Tuesday, 29 March 2011

Thoughts on getting out of the pits....

I had a couple of terrible days where nothing made me happy. I was wallowing in self pity, at least that's the way it might have seemed. I have a lot of internal energy which no meds seem to dent. If the energy works for me, that is all for the good, and I approach a kind of hypomania. I say "kind of" because I am not sure it has made the text books yet!! If the energy turns in on myself, then I am in trouble. I might sleep for 2 or hours and wake close to midnight. I try to stay in bed to avoid the hyper activity. This is fine for 4 or 5 hours. Then I get anxious and increasingly messed up. Any thought of getting up disappears and thoughts of not getting up take over. I start doubting everything including my planned trip to Canada and the US in six months time. There are no doubts other than those conjured by my mind. I hate that this happens but insight into it doesn't seem to help.

I eventually got up and turned on my computer. I made coffee and breakfast, the ritual that I go through most mornings. I felt happy soon because talking to friends on-line dragged me back into the world. I felt quite cheerful if a little edgy. I was okay apart from the continued exhaustion and the thoughts that another night will leave me back in that pit.

I felt happy because I have good friends who care about me even when I may not care about myself !! It is amazing how often "On-line Therapy" saves my bacon. I just need to get on and do it. The rest of my day was amazingly good. I attended the planned introduction to Relaxation class. It was enjoyable and useful. I even made it to my slimming group in the evening, and walked both ways. My wallowing on the previous evening seemed to have given me a chance to recharge because I stayed up later than usual.

My choice is to get up and fuel the hyper tendencies or wallow at the risk of fueling the anxiety!! I decided to split the difference and set a daily alarm for 4 am. I treat 4am as my threshold of morning. Before this time, it is that place we call "middle of the night". On most nights I have done with sleeping by 4am. Typically on the first night trying this, I found it hard to fall asleep and the alarm woke be abruptly from sleep with "Planet Rock..." rather too loud for 4am. I might revert to a regular alarm bleeping sound !! The theory is that I get out of bed soon and get on with stuff. If I am struggling, I will try on-line therapy. If all else fails I will text a friend for some human contact... I think this might be a good strategy might be a good one. I am starting a relaxation class on Friday. Hopefully I can incorporate things I learn into my coping routine?

This post started as a post to a bipolar forum and became a note on Facebook. I thought it was worth extending into a blog post. I hope it might help someone else.

Clive {{hugs}}

Saturday, 19 March 2011

I was happy yesterday because..

I was happy yesterday because.. I was just happy !! I don't need a reason at the moment. It is a change from last year when I didn't need a reason to be anxious or depressed. I don't know what changed but I took it with both hands. I have taken the chance to work on myself and on my moods. It is going on 3 months now, with the odd blip mostly when I get over tired. Touch wood, I bounce back after rest or a sleep. I feel happy, PERIOD!!

It is only just into today. I mis-read my alarm through bleary eyes and got up at 12.30. If I had read it properly , it may not have kept me in bed. That is irrelevant. I was happy yesterday because it was a good balanced day. I went out to town in the morning. I picked up some pills from the Pharmacy, bought groceries from two shops and stopped off for a large skinny latte at Costa Coffee. I kept busy all day but took time out to watch TV and run weekly computer scans. It was a Saturday as I remember them. Lately, I couldn't be bothered to get up.

I have realized that one of the secrets of happiness is to set your goals realistically. If you have achievable goals for a day or a week, you have a much better chance of achieving them. Achieving them will hopefully make you happy. If you set unrealistic goals, failure is likely and you will feel unhappy or worse. It is simplistic but it has helped me a lot. If I expect to have a great life as I remember, it isn't going to happen in a hurry, and I will continue to feel miserable. I think it is best to set yourself realistic goals and work towards them. Baby steps !! You should start doing things that might help you in the long run.


Thursday, 17 March 2011

Feeling very good .. is it legal?

I feel ridiculously good. I am sure it would illegal, except that herbal tea and coffee are legal , as far as I know? You can say I am manic. Good friends have asked politely.. I am not even in the manic spectrum. I feel good. This may be a new sensation but I like it. Elevated mood without the assistance of some chemical imbalance or screwed up brain functioning. I did feel similarly in the brief honeymoon period of my last marriage. That was a few weeks in 1993. That is pretty sad in 61 years. There must have been other periods but not many. After the bipolar appeared, I increasingly began to doubt good moods. This was a necessary side effect of becoming more insightful.

I have realized that you can be brought down by the doubts of nay sayers. No one really understands what mood swings are like. Even less understand how or why they occur. My theories are as valid as anyone's until they get some definitive tests and medications that don't "just work". Most psychiatric meds were initially used for another illness such as epilepsy. They just happened to help bipolar symptoms and they were used thereafter. I can't think of many meds that are uniquely used for treating bipolar disorder. Show me a bipolar patient who doesn't have medication issues. Most of them will say "It helps me, but ....". What I was trying to say before the sidetrack is that we have to ignore nay sayers in order to recover. Much of my life was on hold because I respected everyone else's feelings or opinions. I was never allowed to fly!! Very few people will encourage you to do your best and to push the envelope. They would rather you were in a chemically induced straight jacket. I am sorry .. I want more !! I want a life !! I don't want my life back.. that is about career and practical stuff. It is pretty well over.

In the words of Tom Wooton, in Bipolar in Order : "What is unfortunate today is that far too many people continue to cling to the old belief that it is impossible to live a full life with a mental condition."

I believe strongly that the way MH patients are treated causes most of their MH problems. If they allow themselves to explore the spectrum of moods, they will have a fuller and more fulfilling life. The majority of MH sufferers I have met are very intelligent. What a waste of potential? We are stigmatized and many are unable to work.


Wednesday, 16 March 2011

From Zero to Hero... **possible trigger**

This blog started as a post on a web site that I use often. I started to ramble on and I think it is a good time for a "feel good" blog post. I need to counteract some of my recent downers.

I know I am a mood swinger and it is easy to doubt my good feelings. I have been disappointed in the past and several times in the last 3 months. The difference is that I have been bouncing back after a good rest and on-line therapy. Thanks to my on-line community for the continued support. I am still embarrassed when I hear that I am inspirational but I am getting used to taking it gracefully.

I am really feeling good... Up early but it isn't so bad if you accept it will happen... Same with the mood swings.. It is a pretty simple realization but it has helped me. I think it came from reading the Bipolar in Order book, or maybe from some mindfulness reading, or maybe from both? [B]If you are prepared for something, it won't be so bad !![/B]

I feel a bit fuzzy from the seroquel hangover and I stagger a round around a bit first thing. I just don't like staying in bed when I feel good. That is opposed to my previous period when I couldn't leave my bed day after day...

I treated myself to a DAB (digital) alarm clock radio for the bedroom. It is great. I can now listen to Planet Rock Radio whenever I like, especially with the cordless headphones that I bought recently. I have spent a lot recently but it is no way a manic spending spree. I haven't spent much in ages and it is just a few treats. I need most stuff I bought, If you stretch the meaning of need!!! I especially enjoyed ordering some new clothes at my new reduced size. I have been making do and I was tired of not knowing what to wear. I am thinking of buying a suit, just because I want one !!! It might encourage me to attend stuff more...

I bottomed out last week mood wise. I have bounced back with a vengeance. This week has been great. I have gone from zero to hero on the mood scale. I get the odd blip when I get over tired, but I am managing to pre-empt it when possible. I won’t dwell on my recent crises. It spread over a couple of weeks and incorporated two crisis teams calls (largely fruitless), a call to my psychiatrist to get an early appointment, a call to the Samaritans crisis line and a final call to my GP. Speaking the “S” word was a major breakthrough. In my very disturbed mood (a definite and definitive zero on the mood scale), I wallowed for hours and couldn’t see the wood for the trees. I ideated about “S” and thought of ways I could do it. I dismissed pills after a previous failed attempt in 1997. I am too much of a coward for something violent. I kept thinking of the person who would discover me. I never concern myself with how it would affect family. I was more concerned about disappointing friends. After all, I have stuff to do, not least of much being two new books. I still have to get my first book to sell in North America.

To cut a long story short, I mentioned the “S” word to the Samaritans lady. It is amazing how a total stranger can help you by listening for a few minutes. Thank goodness I found the strength from somewhere to make the call. It was a brief call and she got me to call my GP. My big problem was in not knowing who to call. I had a bad experience of Crisis Team calls. The Psychiatrist was not readily accessible. “999” seemed inappropriate and would probably result in getting sectioned. I secretly wanted to be hospitalized but saw no “good” way of doing it. That is somewhere that the American system might be better.

I was so down that no friends’ names came to mind. How could I impose such a bad situation on a friend? Since the crisis, several friends have said I can call. Even the GP surgery manager said to call and “ask for her”. I probably wouldn’t but it was a nice gesture. I took the advice to call the GP surgery. This was just after they opened at 8.30 on March 10th . For a change I didn’t get the “Your call is important to us” bullshit. How frustrating is it to be to be told to call back at a quite time (repeatedly)? Some supercilious lady saying “if you have a genuine emergency , please call 9 : 9 : 9”. Thank god they are only a phone recording. If I had an old style phone, I would probably slam it down!!! No one seems to realize that you are struggling to even make a call when in crisis: you just need help fast with little bullshit.

Do you have to be so unwell that you can’t make a call? I feel so angry for other people when I think about the system. I live alone with a very serious mood disorder. I don’t see anyone face to face for a whole week sometimes. My on-line community of friends are my lifeline. No one hears me scream!!! I spend many sleepless nights passing time and listening to music on my cordless headphones. It is not perfect. Even my insomniac friends have to sleep sometimes. It helps to have friends in many time zones from West coast USA to New Zealand. UK peeps seem to love their beds more than most. My Facebook is often a wasteland in the wee small hours. Facebook must be the biggest social network in the world. It has a zillion users. I have close to 300 friends and that is deliberately kept down to people I know vaguely. 90% of my friends have some interest in mental health. Most of the rest are slimming friends or friends I met on holidays.

I hope I haven’t rambled too much. I tend to do that if I write off the top of my head !! In short, I often need someone to talk to. By talk, I usually mean chat on the interweb. When you are slight hyper or some degree of manic, it is healthier to talk to someone and on rare occasions, actually listen !!

I was calling the GP surgery. I mentioned the “S” word again. They got me an appointment within the hour. Impressive!! Luckily I only live 5 minutes walk from the surgery. In more severe crises, I am only 10 mins from the hospital!! I went early because I hate waiting around for anything. I sat in the surgery for 20 minutes. Dr M was nice although he didn’t recognise me. I have seen him a lot of times but I am not really a regular GP user (I am pleased to say). The surgery has about 6 doctors. I think I have seen them all bar one in the last few years. Dr M said the usual “I don’t know your case”. I am sorry but no one does. My psychiatrist knows a lot but even she is learning about me. When I see doctors, it is usually about something particular such as sleep, constipation, diabetes, blood pressure, cholesterol or the cyst on my arm that wouldn’t go away. The latter was mostly treated by the nurse after initial mis-diagnoses by GP’s. My notes are a mishmash of anecdotes. !5 years of my bipolar history was spent in California and I was diagnosed there, My onset was during my year in Saudi Arabia. I did get my US notes sent over but I am not sure they shed much light on “what I am like”.

Dr M read my notes and made copious new notes in my files. I do like him as a GP and I would choose him to handle a crisis. That’s if I had a choice or was capable of making one. We discussed my lack of sleep because that seemed to be a key problem. I was dead on my feel but not tired. I knew that anything he prescribed would not do much and that they wouldn’t give me a big supply. I was suicidal after all and I had tried before. Most meds don’t touch me and if they say two can be taken, I will definitely need two. Very rarely have I ever been highly sensitive to medication. Haloperidol was an exception. I once took something called Serenace but it may not exist now. This gave me a lot of problems. Basically with me, it is like a vet knocking out an elephant !! I have seroquel on prn (to take as I see fit). Seroquel knocks most of my friends out. I take 100mg at night. For example, I recently took 200mg as a prn and didn’t even slow down. It used to help my sleep but the effect is not much now. I wake up a bit groggy after 4-5 hours sleep if I am lucky. I went off “happily” with the prescription for 14 tablets of temezepam. At two per dosage, this was 7 days supply. I was not hopeful but it gave me some hope. I always give new meds a chance.

My instinct was to return from the pharmacy, take two and sleep for hours. I knew the latter wouldn’t happen but I could dream. Dr M said to wait as late as possible, and the usual “go for a walk” speech. That had been the Crisis Team’s highly thought out suggestion. I got “really” exhausted about 3pm. I took two pills and lie down. I did not sleep but I got up in a cheerful mood before 4pm. Things can flip moods that way. Not sure why but I took it. Crisis was over. My mood swung wildly for a couple of days and then settled to a good level. “good” being 8 on the Richter scale !! I avoided all TV coverage of the Japanese disaster to avoid triggering. Not that I didn’t care, but enough people were worrying about it. One more might not make a difference.

I had a very high mood in January and February. I protested it was not hypomania. It was not in my definition but it was akin to hypomania. I am not sure what it was. It was probably just hypomania that has been modified by my years of insight and attempts to achieve that. My sleep was brief but regular but the crash came inevitably, most out of tiredness. It was different to past experiences because rest usually restored the good mood. It is almost 3 months now and I feel tremendous. I am very calm and the hypomanic jerkiness has gone. I maybe a bit over excited!!

I am okay as long as I manage activity, sleep and rest. I find it best to pre-empt tiredness where possible and I am getting better at doing that. I still struggle to take breaks and push myself too hard most of the time.

That is my story of the last couple of weeks or months.


Friday, 11 March 2011

My Mood - A Work-in-Progress

I feel great. Not powered by hypomania or random chemical imbalances {maybe a touch LOL}. Wednesday I hit zero on the mood scale. I still don't "get" these mood swings after 27 years plus. I do know they can work for you or badly against you. I told my psychiatrist recently that I sometimes wish I was a bit less mentally driven (tries to not be offensive).

I had one of those all too rare moments of clarity after I turned into bed yesterday. I was so excited that I got up and worked on the computer for an hour more. I even set up a new facebook group. I think it all came out of a good day of on-line therapy, mostly chatting with my recent friend Dale in Australia.

Sometimes talking stuff over makes it clearer. Sometimes not !!

My breakthrough may not be earth shattering but for me it was that "Eureka Moment". The apple fell well and truly on my thick skull. I realized that much of my malaize is due to an irrational need to have a regular life, to "have a life" in more brutal terms.. I had this Rose Tinted view of what life should be. Nothing else would ever be enough. Because of my situation, nothing was going to change unless I did something to make it happen. Friends were more likely to back off further, rather than come closer.

I have to make a life for myself. I have done this before when I lived in a new area and I have done it for a group of bipolar friends. The crux of my idea was a Facebook Group to allow 50 somethings to meet and arrange social and sports activities. Why should social networking be something for the young? I live on facebook, so why shouldn't I use it to my advantage. The trick will be in getting people to join !!

Have a great weekend !!

Welcome to the:

South Warwickshire Young Farts Activity Club S.W.Y.F.A.C.


Friday, 4 March 2011

What does Seroquel actually achieve?

I deliberately say achieve. I am sure there are numerous studies about what it does in "med speak". I am not too concerned with what it does to various parts of the brain. I am concerned with how I feel when on Seroquel.

In the honeymoon period, I guess I was blinded by the improvement in my sleep, but what price sleep? My mornings are a constant struggle, anywhere from general anxiety to depression. I very rarely want to get out of bed. If I manage to get up, I have no motivation to do anything. I am writing this just after noon. I couldn't have concentrated well enough until very recently. My evenings and often my afternoons are a different picture to my mornings. I feel like a different person. I suspect Seroquel because of my experiences last year. I reported to my doctor that I had the anxiety. The response was to increase my dosage from 100mg to 200mg and then to 400mg. The anxiety increased and I returned to 100mg, my current dosage.

What about the anti manic properties? I recently had a 7 or 8 week period of hypomania. I took my Seroquel regularly throughout. The only effect that I noticed was that I was physically impaired longer than I was sleeping. I was only sleeping 2-3 hours each night. I don't think the Seroquel did much for the mania.

I am beginning to wonder if Seroquel is causing more problems than it solves. My sleep is erratic. My mornings are a nightmare, And then there are the incessant dreams and disturbed patterns of dreaming. Does anyone else share my concerns?

Tuesday, 1 March 2011

Knowing what I want

I have been struggling lately. I called my pdoc's secretary yesterday and managed to talk to my pdoc. This helped in itself and she agreed to see me today. At that point, I knew what I wanted to talk about at the appointment.

By a strange coincidence, I changed to Seroquel XL (extended release)last night. I am not sure if the doctor had requested this on a precription. This morning has been a lot better than recent ones, but it is only one morning.

Time with a doctor is limited and it is important to know what you want or expect. It is not always as simple as it might seem. I wish I knew the answer. I guess I need to work out my priorities, such as getting help with my sleep.