Break Out 'The Routine'

       One of the things they are very adamant about when you have bipolar or ADHD is that you stick to a routine. You’re supposed to wake up at the same time, eat at the same time, take your meds at the same time, exercise at the same time, and go to sleep at the same time every single day. Unfortunately, I don’t do routine, and my work isn’t routine either and I’m assuming this adds to the sleep trouble I already experience and likely also affects my moods. The reason I’m bringing this up now is that I arrived at the field station a little over a week ago and had to deal with a 3 hour time change and a whole new, incredibly sporadic schedule. For the first week I was happy, energetic, and didn’t sleep very much (hypomania at its finest) which would have been great if I had had work to do but work-wise the first week was pretty slow. Unfortunately a few days ago I experienced the not-so-unfamiliar crash into depression (although somewhat milder than I used to experience). I’ve been oversleeping, I’m always tired, and I’m completely apathetic about everything, I just can’t get myself to care (which is not ideal when you only have a few weeks to get experiments done). On top of that, I feel like a failure because I can’t motivate myself and I’m worrying about what other people think when I stay in bed for 12 hours. 

       One of the worst things about it is that the depression phase always lasts so much longer than the hypomanic phase so my times of not being able to get motivated are not completely balanced out by my times of extreme productivity. One of the other worst things is that I have had zero success in finding a way to overcome my lack of motivation. I can’t seem to overcome the extreme desire to ignore the alarm and fall back asleep for another few hours, or to just lie on the couch and watch TV. This is also the one area where my therapist has been very little help. She refuses to suggest ways that I could get myself motivated, she just sits there and waits for me to come up with something on my own but I never can so we end up just sitting there in silence for a while. I get that your therapist wants to teach you to become self-sufficient when it comes to solving these sorts of problems but there has to be a point where they can give you a hand. I’ve been struggling with these periods of depression where I can’t get myself motivated for a long time and clearly the things I try aren’t working so I could really use some help. Anyway, getting back to the disruption of my not-so-routine routine, being at the field station has definitely affected my mood but this happens at home as well, probably because I’ve never fully followed a routine. I abhor the idea of a 9 to 5 workday and I enjoy being able to get work done on my own terms but I may have to give this whole routine thing a try when I get home. I just hope I can find the motivation to stick with it.

Stress

     The other day I mentioned that I’ve been having a bit of a rough time lately, and I couldn’t really put my finger on why (except that we’re still working out my drug regimen). And then last night something happened that had me a little stressed out and panicked and I became hypomanic (which was followed by a short but intense bout of depression). Now, I normally lack any ounce of self-awareness. Doctors and therapists ask me questions about myself or about the effects of increasing the dose of one of my medications and I honestly have no idea what the answers are. I’m sure it’s very frustrating for them because it’s not like anybody else can answer those questions for me but most of the time, I know nothing about myself. So imagine my surprise when I was able to make the connection between me being under stress and the occurrence of hypomanic episodes. This makes perfect sense though, and if I was self-aware I would have realised this a long time ago, because stress is on the list of things to avoid if you have bipolar disorder. Unfortunately, I’m a grad student and stress is part of the job description. Not to mention I am currently studying for an exam that I really need to pass, so a little extra stress is inevitable. But how do you study when your mind is going at a million miles an hour and you couldn’t sit still to save your life? And then when the depression hits and you can barely get out of bed, how do you study then? What about on exam day, how do you get through it if the stress induces a hypomanic episode and you can’t get your thoughts straight? The answer: I have no idea.

     I’m sure there are a number of therapeutic techniques that allow you to cope with stress and prevent it from triggering a hypomanic episode, or to lessen the severity of an episode once it hits, but I haven’t been dealing with this disorder long enough to have mastered any of them. I’m still working on recognising when an episode is starting so that I can ignore my brain and keep myself from doing something stupid and irresponsible. And since there’s only a month until my exam, I don’t really have a surplus of time in which to work on any coping strategies. Hopefully my therapist will have a quick fix, or the new psychiatrist can adjust my meds to make me a bit more stable, otherwise I’m seriously out of luck. Then again, I was pretty much out of luck when I developed the disorder so this really isn’t anything new, just another wonderful hoop to jump through.        

The Ups and Downs of Bipolar

     So I’ve been having a pretty crappy bipolar week this week. It started last Friday, I felt really good about the fact that I was no longer hiding my disabilities and that people were interested in what I had to say and by that night it had escalated into the beginnings of a hypomanic episode. I guess I should explain what hypomania is; in short it's mania without the hallucinations and delusions (which is characteristic of Bipolar Type I, hypomania is characteristic of Type II). When you’re experiencing a hypomanic episode, you are excited and almost euphoric, you have intense amounts of energy, it’s “go go go” all the time and at superhuman speeds. You talk fast, you multitask like it’s nobody’s business, you sleep less, and sometimes you have an incredibly short fuse and will lash out at anyone around you without warning. Now, on one hand, you’re experiencing a true “high” and feel pretty awesome for most of the episode and you can be extremely productive (provided you can control the restlessness). On the other hand, you have no impulse control whatsoever and also, the higher you fly, the farther you fall. Once the hypomania ends, you are left exhausted and depressed. 

               

     When my episode started Friday night, I felt awesome! Actually, I felt awesome for the entire weekend and my mood kept improving every minute. By Monday night I was talking (to myself) at a hundred miles a minute, blasting music, pacing/dancing around my apartment, and just having the time of my life. And then all of a sudden I was calm. My euphoria had subsided and I was on my down. At first I just got super tired and ended up passing out a lot earlier than usual. Now, normally the depression sets in right away and when I woke up Tuesday morning I wasn’t expecting to be able to get out of bed but to my surprise I didn’t feel all that bad. I wasn’t happy but I wasn’t depressed either and judging by the degree of hypomania I had reached, the depression should have been pretty severe, but it didn’t come. I had a relatively normal day that day and yesterday started out pretty normal too, until I got home that night. Apparently the depressive episode had just decided to hold off for a bit, to make me feel secure and then when I least expected it rip the rug right out from under me. I had felt fine all day, we went out for a celebratory dinner and I was in a perfectly good mood when I got home. I got into bed and put on an episode of Bones and then it hit, the intense depression that allows follows a hypomanic episode. For no reason I was crying hysterically and I couldn’t stop. I was (silently) screaming because my mind was going at a million miles an hour and I had no control over the thoughts that were racing through. Good thoughts, bad thoughts, neutral thoughts, you name it. It was all rushing through my head at once, like trying to watch fifty different TV channels. I eventually ended up crying myself to sleep and then spent all morning in bed. I had to go to school for a bit this afternoon and I’m glad that I actually got myself up and left the house because it brought my mood way up. That’s not always the case though. A lot of times I can’t get out of bed for two or three days, and even if I do manage to get out of the house for a bit, I just end up going straight back to bed when I get home. Hopefully this is a sign that my condition is improving but I’m not holding my breath. There is nothing predictable about bipolar disorder, regardless of how well your treatment regimen is working and mine clearly isn’t figured out yet.

     I’m seeing a second psychiatrist in a couple of weeks, maybe she’ll be able to make some changes and get me back to my life.