about doing things over and over, be it eating the same dinner every night for three months (it was beans on toast when I did that) or cleaning the kitchen just right, making it ‘safe’ enough to rest.  Part of me goes to sleep, is silenced, is numbed, is crucified.  It doesn’t leave a mark though – the hours, the days, spent doing the actions that bring temporary quiet to my mind – no evidence of the violent compulsion that came before.  Not a drop of blood spent.

 

Writing this entry has been excruciating.  I am going through a period of compulsion and anxiety and getting each successive word down has been like pulling out a piece of me. I’m left exhausted after each sentence. Pushing out of the compulsion, pushing out of the places I feel safe, in order to write something ‘new’ is a huge undertaking. It’s easier, maybe even safer, to stay sealed in.

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Filed under diagnosis, media &c, symptoms and habits