Bipolar Hypomanic Update Second Day of Spring

High Gear With Gray Skies


In true form, I have been out of touch with the blog for a long time. Anyone see a pattern?

This photo is the weather outside right now, the second day of spring. Still looks like a winter wonderland.

Although outside it's all wintery grey skies, and has been for some time, I have been maintaining a hypomanic state since I pulled out of the depressive episode I last described.

It may not seem like a good thing to maintain hypomania, but I am always mainly aiming to keep depression away, and this state is much better. I have used my behavioral (get enough sleep, manage stress) and other tools (medication) to try and prevent severe mood swings. Seroquel keeps me from going full-on manic, and, with taking prozac not such a great idea when hypomanic, I am using low-dose marajuana (mainly female leaves) to manage depression. Seroquel on one end and marajuana on the other is pretty effective for keeping me functioning. 

I do want to slow down some. Working too much. Stressed by schedule. Maybe I will ask doc about upping the Seroquel dose for a bit to reign me in. 

In writing about what I am using to manage my bipolar, I am not advising anyone what to use to manage theirs. Only you and your psychiatrist an determine what is besst for managing your disorder.  

Description of Two Day Depressive Episode 11/15 - 16/2012

How Depression Can Feel

Thursday morning I woke up sad and teary. I was not having negative though patterns. I did not feel hopeless. I just had very low energy (the moving through molasses feeling) and was uncontrollably teary. 

The kids were difficult that morning when I was getting them up and off to school. I had two hours between the kids leaving and getting to work. I did some computer work, then showered and left for my workplace. 

On my way to work tears kept running down my face. My husband called to see if I was all right. He could tell I was having a difficult morning earlier. This was very sweet and caring, but it seemed to make the crying worse. It's like the dam broke. I went in my office, closed the door, and kept unsuccessfully trying to get the crying under control. So I figured out how I could work at home, and took a sick day.

The following morning I was still having the same issues. I was not as teary, but still had low energy. I was able to go to work for a while, but, in the afternoon, again opted to work from home. 

11/19 & 20th: I had another dip in mood. Same type of thing, teary and slow. Then my period started on 11/20. That may explain a lot about this two-part, somewhat mild depressive episode. 

11/27: No more depression. Back to hypomania. No exercising enough. Gotta get back in that habit.

 

What May Have Triggered This Episode of Depression

This Wednesday, one of my days off, I went out with a group of friends during the day and hosted my in-laws for dinner that evening. Although on many workdays, I am in front of large groups of people for many hours, this day out and dinner was way more socializing than I usually do. I also took almost the entire day off. It is rare that I don't do at least some work every day. I also had not been reliably compliant with my daytime depression meds for the preceeding few days. Thinking about all of this, these are some of the possible triggers for this episode:

• A change in my social behavior. I sometimes slip into depression when we have family visiting, with a steady stream of social activities. My head needs a certain amount of downtime to decompress.
• Slowing down from my Type-A, high-efficiency get-things-done mode. I normally operate in a hypomanic state, and find when I slow down, depression often "catches up" with me.
• Obviously not being consistent with some of my meds could have been, at the very least, partially responsible for this depressive episode.
• Looks like menstrual cycle could have had a lot to do with this series of depressed days. Will see what happens pre-period in months to come.

How I Pulled Out of My Depressive Episode

A couple of things definitely contributed to my emergence from this brief bout of depression. I did start taking my meds as directed, but this would not have had an effect on my mood immediately. 

• Taking a couple days with a lot of alone time definitely helped.
• My secret weapon: I haven't been totally honest on is blog about how I manage my disorder. I used to take Ritalin to pull out of depression, but found that it made me way too jumpy and nervous. I found that cannabis, smoked in very low doses (leaves of female plant, not buds) nearly always propels me out of depression. It makes me a little jumpy, but no where near as much so as Ritalin or Zoloft did.  I haven't talked about this on the blog for a couple of reasons...the fact that use of cannabis is still illegal federally, and that marijuana is not necessarily a good treatment for other people with bipolar. Everyone reacts differently to cannabis, and it is difficult to precisely control the dose. I have found some scientific articles on cannabis use in bipolar, and plan to write a post on the findings, but overall cannibis use is associated with a history of psychosis and appears to be suggestive of poorer clinical prognosis, and I do not know how much cannabis the study subjects had used.

 

What Does Major Depression Feel Like? A Bipolar Patient's Perspective

This post is going to be an ongoing project that I will add to over time, while in different states of mind and mood. I'll record my thoughts while depressed (inside depression) and while not depressed (outside depression). 

I hope this post will become a valuable resource to help people better understand how depression feels and what a person can do to avoid, minimize or pull out of a depressive episode.

WARNING! If you are currently depressed, or in an unstable mood, come back and read this later, not now. The description of depression could trigger you to feel more depressed. If you are currently depressed:

• make sure you are taking your meds as directed.
• if you are taking your medication as directed and are still depressed, contact your psychiatrist so he/she can evaluate and possibly adjust your medications.
• go for a walk! (Even if you don't feel like it. It really will make you feel better.)
• contact an upbeat friend who you are happy to be around.
• if you feel like harming yourself, reach out for help. Contact the National Suicide Prevention Hotline 1-800-273-HELP.

Outside Depression
I don't spend a lot of time in a "neutral mood." When I am not depressed, I'm usually in some degree of hypomania. Maybe rushing around and being over scheduled is may way to avoid depression.

What hypomania feels like: I feel slightly (or a lot) agitated, propelled through my day. My thoughts rush. I have ideas for creating or doing things that come so fast and frequent that I sometimes don't even have time to write down my ideas before they fly away. I have pressured speech, meaning I talk really fast. I don't want to sleep, and wouldn't be able to without my Seroquel. The more manic I get, the more pronounced all of these symptoms become. When I am very manic, I can be irritable and short tempered as well. I will soon be creating a post with more details on what mania and hypomania feel like.

Wobbly Mood
Sometimes I experience "wobbly" mixed moods where I can be both depressed and hypomanic at the same time. In this state, my moods change rapidly and seem out of control. When I feel like this, I try to be extremely careful to avoid things that might trigger depression or mania. In this state, I can easily be "bumped" into depression, even by minor frustration or stress.

Inside Depression
I plan to be adding to and developing this section during bouts of depression as they occur. I was wobbly and heading toward depression two days ago, so I can provide a bit of insight to start things off. In my recent wobbly mood I was teary and felt on the verge of crying throughout the day. My thought cycles were negative...I can't, I should, I didn't, I suck...kind of thoughts.

What major depression feels like: When I am in a depressive episode it is extremely physical, not just a mood or mental experience. Moving my body is difficult. I feel like both my body and my mind are moving through molasses when depressed. Doing even the simplest things takes a tremendous amount of effort. Crying bouts are frequent. Thoughts are confused and mostly negative, such as...what's the point of living when I will just die and be forgotten anyway, I suck as a mother, my business will never be successful...kind of thoughts.

Here is a growing list of links to descriptions of depressive episodes I have experienced:

• Description of Two Day Depressive Episode 11/15 -16/2012

Avoiding and Pulling Out of Depression
Although it is not always possible for me to avoid a depressive episode, I have been bipolar long enough (20+ years) to have learned a few things about controlling my mood.  When I feel depression coming on, it helps to:

• make sure I am taking my meds, as directed.
• seek out social situations, rather than isolating myself.
• get some exercise / go outside.
• have obligations that prevent me from laying in bed all day sleeping and crying.
• remember that the depression is temporary. It always eventually goes away.

Bipolar Disorder Patient's Depression Art

I just recently realized that a couple of art pieces in my home really remind me of my "shadow" side, the depression in me. I didn't create these pieces, but I really feel a connection with them. 

The first picture is a ceramic sculpture of a faceless girl holding a jar. This was my mother's. She collected quite a bit of art, and when this piece was in her home, it always bothered my, kind of creeped me out. After my mother died, I kept some of her art pieces and sold others. When I was considering what to do with this one, I stared at it for a long time, and suddenly it looked beautiful and sad to me. Now it hangs in my living room. 

This second photo is of a painting I purchased while on vacation last year in Northern California. It's titled "Grace" by artist Yarrow Summers. As soon as I saw it, I had to have it. The way the woman in blue is staring off into the unknown seemed very melancholy to me. I looks like I feel when I am sad and still.

Do you have, or know of, any pieces of art that really relate to your depression of mania? Leave a comment.

Click here to see my post on Bipolar Art. 

Bipolar Disorder: Qualifying for Disabilty Benefits & Income Support

Although more mentally ill people are qualifying for disability benefits than ever before, only a fraction of applicants get approved.

There are numerous ads on mental health sites (including mine) in which law firms offer their assistance to those seeking income support for mental health disability. These ads piqued my interest, and I began to wonder, would I qualify? What's involved in the application process? Do you need a lawyer to get approval? 

The main thing that I learned through my research is that getting disability benefits for mental illness is a complicated and often unsuccessful process. I still have more investigating to do, but, at this point, my recommendation to others is: 1. learn as much as possible through your own research, 2. get a free consultation from lawyer (or 2) who specializes in disability benefits. 

The following is a summary of what I learned, as well as several helpful links to additional information.

Mental Illness, Work and Income Support Programs 

That's the title of a 2009 study published in the American Journal of Psychiatry. Although the study is more than three years old, it did provide some interesting info, and is worth reading (Click here for the full article). 

In 1978, less than 2% of new disability awards were for mental illness. By 2005, 30% of new awards went to the mentally ill. That more recent statistic may sound promising, but still only a fraction of those who apply for benefits are approved. The application screening process is involved and requires substantial documentation to support the existence of disability. The study described three main types of assistance available: 

• Social Security Disability Insurance (SSDI): Only people who have paid Social Security taxes can become insured for benefits, meaning you have to have a work history.

• Supplemental Security Income (SSI): Based on need and qualifying as disabled.

• Temporary Assistance for Needy Families (TANF): The study mentioned that many people with symptoms of mental illness utilize this program.

For help understanding the difference the difference between SSDI and SSI, see:

• Difference between Social Security disability and SSI disability

• Social Security Disability Benefits

The following sites have useful information on what is involved in the screening process to qualify for social security disability income:

• Mental Illness and Social Security Disability, by NoLo, Law for All

• Allsup, a private Social Security disability claims services company, provides a helpful explanation of Social Security's five-step process to determine if a bipolar patient qualifies for SSDI.

• Disability Evaluation Under Social Security: Mental Disorders (Affective Disorders 12.04)

Do you have experience with disability benefits for your bipolar disorder? Please share your experience so that we can learn from each other!

Depression vs. Sunshine & Fresh Air: Get Outdoors and Get Happy!

Went to the big lake today! It was windy and beautiful, with crashing whitecaps close to shore for the kids to jump.

Although there's a good deal of stressful stuff going on for me, and our entire family, right now, a day outside, in a beautiful place, did a lot to make everyone feel better. It was a bargain too, costing only the gas to get there and the nominal beach parking fee. The grandparents even came along, so it was a multi-generational fun-fest. Going to the beach with little ones is a lot of work, but it makes memories that are well worth it!

If you don't have a lake near you, just get outside and have fun! We have a great nature center nearby. They have a hiking program where you buy a walking stick and earn metal badges to add to your stick after completing certain sets of hiking trails. The badge program motivates the kids to participate, which is very helpful. Fresh air encourages deep, restful sleep, and a day away from all the stress goes a long way to put life's difficulties in perspective. 

I worry about everything, sometimes to the point that I have problems with anxiety and obsessive negative/worrying thoughts. Physical exertion outside is  one of those handy valves that releases stress and worry, and helps me get the deep, restful sleep that anyone with bipolar disorder really needs.

Enjoy summer while it lasts!