The Last Days of Summer

I'm enjoying the last days of summer. I feel like I've taken full advantage of the season. I've spent a lot of time outside, I took a 12-day staycation, and I've spent ample time hanging out at my condo pool where I exercised, sunbathed, and enjoyed talking with neighbors and making new friends. I also worked on decluttering my condo and having needed repairs done.

One reason I think I enjoyed this summer so much is that I focused on self-care, including working to improve my physical health, and it has paid off. I started taking Deplin for my MTHFR homozygous C667T genetic mutation and I also started taking iron supplements for an iron deficiency that I have probably struggled with for years. I switched doctors in the spring and my new doctor tested my iron levels, when I reported having heavy periods, which my old doctor had never done. Taking care of these health problems seems to have increased my energy level, and I also look and feel healthier. I have better color and my hair is growing in thicker (iron deficiency can lead to both paleness and hair loss).

I've also continued my weekly therapy sessions which I started in February of 2016. Although I've been in some form of therapy for years, this is the only time I have ever been able to afford weekly sessions. In earlier years, I tried to make it once a month, but that wasn't always possible. Having weekly therapy has helped me so much because I can work on problems I face every week. Before, therapy was overwhelming because I felt I had so much to rehash in my infrequent appointments. I have experienced a tremendous amount of personal growth over the past two years that I attribute to these weekly therapy sessions. I'm so grateful for them!

I also read two daily meditations every morning which help to give me a lot of clarity. It is a great way to start my days. I read The Language of Letting Go and A Restful Mind: Daily Meditations for Enhancing Mental Health. Both of these daily meditations have been incredibly helpful to me!

I love my job, but sometimes it is stressful. At those times, I use wellness tools from my WRAP. My favorite wellness tools to use at work are: taking a short walk, using some scented hand lotion, or doing a few rounds of square breathing. I also make sure to drink plenty of water during the day.

So, I'm feeling really good about the end of summer. I always notice seasonal changes since I feel so different at different times of the year. I'll miss the relaxing afternoons at the pool, and leisurely chats with my neighbors, but I'm ready to make the transition to indoor exercise and swimming at the Y. And, one of my new friends that I met this year at the condo pool is also a member of the Y, and we have already taken a trip there together. We are both going to miss the outdoor pool, but we both know we need to keep exercising!

Wellness

It has been 28 years since I was diagnosed with bipolar disorder, and I finally feel like I have figured out how to stay well for the rest of my life. It has been almost three years since I was  last hospitalized for mania. In the time since, I have made wellness the focus of my life. I work in the mental health field and my job is not too stressful. I work 37.5 hours a week and have good benefits and generous vacation time. It is never hard for me to get time off for doctors' appointments. It is a very good, healthy work environment. Having an interesting job that is easy to live with is very important to my mental health recovery. I have other health conditions besides bipolar disorder: PCOS, sleep apnea, psoriasis, allergies, and high blood pressure, and these health conditions are all well controlled by lifestyle changes and medications. I have found that keeping these conditions under control helps my mental health.

I am taking the lowest effective doses of my medications for bipolar disorder and they are working well: 200 mg. Lamictal and 100 mg. Seroquel. I have no complaints about side effects besides having to sleep a little bit more than I would like. It is much better than struggling with insomnia, psychosis, and mood instability as I have in the past though. When I think about the days when I was heavily medicated, being on such low doses of medications and doing well seems like a miracle. I also take the following supplements: a multivitamin, fish oil, vitamin D-3, and biotin. I take them because I believe they contribute to my overall wellness.

I stick to a routine. I have a regular bedtime and wake time. I believe that prioritizing quality sleep is the most important habit that keeps me well. I take my Lamictal and Seroquel between 8 and 9 p.m. and usually fall asleep between 10 and 11 p.m. I wake up at 7 a.m. on work days. I usually stick to the same routine on the weekends, but I occasionally stay out late with friends. Staying out late always requires sleeping late the next day because, with my medication, I always need 8-9 hours of sleep to feel rested.

I exercise every day. On Mondays, Wednesdays, and Fridays, I do a full-body strength training routine using dumbbells and a kettlebell. I have realized that I feel much better when I feel strong. Lifting weights also helps me to sleep much better. On the days that I don't lift weights, I at least take a walk, but I also enjoy cycling, hiking, and swimming.

I make time to spend time with friends and family. I am also friendly with my neighbors and people I encounter while out running errands and shopping. Having good relationships with people in my community is important to me. I eat well, limit my caffeine intake, and drink lots of water. I have made a Wellness Recovery Action Plan, and I follow it. I meditate twice a day -- in the morning and at night. I also take deep breaths as needed. I never realized how much these habits would help me until I incorporated them into my life. I go to therapy once a week. My therapist is encouraging and helpful and understands the challenges I face living with bipolar disorder. This kind of support helps me stay motivated to stay well.

Staying well is fairly simple, but it takes attention to detail and commitment. Doing all of these things regularly and keeping a routine is what keeps me well. Life is good. The things I am currently working on to improve my life are losing weight and decluttering my home, and these things are much easier to focus on when I am well.

Reclaiming My Health

When I was diagnosed with manic depression (now called Bipolar I), at the age of 19, as a student at Indiana University in Bloomington in 1989, I was told that I would have to take lithium for the rest of my life. I started taking it the summer before my sophomore year, and my athletic performance was immediately negatively affected. I quit the soccer team because my coordination had become so poor. I could no longer quickly visually track the ball on the field and I couldn't handle the ball or pass or kick as well. My body felt alien to me.

I spent my sophomore year focusing on school and trying to get used to my new life on medication. I had some friends on a cycling team who knew that I had quit playing soccer, but not really why, and they asked me to ride with them the upcoming summer. After a couple of rides they told me that I was really good and asked me to join the team. So, I joined the team, but something was still off physically, and I knew it. After not performing as well as I would have liked in the first few races, and also having unpleasant problems with dehydration, I decided to quit taking lithium. I told my teammates that I had manic depression, as it was called at the time, and that I had decided to quit taking my medication because it slowed me down too much. My athletic performance improved almost immediately. After discontinuing lithium, I usually placed first, second, or third in my races and was ranked third in the Midwest in women's collegiate cycling. My team also won the Women's Little 500 bike race, which was very exciting! However, I was having trouble concentrating, and feeling very restless, unstable, and pulled in different directions, and also experiencing psychosis at times, so after not graduating on time, I decided to start taking lithium, quit racing, and focus on my studies. Of course, I ended up gaining weight and suffering physically. I did not enjoy feeling slowed down, but I thought it was the price I would have to pay to get on with my life, and I finally graduated.

After graduating, it seemed like the best thing to do would be to continue to take my medication, even though it felt like a weight was tied to my feet when everyone was encouraging me to swim. I was not only physically slowed down, but I also experienced cognitive dulling. When I moved to Louisville, where I still live, I started seeing a new psychiatrist. I remained in his care for 16 years because he had a good reputation, my parents had chosen him for me, and it is really hard to find a good, or even decent psychiatrist. He seemed to believe that I needed to be heavily medicated.  At my most highly medicated, I was taking 1800 mg. lithium, 400 mg. Lamictal, 600 mg. Seroquel XR, Ambien to sleep, and Provigil for alertness (which didn't work for me). It felt like way too much medication and I was exhausted all the time. My life was out of balance. Work was my focus because I had little time or energy for anything else. My psychiatrist was resistant to making changes to my medication, insisted that I take lithium, and told me that he would not continue to treat me if I quit taking lithium, as he considered it to be the cornerstone of my cocktail of psychiatric medications. I consulted with a lawyer to discuss filing a lawsuit for malpractice, because I felt I had been turned into a zombie, and she did some research and told me that I was taking enough medication to knock a horse over. Instead of going through with the lawsuit though, I let it go and quit taking my medication without consulting with my psychiatrist. I lost 60 pounds in a year without trying that hard, and felt better, but I ended up becoming manic and being hospitalized again. After that hospitalization I told myself I would take my medication no matter what, and I did. I still had severe mood episodes and I developed serious side effects: hypertension, borderline metabolic syndrome, and sleep apnea. I also gained a tremendous amount of weight. When I was diagnosed with bipolar disorder, I weighed 130 pounds, and after taking medication for close to 20 years, I was up to 278. I had gained 148 pounds. My weight had more than doubled.

After suffering a terrible depression, having ECT, and ending up on disability, I finally decided that the seemingly substandard psychiatric treatment was just too much for me to handle and I couldn't take it anymore, so I found a new psychiatrist. She is a woman who is a few years younger than I am and she understands my concerns about weight gain and side effects and agreed to help me change my medication since I knew I could not just quit taking it myself without serious repercussions. I had educated myself about withdrawal from psychiatric medication and I found that many medications have withdrawals that mimic symptoms of bipolar disorder. She agreed to let me taper off of lithium. When I did, I experienced a bout of hypomania, but I also lost weight, was not thirsty all of the time, my hair became thicker (it had been falling out for years at that point), my psoriasis began to clear up, and I felt sharper and had more energy, and started becoming more active and taking better care of myself, and with alternative medications, my moods began to stabilize.

I have kept regular appointments with my new psychiatrist since 2010 and my health has improved a great deal. I no longer feel extremely slowed down by my medication and it is easier to work, cook, clean, exercise, socialize, spend time with family, go to doctors' appointments, and to appointments with my therapist. I have realized that in the past I waited too long to seek treatment too many times. Mania, psychosis, anxiety, paranoia, and depression can overwhelm me pretty quickly both mentally and physically. I need to take action and get help from my psychiatrist and therapist before I get swept into a downward or upward spiral.

Now that I have time to live a balanced life, because I am appropriately medicated instead of overmedicated, I focus on taking care of myself physically, mentally, and spiritually. I do not live a perfect lifestyle, but it is greatly improved from how I lived after my first breakdown, and for many years afterward. I work part-time and try to keep my stress levels low. I exercise, meditate, spend time with friends and family, and do volunteer work. Wellness is the focus of my life because if I am not well I can't enjoy anything or be of service to others.

Stress

Tonight, while attending my biweekly support group, one of two support groups I attend, everyone spoke of stress more than usual. We all experience relationship stress, work stress, and the stress of having bipolar disorder itself. It's stressful to think about whether or not to disclose the illness to friends, families, and coworkers, and the mania and sleeplessness that occur at times with the illness, along with the with the seemingly endless depressions, are stressful states to be in.

At many times in my life, stress has sent me over the edge into mania and depression, and has caused me to be hospitalized more times than I can remember. As people with bipolar disorder, it is essential that we try to get a handle on our stress levels. For me, medication, diet, exercise, meditation, lifestyle changes, and therapy, have helped me to manage my stress. When stress seems to be getting out of control, I know I need to do something about it. If I can't handle the stress on my own, it's definitely time to call both my psychiatrist and my therapist. Spending time in a serious state of stress often leads to unpleasant outcomes for me: mania and depression. Hospitalization always seems like a huge setback, plus it's time consuming, often at the worst times, and expensive.

The biggest lifestyle change I've made is going on disability. At the time I went on disability, I was mired in a serious depression that I spiraled into after becoming so inert that I couldn't continue to teach. I had chosen to become a special education teacher because I thought that, as a person who had experienced many years of stability, I was ready to handle the stress, and my diagnosis of bipolar disorder would give me the insight and compassion to help students who were struggling with learning and behavior disorders. I did a good job for almost five years. In fact, I earned several awards and a lot of positive feedback from students, parents, and my principal. But the stress eventually got to me and I became almost immobile and was no longer able to gather the energy to teach. In fact, waking up was hard, as was attending to daily tasks such cooking and cleaning, and even getting dressed. I got to the point where I was barely able to care for myself, and I applied for, and was granted disability.

The period before I went on disability was the lowest part of my life. After I received disability, a lot of the stress I had felt was removed. Ironically, I saw disability as a time to focus on my health. I gradually regained my mental and physical strength. For anyone who has experienced long periods of depression, it's obvious that it's physically unhealthy. Too much time spent in bed or sitting causes muscular weakness, and many people who are depressed don't eat enough, or eat the wrong foods, and the poor nutrition causes a deterioration in health.

After a year on disability, I was able to begin working at a part time job, and now I've been working part time for slightly over three years. I'm feeling much better about myself, and people are beginning to wonder why I'm still on disability. The answer is stress. It has been a breaking point for me in the past and I need enough experience with my stable self to prevent stress from harming me again. I feel that I need a longer period of stability behind me before I go off of disability. My therapist and psychiatrist have shared their opinions that I am not ready to go off of disability yet, if at all.

Although I've been on disability for several years, and have reduced my stress, I've still become manic and have had to be hospitalized twice in the past three years. And I've experienced one serious depression where I was unable to work as many hours as usual for a couple of months. I'm hoping that my medication changes and lifestyle changes will continue to work, and I'll improve in my ability to handle stress to the point where I'll be able to handle the stress of working full time. I want nothing more than to deal with my bipolar disorder in a healthy way and to live the most productive life that I possibly can.

Soccer, Swimming, Saphris, and Summer!

Things are looking up for me since my hospitalization last month. I've been back to work for almost a month, and I'm enjoying my days both at work and outside of work. I started playing soccer again, after a ten year hiatus, and I'm delighting in it. I look forward to the once-a-week game all week, and it inspires me to exercise every day.

Taking less lithium, as my psychiatrist has directed me to do, makes it much easier to play soccer, and also to stay hydrated. I started taking Seroquel in the hospital to stop my mania. I've taken it before, and it caused a lot of weight gain. However, this time, I snacked on low calorie foods whenever I had the munchies and ended up losing 7 pounds also probably, in part, to playing soccer again.

Last week, when I went to see my psychiatrist, she suggested that I replace Seroquel with Saphris. The last time I tried Saphris, I was depressed, and I felt that it made my depression worse. However, I wasn't taking Lamictal, at the time, which I am now. So, I started Saphris about a week ago, and I feel great. Last night, I played better soccer than I've played so far this season, and I felt more coordinated. Also, I'm more alert and have not needed as much sleep as I did when I took Seroquel. I'm back to sleeping 7 or 8 hours instead of my usual 10 hours when I was taking Seroquel. I've heard that Saphris is a "wonder drug" for some people, and I'm hoping that will be the case for me.

Every year, I look forward to the beginning of swimming season, and this year was no different. I had a great time swimming at my condo pool for the first time this year. My conditioning for soccer consists of walking in hilly places, swimming, and taking a spinning class. I'm still going to the YMCA for swimming workouts, but my condo pool is so nice for a peaceful dip after a long, hot day, and sometimes, if I'm inspired, I swim some extra laps. This happens more often as the water warms up. I absolutely love to swim in a warm pool with the sun shining down on me!

It's definitely summer in Kentucky. The temperatures have already reached the mid nineties. I don't have any big plans for the season. It's hard to save money for a vacation, as I'm collecting Social Security Disability, and only allowed to work part-time. So, I'm working on being patient and appreciating the simple things in life, such as spending time with friends and family, and enjoying the sunny weather and lazier days.

Luckily, in my town, there are lots of  inexpensive things to do--art festivals, neighborhood fairs, free and cheap musical performances, etc. I have a lot to be thankful and grateful for, and I'm happy that I'm getting back on track. Someday, I hope that I'll be stable enough to start working full-time again. But, for now, I'm going to take advantage of the extra time that I have each day, and work on strengthening myself, both mentally and physically.

Everything's Okay!

 
At this moment in time, I feel like I've covered all of the really serious aspects of dealing with bipolar disorder in this blog. If something else comes up, I'll be sure to address it, but for now, I'm happy to announce that everything is going well for me. This is the first year that I spent time gearing up to prevent my not unusual fall/winter depression. I'm definitely going to continue trying to prevent seasonal mood changes, but this year, my preparations seem to have been overdone. This winter has been unusually mild, making it easier for me to get out and be active. I haven't felt any hesitation about going to the grocery store, running to the bank, or completing any of the other errands required to keep my life running smoothly. I've enjoyed all of the winter holidays so far, and am now looking forward to Valentine's Day.

Lately I've been walking with a few different friends. I've enjoyed the exercise as well as their company. We usually walk for an hour or two, so we have lots of time to talk. It's very therapeutic, and a great way to get exercise and relax in our hectic, modern world. In the past, it's been harder for me to find walking partners. I'm really glad that more of my friends are interested in walking now...maybe it's because we're getting older (?).

For the past few months, I've been focusing on preparing healthier meals and eating a more wholesome diet in general. I've long been frustrated by thinking of all of the chemicals I have to ingest, in the form of bipolar medications, that seem to throw my chemistry out of balance with the result being unpleasant side effects. While I have always understood the value of eating whole, unprocessed foods, I'm trying to become more vigilant about eating a cleaner diet with fewer added chemicals, thus avoiding the negative health effects of eating too much processed food, because I'm already tired enough of dealing with the side effects from medication. I believe that our bodies can only handle so many foreign chemicals! 

I can also report that I've been sleeping well and waking up easily. I've been enjoying spending time at home, at work, out in the community, and with my friends. In the fall, I joined two interesting community organizations. One is called Forge, which is a "community for innovators". So far the meetings have been very interesting. I met one entrepreneur who was looking to hire someone, and I told a friend with the right qualifications about the position, and she got the job! She told me that she'll take me out for dinner when she gets her first paycheck. The other organization I've been meeting with is called Let Them Tweet Cake , a group for women who are interested in social media--right up my alley. I'm really glad that I found these organizations, because both of them seem to be a really good fit for me.

So things are humming right along. I know I'll feel even better come spring and summer, but I'll also have to be watching myself and making sure I don't get too carried away. It's strange to be so dramatically affected by things both large and small. I guess that's why I was diagnosed with bipolar disorder. I'm happy that I understand my mood conditions, as well as myself, better than I used to. Time and experience have helped me so much in my quest to live a fulfilling life.

Recovery

From 2002 through 2007, I experienced the longest stretch of recovery that I have experienced since I was diagnosed with bipolar disorder in 1989. I believe that  this recovery came about as a result of the medications I was taking and the ways I was trying to improve my life, but I wasn't focused on it, it just happened.

In 2002 I went through an upsetting breakup. Afterward, I decided  to put my energy into my work, my education, and my friendships. I wasn't thinking in terms of preventing a relapse of bipolar disorder at all, but I ended up concentrating my efforts into some areas of my life that contributed to my wellness.

Although I had been compliant with my treatment for bipolar disorder for many years, I still had not fully accepted my diagnosis. I secretly hoped that I would grow out of it, or it would just disappear. By 2005, I had earned a Master of Arts in Teaching and had been teaching for almost two years. At that point, it seemed like I had my life under control, so I asked my psychiatrist to make some changes to my medication because of some side effects I was bothered by. In hindsight, I realize that this wasn't the best idea, because the changes increased the likelihood that I would become unstable. That is how psychiatry works though. Everything is done through trial and error, because the brain and its disorders are still poorly understood.

Teaching was my life and my life was becoming more and more unbalanced. I was putting all of my energy into work. The hours I worked,  as well as the sedation caused by my medication, made it very difficult for me to exercise, something that has always contributed to my wellness. When I got home at the end of the day, I was exhausted and rarely ate anything more nutritious than a microwave dinner. I spent most nights preparing for my next day at school and then reading until I fell asleep. I spent less and less time with my friends. My students and coworkers brought me joy, and that sustained me for a while, although my life away from school was taking a steady downturn.

In 2006 I found out that I had developed workplace-related asthma because toxic black mold was growing in my classroom. My allergist advised me to transfer to another school because he felt that it was unlikely that my school would clean up the problem anytime soon. I took his advice and transferred to a new school in 2007. My health habits had been slipping while I worked at my old school, but when I entered my new environment, where I didn't know anyone, and was also an unknown, I quickly fell into a deep depression. My classroom was immaculate, and my asthma disappeared, but I was overwhelmed, became unable to work, went through shock therapy, and qualified for Social Security Disability. Everything I had worked for seemed to slip away so quickly. It was the biggest wake-up call I have ever experienced.

Ironically, becoming disabled has enabled me to focus on my wellness. I think my problem with recovery in the past is that I just tried to forge ahead, without properly acknowledging and respecting my disorder. I have bipolar disorder and I can never forget that. I have given up the hope that it will ever disappear and have become vigilant about staying well. So few people, without the condition, understand the discipline it takes to live well with bipolar disorder. Things that are no big deal for many people, like staying up all night, or getting drunk, can lead to rapid mood changes, serious depression or mania, and the need for immediate psychiatric intervention, including hospitalization, for people with bipolar disorder.

Twenty three years after my diagnosis, I finally understand all that it takes for me to stay well. I have gone through a great deal of trial and error with medication, therapy, support groups, relationships, work, exercise, diet, and more. I have seen attitudes toward mental illness change in the years since I was diagnosed, and I think if there were as much acceptance when I was diagnosed as there is now, it wouldn't have taken me as long to reach my current level of recovery. My hope for myself is that I will be able to stay on the path of recovery, and my hope for others is that attitudes toward those with mental illness will continue to improve so that it will be easier for those who need help to get it. I also hope that more research will lead to a better understanding of all mental illnesses and also to better treatments, with fewer side effects, for those who are affected.

Spinning

At the beginning of the month, I started thinking about spending more time in the gym now that the weather is getting cooler, and the days are getting shorter. I am prone to depression in the fall and winter, and exercise is a major antidepressant for me.

Last fall and winter, I became extremely depressed soon after a bout of mania that required hospitalization. I knew that exercise would help to relieve my depression, but it was almost impossible for me to drag myself to the gym, or even go for a walk. I ended up becoming very weak, and it took a lot of effort to get back in shape over the spring and summer. I knew that this year I had to be proactive and make sure I had a good exercise routine going at the gym before the cold and dark weather set in. As I get older, I am realizing that depression can be physically debilitating, and that it is harder to spring back after each episode, so I need to work harder to prevent it.

I have always enjoyed exercise classes. I like having an instructor charged with giving me the best workout possible, and I look forward to seeing familiar faces in the group. I belong to my local YMCA, and I appreciate the diversity present there.

So, a couple of weeks ago, I went to my first spinning class at the YMCA. I have been to spinning classes before, but this one is the best ever. My instructors are great, the music is uplifting, and the room is well ventilated and sunny, as there is a row of floor-to-ceiling windows in the back letting the daylight in. The people in my class appear to range in age from early twenties to mid sixties. It really motivates me to see such an assorted group of people working out together. I'm on a schedule now where I'm spinning on Tuesdays, Thursdays, and Sundays. I'm pushing myself as hard as I can, and I'm loving it. I'm pretty sure that if I keep this up, I'll have a great fall and winter.