Feeling very good .. is it real?

This is one of the continued frustrations of someone who suffers mood swings. What is normal? Is my mood a function of brain chemistry, be it elation, depression, anxiety or plain old blah-ness. I find myself doubting my moods and I start wondering if it will last. Will it change back as fast as it became that way. This can happen over night for no particular reason. Mood swings, as in Bipolar Disorder, are not about something. This is a common misconception of the layman. They will say "What are you worried about?” or something equally meaningless to the sufferer. I guess friends and family mean well, but they probably won't get it. It is my goal to explain this issue in a way that outsider can understand. It's not like clinical depression. The symptoms are similar but the Bipolar person is rarely depressed about something when suffering a bipolar depression. The things that someone is depressed about may be a trigger of mood swings, but it is just a trigger. The mechanism of the mood swing is down to brain chemistry.

I became so good at controlling upwards mood swings that I was in danger of suppressing natural joy. This might a price that has to be paid but it is not good for the sufferer.

Recently my whole mood and outlook changed over night. I have no clue why it happened except that I had called the crisis team on the day before. I suspect that it made me realise that I was on my own. Subconsciously, I might have processed it over night. I'll never know, but I'll take it with both hands.

Since the epiphany, I have been a bit out of sorts. I have had a lot of the characteristics of hypomania. I dash about from task to task, as if there is no time to lose. I think it is a common characteristic of most manias. At least that is my experience. I have pushed myself hard all day from waking at 2am to 4am. Straight on to the computer, getting coffee, and really buzzing. It is on and on and on, without a break. It was as though it would fall apart if I took a break. I have been chatting in excess of 15 hours a day and I have been awake much longer, 19 hours on one occasion. It is not surprising that I have been getting exhausted by early evening. My appetite has increased significantly. I feel like I need to constantly refuel myself. Thanks to my slimming world experience, I am making mostly good food choices. Monday was a slight blip. I went to the store on a mission to treat myself. I came back loaded with pizzas, bagels, croissants, bread rolls and some deli cooked meats. I went way over the top. I did freeze most of the stuff and I haven't been over indulging. I really enjoyed the half pepperoni pizza for lunch. I couldn't resist eating the rest cold in the evening. It was just one bad day and I drew a line under it.

Yesterday I tried to get ready for slimming world by cutting back on food. I think my need for fuel wasn't met and I crashed prematurely in the late afternoon. I had to cancel my plans to go to group. I laid down for a couple of hours in the early evening. I salvaged the rest of the evening and managed to stay up until about 10:30. I committed in the chat room not to go in next day until 6am. I did this by having a lie in after I woke up. I was a bit restless but I made it. I entered chat at 6:01am.

I have been pacing myself today. The day is going a lot better. If I find myself going fast, I try to rein it back a little. I left the chat room deliberately to take a break from the intensity.

I feel really good. People might say it is delusion. I have suffered from bouts of mania and hypomania. While similar, it is also very different. I am sleeping fairly normally and that doesn't happen in the manias. It feels like I have the good side of a hypomania. I get stuff done. I think clearly. Washing up rarely stays around for more than 5 minutes. I have been cooking at 100 mph. I have been doing most things at 100 mph. Each time I have suffered a mania, I have gained more insight. Each time I have handled it better. This might be the final result of that process. I certainly hope so. I would like to think I can maintain something of this state.

I hope I am not deluding myself. I have 27 years experience of being bipolar and I think that counts for something. I have a very good support system on-line and my friends will tell me off if I seem out of control. It is good that many of my recent friends have only known me like this. Preconceptions are not helpful when supporting a bipolar sufferer. Friends and family need to recognise the vast swings that can happen in personality. They need to go with the flow if possible. I don't claim that it is easy. I sometimes feel that other sufferers are the only ones who truly understand. Even psychiatrists react to the manic persona.

The Secret Life of the Manic Depressive..

I am not talking about the depression , the anxiety or even the mania. Maybe I am talking about the hypomania? I think it is possible to achieve a state that stays below that edgy and jerky feeling of hypomania. It's sometimes productive, but sleep suffers and you are not fully in control.

You may think me delusional but I have honestly not gone that far in any of my manic experiences. I am in a state of happiness, not elation of hypomania, a really nice relaxed place. It is true I have been a bit edgy, my sleep is a bit off, my appetite is higher. I find myself smiling a lot, even at 2-8am in the night. That is the secret life I am talking about. Those night time hours when no one can hear you scream.

All I can say is, "thank goodness for the internet, email, chat rooms and all that". I don't know how I would have coped in the past, even 15 years ago. I am thankful for my IPOD and a good set of headphones. I can keep myself entertained without upsetting the neighbours. This is a good secret life and it it can be nurtured with a little attention to coping skills. I just try to keep my mood from drifting into hypomania. I no longer see mania has a real threat. I have found lots of insight through the school of hard knocks.

I am in a good place. It is unfortunate that it happens mostly in the hours of darkness. I am not sure even my good online friends understand where I am. they might ask "Are you sure your okay?" At least there is little chance of a visit from the men in white coats, the MH police. I hardly exist in the eyes of the MH system. I see my psychiatrist on infrequent occasions and that is worthwhile. I have called the crisis team on rare occasions, most recently on Jan 4th, 2011. My mood picked up on the 5th. No rhyme or reason. I suspect it was the fact that the crisis team offered nothing of note. I just woke up next day as a different person.

I wouldn't go as far as saying I was normal. I am not sure I ever was "normal", whatever that is. if normal is what I was most of my life, I don't ever want it again. I want to to retain my current "happy" state. My sleep pattern is a bit odd right now, but I am sleeping, maybe 4-6 hours. I started getting tired early in the evening and turned in early quite often. This led to early waking (2-3am) and long waking nights. I have blogged about this in the past and I find it the biggest challenge.

In depression or anxiety, you can usually just plod along in a zombie-like state. In full-blown mania you can be away with the fairies. While this is not good, you can be impervious to any problems. My current state, or even hypomania, is a big challenge. I still think pretty clearly and need to keep busy, entertained, fed etc etc. I find that blasting music loudly in the IPOD helps. In depressed or anxious moods, I cannot even play the radio, and sometimes not the TV. I have recently found that I can handle audio books when reading wouldn't be an option.

I hope I am not rambling on. I will stop now in case I do.

Life is good. I found a really supportive chat room that I go to a lot. I have found someone who might be able to produce an audio copy of my first book. I have sent pdf's of the book to several friends and I await their feedback. I have found my focus for the follow up book and I have a working title. I am blogging again and engaging with people.

Thanks for reading this. I hope it is thought provoking? Please comment or send feedback by email, thru facebook or W.H.Y?

An open note to doctor, a review of 2010 and whatever

How it’s been:

I sometimes lose touch with how I have been, especially if my mood has recently picked up. I wanted to write a bit so I get across what I need.

2010 was not my best year. It was punctuated by long periods of anxiety. Anxiety usually starts in the morning. It sometimes clears by the evening but not always. I start off by not wanting to get out of bed. Once I get up, I struggle to get coffee and breakfast. I rigidly structure my days and that seems to help. I have a list of key things which I check off every day. Meds, etc, etc. It seems excessive but it helps.

I postpone a lot of stuff and worst still, I cancel anything that I can. I have become more and more reclusive. I manage to make appointments but they can be cancelled if I am not well. My “to do” list builds up and up, adding more stress.

The most frustrating thing about 2010 was the cancellation of a trip to a concert in Birmingham. I had booked it a while back and even arranged a hotel room for the night. My anxiety was particularly bad. Right up to the morning, I was trying to get there. I finally missed it. It wasn’t a money thing but I did lose over a £100 that I couldn’t afford.

I did manage to get away on my holiday to Lanzarote in October, but that was in the balance up to the last few days. It went off well and I need not have worried. That is not the point about worry and anxiety. It is never logical.

I didn’t leave the house much in 2010. I even cancelled several of my monthly trips to the support group. I usually make that. The good thing was that I made my weight loss group every week up to reaching target in October. I made that a priority and that kept me going. I think I would have been a real mess if I hadn’t had the focus on my weight loss.

I did get away for two night’s at Christmas. It was ok but I was not very comfortable. I was out of comfort zone and I returned home on Boxing Day. I avoided three social opportunities, one with family and two with friends. I was not up to it. The week before New Year was typically down. New Years Day was a “lost day”. I think I only emerged to eat.

The anxiety hit a real low point on January 4th. I called the crisis team. I don’t think they were very helpful and more or less said “What do you expect us to do?” They were not the exact words. They committed to call my doctor and talked about possible day services helping. The short chat helped. I suspect that it told me I was “on my own”. Next morning, I woke up in a kinder mood. I took the opportunity to work on my coping strategies. My mood improved and it has remained good ever since. I found a very supportive on-line environment on the Wednesday and also found an email pen pal who had responded to my blog. The nine days since have been my best in many months, if not years.

Before the day of improvement, I was gung ho to find new medication. I was convinced that quetiapine was the cause of my issues. I still think it leaves me open to much of the anxiety. The new 100 mg dosage usually gives me 7 hours sleep, but I did wake at 2-3 am on a couple of mornings this week. My mood bordered on hypomania but I felt happy that I was sleeping. I never crossed the line but I had that familiar jerky thing where I dash around, especially in the morning. My appetite has been normal.

This week has been particularly busy. It was a test but I felt up to it. I have made all appointments and I even got to the weight loss group. I have been to support group, dentist, slimming world and my psychiatrist. I have torn into my "to do" list and kept on top of things. I have read some of an audio book, watched a new music DVD and 4 episodes of a TV program on DVD. My life is as it should be, except that I need to find outside activities that involve people.

I want to be considered for a meds change because I don’t like quetiapine. Its initial attractiveness was due to the sleep I was getting. It is too strong a medication for that purpose. My moods seem to be very stable. I do think some day services might help to get me back into life and to get me out and about. The crisis team is helpful but there is a big gap between psychiatrist visits and losing it. I am on my own, my own support system, and I can’t always do it. If I am not able to call for help, I am lost. I was turned down for a CPN after I re-applied. I hope to return to the resource café but it is only a band aid.

Crisis, what crisis?

I sometimes feel vulnerable. I have always felt well enough to look after my own affairs. Medication gave me some stability. 4 monthly or 6 monthly visits to the psychiatrist were enough. I no longer had a CPN (community psychiatrist nurse) because I was "too well". The CPN gives more personal support between visits to the doctor.

I have been struggling lately, for most of the previous year if I am honest. My only recourse was to call the crisis team and I did this earlier today. They were helpful but couldn't help directly. They would talk to my doctor who I see next week. Crisis suggests a major emergency, comparable to calling the emergency number for a physical problem. I need help to set up a support system. Some people do not have close friends or close family, at least no one they would call in an emergency. My only recourse seems to be the crisis team.

There should be a recommended course of action. Crisis suggests that you need immediate help, for example when you are a danger to yourself or others. Going through the motions until you see a doctor is sometimes not enough. I am scared that I might struggle so badly that I cannot call for help.

I am in the UK. I am sure it is different in the US and other countries.

My weight loss journey

My weight has fluctuated for the last 30 years. I remember reaching 17 stone in my early thirties. This led me to diet and I lost about 3 stone. I don’t think I ever thought about maintaining my new weight. I made no attempts to change my eating habits. It was pure luck that kept my weight fairly stable for a few years. I didn’t pile on the pounds. It just crept up on me over the years. It was mainly due to a sedentary occupation and general lack of activity. I have not been able to work much in the last ten years and this is when my weight began to increase. I first noticed the problem when I was pushing 19 stone. I joined a gym and dieted again. I lost about one stone. I stopped going to the gym and my bad eating habits returned. I had soon gone past 19 stone and approached 20 stone. This raised major flags because I had never been 20 stone in my life. This was late in 2007. I still thought I was okay.

In September of 2007, I went on an “activity” holiday to Club La Santa in Lanzarote. I was quite active and I enjoyed the holiday. In reality, this experience started the downward slide that led me to joining Slimming World. I think it was a combination of doing too much for my fitness level and the four hour return flight wedged in an airplane seat. The following 18 months was marked by a series of physical problems. My lower body was giving up. I had pains and discomfort in my legs, and it would shift from location to location. At the worst point, I remember that I could not get myself into or out of the bed. I ended up sleeping in my recliner on some occasions. In hindsight, I was slow in getting help. I tried the conventional approach at my GP surgery. This gave no relief. I finally found a good chiropractor and massage therapist. They managed to get me moving again, but I was still weighing in at about 20 stones.

By April of 2009, I realized that I had to do something. It was more due to the physical problems than the weight itself. I think I was still in denial about the weight. Fortunately my neighbour, Carol, was attending a Slimming World group in Claverdon. She invited me to go along with her to the group. I went along on 28th April, 2009 and began my food optimising journey. I weighed in at 20 stone 6.5 pounds. I lost weight from the first week and I was soon convinced that it worked. I am very good at following instructions and that is why I found the plan so good. I found a focus that surprised me. By early in August I had lost about 2 stone. The group was several miles from home and I wouldn’t be able to get there without a lift. Sarah Langford was starting a new group in Warwick at the Cricket Club. It was somewhere that I could walk to and I could also get some extra Body magic at the same time. Carol and I decided to try out the new group. We liked it immediately and decided to transfer.

Sarah’s new group went from strength to strength. It was eventually so successful that it split into two groups. I only missed one group session from early in August, 2009 until I reached my target on 5th October, 2010. On the week that I missed, I weighed in at another group locally. That was 62 consecutive weigh-ins. The Slimming World group became a very important part of my life, often my only social interaction in any week. I tried to get to group every week, no matter how I had felt during the day.

My PAT had been set some time ago at 14 stone. It became clear that it might be unrealistic and I adjusted it to 14 stone 6.5 pounds, for a total loss of 6 stone. This gave me the impetus to focus more and work hard for the target. Earlier in 2010, the group members were asked to set themselves a goal for the year. My goal was to reach my target before my holiday in October. I reached it with 9 days in hand and I was delighted. My holiday had been arranged to the same resort as I visited in September of 2007. It would be a celebration of my weight loss and a chance to be more active on the “activity” holiday. My main “before” photo had been taken in 2007 on one of the excursions. It would be a chance to repeat the excursion and get an excellent “after” photo at the same spot.

On the 2007 holiday, I was as active as could be considering my weight. I did some classes, swam a bit, played some social tennis and did some gym work. On the second visit I was far more involved. I added two sessions of social badminton, I did four 18Km sessions on the exercise bike, had a one to one golf lesson and practised what I had learnt. I had far more energy and got more out of the La Santa experience. I was pleased to find out that the same excursion was running. I managed to get my “after” photo in front of the El Golfo rock. In 2007, the walk down to the beach and back to the bus was quite an ordeal. This time it was a simple stroll. Before I joined Slimming World, I struggled after walking 10 minutes from my flat. I became breathless and my legs began to hurt. Recently, I have frequently walked for over an hour without any discomfort and I really enjoyed it.

My physical and mental healths are now so much better. I have suffered from Bipolar Disorder for almost 28 years. This basically means I am prone to mood swings even while taking medication. As I followed the plan and lost weight my mood swings became almost a thing of the past. Despite reaching 60 in February, I feel mentally and physically better than I have for many years. I have taken medication for high blood pressure and high cholesterol for over ten years. In 2008, my glucose intolerance shifted to Diabetes 2 and I started taking more medication. In my recent diabetes review, my blood pressure, cholesterol and blood sugar values were in the middle of the healthy ranges. I hope that it will be possible to reduce or even stop some medications at some point.

I take two medications for my Bipolar Disorder. One of them is Seroquel (Quetiapine) and it is notorious for causing weight gain. I have taken this medication for the full 18 months of food optimising and have lost weight steadily during this time.

I see reaching target as a beginning rather than a conclusion. I really think that food optimising has been the biggest factor in my continued weight loss. Despite my best intentions, I didn’t really increase my activity levels to any great extent. As I approached target, I hit a serious plateau. I fine tuned my diet as best I could and I also started to use my exercise bike. It had become something of a clothes rack. These efforts paid dividends and I soon reached my target. I see my biggest challenge as increasing my activity levels to help with my target maintenance. I see food optimising as my lifestyle choice from now onwards. I enjoy the food and I have never felt hungry. I followed the Green plan for most of the 18 months. I tried changing to Extra Easy completely but settled on 4 green days and 3 Extra Easy days each week. I have always tried to plan out a meal plan for the week between group meetings. I have also used the online food diary but now I only use it to check syn values. I have changed from being someone who lives on ready meals. I now eat mostly fresh food with plenty of fruit and vegetables. I cook more than I ever have and more than I ever thought I would.

I gave up on finding work three years ago. Now I am slimmer and a little fitter, I am actively seeking a voluntary position with a local company. I worked there on a job placement scheme when I was 6 stone heavier.

Thoughts on My Vacation / Holiday etc

My previous holiday had been in September 2007 with Spice UK. I went to Club La Santa in Lanzarote (Canary Islands). I was very apprehensive before I went but I had a great two weeks. I got on well with the other people in the group. I determined that I would go back in the future.

I returned to Club La Santa with Spice on Oct 14th on the holiday which is now one week. I have been suffering from a lot of anxiety this year, most likely due to the medication that is supposed to help me. It does help me sleep. I was really doubting whether I should go to La Santa, right up to the day before the flight, maybe even up to the morning of the flight. Thanks to a chat with a friend, I made it. I met seven others at the airport and I was less apprehensive. I didn't really relax until we got to the resort. I had a bedroom to myself in a four-bed sports apartment. It was not huge but it was my own space. I chose to go single occupancy because my sleep pattern can be a bit strange. The other three bedrooms had another single guy and two couples. We all got on very well. By the morning after arrival, I had already met 12 of the 24 others in the group. I knew the coordinator from my last visit, so that made 13. I met the others over the week. There was only one person from the previous holiday but it didn't matter. Everyone got on well and had a great week. Some were very sporty and did lots of stuff. Others, like me, did what they could. By the end of the week, I was more relaxed than I have been in years, probably since I was there last time.

I learned one big lesson. Even though I have been isolated for a long time, I can still get on well with people "face to face". I thought I had turned into someone who only relates to people electronically. It has been a shock coming back to an empty (cold) flat. I am not so lonely now. I am keen not to slip into such isolation again. I am sending off an application form for voluntary work. I spent 6 weeks at the same company on a work placement, so I am quite hopeful. I also need to find some other activities where I meet people. My slimming group has been a life saver over the last 19 months. I will continue to go when I can even though I have reached my target weight.

Not pushed my book in a while...

I am sorry to advertise my own book but no one else will do it. I wrote my autobiography, mostly as it relates to bipolar disorder. I am not going to make any money out of it, in fact it has cost me a lot. Being bipolar, that goes with the territory.

It is called "My Life as a Mood Swinger", written under the name Clive Wild. It was published by Xlibris in April 2009 and is available from Amazon or other good on-line retailers. I have a very limited number of signed copies if you have Paypal. Let me know at clivewild@hotmail.com .

Regards,
Clive